Cost-benefit analysis in occupational health: a comparison of intervention scenarios for occupational asthma and rhinitis among bakery workers

Abstract

Objectives Use of cost-benefit analysis in occupational health increases insight into the intervention strategy that maximises the cost-benefit ratio. This study presents a methodological framework identifying the most important elements of a cost-benefit analysis for occupational health settings. One of the main aims of the methodology is to evaluate cost-benefit ratios for different stakeholders (employers, employees and society). The developed methodology was applied to two intervention strategies focused on reducing respiratory diseases. Methods A cost-benefit framework was developed and used to set up a calculation spreadsheet containing the inputs and algorithms required to calculate the costs and benefits for all cost elements. Inputs from a large variety of sources were used to calculate total costs, total benefits, net costs and the benefit-to-costs ratio for both intervention scenarios. Results Implementation of a covenant intervention program resulted in a net benefit of V16 848 546 over 20 years for a population of 10 000 workers. Implementation was cost-effective for all stakeholders. For a health surveillance scenario, total benefits resulting from a decreased disease burden were estimated to be V44 659 352. The costs of the interventions could not be calculated. Conclusion This study provides important insights for developing effective intervention strategies in the field of occupational medicine. Use of a model based approach enables investigation of those parameters most likely to impact on the effectiveness and costs of interventions for work related diseases. Our case study highlights the importance of considering different perspectives (of employers, society and employees) in assessing and sharing the costs and benefits of interventions.

Productivity estimation in economic evaluations of occupational health and safety interventions: a systematic review

“…The remaining 4 studies (4%) all used ad hoc approaches that (41, 45-48, 51, 56-58, 60, 62, 64, 66, 68, 70, 72-75, 79, 81, 83, 84, 87-90, 92, 93, 95, 97, 98, 100-102, 105, 107-110, 113, 117-125) North-America 34 (39, 40, 43, 44, 50, 52-55, 59, 61, 63, 65, 69, 71, 76, 80, 82, 85, 86, 91, 94, 96, 99, 103, 106, 111, 112, 114-116, 126- (39, 41, 42, 44, 45,49,50,(52)(53)(54)(55)59,60,67,68,70,71,76,77,82,87,95,115, 128) Inferred: 19 (40, 43, 46,57,61,63,65,80,86,91,92,94,96,103,111,116,(125)(126)(127)56,62,64,66,69,72,73,75,78,79,81,(83)(84)(85)…”

“…A generic national or regional price weight was used in 13 studies (19%), 9 (13%) used a worker-specific weight, 3 (4%) the industry or company average, and 1 (1%) a job average with age differentiation. Variations -such as using the mean annual salary per staff member in the NHSL (47), the study group average (75, 100), or the national average (41, 45,48,56,60,62,64,(66)(67)(68)(69)(70)72,(83)(84)(85)87,89,93,95,97,99,103,107,(118)(119)(120)(121)(122)(123)(124) 47,63,65,74,(77)(78)(79)81,82,87,(100)(101)(102)108,109,112,114,117,(126)(127)(128) (48, 52, 53, 58, 65-67, 69,...…”

“…In total, 15 studies incorporated an elasticity factor; 14 used a value of 0.8 and 1 used several values: 0.3, 0.55, 0.8. Interestingly, 4 of the 14 studies did not follow the FCA but did include an elasticity factor (45,66,81,83). The source for these elasticity values was Koopmanschap et al (16) and/or the Dutch Costing Manual (130, 131), except for Bernaards et al (45), who used the Netherlands economic institute as a source.…”

Musculoskeletal Disorders Symptoms among Taiwanese Bakery Workers

“…Due to the small scale of most stores and cost considerations, the dough processing operation is still manual, which has long caused musculoskeletal disorders in employees. Most studies on the health of bakery workers have mostly focused on industrial bakeries in high-income countries, with emphasis on the effects of flour dust on the respiratory system [12][13][14]) or the allergies and skin problems it causes [14,15]. Forcier et al, compared musculoskeletal pain in workers among 7 departments of supermarkets in Canada and found that bakers were the second most likely to experience pain among all groups [13].…”

Evaluating Uncertainty to Strengthen Epidemiologic Data for Use in Human Health Risk Assessments

“…This would more closely align epidemiology with the risk characterization phase of risk assessment in which costs and benefits of risk management interventions are weighted and risks are appraised quantitatively (Phillips 2001). Alternative outcomes analysis, an example of a technique that can provide important insights in distinguishing association from causation, could be more routinely applied in assessing causal inference and attributable risk estimation (Jager et al 1990; Meijster et al 2011a, 2011b; Thomsen et al 2006). Alternative outcomes analysis allows for the conceptualization of causation in terms of causes of meaningful versus ignorable consequences, assuming these can be readily differentiated into one of these two options.…”