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Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden

Kriit, Hedi Katre ; Forsberg, Bertil ; Åström, Daniel Oudin LU and Oudin, Anna LU (2021) In Environmental Health: A Global Access Science Source 20(1).
Abstract

Background: Alzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking. Methods: We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish... (More)

Background: Alzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking. Methods: We used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. Results: The annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 μg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. Conclusion: This study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Air pollution, Dementia, Incidence, Particulate matter, PM, QALY, Societal costs
in
Environmental Health: A Global Access Science Source
volume
20
issue
1
article number
65
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85106988294
  • pmid:34044832
ISSN
1476-069X
DOI
10.1186/s12940-021-00750-x
project
How is our health affected by particles from wood burning?
language
English
LU publication?
yes
id
529031fa-50e2-4923-85c6-bced4996386c
date added to LUP
2022-03-08 13:23:53
date last changed
2024-06-09 08:37:19
@article{529031fa-50e2-4923-85c6-bced4996386c,
  abstract     = {{<p>Background: Alzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM<sub>2.5</sub>) air pollution and resulting monetary estimates are lacking. Methods: We used data on average population-weighted exposure to ambient PM<sub>2.5</sub> for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM<sub>2.5</sub> exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives. Results: The annual number of dementia cases attributable to PM<sub>2.5</sub> exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM<sub>2.5</sub> by 1 μg/m<sup>3</sup> was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019. Conclusion: This study estimated that 5% of annual dementia cases could be attributed to PM<sub>2.5</sub> exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.</p>}},
  author       = {{Kriit, Hedi Katre and Forsberg, Bertil and Åström, Daniel Oudin and Oudin, Anna}},
  issn         = {{1476-069X}},
  keywords     = {{Air pollution; Dementia; Incidence; Particulate matter; PM; QALY; Societal costs}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Environmental Health: A Global Access Science Source}},
  title        = {{Annual dementia incidence and monetary burden attributable to fine particulate matter (PM<sub>2.5</sub>) exposure in Sweden}},
  url          = {{http://dx.doi.org/10.1186/s12940-021-00750-x}},
  doi          = {{10.1186/s12940-021-00750-x}},
  volume       = {{20}},
  year         = {{2021}},
}