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Integrated Environmental Strategies (IES), India Project

Health Effects Analysis & Economic Valuation of Health Effects

Many countries are struggling to meet public health and economic development objectives while managing local and global environmental problems. Identifying integrated strategies that provide multiple economic and health benefits while improving local air quality and reducing greenhouse gas emissions can help decision-makers make the most of limited resources. The city of Hyderabad has been selected as the project site, for IES, India Project. IES work will provide Indian policy makers with recommendations backed by quantified analysis.

IHS is carrying out the "Health Effects Analysis & Economic Valuation of Health Effects" components of the IES, India Project. This project is being taken up in collaboration with the Environmental Protection Training & Research Institute (EPTRI), Hyderabad.

Geographic Scope
The health effects analysis will be carried out in the Hyderabad Urban Agglomeration area (HUA), which encompasses a total area of 589 sq. kms., and having 5.6 million population. This includes the Municipal Corporation of Hyderabad (MCH) area and       10 municipalities - LB Nagar, Malkajgiri, Uppal Kalan, Kapra, Kukatpally, Serilingampally, Rajendranagar, Quthbullapur, Alwal, and Gaddianaram, falling under Ranga Reddy district.
Pollutants considered
Since PM10, the fine fraction (<10 m diameter) particulate matter concentrations are most strongly associated with respiratory morbidity and premature mortality, it has been identified as the criteria pollutant for both ambient and indoor air quality analysis, as well as health effects analysis.
Objectives of the study
  • Develop an initial estimation of the health impacts of air pollution in Hyderabad and their social costs, based on available secondary data.
  • Identify the most relevant health and social welfare impacts.
  • Identify data gaps and research needs for future assessments.
  1. The health endpoints have been identified for health effects analysis, based on a review of existing epidemiological studies and local health data.
  2. Collect data on Demography and Base Rates
Population data: Demographic data i.e., age-wise and sex-wise population data will be collected from 10 municipalities of Ranga Reddy district and Municipal Corporation of Hyderabad.
Mortality data: Data on all cause and cause specific deaths, age and sex-wise, from MCH area and the 10 municipalities belonging to Ranga Reddy district (the HUA study area) will be collected from the respective Municipal Health Offices.
Morbidity data: for the identified health endpoints will be collected from hospitals. A survey was conducted to identify all HCIs, including OP clinics within a radius of 0.5 to   2 kms. from the Air Quality Monitoring Stations (AQMS), operated by APPCB. This was done to build a sampling frame of HCIs using the APHIDB as the base.
Health Effects Analysis
Health effects will be estimated using Damage Function Approach, based on the Rapid Assessment Methodology.
It involves the following steps:
  1. Computing total exposure in the absence of regulation.
  2. Estimating number of baseline cases for each quantifiable health effect.
  3. Computing total exposure with regulation in place.
  4. Estimating number of cases for each quantifiable health effect with regulation.
  5. Baseline scenario exposure:                                                                       Number exposed X Amt. of baseline exposure X C-R coefficient

  6. Mitigation scenario exposure:                                                                     Number exposed X Amt. of reduced exposure X C-R coefficient

  7. Quantified Health Effects:                                                                      Baseline cases resulting from exposure to pollutants- Post-regulatory cases resulting from exposure to pollutants.

Economic Valuation of Health Effects
Selected health endpoints will be valued using the following methods:
  1. Economic valuation of mortality                                                                Human Capital Approach (HCA): This approach values mortality by the loss of "productive days" due to premature death and, hence the net present value of income lost.
  1. Economic valuation of morbidity                                                                        Cost of illness (COI) approach : Direct (medical) costs: Medical costs for related hospitalisation (respiratory, cardiovascular), average length of stay due to air pollution related illnesses, and costs of emergency room visits. Source: NSSO 42nd (Morbidity & utilisation of medical services) and 52nd rounds (Morbidity & treatment of medical ailments), National Council of Applied Economic Research (NCAER) & Health Ministry.                                                                             Indirect (Lost work days) Costs - Loss of Productivity (patient and attendants) due to restricted activity. Complete lost work days can be valued at the average monthly wage. Minor restriction days can be valued at 60% of wages ( Maddison et al., 1997). Source: Labor Ministry.
       Updated on 05/05/2002                     For details and enquiries write to Satish Kumar  

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