Balancing the risks and benefits of drinking water disinfection: disability adjusted life-years on the scale
| Autor: | H J Van Kranen, A E De Hollander, J. F. M. Versteegh, Arie H. Havelaar, Peter Teunis, W Slob, J E Van Koten, Evers Eg |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Health Toxicology and Mutagenesis Cost-Benefit Analysis Population Water supply Cryptosporidiosis Risk Assessment Life Expectancy Ozone Water Supply Environmental health medicine Animals Humans Disabled Persons education Child Carcinoma Renal Cell Aged Cryptosporidium parvum education.field_of_study Cost–benefit analysis business.industry Bromates Risk of infection Public health Public Health Environmental and Occupational Health Infant Newborn Infant Middle Aged Kidney Neoplasms Surgery Quality-adjusted life year Disinfection Child Preschool Life expectancy Female Public Health Quality-Adjusted Life Years Risk assessment business Research Article |
| Zdroj: | Environmental Health Perspectives |
| ISSN: | 0091-6765 |
| Popis: | To evaluate the applicability of disability adjusted life-years (DALYs) as a measure to compare positive and negative health effects of drinking water disinfection, we conducted a case study involving a hypothetical drinking water supply from surface water. This drinking water supply is typical in The Netherlands. We compared the reduction of the risk of infection with Cryptosporidium parvum by ozonation of water to the concomitant increase in risk of renal cell cancer arising from the production of bromate. We applied clinical, epidemiologic, and toxicologic data on morbidity and mortality to calculate the net health benefit in DALYs. We estimated the median risk of infection with C. parvum as 10(-3)/person-year. Ozonation reduces the median risk in the baseline approximately 7-fold, but bromate is produced in a concentration above current guideline levels. However, the health benefits of preventing gastroenteritis in the general population and premature death in patients with acquired immunodeficiency syndrome outweigh health losses by premature death from renal cell cancer by a factor of > 10. The net benefit is approximately 1 DALY/million person-years. The application of DALYs in principle allows us to more explicitly compare the public health risks and benefits of different management options. In practice, the application of DALYs may be hampered by the substantial degree of uncertainty, as is typical for risk assessment. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 |
| Databáze: | OpenAIRE |
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