Impacts of Air Pollution on Health and Cost of Illness in Jakarta, Indonesia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Area
2.2. Exposure Data (PM2.5 and O3 Concentration)
2.3. Health Data
2.4. Estimation of the Health Burdens of Air Pollution
2.4.1. Long-term Impacts of Air Pollution
2.4.2. Short-term Impacts of Air Pollution
2.4.3. Calculating Health Burdens Attributable to Air Pollution
- = Number of health outcomes attributable to air pollution
- = Baseline number of health endpoints over the study period
- = the coefficient as the slope of the log-linear relationship between ambient air pollution concentrations and health outcomes, or the exponentiation of RR
- = baseline PM2.5 concentration (in µg/m3) in a day or in a year (e.g., 2019)
- = counterfactual concentration of pollutants (i.e., 4.2 µg/m3 for PM2.5 and 32.4 ppb for O3), below which no additional health risk is conferred
2.4.4. Estimation of Economic Impacts of Health Burdens Attributable to Air Pollution
2.4.5. Estimating Hospitalization Days
2.4.6. Estimating Inpatient Health Care Cost
2.4.7. Estimating Non-Health Care Cost
2.4.8. Estimating the Value of Statistical Life Year (VSL)
2.4.9. Estimating the Cost of Stunting
3. Results
3.1. Demography and Air Pollution Level in Jakarta
3.2. Health Impacts
3.2.1. Long-Term Impacts of Air Pollution
3.2.2. Short-Term Impacts of Air Pollution
3.2.3. The Economic Cost of Health Impacts from Air Pollution
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Health Endpoints | Age | RR (95% CI) |
---|---|---|
Infant Mortality, all-cause | 1–12 months | 1.09 (1.04, 1.14) [19] |
Stunting | <5 years old | 1.19 (1.10, 1.29) 1 [10] |
Low Birth Weight at term | At birth | 1.18 (1.06, 1.33) [9] |
Preterm Birth | At birth | 1.007 (1.005, 1.08) [9] |
Total Hospitalizations | Age | RR (95% CI) |
---|---|---|
For PM2.5 | ||
Due to Cardiovascular diseases Due to Respiratory diseases | All ages All ages | 1.0091 (1.0017, 1.0166) [18] 1.0019 (0.9982, 1.0402) [18] |
For O3 | ||
Due to Cardiovascular diseases | 65+ | 1.0089 (1.0050, 1.0127) [18] |
Due to Respiratory diseases | 65+ | 1.0044 (1.0007, 1.0083) [18] |
No | Assumption | Amount |
---|---|---|
1 | Exchange Rate USD 2019 (rounded) [23] | IDR 14,000 |
2 | Jakarta Monthly Minimum Wage 2019 [24] | USD 281.50 |
3 | GNI Indonesia Per Capita 2019 (current) [25] | USD 4051.78 |
4 | GNI United States Per Capita 2019 (current) [25] | USD 66,061 |
5 | VSL (value of statistical life) United States 2019 [26] | USD 10,900,000 |
6 | VSL Indonesia 2019 (adjusted) [27] | USD 284,184.25 |
7 | Income Elasticity [27] | 1.5 |
8 | Purchasing Power Parity (USD–IDN) [25] | IDR 4.75 |
9 | Productive Age [28] | 15–64 |
10 | Productive Years | 49 Years |
11 | GDP Jakarta 2019 (In Billion USD) [29] | USD 131.64 |
12 | Healthcare Inflation (2014–2019) [12] | 5.71% (2014); 5.32% (2015); 3.92% (2016); 2.9% (2017); 3.14% (2018); 3.46% (2019) |
13 14 15 16 17 | Low Birth Weight * Cost Preterm Birth * Cost Stunting *^ Cost Hospital Admission for CVD * Cost Hospital Admission for RESP * Cost | USD 1513.03 USD 1136.17 USD 128.26 USD 1313.83 USD 638.98 |
Characteristics | Jakarta Province * | Central Jakarta | North Jakarta | West Jakarta | South Jakarta | East Jakarta |
---|---|---|---|---|---|---|
Total Area (km2) | 664 | 52.4 | 140 | 124.4 | 154.3 | 182.7 |
Number of Population | 10,557,810 | 928,109 | 1,812,915 | 2,589,933 | 2,264,699 | 2,937,859 |
Population Density (per km2) | 15,900 | 17,719 | 12,950 | 20,813 | 14,675 | 16,080 |
Poverty Line (IDR/capita/month) | 667,260 | 625,177 | 549,506 | 517,646 | 729,256 | 539,510 |
Number of Poor People (% within the municipality) a | 365,550 (3.5%) | 34,130(3.7%) | 91,090 (5.0%) | 84,020 (3.2%) | 61,760 (2.7%) | 91,610 (3.1%) |
GRDP per capita (in USD) | 19,056.71 | 53,886.57 | 20,592.21 | 12,976.36 | 20,267.86 | 11,880.43 |
Land-use Characteristic | Mixed | Governmental Center | Industrial & Port | Industrial (small-scale) | Residential | Industrial |
Health Outcomes | Total burden | Air Pollution Attributable Indicators | |
---|---|---|---|
Number of Cases | Rate | ||
PM2.5 (annual mean: 52 µg/m3) | |||
Adverse outcomes in children (2019) | |||
Infant Deaths | 986 | 327 | 2 per 1000 births |
Stunting | 11,211 | 6153 | 7 per 1000 children under 5 |
Low Birth Weight | 1269 | 680 | 5 per 1000 births |
Preterm Births | 1919 | 62 | 4 per 10,000 births |
Mortality (2019) * | 23,430 ^ | 9692 | 88 per 100,000 population |
O3 (annual daily max 8 h average: 274 µg/m3) | |||
Mortality due to COPD (2019) * | 3635 | 310 | 5 per 100,000 aged 25+ |
Hospitalizations | Disease Cause | |
---|---|---|
Cardiovascular | Respiratory | |
PM2.5 | ||
Total Hospitalizations | 150,272 | 108,560 |
PM2.5 Attributable Indicators | ||
Number of Cases | 3043 | 455 |
Rate (per 100,000 population) | 28 | 4 |
O3 * | ||
Total Hospitalizations | 37,039 | 12,147 |
O3 Attributable Indicators | ||
Number of Cases | 1357 | 182 |
Rate (per 100,000 population *) | 282 | 38 |
Adverse Health Outcomes in Children | Mortality | Hospitalizations | |||
---|---|---|---|---|---|
Infant Deaths | Stunting | Adverse Birth Outcomes * | |||
Health Burden | 327 | 6153 | 742 | 10,002 | 5037 |
Economic Cost | 92.93 | 0.79 | 1.10 | 2842.41 | 6.19 |
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Syuhada, G.; Akbar, A.; Hardiawan, D.; Pun, V.; Darmawan, A.; Heryati, S.H.A.; Siregar, A.Y.M.; Kusuma, R.R.; Driejana, R.; Ingole, V.; et al. Impacts of Air Pollution on Health and Cost of Illness in Jakarta, Indonesia. Int. J. Environ. Res. Public Health 2023, 20, 2916. https://doi.org/10.3390/ijerph20042916
Syuhada G, Akbar A, Hardiawan D, Pun V, Darmawan A, Heryati SHA, Siregar AYM, Kusuma RR, Driejana R, Ingole V, et al. Impacts of Air Pollution on Health and Cost of Illness in Jakarta, Indonesia. International Journal of Environmental Research and Public Health. 2023; 20(4):2916. https://doi.org/10.3390/ijerph20042916
Chicago/Turabian StyleSyuhada, Ginanjar, Adhadian Akbar, Donny Hardiawan, Vivian Pun, Adi Darmawan, Sri Hayyu Alynda Heryati, Adiatma Yudistira Manogar Siregar, Ririn Radiawati Kusuma, Raden Driejana, Vijendra Ingole, and et al. 2023. "Impacts of Air Pollution on Health and Cost of Illness in Jakarta, Indonesia" International Journal of Environmental Research and Public Health 20, no. 4: 2916. https://doi.org/10.3390/ijerph20042916