Study On Disability Weight Of Health Hazards Caused By Mercury Pollution Site

Objective: With the rapid development of modern industrial production,there are a large number of mercury contaminated sites in cities and surrounding areas.The cases of compensation for health damage caused by mercury are increasing day by day.However,due to the long-term,hidden and cumulative multi-system damage caused by mercury site pollution to human health,it is difficult to determine the cause and effect,and the standard of compensation for damages has not yet been established.It is currently difficult to get a better solution for compensation for the injured group.Based on health economics theory,health damage quantification can be measured by direct economic loss,indirect economic loss,and intangible economic loss.Among them,the assessment of indirect economic loss cannot be carried out due to the lack of corresponding disability weights.Therefore,we propose to investigate the disability weights of chronic mercury poisoning(mild,moderate,and severe)in China among health care professionals and community general population using the paired comparison method used by GBD,based on the idea of mercury disability weight studies in Zimbabwe.This study will be the first to clarify the parameters of disability weights for different levels of health damage caused by mercury pollution,which will provide important support for the accurate calculation of the economic burden of indirect diseases caused by mercury pollution and promote the establishment of standardized damage compensation.Methods: The disease-specific descriptions of chronic mercury poisoning(mild,moderate,and severe)were determined based on the National Occupational Health Standard GBZ 89-2007 of the People’s Republic of China and occupational disease specialists’ consultation.Conversion of the above disease-specific descriptions into lay descriptions based on the European Quality of Life Scale and consultation with clinical experts in various disciplines.According to the results of the European Disability Weighting Project,12 health states were selected from mild to severe: mild Vision disorder,Breast cancer(disease-free stage without sequelae),chronic low back pain,diabetes,mild dementia,severe asthma,colorectal cancer(diagnosis and primary therapy),AIDS(minor symptoms and HAART),coronary heart disease(severe stable angina),stroke moderate impairment(acute onset plus recovery phase),severe depression,tetraplegia.Due to the stability of the deafness’ disability weight,it was also included.A total of 13 health states constituted the health state spectrum for this study.An expert validation method was used to identify 13 disease-specific descriptions of this health state spectrum,which were further transformed into lay descriptions by the European Quality of Life Scale combined with expert validation.Fifteen clinical experts were invited to determine the match between the health state spectrum in this study and the corresponding health state descriptions in GBD 2019 by the Delphi method,and the DW values corresponding to the matched health states would be used for the subsequent anchor points.The paired comparison method of the GBD was used to design the questionnaire.The questionnaire consisted of two parts: demographic information and paired comparison questions.A two-stage sampling method and a multi-stage stratified random sampling method were used to conduct the questionnaire from June to August 2022 for the health professional population and the general community population in Shenyang.A total of 500 people in the health professional population and 550 people in the general community population were surveyed,with427 and 490 valid questionnaires,respectively.The effective response rate of the questionnaire was 85.4% and 89.1%.“Heat map” was drawn to test the consistency of the data for the paired comparison questions.Perform reliability analysis.The results of the paired comparison questions were subjected to probability regression analysis and disability weight modeling to obtain disability weights for chronic mercury poisoning(mild,moderate,and severe).Pearson correlation analysis was performed on the probability regression coefficients of populations with different sociodemographic characteristics.The estimates of the health state disability weights in this study were compared with the corresponding GBD 2019 disability weight study.Results: 1.According to Delphi method,a total of 11 health states in GBD 2019 match the health states in the health spectrum,and the corresponding disability weight values would be used for subsequent anchor analysis.2.Heat map analysis revealed a high agreement between the data of paired comparisons of the two populations and a good retest reliability of the questionnaire,with a retest reliability of 0.81 for the health care professional population and 0.77 for the general community population.3.The disability weights calculated for the health status spectrum in this study were lowest for mild visual impairment(health professional population: 0.018,community general population: 0.014)and highest for tetraplegia(health professional population: 0.500,community general population: 0.478).4.In the health professional population: the disability weight for chronic mild mercury poisoning was 0.294,with 95% uncertainty interval 0.181-0.436;for chronic moderate mercury poisoning was 0.387,with 95%uncertainty interval 0.227-0.573;for chronic severe mercury poisoning was 0.560,with95% uncertainty interval 0.311-0.780.In the general community population: the disability weight for chronic mild mercury poisoning was 0.283 with 95% uncertainty interval 0.177-0.420;the disability weight for chronic moderate mercury poisoning was0.374 with 95% uncertainty interval 0.224-0.553;the disability weight for chronic severe mercury poisoning was 0.559 with 95% uncertainty interval 0.315-0.777.5.There was a high correlation between the probability regression coefficient of medical and health professionals and the general population in the community,and the probability regression coefficient of different age,gender,education level and income level also had a high correlation(Pearson correlation test P <0.01).6.The disability weight values investigated in this study were moderately correlated with the GBD 2019study on the whole(Pearson correlation test P <0.01),but the ranking of health status and some specific health status disability weight values were still different.Conclusions: 1.This study was the first to obtain disability weights for chronic mercury poisoning(mild,moderate,and severe).In the health professional population: the disability weight for chronic mild mercury poisoning was 0.294(0.181,0.436),for chronic moderate mercury poisoning was 0.387(0.227,0.573),for chronic severe mercury poisoning was 0.560(0.311,0.780).In the general community population: the disability weight for chronic mild mercury poisoning was 0.283(0.177,0.420),the disability weight for chronic moderate mercury poisoning was 0.374(0.224,0.553),the disability weight for chronic severe mercury poisoning was 0.559(0.315,0.777).2.There was no difference in the evaluation and judgment of the severity of different health states between the medical and health professionals and the general population in the community.