Economic evaluation of the impact of air pollution in the health of the population of the city of São Paulo

Abstract

Objective: To evaluate the economic impact of air pollution in the city of São Paulo, concentrating in hospitalization costs related to respiratory and cardiovascular diseases and to productivity losses due to early mortality. Methods: The cases attributable to air pollution were estimated considering PM10 as reference pollutant. The applied calculation model considers: relative risk associated to an increase in PM10, frequency of outcomes in the population of interest and level of exposure to air pollution. The impact of relative risks variation was evaluated through sensitivity analysis. A societal perspective was adopted, including direct medical costs for the Brazilian Unified Health System (SUS) and indirect costs for the society. Results: The level of PM10 showed impact on the number of deaths and hospitalizations due to pneumonia in children < 5 years and hospitalizations due to cardiovascular disease in people aged ≥ 65 years. Reductions in the level of PM10 in the city might lead to an economy of up to R$ 5.8 million with hospitalization reductions. Estimated losses of R$ 42,371,578 and R$ 306,782 were associated to premature deaths due to pneumonia and Chronic Obstructive Pulmonary Disease (COPD), respectively. Conclusions: Efficient measures with the aim of improving the air quality in the city of São Paulo are fundamental due to their potential impacts in reducing deaths and hospitalizations among children and the elderly, besides representing cost offsets for SUS and the society.