OECD Environment Working Papers No. 99 Alistair Hunt, Social Costs of Morbidity Julia Ferguson, Impacts of Air Pollution Fintan Hurley, Alison Searl https://dx.doi.org/10.1787/5jm55j7cq0lv-en Unclassified ENV/WKP(2016)1 Organisation de Coopération et de Développement Économiques Organisation for Economic Co-operation and Development 19-Jan-2016 ___________________________________________________________________________________________ _____________ English - Or. English ENVIRONMENT DIRECTORATE Unclassified ENV/WKP(2016)1 SOCIAL COSTS OF MORBIDITY IMPACTS OF AIR POLLUTION - ENVIRONMENT WORKING PAPER No. 99 by Alistair Hunt (University of Bath), Julia Ferguson (University of Cranfield), Fintan Hurley (Institute of Occupational Medicine) and Alison Searl (Institute of Occupational Medicine). OECD Working Papers should not be reported as representing the official views of the OECD or of its member countries. The opinions expressed and arguments employed are those of the author(s). Authorised for publication by Simon Upton, Director, Environment Directorate. JEL Classification: I180, Q530,Q58 Key words: Air quality regulation, non-market valuation, health impact assessment. OECD Environment Working Papers are available at www.oecd.org/environment/workingpapers.htm English JT03389103 Complete document available on OLIS in its original format - This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of Or. English international frontiers and boundaries and to the name of any territory, city or area. ENV/WKP(2016)1 OECD ENVIRONMENT WORKING PAPERS OECD Working Papers should not be reported as representing the official views of the OECD or of its member countries. The opinions expressed and arguments employed are those of the author(s). 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All requests for commercial use and translation rights should be submitted to [email protected]. 2 ENV/WKP(2016)1 TABLE OF CONTENTS ABSTRACT .................................................................................................................................................... 5 RÉSUMÉ ......................................................................................................................................................... 7 FOREWORD ................................................................................................................................................... 9 SOCIAL COSTS OF MORBIDITY IMPACTS OF AMBIENT AIR POLLUTION ................................... 10 1. Introduction ........................................................................................................................................ 10 1.1 Background ................................................................................................................................ 10 1.2 Health end-points to be covered when estimating the costs of morbidity ................................. 11 1.3 Outdoor air pollution and health: Methodology used ................................................................ 12 1.4 A core set of pollutant-health outcome pairs ............................................................................. 14 1.5 What is involved in applying this core set in OECD countries and beyond .............................. 15 1.5.1 Pollutant-health combinations based mostly on applications in the EU and North America .... 16 1.5.2 Pollutant-health combinations based on the work of the Global Burden of Disease study ....... 17 2. A core set of pollutant-health combinations ....................................................................................... 17 2.1 Pollutant-morbidity combinations (and associated CRFs) ........................................................ 17 2.2 Additional notes on core morbidity outcomes and causality ..................................................... 22 2.3 Transferability: the role of pollution metrics ............................................................................. 25 2.4 Transferability: effects on CRFs of the pollution mixture ......................................................... 27 2.5 Transferability: effects of differences in population and health ................................................ 28 2.6 Choice of CRFs: Using local and international evidence .......................................................... 30 2.7 Evidence about outdoor air pollution and HIAs from other OECD countries, China and India32 2.8 Pollutant-health combinations not included in the proposed core set ....................................... 37 2.9 Summary and working conclusions ........................................................................................... 39 3. Current partial or comprehensive estimates of the cost of morbidity from air pollution .................... 41 3.1 The social cost components of air-pollution induced health impacts ........................................ 41 4. Survey of economic unit values related to air pollution-related morbidity ........................................ 43 4.1 Method ....................................................................................................................................... 43 4.2 Chronic bronchitis ..................................................................................................................... 45 4.3 Hospital admissions (Respiratory and Cardiovascular) ............................................................. 49 4.4 Work loss days .......................................................................................................................... 54 4.5 Restricted activity days and minor restricted activity days ....................................................... 56 4.6 Acute lower respiratory infections and acute bronchitis in children ......................................... 60 5. Concluding comments ........................................................................................................................ 62 REFERENCES .............................................................................................................................................. 65 ANNEX 1. SUPPLEMENTARY MATERIAL FOR SECTION 1 ............................................................... 72 ANNEX 2. ECONOMIC VALUATION OF MORBIDITY HEALTH END-POINTS ............................... 73 ANNEX 3. DESCRIPTIONS OF CHRONIC BRONCHITIS ...................................................................... 76 3 ENV/WKP(2016)1 Tables Table 1. Morbidity pollutant-health combinations recommended by HRAPIE for inclusion ............. 19 Table 2. Pollutant-health pairings used by US EPA for cost-benefit analysis - US Clean Air Act ..... 20 Table 3. Checklist of potential over-lapping cost components ............................................................ 43 Table 4. Summary of original valuation studies: Chronic bronchitis .................................................. 47 Table 5. Summary of original valuation studies: Hospital admissions ................................................ 50 Table 6. Summary of original valuation studies: Work loss days ....................................................... 55 Table 7. Mean daily wages .................................................................................................................. 56 Table 8. Summary of original valuation studies: Restricted activity days .......................................... 58 Table 9. Summary of original valuation studies: Acute lower respiratory infections ......................... 61 Table 10. Suggested unit values ............................................................................................................ 62 Table 11. The health impact