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标题：Annual dementia incidence and monetary burden attributable to fine particulate matter (PM _2.5) exposure in Sweden
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作者：Hedi Katre Kriit ; Bertil Forsberg ; Daniel Oudin Åström 等
期刊名称：Environmental Health - a Global Access Science Source
印刷版ISSN：1476-069X
电子版ISSN：1476-069X
出版年度：2021
卷号：20
DOI：10.1186/s12940-021-00750-x
语种：English
出版社：BioMed Central
摘要：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 2.5) air pollution and resulting monetary estimates are lacking. Methods We used data on average population-weighted exposure to ambient PM 2.5 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 PM 2.5 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 PM 2.5 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 PM 2.5 by 1 μg/m 3 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 2.5 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.
关键词：Dementia; Incidence; Particulate matter; Air pollution; PM2.5; Societal costs; QALY