Updated Review of Overall Costs of Asbestos Cancers in Canada

Study update: New cases of mesothelioma and asbestos-related lung cancer from one year cost $2.35B

IWH’s new estimate of economic burden higher than earlier figure

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.

Table 1: Economic burden of mesothelioma
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

 

 

 

Table 2: Economic burden of asbestos-related lung cancer

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.

Source:  At Work, Issue 90, Fall 2017: Institute for Work & Health, Toronto