Environmental Asthma Reduction Potential Estimates for Selected Mitigation Actions in Finland Using a Life Table Approach
Abstract
:1. Introduction
2. Material and Methods
2.1. Asthma Statistics
2.2. Identification of Risk and Protective Factors
2.3. Exposure Trend and Population Attributable Fractions (PAF) for Risk and Protective Factors
Scenario | Factor | Exposure in 2011 | Ref. | Relative Risk (RR) | Ref. | Population Attributable Fraction (PAF) a |
---|---|---|---|---|---|---|
1 | Active smoking | 17% | [17] | 1.03 | [8] | 0.3% |
Second Hand Smoke (<14 y) | 4% | [18] | 1.32 | [9] | 0.6% | |
Second Hand Smoke (≥21 y) | 10% | [10] | 1.97 | [10] | 4.4% | |
2 | Fine particles (PM2.5) | 100% b | [19] | 1.015 c | [12] | 11.6% |
3 | Dampness | 15% | [21] | 1.34 | [11] | 4.8% |
4 | Cat | 18.5% d | [22] | 0.47 | [13] | 3.4% |
Cat | 1.5% e | 1.67 | [14] | 0.3% | ||
Dog | 22.2% d | 0.37 | [13] | 5.2% | ||
Dog | 1.8% e | 2.78 | [14] | 0.8% |
2.4. Attributable Asthma Burden
2.5. Selection of Mitigation Actions
3. Results and Discussion
3.1. Historical Records of Asthma Entitlements (1986–2011) and Future Projection (to 2040)
3.2. Environmental Burden of Disease (EBD) of Asthma
3.3. Asthma Reduction Potential
Scenario | Exposure change | Action | 25-Year Cumulative Patient Years | |||
---|---|---|---|---|---|---|
Attributable | % | Reducible | % | |||
Total asthma burden | 6,796,162 | 100 | ||||
Attributable to risk factors studied here * | 1,208,902 | 17.8 | 726,441 # | |||
Tobacco a | 383,209 | 5.6 | ||||
1a | Ban | 100% reduction in 2015 | 383,209 | 5.6 | ||
1b | 50% Reduction | 50% reduction in 2015 | 103,642 | 1.5 | ||
1c | Smoke Free Finland | 10% annual reduction in 2015–2040 | 205,930 | 3.0 | ||
Fine particle (PM2.5) | 624,512 | 9.2 | ||||
2a | Ban Wood Combustion b | 100% reduction of PM2.5 fraction due to residential wood combustion in 2015 | 45,971 | 0.7 | ||
2b | 50 % Reduction Wood Combustion b | 50% reduction of PM2.5 fraction due to residential wood combustion in 2015 | 22,943 | 0.3 | ||
Dampness c | 329,785 | 4.9 | ||||
3 | 50 % Reduction | 50% reduction in 2015 | 160,792 | 2.3 | ||
Pets d | −128,604 | −1.8 | ||||
4 | 50 % Increase | 50% increase leading to exposure of 3.5% of atopic population and 46.5% exposure of non-atopic population | 136,469 | 2.0 | ||
Feasible | Combination of actions 1.c, 2.b, 3, 4 | 526,134 | 7.7 | |||
Most efficient | Combination of actions 1.a, 2.a, 3, 4 | 726,441 | 10.7 |
3.4. Burden of Asthma by Age Groups
4. Discussion
4.1. Model Uncertainties
4.2. Parameter Uncertainties
4.3. Scenario Uncertainties
4.4. Validity of the Burden of Disease Approach
4.5. Asthma Reduction Potential and Economic Considerations
5. Conclusions
Supplementary Files
Supplementary File 1Acknowledgments
Author Contributions
Conflicts of Interest
References
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Rumrich, I.K.; Hänninen, O. Environmental Asthma Reduction Potential Estimates for Selected Mitigation Actions in Finland Using a Life Table Approach. Int. J. Environ. Res. Public Health 2015, 12, 6506-6522. https://doi.org/10.3390/ijerph120606506
Rumrich IK, Hänninen O. Environmental Asthma Reduction Potential Estimates for Selected Mitigation Actions in Finland Using a Life Table Approach. International Journal of Environmental Research and Public Health. 2015; 12(6):6506-6522. https://doi.org/10.3390/ijerph120606506
Chicago/Turabian StyleRumrich, Isabell Katharina, and Otto Hänninen. 2015. "Environmental Asthma Reduction Potential Estimates for Selected Mitigation Actions in Finland Using a Life Table Approach" International Journal of Environmental Research and Public Health 12, no. 6: 6506-6522. https://doi.org/10.3390/ijerph120606506