Response to Bruce Busby: Looking for something...

["Leif E. Peterson, PH.D." <PETERSON@plato.jsc.nasa.gov>]

   Looking for something...

   Tengs et al. (1994) reported the following medians of cost/life-
   year saved for various activities in the report "Five-Hundred Life-
   Saving Interventions and Their Cost-Effectiveness," Harvard Center 
   for Risk Analysis, 1994.  With regards to their methods, 1200 
   documents were reviewed, 229 met their inclusion criteria and 
   contained enough information to estimate cost/life-year saved for 
   587 interventions.  

   I will list their ten cost saving interventions and ten most 
   expensive interventions.  It was disappointing to see "radionuclides"
   in four out of ten of the most expensive interventions.


                   TEN COST SAVING INTERVENTIONS
                                                            Median cost
                                                            per year of
Life-saving intervention                                    life saved
------------------------------------------------------------------------
Smoking cessation advice for pregnant women who smoke                  0
Ban residential growth in tsunami-prone areas                          0
Chloroform emission standard at 17 low-cost pulp mills                 0
Truss (vs. elective inguinal herniorrhaphy) in elderly                 0
Auto windshields with adhesive bonding (vs. rubber gaskets)            0
Flammability standard for children's sleepware size 0-6X               0
Measles, mumps & rubella immunization for children                     0
1988 (vs. 1971) safety standard for concrete construction              0
Terminate sale of all 3-wheeled All-Terrain Vehicles                   0
Ban amitraz pesticide on apples                                        0


                    TEN MOST EXPENSIVE INTERVENTIONS
                                                               Median cost
                                                               per year of
Life-saving intervention                                       life saved
---------------------------------------------------------------------------
Benzene emission control at chem. manufac. proc. vents         $526,323,000
Arsenic emission control at low-emitting Copper Range          $890,822,000
  White/Pine copper smelter
Radionuclide emission control at coal-fired industrial         $925,403,000     
  boilers
Ban asbestos in diaphragms                                   $1,434,478,000
Radionuclide emission control at coal-fired utility          $2,395,161,000
  boilers              
Radionuclide emission control at NRC-licensed & Non-DoE      $2,612,903,000
  facilities         
Benzene emission control at rubber tire manufacturing       $19,865,323,000
  plants
Radionuclide emission control at uranium fuel cycle         $33,750,000,000
  facilities
Sickle cell screening for non-black low-risk newborns       $34,239,773,000
Chloroform private well emission standard at 48 pulp        $99,351,684,000
mills         


The authors of the report were:

Tammy O. Tengs, Sc.D. (Ctr. for Hlth. Policy Res. and Educ., Duke University)
Miriam E. Adams, Sc.D. (Simmons College, Boston)
Joseph S. Pliskin, Ph.D. (Ben-Gurion University of the Negev, Israel)
Dana Gelb Safran, Sc.D. (New England Med. Ctr., Boston)
Joanna E. Siegel, Sc.D. (U.S. Off. Dis. Prev & Hlth. Prom. , Washington,D.C.)
Milton C. Weinstein, Ph.D. (Hlth. Policy & Mgmt., Harvard University)
John D. Graham, Ph.D. (Ctr. for Risk Anal., Harvard University)


----------------------------------------------------------------------
Leif E. Peterson, Ph.D., M.P.H.
Epidemiologist and Health Physicist
Kelsey-Seybold Clinic
NASA/JSC Mail Code SD23
Houston, Texas  77058
e-mail: peterson@plato.jsc.nasa.gov