The cost effectiveness of occupational health interventions: Prevention of silicosis

Abstract

Background The failure to recognize occupational health as an economic phenomenon limits the effectiveness of interventions ostensibly designed to prevent disease and injury. Hence, consideration of economic efficiency is essential in the evaluations of interventions to reduce hazardous working conditions. In this paper, we present an analysis of the cost effectiveness of alternative means of preventing silicosis. Methods To evaluate the cost effectiveness of specific interventions for the prevention of occupationally induced silicosis, we have used the simulation models based on the generalized cost‐effectiveness analysis (GCEA) developed by the WHO‐CHOICE initiative for two representative subregions namely AMROA (Canada, United States of America), and WPROB1 (China, Korea, Mongolia). Results In both of the two subregions, engineering controls are the most cost effective with ratios varying from $105.89 per healthy year or disability adjusted life year saved in AMROA to approximately $109 in WPROB1. In the two subregions, the incremental cost‐effectiveness ratio of engineering controls (EC) looks most attractive. Although dust masks (DM) look attractive in terms of cost, the total efficacy is extremely limited. Conclusions To the extent that this analysis can be generalized across other subregions, it suggests that engineering control programs would be cost effective in both developed and developing countries for reducing silica exposure to save lives. Note that this analysis understates health benefits since only silicosis and not all silica‐related diseases are considered. Am. J. Ind. Med. 48:503–514, 2005. © 2005 Wiley‐Liss, Inc.

Attenuation of Silica-Induced Pulmonary Fibroblasts Proliferation by Taurine and Niacin in Vitro

“…Despite the serious complications and poor prognosis, the improvement of workers' health status with silicosis is still hampered by the fact that, to date, there have been no effective treatments for silicosis, especially in advanced stage. Routine and regular medical surveillance and engineering control programs of high-risk population remain to be cost-effective measures [8].…”

Particulate polycyclic aromatic hydrocarbons and n-alkanes in recycled paper processing operations

“…filtration and air-exchange rates); however, the use of engineering control strategies is found to be more effective, compared to personal protective equipment (the most common practice in most of occupational settings) [46]. In addition to benefits in occupational health, engineering control strategies exhibited cost-to-effectiveness ratios of about US$ 105.00 per healthy year in U.S. and Canada only for silicosis patients, in contrast to conventional dust masks and respirators that exhibited values higher than US$ 191.38/year [49].…”

Los costos de la enfermedad laboral: revisión de literatura

“…Los costos directos incluyen pagos por hospitalización, consulta médica y servicios relacionados, como el costo de la rehabilitación, hospitalización en casa y los seguros, tal como lo proponen los estudios de Gardner [10], Leigh [22,34,36], Watterson [15], Horwitz [26] y Lahiri [44,46] Por lo general, las enfermedades ocupacionales como asma, dolor lumbar, dermatitis y particularmente el cáncer, requieren altas sumas de dinero para poder cancelar los tratamientos médicos [15,44,46]. Este tipo de costos es uno de los más fáciles de estimar, debido a que se puede obtener información de los registros contables de los hospitales o clínicas [22,34,36], de ahí que la mayor parte de las investigaciones los incluyen, tal como se refleja en la Tabla 3.…”