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ESTIMATING THE HEALTH BENEFITS OF ENVIRONMENTAL REGULATIONS
DOSE-RESPONSE RELATIONSHIP NEEDS
BCA
CLASSIFICATION OF HEALTH EFFECTS
STEPS FORWARD
PROBLEMS RELATED TO BCA
WHAT IS A BCA?
BCA is a process by which we estimate the value of goods and services that will not be produced as a result of a regulation
WHAT IS WTP?
With the acronym WTP we refer to society's willingness to pay to reduce adverse health outcomes.
WTP FOR HEALTH IMPROVEMENTS INCLUDES VALUES OF:
avoided pain and suffering
avoided treatment costs
lost productivity
PROBLEMS RELATED TO BCA
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BCA isn't always based on WTP
BCA includes benefits deriving from the reduction of exposure to environmental pollutants only for cancer
CONSEQUENCES
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Including health effects of disease other than cancer in BCA
The reduction in the possibility of developing diseases other than cancer is not quantified as one of the benefits
We get underestimated values
- dose response relationships are unquantified
- exclusion of health effects with a moderate confidence
CLASSIFICATION OF HEALTH EFFECTS BASED ON THEIR DEGREE OF CONFIDENCE
EPA (Environmental Protection Agency) use standard terms to express the degree of confidence in the association between the exposure polluttant and a health outcome
MODERATE DEGREE OF CONFIDENCE
HIGH DEGREE OF CONFIDENCE
"suggestive"
PROBLEMS IN CLASSIFICATION
"known"
"causal"
"likely"
suggestive evidence
EPA excludes it from BCA
but
WTP to reduce the risks is usually greater for more sever health effects with "suggestive" evidence rather than for less serious effects on health with a “known” evidence.
so
if the EPA does not quantify serious health effects with less certain evidence, we have underestimated WTP values.
THE IMPORTANCE OF A DOSE RESPONSE RELATIONSHIP
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EPA provides a reference dose (RfD) for health effects other than cancer
and
RfD is different for each person both for intrinsic factors and for acquired ones.
CONSEQUENCES
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we cannot measure the risk of adverse outcomes for every level of exposure above or below the RfD.
2
If we considered a single reference dose, we would underestimate benefits
The NAS recommends not to assume a reference threshold, unless we consider a single category of people.
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WHAT SHOULD WE DO
Goals:
estimate a dose-response relationship when sufficient data are available.
use experimental data to understand how exposure to the same pollutant produce different health outcomes on the population
greater collaboration between economists and risk assessors
including in BCA benefits from reducing noncancer health-effects
A presentation by:
Elena Biondi
Giovanni Sideri
Gianluigi Sponsillo