Aspects of economic costs and evaluation of health surveillance systems after a radiation accident with a focus on an ultrasound thyroid screening programme for children.

Viviana Albani,Mark Pearce,Liudmila Liutsko,Evgenia Ostroumova,Luke D Vale

doi:10.1016/j.envint.2021.106571

Abstract

Health surveillance initiatives targeted at populations evacuated from, and residing in, areas affected by radiation contamination were implemented by international institutions as well as national and local governments after the nuclear accidents of Chernobyl and Fukushima Dai-ichi nuclear power plants. Most of these initiatives included a component of childhood thyroid cancer monitoring, with the more comprehensive schemes corresponding to national programmes of health monitoring for adults and children around general health and wellbeing. This article provides a short overview of available data on the costs and resources associated with surveillance responses to two recent nuclear accidents: Chernobyl and the Fukushima Dai-Ichi nuclear plant accidents. Moreover, because the balance of costs and benefits of health surveillance after a nuclear accident can influence decisions on implementation, we also present a brief overview of the principles of economic evaluation for collecting and presenting data on costs and outcomes of a surveillance programme after a nuclear accident. We apply these principles in a balance sheet analysis of a post-accident ultrasound thyroid screening programme for children.

Highlights

After the accidents at the Chernobyl and Fukushima Dai-ichi nuclear power plants, international institutions and local governments deployed a series of health surveillance initiatives targeted at populations evac uated from, and residing in, areas affected by radiation contamination
Given the importance given to childhood thyroid cancer screening in previous health surveil lance initiatives, we focus on a routine ultrasound thyroid examinations surveillance system similar to that implemented in the Fukushima Health Management Survey (Yasumura, 2012)
This study briefly summarized available data on costs and resource use of a series of health surveillance programmes carried out after the Chernobyl and Fukushima Dai-Ichi nuclear plant accidents and reports a simple economic evaluation modelling exercise of a hypothetic child hood ultrasound thyroid cancer screening programme

Summary

Introduction

After the accidents at the Chernobyl and Fukushima Dai-ichi nuclear power plants, international institutions and local governments deployed a series of health surveillance initiatives targeted at populations evac uated from, and residing in, areas affected by radiation contamination These initiatives typically included a component of childhood thyroid cancer monitoring along with monitoring of general health and well being for adults and children. An economic evaluation sheds light on how benefits and costs are distributed across the population, i.e. who gains and loses out when resources are allocated to a surveillance programme (McIntosh et al, 1999) In this sense, the economic evaluation serves as an aid to decision-making (Public Health England, 2018; Hutubessy et al, 2003; Wilkinson et al, 2016), by presenting information that decision-makers can use in arriving to a decision. The economic evaluation of a health surveillance programme after a nuclear accident, presents challenges in assessing the outcomes and costs of health surveillance in the long-term, including determining the most appropriate economic measure of costs per outcome or outcomes of the surveillance programme

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Conclusion