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Research article
SeyedBagher Mortazavi
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9454-0598
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situation. Methods: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables effects interventions net benefit. Results: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. Conclusions: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.
Keywords
cost-benefit analysis, lung cancer, uncertainty, probabilistic modeling approach, net benefit, Bayesian networks.
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CURRENT STATUS: Published
View the published article at BMC Public Health.
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Editorial decision: Accept
On 31 Jan, 2020
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On 30 Jan, 2020
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On 29 Jan, 2020
Editor invited
On 29 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 29 Jan, 2020
Editor assigned
On 28 Jan, 2020
Submission checks complete
On 27 Jan, 2020
Editor invited
On 27 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 24 Jan, 2020
Editor assigned
On 23 Jan, 2020
Submission checks complete
On 22 Jan, 2020
Editor invited
On 22 Jan, 2020
Version 2
Posted 19 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 06 Jan, 2020
Review #1 received
Received 02 Jan, 2020
Reviewer #1 agreed
On 19 Dec, 2019
Reviewers invited
Invitations sent on 16 Dec, 2019
Editor assigned
On 15 Dec, 2019
Submission checks complete
On 14 Dec, 2019
Editor invited
On 14 Dec, 2019
No comments provided
Review #2 received
Received 14 Nov, 2019
Editorial decision: Major revision
On 14 Nov, 2019
Reviewer #2 agreed
On 12 Oct, 2019
Review #1 received
Received 30 Sep, 2019
Reviewer #1 agreed
On 17 Sep, 2019
Reviewers invited
Invitations sent on 12 Sep, 2019
Editor assigned
On 03 Sep, 2019
Submission checks complete
On 29 Aug, 2019
Editor invited
On 29 Aug, 2019
First submitted
On 22 Aug, 2019
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
SeyedBagher Mortazavi
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9454-0598
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Editorial decision: Accept
On 31 Jan, 2020
Editor assigned
On 30 Jan, 2020
Submission checks complete
On 29 Jan, 2020
Editor invited
On 29 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 29 Jan, 2020
Editor assigned
On 28 Jan, 2020
Submission checks complete
On 27 Jan, 2020
Editor invited
On 27 Jan, 2020
No comments provided
Editorial decision: Minor revision
On 24 Jan, 2020
Editor assigned
On 23 Jan, 2020
Submission checks complete
On 22 Jan, 2020
Editor invited
On 22 Jan, 2020
Version 2
Posted 19 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 06 Jan, 2020
Review #1 received
Received 02 Jan, 2020
Reviewer #1 agreed
On 19 Dec, 2019
Reviewers invited
Invitations sent on 16 Dec, 2019
Editor assigned
On 15 Dec, 2019
Submission checks complete
On 14 Dec, 2019
Editor invited
On 14 Dec, 2019
No comments provided
Review #2 received
Received 14 Nov, 2019
Editorial decision: Major revision
On 14 Nov, 2019
Reviewer #2 agreed
On 12 Oct, 2019
Review #1 received
Received 30 Sep, 2019
Reviewer #1 agreed
On 17 Sep, 2019
Reviewers invited
Invitations sent on 12 Sep, 2019
Editor assigned
On 03 Sep, 2019
Submission checks complete
On 29 Aug, 2019
Editor invited
On 29 Aug, 2019
First submitted
On 22 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situation. Methods: We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables effects interventions net benefit. Results: A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. Conclusions: This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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