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Annual dementia incidence and monetary burden attributable to fine particulate matter (PM2.5) exposure in Sweden

Authors
  • Kriit, Hedi Katre1
  • Forsberg, Bertil1
  • Åström, Daniel Oudin1
  • Oudin, Anna1, 2
  • 1 Umeå University, Umeå, Sweden , Umeå (Sweden)
  • 2 Lund University, Tornblad Institute, Biskopsgatan 7, 223v62, Lund, Sweden , Lund (Sweden)
Type
Published Article
Journal
Environmental Health
Publisher
BioMed Central
Publication Date
May 27, 2021
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12940-021-00750-x
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundAlzheimer’s disease (AD) and other dementias currently represent the fifth most common cause of death in the world, according to the World Health Organization, with a projected future increase as the proportion of the elderly in the population is growing. Air pollution has emerged as a plausible risk factor for AD, but studies estimating dementia cases attributable to exposure to fine particulate matter (PM2.5) air pollution and resulting monetary estimates are lacking.MethodsWe used data on average population-weighted exposure to ambient PM2.5 for the entire population of Sweden above 30 years of age. To estimate the annual number of dementia cases attributable to air pollution in the Swedish population above 60 years of age, we used the latest concentration response functions (CRF) between PM2.5 exposure and dementia incidence, based on ten longitudinal cohort studies, for the population above 60 years of age. To estimate the monetary burden of attributable cases, we calculated total costs related to dementia, including direct and indirect lifetime costs and intangible costs by including quality-adjusted life years (QALYs) lost. Two different monetary valuations of QALYs in Sweden were used to estimate the monetary value of reduced quality-of-life from two different payer perspectives.ResultsThe annual number of dementia cases attributable to PM2.5 exposure was estimated to be 820, which represents 5% of the annual dementia cases in Sweden. Direct and indirect lifetime average cost per dementia case was estimated to correspond € 213,000. A reduction of PM2.5 by 1 μg/m3 was estimated to yield 101 fewer cases of dementia incidences annually, resulting in an estimated monetary benefit ranging up to 0.01% of the Swedish GDP in 2019.ConclusionThis study estimated that 5% of annual dementia cases could be attributed to PM2.5 exposure, and that the resulting monetary burden is substantial. These findings suggest the need to consider airborne toxic pollutants associated with dementia incidence in public health policy decisions.

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