Assessment of Health Care and Economic Costs Due to Episodes of Acute Pesticide Intoxication in Workers of Rural Areas of the Coquimbo Region, Chile

Muriel Ramírez-Santana; Juan Iglesias-Guerrero; Marianela Castillo-Riquelme; Paul T J Scheepers

doi:10.1016/j.vhri.2014.07.006

Assessment of Health Care and Economic Costs Due to Episodes of Acute Pesticide Intoxication in Workers of Rural Areas of the Coquimbo Region, Chile

Value Health Reg Issues. 2014 Dec:5:35-39. doi: 10.1016/j.vhri.2014.07.006. Epub 2014 Aug 28.

Authors

Muriel Ramírez-Santana¹, Juan Iglesias-Guerrero², Marianela Castillo-Riquelme³, Paul T J Scheepers⁴

Affiliations

¹ Faculty of Medicine, Public Health Department, Universidad Católica del Norte, Coquimbo, Chile. Electronic address: mramirezs@ucn.cl.
² Faculty of Medicine, Public Health Department, Universidad Católica del Norte, Coquimbo, Chile.
³ Division of Health Planning, Department of Health Economics, Ministry of Health, Santiago, Chile.
⁴ Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.

PMID: 29702785
DOI: 10.1016/j.vhri.2014.07.006

Abstract

Background: The increase in agricultural activity that Chile experienced in the past 20 years resulted in a boost in the use of pesticides. Despite pesticides' productivity benefits, they caused health problems such as the increased frequency of episodes of acute poisoning, which constitutes a relevant problem in terms of occupational health. The Chilean authorities require several preventive measures at workplaces, which are not always implemented, increasing the risk of intoxications in farmers. So far in Chile, there are no studies concerning the public health care expenses associated with acute work-related pesticide intoxications. From the societal perspective, there are costs involved if the worker needs to take sick leave and families incur costs to take care of their sick members.

Objectives: This study aimed to determine the costs associated with health care services used by people who suffered from work-related acute pesticide poisoning, as well as the economic costs for the families of the workers involved, and finally the costs of these episodes for the employer/industrial sector.

Methods: This study considered a 3-year period (January 2009 to December 2011). Three sources of data were reviewed: reported cases at the Regional Health Authority, for the profile of the intoxications; registers of patients attended in public hospitals, for data on costs of health care services; and public information of living conditions nationwide.

Results: The overall costs of a single case depend on the severity of intoxication, days of sick leave, and type of health care needed. Most cases (77%) would be ambulatory and would be assisted at an emergency room, with an average cost of US $330 per case. Those cases that might need hospitalization (23%) and, therefore, more days off work have an average cost of US $1158 per case. Taking into account the number of patients reported each year in the country, the cost per annum would be about US $185,000, but considering the underreporting of intoxications and underestimation of costs at the public insurance system fees, this amount could be six to eight times higher (US $1.1 million to US $1.4 million a year).

Conclusions: This study is the first attempt to estimate costs related to this occupational and public health problem. There is an opportunity to further improve the cost-benefit balance of preventive measures that relate not only to acute poisonings but also to health problems originating from chronic and low-dose exposure to pesticides (e.g., neuropsychological impairment).

Keywords: cost analysis; occupational health; pesticide poisoning.