| The ERS salmonellosis
cost estimate includes three cost components: medical
costs due to illness, the cost (value) of time lost
from work due to nonfatal illness, and the cost
(value) of premature deaths. The ERS estimate excludes
a number of other potential costs, such as those
due to chronic complications like arthritis; disutility
costs for nonfatal illnesses, such as pain and suffering;
travel costs; childcare costs; etc. Please see the
per-case
assumptions page for a summary table of the
per-case assumptions used in the calculations. Comprehensive
details about the ERS assumptions, some alternative
assumptions, and literature citations are provided
below.
Annual Number
of Cases
ERS Assumption
The ERS estimate sets the annual number of Salmonella
cases at
1,397,187
. ERS based its case numbers on estimates from
the Centers for Disease Control and Prevention
(CDC). The CDC estimate of the annual number of
cases, hospitalizations, and deaths due to Salmonella
is an update by Voetsch et al. (2004) of the earlier
CDC estimate reported in Mead et al. (1999).
CDC Foodborne Assumption
In 1999, the CDC estimated the share of cases
due to consumption of contaminated food at 95
percent, or
1,327,328
cases. The CDC estimate of the annual foodborne
share of cases due to Salmonella is reported
in Mead et al. (1999). Calculator users may choose
to use a different assumption about the percentage
of Salmonella cases due to foodborne sources.
Food Safety and Inspection Service (FSIS) Assumption
FSIS estimates that 63 percent of foodborne
Salmonella cases (
995,496
) are due to the consumption of meat or poultry
(USDA 1996).
Food and Drug Administration (FDA) Assumption
FDA estimates that
200
of the annual cases of salmonellosis are caused
by eating seafood (FDA 1993).
References
Food and Drug Administration. 1993. Preliminary
Regulatory Impact Analysis of the Proposed Regulations
to Establish Procedures for the Safe Processing
and Importing of Fish and Fishery Products.
Mead, P.S., L. Slutsker, V. Dietz, L.F. McCaig,
J.S. Bresee, C. Shapiro, et al. "Food-Related
Illness and Death in the United States." 1999.
Emerging Infectious Diseases (5)5:607-25.
U.S. Department of Agriculture, Food Safety and
Inspection Service. "Pathogen Reduction: Hazard
Analysis and Critical Control Points Systems: Final
Rule," Supplement—Final Regulatory Impact Assessment
for Docket No. 93-016F, May 17, 1996.
Voetsch, A.C., T.J. Van Gilder, F.J. Angulo, M.M.
Farley, S. Shallow, R. Marcus, P.R. Cieslak, V.C.
Deneen, and R.V. Tauxe. 2004. "FoodNet
Estimate of the Burden of Illness Caused by Nontyphoidal
Salmonella Infections in the United States."
Clinical Infectious Diseases 38 (Supplement):127-134.
Outcome Distribution
by Severity Level
To facilitate the calculations, ERS researchers
grouped Salmonella cases into four outcome
severity levels:
- Severity 1: cases who do not visit a physician
and recover fully
- Severity 2: cases who visit a physician and
recover fully
- Severity 3: cases who are hospitalized and recover
fully
- Severity 4: cases who visit a physician and/or
are hospitalized and die
The Calculator calculates costs by severity level
and then sums over severity levels to get total
costs. Total costs change depending on the number
of cases in each severity level, with more severe
cases costing more than less severe cases.
ERS excludes outcomes involving chronic complications
such as arthritis. Inclusion of chronic complications
in the Calculator would change the distribution
of outcomes.
ERS Assumptions
ERS adjusted the CDC case estimate reported
in Voetsch et al. (2004) so that each case was
counted in only one of the four ERS severity categories.
The adjustments were based on information about
medical care for Salmonella infections
from two data sources: the Foodborne
Diseases Active Surveillance Network (FoodNet)
Project, and the MEDSTAT
MarketScan database. The data sources and
adjustment strategy are described in more detail
in Frenzen
et al. (1999).
In brief, ERS examined the medical claims for
every individual diagnosed with a Salmonella
infection in the population covered by the MarketScan
database during 1994-96. The salmonellosis patients
in the database were assumed to receive the same
average amount of medical care as all U.S. salmonellosis
patients.
The salmonellosis patients in the MarketScan
database were categorized into those who visited
a physician and recovered without being hospitalized
and those who were hospitalized. Four separate
categories of health care utilization were identified
and measured: physician office visits, emergency
room visits, outpatient clinic visits, and hospitalizations.
Using information about the Salmonella
cases identified by FoodNet,
ERS determined that 36 percent of hospitalized
cases did not visit a physician prior to hospitalization
because some cases first sought medical care in
a hospital emergency room. ERS also determined
that 10 percent of fatal cases were not hospitalized
prior to death. The number of cases not visiting
a physician was determined by subtracting the
other three severity categories from the CDC estimate
of total cases. The CDC estimate of physician
visits is reported in Voetsch et al. (2004).
References
Frenzen, P.D., T.L. Riggs, J.C. Buzby, T. Breuer,
T. Roberts, D. Voetsch, S. Reddy, and the FoodNet
Working Group. "Salmonella Cost Estimate
Updated Using FoodNet Data." 1999. FoodReview
(22)2: 10-15.
Mead P.S., Slutsker L., Dietz V., McCaig L.F.,
Bresee J.S., Shapiro C., et al. "Food-Related
Illness and Death in the United States." 1999.
Emerging Infectious Diseases (5)5: 607-25.
Voetsch, A.C., T.J. Van Gilder, F.J. Angulo, M.M.
Farley, S. Shallow, R. Marcus, P.R. Cieslak, V.C.
Deneen, and R.V. Tauxe. 2004. "FoodNet
Estimate of the Burden of Illness Caused by Nontyphoidal
Salmonella Infections in the United States."
Clinical Infectious Diseases 38 (Supplement):127-134.
Adjustments for
Price Inflation
The Calculator adjusts each type of cost for price
inflation, using six annual Consumer Price Index
(CPI) series (Bureau of Labor Statistics 2008).
The six series are the CPI for all items, hospital
services, inpatient hospital services, physician
services, prescription drugs and medical supplies,
and internal and respiratory over-the-counter drugs.
The Calculator uses a weighted average of the CPI
series for inpatient hospital services and physician
services to adjust the cost of hospital admissions.
See table
of CPI components.
Calculator users can choose to have costs reported
in dollars for any year from 1997 to 2008 through
the pull-down menu at the top of the main table.
The default year is 2008. Calculator users should
be aware that most of the information about costs
is from 2001 or earlier years, so adjustments for
inflation for years after 2001 may produce estimates
that differ from the results that would be obtained
if more recent cost information was available.
References
Bureau of Labor Statistics, U.S. Department of
Labor. 2008. Consumer
price indexes.
Medical
Care Utilization
ERS Assumptions
ERS obtained data about medical care utilization
from two data sources: the Foodborne
Diseases Active Surveillance Network (FoodNet)
Project and the MEDSTAT
MarketScan database. The data sources are
described in more detail in Frenzen et al. (1999).
ERS determined that Severity 2 cases (visit physician;
recover fully) averaged 1.4 physician office visits,
0.1 emergency room visits, and 0.3 outpatient
clinic visits; and that Severity 3 cases (hospitalized;
recover fully) averaged 0.7 physician office visits,
0.3 emergency room visits, 0.2 outpatient clinic
visits, and 1.0 hospitalizations. The MarketScan
database did not include any fatal salmonellosis
cases. Therefore, ERS assumed that Severity 4
cases (visit physician/hospitalized; die) averaged
1.0 physician office visits, 0.3 emergency room
visits, 0.2 outpatient clinic visits, and 0.9
hospitalizations, based in part on information
about the Salmonella cases identified by
FoodNet.
References
Frenzen, P.D., T.L. Riggs, J.C. Buzby, T. Breuer,
T. Roberts, D. Voetsch, S. Reddy, and the FoodNet
Working Group. "Salmonella Cost Estimate
Updated Using FoodNet Data." 1999. FoodReview
(22)2:10-15.
Medical Care
Costs
ERS Assumptions
ERS used a variety of different data sources
to calculate the average national cost of a physician
office visit, emergency room visit, outpatient
clinic visit, and hospitalization for a Salmonella
infection.
Medications: ERS does not include
costs for medications in its Salmonella
estimates.
Cost of a physician office visit:
The annual national expenditure on physician and
clinical services in 2000 was obtained from the
National Health Accounts, maintained by the Centers
for Medicare and Medicaid Services. ERS estimated
that 60 percent of these expenditures were for
physician office visits, based in part on Medicare
physician payments by type of service (see Wassenaar
and Thran, 2001).
The annual number of physician office visits
was calculated based on American Medical Association
data on the average number of weekly patient visits
per physician in 1999, the average annual number
of weeks in practice per physician in 1998, and
the number of office-based patient care physicians
in 2000 (Pasko and Seidman, 2002; Wassenaar and
Thran, 2001). (More recent data on patient visits
and practice weeks were not available.)
The average national cost of a physician office
visit in 2000 was determined by dividing the national
expenditure on physician office visits by the
annual number of physician office visits. The
cost was updated using the physician services
component of the CPI.
Cost of an emergency room visit: National
expenditures on emergency department visits during
1987 were obtained from a study based on the 1987
National Medical Expenditures Survey (Tyrance
et al., 1996). The number of emergency department
visits during 1987 was obtained from American
Hospital Association data (U.S. Census Bureau
1991).
The average national cost of an emergency room
visit in 1987 was determined by dividing national
emergency department visit expenditures by the
number of visits. The cost was updated using the
hospital and related services component of the
CPI.
Cost of an outpatient clinic visit:
The outpatient clinic care for salmonellosis patients
reported in the MEDSTAT
MarketScan database included a variety of
different diagnostic and therapeutic services.
Therefore, the cost of an outpatient clinic visit
was determined based on the average charges for
outpatient clinic visits by salmonellosis patients
in the MarketScan database during 1995-96. (Information
on 1994 charges was not available, and the database
did not include payments received.) The average
cost was updated using the medical care component
of the CPI.
The MarketScan database information on charges
may overestimate the actual costs of outpatient
clinic visits for salmonellosis, because health
care providers do not always receive the full
amount billed for their services. Some of the
reasons why revenue is likely to be lower than
charges include discounts for health insurance
plans, unpaid bills, and charity care. No information
about the difference between charges and revenue
was available for outpatients with salmonellosis.
Cost of a salmonellosis hospitalization:
The average national cost of hospitalizations
due to Salmonella infections was determined
based on Health
Care Cost and Utilization Project data on
hospital charges from the 1999 Nationwide Inpatient
Sample (NIS). Salmonellosis hospitalizations were
defined as any hospitalization with a principal
diagnosis of Salmonella infection (ICD-9-CM
codes 003.0-003.9).
The NIS reports hospital charges, which exceed
the payments actually received by hospitals because
health plans negotiate substantial price discounts
for their enrollees. Therefore, the average hospital
charge was multiplied by the average cost-to-charge
ratio for U.S. hospitals in 2001, which was 0.454.
This ratio was obtained by weighting the hospital
cost-to-charge ratios for the urban and rural
areas of each state in 2001 (Centers for Medicare
and Medicaid Services 2001) by the number of hospital
admissions in each area in 2001 from the Area
Resources File (Health Resources and Services
Administration 2003). (The cost-to-charge ratio
for 2001 was used because this information was
already available from the ERS cost estimate for
STEC O157.)
The NIS estimate of the average hospital charge
excludes the cost of physician services billed
separately from hospital services. These additional
costs were estimated using the 2001 Medical Expenditures
Panel Survey (MEPS) hospital inpatient stays file,
which reports expenditures on hospital inpatient
care for households classified by whether payments
were made to hospitals or physicians (Agency for
Healthcare Research and Quality 2004). The MEPS
sample was too small to provide reliable estimates
for Salmonella cases, so payments to physicians
were assumed to equal the physician share of payments
for all hospitalizations, which was 17.3 percent.
(The physician share of payments for 2001 was
used because this information was already available
from the ERS cost estimate for STEC O157.)
The average cost per salmonellosis hospitalization
was updated using the weighted average of the
CPI series for physician services and inpatient
hospital services.
References
Agency for Healthcare Research and Quality, U.S.
Department of Health and Human Services. 2004. MEPS
HC-059D: 2001 hospital inpatient stays file.
Centers for Medicare and Medicaid Services, Department
of Health and Human Services. 2001. Medicare Program;
Changes to the Hospital Inpatient Prospective Payment
Systems and Rates and Costs of Graduate Medical
Education: Fiscal Year 2002 Rates; Provisions of
the Balanced Budget Refinement Act of 1999; and
Provisions of the Medicare, Medicaid, and SCHIP
Benefits Improvement and Protection Act of 2000.
Federal
Register 66 (August 1):39827-40102.
Health Resources and Services Administration, U.S.
Department of Health and Human Services. 2003. Area
Resource File (ARF), February 2003 release.
(Electronic database.)
Pasko T., and B. Seidman. "Physician Characteristics
and Distribution in the US: 2002-2003 Edition."
Chicago: American Medical Association,
2002.
Tyrance, P.H., D.U. Himmelstein, and S. Woolhandler.
"U.S. Emergency Department Costs: No Emergency."
1996. American Journal of Public Health (86)11:
1527-31. [Abstract
available online]
U.S. Bureau of the Census. "Statistical Abstract
of the United States: 1991," Washington: U.S.
Bureau of the Census, 1991.
Wassenaar, J.D., and S.L. Thran. "Physician
Socioeconomic Statistics: 2000-2002 Edition: Profiles
for Detailed Specialties, Selected States, and Practice
Arrangements." Chicago: American Medicial
Association, 2001.
Productivity
Costs
ERS Assumptions
No information about time lost from work due
to Salmonella infections was available.
Therefore, ERS calculated the productivity costs
due to Salmonella infections based on time
lost from work because of acute infectious illness.
Information about work loss due to acute infectious
illness was obtained from the 1992-94 National
Health Interview Survey (NHIS), which was
conducted by the Centers for Disease Control's
National Center for Health Statistics. The ERS
analysis of the NHIS is described in more detail
in Frenzen et al. (1999).
Number of days lost from work:
NHIS estimates of days lost from work due to illness
were restricted to persons who either sought medical
care or else missed at least one-half day of work
due to their illness. The NHIS estimate of work
days lost due to acute infectious illness during
1992-94 indicates that employed persons who visited
a physician lost 1.6 days on average, while other
employed persons who did not seek medical care
lost 1.0 days on average. ERS reduced the latter
estimate to 0.5 days to account for the fact that
employed persons who missed less than one-half
day of work were not included in the NHIS estimate.
The NHIS excludes hospitalized persons, so ERS
conservatively assumed that employed persons who
were hospitalized because of salmonellosis lost
the same number of days from work as those who
visited physicians (1.6 days), plus the average
number of days spent in the hospital adjusted
for a 5-day weekly work schedule (2.9 days), for
a total of 4.5 days. The average length of a hospital
stay for salmonellosis was determined using the
1994-96 MEDSTAT
MarketScan database.
Value of time lost from work: No
information was available about the employment
status or earnings of salmonellosis cases. Therefore,
ERS assumed that the salmonellosis cases in each
nonfatal severity category (Severity 1, 2, and
3) had the same employment rate and average earnings
as the U.S. population.
The salmonellosis cases in Severity categories
1, 2, and 3 were classified into three age groups
(< 18 years, 18-54 years, and 55+ years) because
of the large variation in employment and earnings
by age. Severity 1 cases were assumed to have
the same age distribution as people who had an
acute infectious illness but did not see a physician,
based on the 1992-94 NHIS. Severity 2 and 3 cases
were assumed to have the same age distribution
as the culture-confirmed salmonellosis cases detected
by FoodNet
during 1996-97.
Information about the U.S. employment rate and
hourly earnings by age during 2000 were obtained
from the March round of the 2001
Current Population Survey. Earnings included
wages, salaries, self-employed business income,
and farm self-employment income. ERS adjusted
the hourly earnings estimate to include employer
costs for benefits for civilian wage and salary
workers in March 2001 reported by the Bureau of
Labor Statistics (2001). The estimated daily earnings
were updated based on the CPI.
ERS used information about Salmonella
case age distribution by outcome and the U.S.
employment rate to calculate the employment rate
for Salmonella cases by severity level—the
"employment factor." ERS used information about
Salmonella case distribution by outcome
and U.S. hourly earnings to calculate the average
daily wage rate for Salmonella cases by
severity level. The employment factor and average
wage rate vary by severity level, because case
age distribution varies by severity level. The
following table shows ERS estimates of the employment
factor and average wage rate for each severity
level:
| Variable |
Severity
1:
No physician; recover fully
|
Severity
2:
Visit physician; recover fully |
Severity
3:
Hospitalized; recover fully |
Severity
4:
Visit physician/
hospitalized; die |
| Employment factor |
0.444596 |
0.458895 |
0.430292 |
Not applicable |
| Average daily wage rate (in 2001
dollars) |
$193.382744 |
$194.754478 |
$199.795829 |
Not applicable
|
Alternative Assumption
ERS calculates productivity costs for employed
individuals. An alternative assumption is to calculate
productivity or "value of regular activity" costs
for all cases, including individuals who are not
in the labor force, such as stay-at-home mothers,
children, and the elderly.
References
Bureau of Labor Statistics. 2001. Employer
Costs for Employee Compensation, March 2001.
(USDL No. 01-194). Washington, DC: Bureau of Labor
Statistics.
Frenzen, P.D., T.L. Riggs, J.C. Buzby, T. Breuer,
T. Roberts, D. Voetsch, S. Reddy, and the FoodNet
Working Group. "Salmonella Cost Estimate
Updated Using FoodNet Data." 1999. FoodReview
(22)2:10-15.
Disutility
Costs: Nonfatal Cases
Disutility costs include all the factors leading
to the diminished well-being of a patient due to
illness or premature death. Disutility costs of
illness typically measure the amount of money (or
another measure of well-being) the average patient
would be willing to give up to avoid an illness
or premature death (such as lower wages received
for low-risk jobs). Disutility costs may include
a wide range of costs, including the costs of pain
and suffering, inconvenience, time lost from regular
activities, and productivity losses.
ERS Assumptions
ERS cost estimates do not include any disutility
costs for nonfatal cases. However, like all "willingness
to pay" estimates, the ERS willingness-to-pay
estimate of the cost of premature death is an
estimate of disutility.
Alternative Assumptions
Calculator users may choose to include disutility
costs in their cost estimates for nonfatal cases.
One approach for estimating the loss of well-being
that an individual suffers due to a disease or
condition is by estimating the Quality Adjusted
Life Years (QALYs) or Quality Adjusted Life Days
(QALDs) for each outcome. Researchers establish
the relative disagreeableness of each health state
and assign each one a disutility weight, ranging
from 0 (death) to 1 (perfect health). The FDA
calculated the utility losses from microbial hazards
in juice for the regulatory impact analysis for
proposed juice safety rules (FDA 1998 and 2001).
They calculated the total disutility per day for
nonfatal Salmonella infections at 0.5262
for mild and moderate cases and 0.6246 for severe
cases. FDA did not calculate a separate disutility
cost for fatal cases because disutility is included
in the estimated cost of a premature death derived
from the value of a statistical life.
The health disutility value can then be translated
into dollars by applying it to average dollar
utility estimates (though a 2006 Institute of
Medicine report on valuing health recommends that
regulatory analyses should not assign monetary
values to estimates of health-adjusted life years
(IOM 2006)). FDA researchers converted the Salmonella
disutility values into dollar measures using a
compensating wage midpoint estimate. Compensating
wage estimates calculate the amount of money that
workers would be willing to forego in order to
reduce job related mortality risk. These estimates
have been used to calculate the value of a statistical
life. Two widely cited surveys of compensating
wage studies place the most reliable empirical
results in the $1.6 million to $8.5 million range
(in 1986 dollars) (Fisher et al., 1989) and the
$3 million to $7 million range (in 1990 dollars)
(Viscusi 1993).
For their disutility calculations, FDA researchers
assigned a value of $5 million to premature death
and a proportion of this amount to all other outcomes,
depending on the outcome's disutility weight.
Assuming that the average illness strikes a 40-year-old
with an average remaining lifespan of 36 years,
FDA researchers discounted future health benefits
to estimate the value of a "discounted life year"
at $230,000 and the value of a "discounted day"
at $630.
FDA used the discounted value of a healthy day
(along with information on duration) to calculate
a dollar measure of utility loss per case of Salmonella
of $700 for mild cases (equivalent to Severity
1); $1,600 for moderate cases (equivalent to Severity
2); and $6,700 for severe cases (equivalent to
Severity 3) (FDA 1998, table 7).
ERS assumed that the FDA estimates were in 1998
dollars and updated the values for inflation using
the "All Items" component of the CPI, rounding
the result to the nearest hundred dollars. Although
calculator users can include the FDA disutility
estimates in the cost estimate for nonfatal cases,
this option is not available for fatal cases because
the ERS estimate of the cost of premature death
already includes an estimate of disutility costs.
References
Fisher, A., L.G. Chestnut, and D.M. Violette. 1989.
"The Value of Reducing Risks of Death: A Note on
New Empirical Evidence," Journal of Policy Analysis
and Management 8(1):88-100.
Institute of Medicine. 2006. "Valuing Health
for Regulatory Cost-Effectiveness Analysis."
(Washington DC: National Academies Press).
Research Triangle Institute. Estimating the
Value of Consumer's Loss from Foods Violating the
FD&C Act, prepared for Dr. Richard Williams,
U.S. Food and Drug Administration, September 1988.
U.S. Food and Drug Administration. 1993. Preliminary
Regulatory Impact Analysis of the Proposed Regulations
to Establish Procedures for the Safe Processing
and Importing of Fish and Fishery Products.
U.S. Food and Drug Administration. 1998. "Preliminary
Regulatory Impact Analysis and Initial Regulatory
Flexibility Analysis of the Proposed Rules to Ensure
the Safety of Juice and Juice Products; Proposed
Rule." Federal Register 63 (84):24253-24378.
U.S. Food and Drug Administration. 2001. Hazard
Analysis and Critical Control Point (HACCP); Procedures
for the Safe and Sanitary Processing of Juice; Final
Rule. Federal Register 66 (13):6138-6202.
Viscusi, WK. 1993. "The Value of Risks to Life
and Health." Journal of Economic Literature
(31):1912-46.
Premature
Death
ERS Assumptions
ERS estimates of the costs of premature death
are "willingness to pay" (WTP) estimates based
on results from labor-market studies on wage differentials
for jobs with health risks. These compensating
wage studies calculate the amount of money workers
would be willing to forego in order to reduce
job-related mortality risk. These numbers have
been used to calculate the value of a statistical
life. Two widely cited surveys of compensating-wage
studies place the most reliable empirical results
in the $1.6-million-to-$8.5-million range (1986
dollars) (Fisher et al., 1989) and the $3-million-to-$7-million
range (1990 dollars) (Viscusi 1993). ERS researchers
chose a midpoint estimate of $5 million (December
1990 dollars) for their WTP estimates of the cost
of a premature death. Updated to 2001 dollars
based on the CPI,
the value was $6.6 million.
Using an approach developed by Mauskopf and French
(1991), ERS used information about the age distribution
of Salmonella deaths to adjust the assumed
value of life for age at time of death. The value
of life was therefore treated as an annuity paid
over the average U.S. lifespan at an interest
rate of 3 percent. This estimate of the cost of
premature death includes all disutility costs
such as the cost of pain and suffering.
Information about the age distribution of Salmonella
deaths was obtained from the 1995-97 Multiple
Cause of Death files, which include most of
the information reported on official death certificates.
Salmonella deaths were defined as any death
with a Salmonella infection (ICD-9 codes
003.0-003.9) as a cause of death. Based on this
definition, 308 Salmonella deaths were
reported during 1995-97.
Information about life expectancy by age was
obtained from the 1998 official U.S.
life table. ERS used the abridged life table
and 5-year age groups to simplify the calculations.
The average life expectancy at birth in 1998 was
76.7 years.
The total value of lost life was calculated based
on the assumed value of life, age distribution
of Salmonella deaths, and life expectancy
by age using the method of Mauskopf and French
(1991). The value of a statistical life adjusted
for age (in 2001 dollars) ranged from $8.9 million
at birth to $1.7 million at age 85 or older. On
average, given the age distribution of Salmonella
cases, the value of a statistical life adjusted
for age is therefore $4,624,171.80.
FDA Assumptions
Like ERS, the Food and Drug Administration (FDA)
uses a compensating wage midpoint estimate of
$5 million, which is updated to 2000 dollars resulting
in an estimate of $6.5 million
per life (see FDA 1993). Unlike ERS, FDA
values the cost of each premature death equally,
regardless of age at time of death. To adjust
this estimate for inflation, users should refer
to the Bureau
of Labor Statistics current price indices.
EPA Assumptions
Environmental Protection Agency (EPA) cost of
premature death estimates are based on a mid-range
estimate taken from 21 compensating wage studies
and 5 contingent valuation studies conducted in
the late 1970s and 1980s. To allow for probabilistic
modeling of mortality risk reduction benefits,
EPA set the mean value at $5.8 million (in 1997
dollars) using a Weibull distribution (EPA, 2000).
To adjust this estimate for inflation, users should
refer to the Bureau
of Labor Statistics current price indices.
Though some EPA analyses include adjustments
for age, the EPA Guidelines for Preparing
Economic Analyses do not encourage such value
adjustments (EPA 2000).
References
Environmental Protection Agency. 2000. Guidelines
for Preparing Economic Analyses.
Fisher, A., L.G. Chestnut, and D.M. Violette. 1989.
"The Value of Reducing Risks of Death: A Note on
New Empirical Evidence," Journal of Policy Analysis
and Management 8(1): 88-100.
Food and Drug Administration. 1993. Preliminary
Regulatory Impact Analysis of the Proposed Regulations
to Establish Procedures for the Safe Processing
and Importing of Fish and Fishery Products.
Mauskopf, J.A. and M.T. French. 1991. "Estimating
the Value of Avoiding Morbidity and Mortality from
Foodborne Illness." Risk Analysis 11(4):
619-31.
Viscusi, WK. 1993. "The Value of Risks to Life
and Health." Journal of Economic Literature
(31): 1912-46.
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