High-Efficiency Particulate Air Filters for Preventing Wildfire-related Asthma Complications : A Cost-Effectiveness Study
Rationale: Air pollution caused by wildfire smoke is linked to adverse health outcomes, especially for people living with asthma. Objectives: To evaluate whether government rebates for high-efficiency particulate air (HEPA) filters, which reduce concentrations of smoke particles indoors, are cost effective in managing asthma and preventing exacerbations in British Columbia (BC), Canada. Methods: We used a Markov model to analyze health states for asthma control, exacerbation severity, and death over a retrospective time horizon of 5 years (2018-2022). Concentrations of wildfire smoke-derived particulate matter with an aerodynamic diameter ⩽2.5 μm (PM2.5) from the Canadian Optimized Statistical Smoke Exposure Model and relevant literature informed the model. The base-case analysis assumed continuous use of a HEPA filter. Costs and quality-adjusted life-years (QALYs) resulting from varying rebates were computed for each Health Service Delivery Area (HSDA). Measurements and Main Results: In the base-case analysis, HEPA filter use resulted in increased costs of $83.34 (SE, $1.03) and increased QALYs of 0.0011 (SE, 0.0001) per person. The average incremental cost-effectiveness ratio among BC HSDAs was $74,652/QALY (SE, $3,517), with incremental cost-effectiveness ratios ranging from $40,509 to $89,206 per QALY in HSDAs. Across the province, the intervention was projected to prevent 4,418 exacerbations requiring systemic corticosteroids, 643 emergency department visits, and 425 hospitalizations during the 5-year time horizon. A full rebate was cost effective in 1 of the 16 HSDAs across BC. The probability of cost-effectiveness ranged from 0.1% to 74.8% across HSDAs. A $100 rebate was cost effective in most HSDAs. Conclusions: The cost-effectiveness of HEPA filters in managing wildfire smoke-related asthma issues in BC varies by region. Government rebates up to two-thirds of the filter cost are generally cost effective, with a full rebate being cost effective only in Kootenay Boundary.
Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2024 Jan 15;209(2):126-128. - PMID 38047880 |
---|---|
Medienart: |
E-Artikel |
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:209 |
---|---|
Enthalten in: |
American journal of respiratory and critical care medicine - 209(2024), 2 vom: 15. Jan., Seite 175-184 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Adibi, Amin [VerfasserIn] |
---|
Links: |
---|
Themen: |
Air Pollutants |
---|
Anmerkungen: |
Date Completed 15.01.2024 Date Revised 15.01.2024 published: Print CommentIn: Am J Respir Crit Care Med. 2024 Jan 15;209(2):126-128. - PMID 38047880 Citation Status MEDLINE |
---|
doi: |
10.1164/rccm.202307-1205OC |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM364092475 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM364092475 | ||
003 | DE-627 | ||
005 | 20240115231907.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231226s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1164/rccm.202307-1205OC |2 doi | |
028 | 5 | 2 | |a pubmed24n1260.xml |
035 | |a (DE-627)NLM364092475 | ||
035 | |a (NLM)37917367 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Adibi, Amin |e verfasserin |4 aut | |
245 | 1 | 0 | |a High-Efficiency Particulate Air Filters for Preventing Wildfire-related Asthma Complications |b A Cost-Effectiveness Study |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 15.01.2024 | ||
500 | |a Date Revised 15.01.2024 | ||
500 | |a published: Print | ||
500 | |a CommentIn: Am J Respir Crit Care Med. 2024 Jan 15;209(2):126-128. - PMID 38047880 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Rationale: Air pollution caused by wildfire smoke is linked to adverse health outcomes, especially for people living with asthma. Objectives: To evaluate whether government rebates for high-efficiency particulate air (HEPA) filters, which reduce concentrations of smoke particles indoors, are cost effective in managing asthma and preventing exacerbations in British Columbia (BC), Canada. Methods: We used a Markov model to analyze health states for asthma control, exacerbation severity, and death over a retrospective time horizon of 5 years (2018-2022). Concentrations of wildfire smoke-derived particulate matter with an aerodynamic diameter ⩽2.5 μm (PM2.5) from the Canadian Optimized Statistical Smoke Exposure Model and relevant literature informed the model. The base-case analysis assumed continuous use of a HEPA filter. Costs and quality-adjusted life-years (QALYs) resulting from varying rebates were computed for each Health Service Delivery Area (HSDA). Measurements and Main Results: In the base-case analysis, HEPA filter use resulted in increased costs of $83.34 (SE, $1.03) and increased QALYs of 0.0011 (SE, 0.0001) per person. The average incremental cost-effectiveness ratio among BC HSDAs was $74,652/QALY (SE, $3,517), with incremental cost-effectiveness ratios ranging from $40,509 to $89,206 per QALY in HSDAs. Across the province, the intervention was projected to prevent 4,418 exacerbations requiring systemic corticosteroids, 643 emergency department visits, and 425 hospitalizations during the 5-year time horizon. A full rebate was cost effective in 1 of the 16 HSDAs across BC. The probability of cost-effectiveness ranged from 0.1% to 74.8% across HSDAs. A $100 rebate was cost effective in most HSDAs. Conclusions: The cost-effectiveness of HEPA filters in managing wildfire smoke-related asthma issues in BC varies by region. Government rebates up to two-thirds of the filter cost are generally cost effective, with a full rebate being cost effective only in Kootenay Boundary | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a air filters | |
650 | 4 | |a asthma | |
650 | 4 | |a climate change | |
650 | 4 | |a particulate matter | |
650 | 4 | |a wildfires | |
650 | 7 | |a Particulate Matter |2 NLM | |
650 | 7 | |a Dust |2 NLM | |
650 | 7 | |a Air Pollutants |2 NLM | |
700 | 1 | |a Barn, Prabjit |e verfasserin |4 aut | |
700 | 1 | |a Shellington, Erin M |e verfasserin |4 aut | |
700 | 1 | |a Harvard, Stephanie |e verfasserin |4 aut | |
700 | 1 | |a Johnson, Kate M |e verfasserin |4 aut | |
700 | 1 | |a Carlsten, Christopher |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t American journal of respiratory and critical care medicine |d 1994 |g 209(2024), 2 vom: 15. Jan., Seite 175-184 |w (DE-627)NLM074657305 |x 1535-4970 |7 nnns |
773 | 1 | 8 | |g volume:209 |g year:2024 |g number:2 |g day:15 |g month:01 |g pages:175-184 |
856 | 4 | 0 | |u http://dx.doi.org/10.1164/rccm.202307-1205OC |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 209 |j 2024 |e 2 |b 15 |c 01 |h 175-184 |