Society For Risk Analysis Annual Meeting 2016

Session Schedule & Abstracts

* Disclaimer: All presentations represent the views of the authors, and not the organizations that support their research. Please apply the standard disclaimer that any opinions, findings, and conclusions or recommendations in abstracts, posters, and presentations at the meeting are those of the authors and do not necessarily reflect the views of any other organization or agency. Meeting attendees and authors should be aware that this disclaimer is intended to apply to all abstracts contained in this document. Authors who wish to emphasize this disclaimer should do so in their presentation or poster. In an effort to make the abstracts as concise as possible and easy for meeting participants to read, the abstracts have been formatted such that they exclude references to papers, affiliations, and/or funding sources. Authors who wish to provide attendees with this information should do so in their presentation or poster.

Common abbreviations

Symposium: Burdens From Risk: Valuing Outcomes for Workers and the Public

Room: Marina 6   10:30 am–12:10 pm

Chair(s): Frank Hearl

Sponsored by Society for Benefit Cost Analysis (SBCA), Economics and Benefits Analysis Specialty Group (EBASG), and Occupational Health and Safety Specialty Group (OHSSG)

The burden of illness, injury, and death as measured by cost of treatment and quality of life measures are values needed for multiple purposes such as: 1) prioritization of research; 2) targeting intervention initiatives or enforcement actions; 3) promulgation or revision of regulations; 4) planning long-term budgets to provide for insurance, treatment, or remediation of damages. This symposium will explore ways in which risk analysis can be used to quantify or predict costs and benefits. For example, attributable risks assessed from epidemiological studies can be used to predict potential reductions in fatalities or illness and related therefore to the total burden of disease in terms of health-related quality of life measures such as the disability adjusted life-years (DALYs). Additionally, population-based risk estimates can also be used to forecast the expected costs for treatment for those who are affected by food, environmental, or occupational exposures to toxic substances or biological agents. This symposium will describe these uses of risk analysis through applications in development of research, surveillance, rule-making budgeting, and public health.

W2-D.1  10:30 am  Using attributable risk to assess the burden of worker injury and illness and prioritize research and prevention. Pana-Cryan R*; National Institute for Occupational Safety and Health

Abstract: The limited funds that are available for government-sponsored research aiming to improve worker safety and health are allocated to research and prevention activities that target specific problems in specific industry sectors, such as hearing loss in manufacturing. To understand how to best prioritize the funding of government-sponsored research and prevention activities, we need to assess the burden by condition and sector. This helps to identify where the burden is highest, when measured with several metrics. In turn, this offers a way to prioritize activities that is based in part on addressing the biggest problems first. To demonstrate how this approach can be used, we will describe the distribution of the burden of worker injury and illness in a program portfolio matrix that organizes research activities in 10 sectors and 7 health-outcome focused cross-sectors. We will discuss challenges related to estimating the portion of each condition that is attributed to exposures at work, and will present a recent update of several such attributable risk estimates. Then, we will discuss in detail example conditions to explain two processes. First, how surveillance and epidemiologic data and methods were used to derive cases and rates of conditions attributed to work and, second, how economic data and methods were used to derive economic metrics based on these cases and rates. Economic burden metrics included medical costs and productivity losses, and disability-adjusted life years. Conditions by sector were ranked by each individual metric. Conditions by sector were also ranked through the use of indexes that combine individual metric rankings. Conditions that consistently ranked highest by both individual metric rankings and index rankings indicate the highest priorities for research and prevention, based on burden.

W2-D.2  10:50 am  Application of Health-related Quality of Life Measures to Foodborne Risks. Hoffmann S*; USDA Economic Research Service

Abstract: Use of Health-related Quality of Life Measures are growing in importance as part of analysis to support risk management in federal agencies. This talk looks at how HRQL estimates have been developed for foodborne illness risk in the U.S. It then looks at ways in which these measures could be used to address issues like prioritization of efforts to manage risks from very different hazards, such as chemical and microbial hazards in foods. It ends with an examination of lessons that should be considered in this effort based on a debate on the strengths and limitations of HRQL measures that is ongoing in the literature on health impact measurement.

W2-D.3  11:10 am  Measuring the Benefits of FDA Import Inspections. McLaughlin CF*; U.S. Food and Drug Administration

Abstract: The United States Food and Drug Administration (FDA) inspects thousands of shipments of imported food each year. The benefits from these inspections include preventing the entry of shipments found to be contaminated and deterring importers from attempting to bring contaminated food into the country. As a first step towards a full measure of these benefits, we constructed a measure of the human health benefits from preventing the importation of food found to be contaminated with pathogens such as Salmonella. The public health benefits from preventing the consumption of contaminated food arise from non-events or the illnesses that do not occur. That is, the public health benefits arise when illnesses that would otherwise occur in the absence of FDA action do not occur. To assess these benefits, we must therefore place a value on the risk reduction that has already taken place, or for health-related costs of illnesses that did not take place. The conjectural nature of the risk reduction suggests that any estimate of health benefits from interdicting contaminated food shipments or limiting the distribution of such food shipments must be uncertain. We made the uncertainty explicit by using Monte Carlo simulations to estimate benefits. Before we present the results of the simulations, we explain the method of calculating a single point estimate of the health benefits associated with preventing the distribution and consumption of contaminated food in the U.S.

W2-D.4  11:30 am  Valuing Quality-Adjusted Life Years for Benefit-Cost Analysis. Hammitt JK, Robinson LA*; Harvard University (Center for Risk Analysis and Center for Health Decision Science)

Abstract: Benefit-cost analysis plays an important role in informing risk management decisions, by providing information on how those affected value the benefits they receive in comparison to the costs the policy imposes. However, the usefulness of these analyses is currently hindered by the lack of willingness to pay (WTP) estimates for nonfatal health conditions. As a result, analysts often rely on estimates of quality-adjusted life years (QALYs), valued using a constant WTP per QALY, as a rough proxy. However, both theory and empirical research suggest that that this approach is inconsistent with individual preferences: the value per QALY is likely to vary depending on the severity and duration of the condition as well as other characteristics of the risk and the affected individuals. Several studies are now available that provide estimates of individual WTP per QALY for different health conditions. We combine the results of these studies to develop a function that can be used to estimate the value of a QALY, which may depend on the size of the gain. We find that this approach is promising, but yields uncertain estimates given the limitations of the available research. Our research has implications for the values used as cost-effectiveness thresholds as well as for benefit-cost analysis, suggesting that these thresholds should be varied for different types of health conditions.

W2-D.5  11:50 am  Estimating Future Costs of the World Trade Center Health Program from Cancer Risk Data. Asfaw A*; Centers for Disease Control and Prevention- National Institute for Occupational Safety and Health

Abstract: The James Zadroga 9/11 Health and Compensation Act of 2010 established the World Trade Center (WTC) Health Program. The WTC Health Program was begun on July 1, 2011, and was authorized to operate through September 2016. In 2015, Congress extended the Zadroga 9/11 Health and Compensation Act for an additional 75 years. The major objective of this study was to estimate the incidence and cost of 14 cancer sites covered by the WTC program for years 2016-2032. We formulated an equation that enabled us to estimate the number of responders and survivors that would join the WTC Health Program in each year. We also estimated the number of expected cancer cases by cancer type using a hypothetical cohort of responders and survivors that would potential join the program in each year. We followed the National Cancer Institute approach to estimate the direct medical costs of cancer (initial year care, continuing care, and last year of life care). The total number of cancer cases (new cases plus cases from previous years minus those who died) was estimated to grow from 3,333 in 2016 to 8,682 in 2032. The corresponding medical cancer cost for the WTC Health Program would grow from $74.5 million in 2016 to $184.1 million in 2032 in 2015$. This is a 9.2% increase per year. To test the overall predictive power of our analyses, we compared the estimated number of cancer cases and costs with the actual number of cases and costs in 2015. Our model predicted 3,048 cancer cases in 2015 compared to 2,915 actual cases. Our cancer cost estimation for 2015 was a little bit higher than the actual cost. We estimated the cancer cost for 2015 to be $68.9 million while the actual cost was $42.9 million. One reason for this discrepancy could be the difficulty of the WTC program in assigning costs to cancer and non-cancer cases.

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