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Workplace
Original Article
The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure
  1. Emile Tompa1,2,3,
  2. Christina Kalcevich1,
  3. Chris McLeod1,4,
  4. Martin Lebeau5,
  5. Chaojie Song6,
  6. Kim McLeod4,
  7. Joanne Kim6,
  8. Paul A Demers6
  1. 1 Institute for Work and Health, Toronto, Ontario, Canada
  2. 2 Department of Economics, McMaster University, Hamilton, Ontario, Canada
  3. 3 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  4. 4 School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  5. 5 Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
  6. 6 Occupation Cancer Research Centre, Toronto, Ontario, Canada
  1. Correspondence to Dr Emile Tompa, Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, Canada M5G 2E9; etompa{at}iwh.on.ca

Abstract

Objectives To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada.

Methods We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs.

Results There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively.

Conclusions The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation.

  • ccupational asbestos exposure
  • lung cancer
  • mesothelioma

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/oemed-2016-104173

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    Footnotes

    • Contributors ET: Principal investigator/guarantor of the study. Led the conceptual and methodological design of the economic component of the study, provided analytic oversight and was the lead pen of the manuscript. CK: Study co-investigator. Contributed to the conceptual and methodological design of the economic component of the study, prepared a first cut of the computations, assisted in preparing the methods write-up, reviewed drafts of the manuscript and provided editorial suggestions. CML: Study co-investigator. Contributed to the conceptual and methodological design of the economic and epidemiological components of the study, reviewed drafts of the manuscript and provided editorial suggestions. ML: Study co-investigator. Contributed to the conceptual and methodological design of the economic component of the study, reviewed drafts of the manuscript and provided editorial suggestions. CS and JK: Study co-investigator. Contributed to the conceptual and methodological design of the epidemiological component of the study, reviewed drafts of the manuscript and provided editorial suggestions. KML: Study co-investigator. Contributed to the evidence synthesis of the literature on occupational asbestos exposure, reviewed drafts of the manuscript and provided editorial suggestions. PAD: Project team lead. Led the conceptual and methodological design of the epidemiological component of the study, reviewed drafts of the manuscript and provided editorial suggestions. All authors have participated in the conception and writing of this manuscript and have read the final version of the manuscript. The manuscript represents honest work.

    • Funding This study was funded by the Canadian Cancer Society (grant number 701285-00). The funding was provided as competitive peer-reviewed research funding. The sponsors had no access to study data or involvement in the drafting of and decision to publish the article.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Provenance and peer review Not commissioned; externally peer reviewed.