Potential Public Health Impact Research Articles

Assessment of Municipal Solid Waste Compost Used In Urban Agriculture and Its’ Potential Public Health Impacts In Katsina City, Nigeria.

This research assessed the potential ecotoxicological impacts of municipal solid waste compost (MSWC) as soil fertility improvement material on soil, plants and humans in urban Katsina. MSW Compost samples were collected from different dump sites and mixed with sand and kaolin into 2:2:1 ratio respectively. Maize and beans were planted on the mixture for phytotoxicity assessment as describe by Zucconi et al., 1981. Both the mixture and plant vegetative biomass were tested in the laboratory for non-biodegradable chemicals of Zn, Pb, Mn, Fe, Cd, Cr and pH using Atomic Absorption Spectrophotometer and pH meter methods respectively. In phytotoxicity assessment, Bean show high phytotoxicity while maize considers MSWC as phytonutrients. Paired ttest reports no statistical difference of nonbiodegradable substances concentrations in soils and in plants vegetative biomass. Single factor pollution index values range from clean to slightly polluted. Ecological risk index (ERI) values indicate low risk for all the heavy metals. Estimated daily intake of contaminants in beans and maize plants are far below the maximum allowable limits of WHO/FAO while Target hazard quotients (THQ) values are likely to cause noncarcinogenic effects to the ecosystem. This finding is promising particularly to the maize farmers. Both beans and maize farmers should ensure quality standard and regulations such as source separation and matured composting to remove harmful nonbiodegradable chemical substances before application.

Global regional and national burden of cataract attributable to high body mass index from 1990 to 2019

ObjectivesIn order to estimate long-term trends of the years lived with disability (YLDs) for cataract due to high body mass index (BMI).Design and participantsData were retrieved from the Global Burden...

Conventional and regionally distinctive risk factors for first-onset myocardial infarction: The Bangladesh Risk of Acute Vascular Events (BRAVE) case-control study

South Asians may be particularly susceptible to premature myocardial infarction (MI) owing both to conventional cardiovascular risk factors and practices distinctive to South Asia. Identifying modifiable risk factors for MI in these populations could inform prevention strategies. We have, therefore, studied conventional risk factors and other characteristics in relation to occurrence of first MI in Bangladesh. In a case-control study involving 8133 first-onset MI cases and 8124 controls recruited in Bangladesh, we calculated odds ratios (ORs) for MI adjusted, for age, sex, smoking status, history of diabetes, history of hypertension, family history of MI, and LDL-cholesterol. We assessed the potential public health impact of risk factor modification using population attributable fractions (PAFs). The median (IQR) age of first MI was 53 (45-60) years. Adjusted ORs (95% CIs) were 2.80 (2.57-3.05) for cigarette smoking, 2.17 (1.94-2.43) for family history of MI, 2.27 (2.07-2.48) for history of hypertension, 1.91 (1.72-2.13) for history of diabetes, and 1.53 (1.47-1.58) per 1-SD higher LDL-cholesterol. The highest PAFs (95% CIs) were with current cigarette smoking (49% [46%-52%]), higher LDL-cholesterol (31% [29%-33%]) and history of hypertension (15% [13%-16%]). As for regionally distinctive practices, ORs were 4.02 (3.13-5.17) with biri/hukkah smoking, 2.09 (1.52-2.87) with chewing tobacco, and 1.26 (1.05-1.51) with parental history of first-cousin marriage. Our results confirm the relevance of several conventional risk factors to risk of first MI in Bangladesh, and identify associations with MI of practices distinctive to South Asia, including indigenous modes of tobacco consumption and parental first-cousin marriage. These findings suggest opportunities for cardiovascular disease prevention in Bangladesh that embrace both conventional and regionally distinctive risk factors. The BRAVE Study Coordinating Centre is underpinned by grants from the British Heart Foundation, UK Medical Research Council and National Institute for Health Research Cambridge Biomedical Research Centre.

Modeling the potential public health and economic impact of different COVID-19 booster dose vaccination strategies with an adapted vaccine in the United Kingdom

ABSTRACT Background Updating vaccines is essential for combatting emerging coronavirus disease 2019 (COVID-19) variants. This study assessed the public health and economic impact of a booster dose of an adapted vaccine in the United Kingdom (UK). Methods A Markov-decision tree model estimated the outcomes of vaccination strategies targeting various age and risk groups in the UK. Age-specific data derived from published sources were used. The model estimated case numbers, deaths, hospitalizations, medical costs, and societal costs. Scenario analyses were conducted to explore uncertainty. Results Vaccination targeting individuals aged ≥ 65 years and the high-risk population aged 12–64 years was estimated to avert 701,549 symptomatic cases, 5,599 deaths, 18,086 hospitalizations, 56,326 post-COVID condition cases, and 38,263 lost quality-adjusted life years (QALYs), translating into direct and societal cost savings of £112,174,054 and £542,758,682, respectively. The estimated economically justifiable price at willingness-to-pay thresholds of £20,000 and £30,000 per QALY was £43 and £61, respectively, from the payer perspective and £64 and £82, respectively, from the societal perspective. Expanding to additional age groups improved the public health impact. Conclusions Targeting individuals aged ≥ 65 years and those aged 12–64 years at high risk yields public health gains, but expansion to additional age groups provides additional gains.

Modeling the potential public health and economic impact of different COVID-19 vaccination strategies with an adapted vaccine in the Kingdom of Saudi Arabia

ABSTRACT Background The dynamic evolution of the virus causing COVID-19 necessitates the development of adapted vaccines to protect against emerging variants. Research design and methods A combined Markov-decision tree model estimated the outcomes of alternative vaccination strategies. The Saudi Arabian population was stratified into standard-risk and high-risk subpopulations, defined as either the population comprising individuals aged ≥ 65 years and individuals with at least one comorbidity. The model estimated the health and economic outcomes of vaccination based on age-specific inputs taken from published sources and national surveillance data. Results The vaccination strategy targeting the elderly and high-risk subpopulation (was estimated to prevent 156,694 cases 12,800 hospitalizations, and 2,919 deaths and result in cost savings of SAR 1,239 million in direct costs and SAR 4,145 million in indirect costs. These gains increased with the vaccination strategies additionally targeting other subpopulations. Compared to the base case (aged ≥65 and those at high-risk), expanding vaccination coverage to 75% of the standard-risk population prevented more cases (323%), hospitalizations (154%), and deaths (60%) and increased the direct (232%) and indirect (270%) cost savings. Conclusions The adoption of broad vaccination strategies using a vaccine adapted to the dominant variant in circulation would yield substantial benefits in Saudi Arabia.

The association of diesel vehicle emissions and diesel passenger car preferences with cancer and chronic respiratory airway disease deaths in Türkiye: an ecological study

The first aim of this study was to investigate the relationship of increased emissions from diesel vehicles with the ratios of chronic respiratory disease and cancer deaths. Secondly, this study aims to investigate the types of cancer deaths associated with the increase in diesel passenger cars. The fuel types and engine types of cars in traffic since 2004 were obtained from national statistics data (TurkStat) and Automotive Distributors and Mobility Association data. Chronic respiratory disease and cancer death rates were calculated using the TurkStat data. Time-lag correlation analysis was examined to evaluate the relationship between the increase in the number of diesel vehicles and deaths from diseases (5-year lag). The increase in diesel vehicles correlated with deaths from colon (r: 0.81), pancreas (r: 0.83), rectum (r: 0.79), bladder (r: 0.83), and skin (r: 0.59) cancers in males. For females, there was a correlation between the increase in diesel vehicles and deaths from lung and larynx (r: 0.73), colon (r: 0.66), pancreas (r: 0.85), bladder (r: 0.66), breast (r: 0.85), uterus (r: 0.91), and ovarian (r: 0.81) cancers. The increase in diesel car preference was associated with deaths from lung and larynx (r: 0.57), colon (r: 0.59), and bladder (r: 0.63) cancers in females. The outcomes underscore the potential public health impact of diesel vehicle emissions and the need for regulatory policies to mitigate these harmful effects. Promoting cleaner alternatives can be a supportive step in the fight against cancer.

RWD71 Modeling the Potential Public Health and Economic Impact of Nirsevimab Introduction Using Real-World Data in the United States, Spain, and France

RWD71 Modeling the Potential Public Health and Economic Impact of Nirsevimab Introduction Using Real-World Data in the United States, Spain, and France

EE488 The Potential Public Health Impact of New Immunization Strategies for the Prevention of RSV in Children in Panama

EE488 The Potential Public Health Impact of New Immunization Strategies for the Prevention of RSV in Children in Panama

EE257 Modeling the Potential Public Health Impact and Cost-Effectiveness of BNT162B2 COVID-19 Booster Vaccination in Mexico

EE257 Modeling the Potential Public Health Impact and Cost-Effectiveness of BNT162B2 COVID-19 Booster Vaccination in Mexico

EPH30 Assessing the Potential Public Health Impact of the mRNA-Based Respiratory Syncytial Virus (RSV) Vaccine, mRNA-1345, With a Broad Vaccination Campaign Among Older Adults in the United Kingdom: Modelling Study

EPH30 Assessing the Potential Public Health Impact of the mRNA-Based Respiratory Syncytial Virus (RSV) Vaccine, mRNA-1345, With a Broad Vaccination Campaign Among Older Adults in the United Kingdom: Modelling Study

EPH4 The Potential Public Health Impact of the Adjuvanted Respiratory Syncytial Virus Prefusion F Protein Vaccine Among Older Adults in Italy

EPH4 The Potential Public Health Impact of the Adjuvanted Respiratory Syncytial Virus Prefusion F Protein Vaccine Among Older Adults in Italy

EE250 Modeling the Potential Public Health Impact of Different COVID Vaccination Strategies With an Adapted Vaccine in Colombia

EE250 Modeling the Potential Public Health Impact of Different COVID Vaccination Strategies With an Adapted Vaccine in Colombia

EPH58 Potential Public Health Impact of Respiratory Syncytial Virus (RSV) Vaccines for Prevention of Lower Respiratory Tract Disease (LRTD) Due to RSV Among Older Adults in Canada

EPH58 Potential Public Health Impact of Respiratory Syncytial Virus (RSV) Vaccines for Prevention of Lower Respiratory Tract Disease (LRTD) Due to RSV Among Older Adults in Canada

Cost-effectiveness of respiratory syncytial virus adjuvanted vaccine in Portuguese aged ≥ 60 years

Abstract Background Respiratory syncytial virus (RSV) infections are one of the leading causes of lower respiratory tract disease among adults aged ≥60 years in Europe. This study aims to assess the potential public health impact of the RSVPreF3 OA adjuvanted vaccine, the first approved preventive intervention for the older adult population in Portugal. Methods A monthly-cycle static Markov model was developed to assess RSVPreF3 OA adjuvanted vaccine impact on adults aged 60 years and older in Portugal. A single dose of RSVPreF3 OA adjuvanted vaccine was compared to no-vaccination over a three-year time-horizon. The model captures lower respiratory tract disease (LRTD) RSV cases, hospitalizations, deaths, and healthcare resource utilization. Data inputs were based on local published literature, supplemented by the best available data when local information was lacking. Results Based on preliminary analysis considering 75% vaccine coverage, model outputs estimate that RSVPreF3 OA adjuvanted vaccine can prevent 71,433 LRTD cases requiring medical attendance, 11,067 hospitalizations, 1,793 intensive care unit admissions and 1,003 deaths. The model estimates that 32 adults need to be vaccinated to avoid one RSV LRTD case, 207 adults need to be vaccinated to avoid one hospitalization and 2,283 adults need to be vaccinated to avoid one death. The incremental cost-effectiveness ratio was estimated at 9,541€, hence the RSVPreF3 OA adjuvanted vaccine is cost-effective compared to no vaccination. Conclusions The results demonstrate a strong preventive impact of the RSVPreF3 OA adjuvanted vaccine on health outcomes and healthcare resource utilization in adults ≥60 years, leading to a significant public health benefit. This result emphasizes the importance of preventing RSV to preserve the health and well-being of Portugal’s older adults. In addition, data from ongoing studies may enhance precision and extensive sensitivity analyses validate the robustness of the model’s input assumptions. Key messages • This study shows the robust evidence of RSVPreF3 OA adjuvanted vaccine to improve public health by preventing thousands of hospitalizations and deaths among ≥60 years, in Portugal. • Vaccinating adults aged ≥ 60 years with RSVPreF3 OA adjuvanted vaccine in Portugal is a cost-effective strategy.

Calculating potential impact fractions to assess the impact of tobacco control policies

Abstract This presentation will provide a straightforward and accessible method for evaluating the effectiveness of various tobacco control policies in reducing the smoking-associated disease burden. To estimate numbers and proportions of potentially avoidable disease cases under different policy intervention scenarios (such as cigarette tax/price increases, comprehensive marketing ban, and plain packaging), this approach entails the calculation of age- and sex-specific potential impact fractions, representing the percentage change in disease risk following changes in exposure to smoking. The approach can account for lag and latency periods between reductions in smoking prevalence and declines in disease excess risks. The future disease burden is estimated by combining data on the incidence or mortality of the disease of interest, published effect sizes of tobacco control policies, and national smoking prevalence data. Intervention scenarios are compared against a status quo scenario that assumes the continuation of recent smoking trends. The presentation will outline the approach, using the example of smoking-associated cancer, and discuss model assumptions, required data, and sensitivity analyses. This straightforward modelling framework enables the comparison of different health policy measures’ impacts, providing valuable insights for policymakers and public health officials regarding the potential public health impact of tobacco control policy measures.

Association of Ambient Air Pollution Exposure With Incident Glaucoma: 12-Year Evidence From the UK Biobank Cohort.

Glaucoma is the leading cause of irreversible blindness worldwide. Despite growing concerns about air quality and its impact on ocular health, there remains a knowledge gap regarding the long-term association between air pollution and glaucoma risk. This study investigates the relationship between exposure to ambient air pollution and incidence of glaucoma. In this prospective study, we used land use regression models to estimate levels of various air pollutants, including fine particulate matter (PM2.5), PM2.5 absorbance, PM2.5-10, PM10, nitrogen dioxide (NO2), and nitrogen oxides (NOx). Incidents of glaucoma were ascertained through routinely collected hospital admission records. Multivariate Cox proportional hazards models were used to examine the associations between air pollution exposure and glaucoma incidence, adjusting for potential confounding sociodemographic, physical, and lifestyle factors. Data from 481,113 participants were included. Over a median follow-up of 12.8 years, 9224 incident cases of glaucoma were identified. In the maximally adjusted model, per interquartile range increase in PM2.5 was associated with a 3% greater risk of developing glaucoma (hazard ratio [HR] = 1.03, 95% confidence interval [CI] = 1.00 to 1.06, P = 0.048). Participants in the highest quartile had a 10% increased risk of developing glaucoma compared to those in the lowest quartile (HR = 1.10, 95% CI = 1.03 to 1.17, P = 0.005). Higher levels of exposure to ambient air pollutants, particularly PM2.5, are associated with an increased risk of developing glaucoma. These results highlight the potential public health impact of ambient air pollution on glaucoma risk and underscore the urgent need for further research into targeted environmental interventions in this domain.

Adverse Childhood Experiences and Health Conditions and Risk Behaviors Among High School Students - Youth Risk Behavior Survey, United States, 2023.

Adverse childhood experiences (ACEs) are preventable, potentially traumatic events occurring before age 18 years. Data on ACEs among adolescents in the United States have primarily been collected through parent report and have not included important violence-related ACEs, including physical, sexual, and emotional abuse. This report presents the first national prevalence of self-reported ACEs among U.S. high school students aged <18 years, estimates associations between ACEs and 16 health conditions and risk behaviors, and calculates population-attributable fractions of ACEs with these conditions and behaviors using cross-sectional, nationally representative 2023 Youth Risk Behavior Survey data. Exposures were lifetime prevalence of individual (emotional, physical, and sexual abuse; physical neglect; witnessed intimate partner violence; household substance use; household poor mental health; and incarcerated or detained parent or guardian) ACEs and cumulative ACEs count (zero, one, two or three, or four or more). Health conditions and risk behaviors included violence risk factors, substance use, sexual behaviors, weight and weight perceptions, mental health, and suicidal thoughts and behaviors. Bivariate analyses assessed associations between individual and cumulative ACEs and demographics. Adjusted prevalence ratios assessed associations between cumulative ACEs and health conditions and risk behaviors, accounting for demographics. Population-attributable fractions were calculated to determine the potential reduction in health conditions and risk behaviors associated with preventing ACEs. ACEs were common, with approximately three in four students (76.1%) experiencing one or more ACEs and approximately one in five students (18.5%) experiencing four or more ACEs. The most common ACEs were emotional abuse (61.5%), physical abuse (31.8%), and household poor mental health (28.4%). Students who identified as female; American Indian or Alaska Native; multiracial; or gay or lesbian, bisexual, questioning, or who describe their sexual identity in some other way experienced the highest number of ACEs. Population-attributable fractions associated with experiencing ACEs were highest for suicide attempts (89.4%), seriously considering attempting suicide (85.4%), and prescription opioid misuse (84.3%). ACEs are prevalent among students and contribute substantially to numerous health conditions and risk behaviors in adolescence. Policymakers and public health professionals can use these findings to understand the potential public health impact of ACEs prevention to reduce adolescent suicidal behaviors, substance use, sexual risk behaviors, and other negative health conditions and risk behaviors and to understand current effects of ACEs among U.S. high school students.

Alternative Pharmaceutical Innovation Models in Competitive Markets: A Collaborative Approach to Develop a Novel Drug for Hepatitis C.

Alternative innovation models have emerged to address failures of the traditional pharmaceutical system, particularly for diseases where market incentives do not attract sufficient research and development efforts. However, the feasibility of such models for diseases with significant markets is not well-established. This article analyses the development of a novel drug (ravidasvir) for the treatment of hepatitis C, a highly profitable market. Data from qualitative research methods, including literature reviews and semi-structured interviews, was analyzed using a novel conceptual framework focusing on actors, resources, organizational practices, and outcomes. Dissimilar to other projects, ravidasvir did not involve any major pharmaceutical companies. Rather, it leveraged the capacities of actors less traditionally involved in the development of novel medicines by constructing a collaborative network of private and public partners from low- and middle-income countries with a shared goal. The collaboration was successful in developing a highly effective, easy-to-use, and affordable medicine and contributed significantly to capacity-strengthening. However, the case also highlighted that strategic behavior by competing for-profit firms could pose significant challenges and that changing external conditions reduced the potential public health impact of the drug. Lessons from ravidasvir can inform future efforts to develop alternative innovation models for therapeutic areas with significant commercial interest.

Widening the price gap: the effect of the Netherlands' 2020 tax increase on tobacco prices.

The public health impact of a tobacco tax increase depends on the extent to which the industry passes the increase onto consumers, also known as tax-pass through. In 2020, the Netherlands announced tax increases aimed to increase the retail price by €1 per 20 factory-made cigarettes and €2.50 per 50 grams of roll-your-own tobacco. This study examines the pass-through rate after the tax increase, and whether this differed by type of tobacco and brand segment. Self-reported prices of 117 tobacco brand varieties (cigarettes=72, roll-your-own=45) pre- and post-tax increase were extracted from the 2020 International Tobacco Control (ITC) Netherlands Surveys (n=2959 respondents). We calculated the tax pass-through rate per variant, examining differences between type of tobacco and brand segments. On average, cigarette prices increased by €1.12 (SD=0.49) (112% of €1) and roll-your-own prices by €2.53 (SD=0.60) (101% of €2.50). Evidence of differential shifting across segments was found, with evidence of overshifting in non-discount varieties. The average price of discount varieties increased with €0.20 less than non-discount varieties. Similarly, the net-of-tax price decreased in discount varieties (cigarettes=-€0.02; roll-your-own=-€0.05), but increased in non-discount varieties (cigarettes= +€0.14; roll-your-own= +€0.20). Despite the large tax increase, the industry increased prices in line or above the required level. Through differential shifting, the price gap between discount and non-discount varieties has widened, which may reduce the public health impact of the tax increase. Measures aimed at reducing price variability should be strengthened in taxation policy, such as the European Tobacco Tax Directive. We found that the industry used differential shifting after a significant tobacco tax increase in the Netherlands. Prices increased more than required in higher-priced products, but not in lower-priced products. This pattern was found both for factory-made cigarettes and roll-your-own tobacco. Through differential shifting, the industry undermines the potential public health impact of tobacco tax increases, by offering a relatively cheaper alternative, which discourages people to quit or reduce consumption. The revision of the European Tobacco Tax Directive (TTD) provides an opportunity to address the widening price gap - both between and within product segments - across the European Union.

Modelling the potential clinical and economic impact of universal immunisation with nirsevimab versus standard of practice for protecting all neonates and infants in their first respiratory syncytial virus season in Spain

BackgroundRespiratory syncytial virus (RSV) is associated with substantial morbidity among infants. This study modelled the potential public health and economic impact of nirsevimab, a long-acting monoclonal antibody, as an immunoprophylactic strategy for all infants in Spain in their first RSV season.MethodsA static decision-analytic model of the Spanish birth cohort during its first RSV season was developed to estimate the impact of nirsevimab on RSV-related health events and costs versus the standard of practice (SoP). Spain-specific costs and epidemiological data were used as model inputs. Modelled outcomes included RSV-related outpatient visits, emerging room (ER) visits, hospitalisations – including pediatric intensive care unit (PICU) admission, mechanical ventilation, and inpatient mortality.ResultsUnder the current SoP, RSV caused 151,741 primary care visits, 38,798 ER visits, 12,889 hospitalisations, 1,412 PICU admissions, and 16 deaths over a single season, representing a cost of €71.8 million from a healthcare payer perspective. Universal immunisation of all infants with nirsevimab was expected to prevent 97,157 primary care visits (64.0% reduction), 24,789 ER visits (63.9%), 8,185 hospitalisations (63.5%), 869 PICU admissions (61.5%), and 9 inpatient deaths (52.6%), saving €47.8 million (62.4%) in healthcare costs.ConclusionsThese results suggest that immunisation with nirsevimab of all infants experiencing their first RSV season in Spain is likely to prevent thousands of RSV-related health events and save considerable costs versus the current SoP.