One year’s newly diagnosed cases of mesothelioma and lung cancer due to work-related asbestos exposures cost Canadians $2.35 billion—up from an earlier estimate of $1.9 billion.
This is according to a study led by Institute for Work & Health (IWH) Senior Scientist Dr. Emile Tompa, a health economist who assessed the costs to Canadian society of cases newly diagnosed in 2011.
The study is the first to estimate the costs to society of illnesses associated with work-related asbestos exposures, including secondhand or “para-occupational” exposures (e.g. a family member’s exposure to fibres brought home on work clothing).
The study, conducted with funding from the Canadian Cancer Society, was published July 2017 as an open access article in the Journal of Occupational and Environmental Medicine (doi:10.1136/oemed-2016-104173).
Earlier reports and presentations about this study put the economic burden estimate at $1.9 billion. The new estimate is higher because it includes the value of activities in the home (known as “home production”). This addition to the estimate was requested by the article’s peer reviewers.
2,331 new cases in 2011
Tompa and his team looked at the estimated total lifetime costs of 427 cases of mesothelioma newly diagnosed in 2011, as well as 1,904 cases of lung cancer newly diagnosed in the same year, for a total of 2,331 new cases in 2011. These were all cases attributed to occupational and para-occupational exposures to asbestos.
They considered costs in three areas: direct costs (e.g. health-care and family/community caregiver time), indirect costs (e.g. productivity losses associated with work in the paid labour market and unpaid work in home production) and quality-of-life costs (e.g. pain, suffering and loss of enjoyment of life).
Updated estimates are displayed in the tables below. Table 1 shows the economic burden of mesothelioma due to occupational and para-occupational (i.e. secondhand) exposures to asbestos. Table 2 shows the economic burden of lung cancer due to occupational (not para-occupational) exposures to asbestos.
The cases were diagnosed in 2011. All figures are in 2011 Canadian dollars.
| Based on 427 cases in 2011 | All cases | Per case | |
|---|---|---|---|
| Total health-care costs | $23,212,416 | $54,393 | |
| Health-care sector treatment costs | $17,130,994 | $40,143 | |
| Out-of-pocket costs | $6,081,422 | $14,251 | |
| Total productivity and output costs | $117,884,178 | $276,143 | |
| Wage and salary costs | $26,501,873 | $62,102 | |
| Fringe benefit costs* | $3,710,262 | $8,694 | |
| Home production costs** | $87,632,043 | $205,347 | |
| Total friction costs*** | $2,360,170 | $5,531 | |
| Total informal care-giving costs | $5,790,544 | $13,569 | |
| Total insurance administration costs | $36,886,993 | $86,437 | |
| Health-care administration costs | $2,574,720 | $6,033 | |
| Workers' compensation administration costs* | $34,312,273 | $80,404 | |
| Total health-related quality of life costs | $296,303,160 | $694,325 | |
| Overall total costs | $482,397,461 | $1,130,398 | |
| Based on 1,904 cases in 2011 | All cases | Per case | |
|---|---|---|---|
| Total health-care costs | $81,831,543 | $42,974 | |
| Health-care sector treatment costs | $46,154,063 | $24,238 | |
| Out-of-pocket costs | $35,677,480 | $18,736 | |
| Total productivity and output costs | $498,309,077 | $261,690 | |
| Wage and salary costs | $126,275,066 | $66,314 | |
| Fringe benefit costs* | $15,507,464 | $8,144 | |
| Home production costs** | $356,562,546 | $187,232 | |
| Total friction costs*** | $10,542,816 | $5,537 | |
| Total informal care-giving costs | $32,857,086 | $17,255 | |
| Total insurance administration costs | $21,201,183 | $11,134 | |
| Health-care administration costs | $7,627,244 | $4,005 | |
| Workers' compensation administration costs | $13,573,939 | $7,128 | |
| Total health-related quality of life costs | $1,224,370,103 | $642,986 | |
| Overall total costs | $1,869,111,809 | $981,576 | |
*Fringe benefits in paid work were estimated at 14 per cent of wages. Fringe benefits include items such as dental care, extended health care, disability and employment insurance and retirement benefits.
** Home production pertains to the value of an individual’s contribution to the upkeep of his or her home.
***Friction costs refer to employers' short-term cost of production disturbances associated with employee turnover. This may include costs such as search expenses, management time for interviews, and reduced productivity of the new hire during the training period.