Burden of disease, health and population data

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For this project, the harmonized health statistics database as held by the World Health Organization was used. This database provides health data specific for each country, health endpoint as defined by the Environmental Burden of Disease -programme, age group and gender. We used data (deaths and DALYs) for the year 2004 (WHO, 2009b; more detailed data available on request)(World Health Organization. The global burden of disease: 2004 update. Geneva: World Health Organization; 2009. Available at: http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html).

The data were obtained in discounted/age-weighted and undiscounted/un-age-weighted format.

Depending on the type of calculation (see section 2.1), different data were needed. For calculations according to methods 1A and 2A (Table 3-19 shows which methods were used for which calculation), the total YLL and YLD were needed per age group and country. The WHO database provides data for pre-defined age categories (e.g. 0–4; 5–14, etc). Age-specific values were derived assuming an equal distribution of people within the age categories in the WHO data. Table 3-15 shows a sample of the burden of disease as available from the WHO database, aggregated over all ages and for a selection of health endpoints only.

For calculations according to method 2B (see section 2.1 and Table 3-19), no background health data was applied; the incidences were calculated using a unit risk model and the burden of disease was estimated using the WHO disability weights and duration estimates. For these calculations (IQ loss and HTD from lead), no age-weighing was applied due to the lack of information on the age distribution of the effects; however, the impact of the simplification was estimated to be small and to affect only the discounted results. Table 3-16 shows the disability weights and durations that were used.

We have carried out preliminary calculations to investigate the potential effect of lag times on the discounted estimates. The lag times used per health endpoint are provided in Table 3-17.

Population data (number of people in 2004) were used to calculate numbers of DALYs per million people and are provided in Table 3-18.


TABLE 3-15. WHO burden of disease data (total undiscounted, not-age-weighted DALYs) in 2004 (sample of health endpoints; aggregated over all ages).
Health endpoint YLL/ YLD Burden of disease data (WHO) – discounted (3%) and age-weighted
Belgium Finland France Germany Italy Netherlands
Total mortality (non-violent)

Total morbidity

YLL 1 137 042 520 755 5 904 337 9 261 877 5 780 589 1 585 775
YLD 930 436 460 350 5 219 164 7 283 809 4 838 018 1 360 245
Total cancer YLL 413 390 154 033 2 447 205 3 193 738 2 215 606 622 914
YLD 34 945 12 796 198 478 254 086 172 230 50 271
Leukaemia YLL 15 490 5 586 99 669 119 106 93 212 22 131
YLD 487 167 3 222 3 845 2 859 689
Lung cancers YLL 103 461 27 142 514 569 653 118 465 809 154 443
YLD 2 125 583 9 473 12 740 10 014 3 031
Otitis media YLL n/a n/a n/a n/a n/a n/a
YLD 1 184 611 7 447 8 038 5 469 2 004
Ischemic heart disease YLL 178 793 115 258 478 408 1 624 841 841 741 177 269
YLD 21 764 13 676 56 462 188 782 98 850 22 340
Cardiopulmonary disease YLL 385 102 203 063 1 222 063 3 067 603 1 861 658 425 443
YLD 147 553 58 363 502 501 1 003 277 559 717 189 275
Chronic bronchitis YLL 47 784 9 982 69 644 239 985 134 312 55 767
YLD 66 091 14 949 125 272 404 043 151 689 83 814
Asthma induction/ aggravation YLL 4 632 935 17 794 31 851 9 902 1 882
YLD 13 818 9 264 99 867 100 872 60 658 31 209
Lower respiratory infections YLL 30 003 13 331 97 589 168 799 78 505 44 596
YLD 629 361 1 981 3 721 2 317 1 072
Sum of all above YLL 2 313 816 2 313 816 2 313 816 2 313 816 2 313 816 2 313 816
YLD 1 220 913 1 220 913 1 220 913 1 220 913 1 220 913 1 220 913
DALY 3 534 729 3 534 729 3 534 729 3 534 729 3 534 729 3 534 729

[1]

References

  1. ↑ Otto Hänninen, Anne Knol: European Perspectives on Environmental Burden of Disease: Esimates for Nine Stressors in Six European Countries, Authors and National Institute for Health and Welfare (THL), Report 1/2011 [1]
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