An assessment of uncertainty using two different modelling techniques to estimate the cost effectiveness of mitigating radon in existing housing in Canada

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DOI

https://doi.org/10.1016/j.scitotenv.2020.138092

Language of the publication
English
Date
2020-03-20
Type
Article
Author(s)
  • Gaskin, Janet
  • Whyte, Jeff
  • Coyle, Doug
Publisher
Elsevier

Abstract

The burden of lung cancer associated with residential radon in existing housing can be reduced by interventions to screen and mitigate existing housing having radon levels above a mitigation threshold. The objective of this study is to estimate the cost effectiveness of radon interventions for screening and mitigation of existing housing for the 2016 population in Canada and to assess the structural uncertainty associated with the choice of model used in the cost-utility analysis. The incremental cost utility ratios are estimated using both a Markov cohort model and a discrete event simulation model. A societal perspective, a lifetime horizon and a discount rate of 1.5% are adopted. At a radon mitigation threshold of 200 (100) Bq/m3, the discounted ICERs for current rates of screening and mitigation of existing housing are 72,569 (68,758) $/QALY using a Markov cohort model and 84,828 (76,917) $/QALY using discrete event simulation. It appears that minimal structural uncertainty is associated with the choice of model used for this cost-utility analysis, and the cost effectiveness would improve at increased rates of radon testing and mitigation. The mitigation of radon in existing housing is estimated to be a practical policy option for reducing the associated lung cancer burden in Canada.

Subject

  • Health,
  • Health and safety

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Healthy environments, consumer safety and consumer products

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