THE COST OF LOST PRODUCTIVITY DUE TO FETAL ALCOHOL SPECTRUM DISORDER-RELATED PREMATURE MORTALITY
Main Article Content
Keywords
Fetal Alcohol Spectrum Disorder, productivity losses, mortality, demographic approach, Canada
Abstract
Background
Individuals with Fetal Alcohol Spectrum Disorder (FASD) have increased mortality as compared to the general population.
Objectives
To estimate the productivity losses due to premature mortality of individuals with FASD in Canada in 2011.
Methods
A demographic approach with a counterfactual scenario in which nobody in Canada is born with FASD was used. Population estimates were calculated using data on the labour force, unemployment rate, and average weekly wage obtained from Statistics Canada. The number of FASD -related deaths, coded in the International Classification of Diseases, version 10, was estimated based on data from Statistics Canada and pooled prevalence estimates of the major disease conditions associated with FASD were obtained from a meta-analysis. The estimates of FASD -related mortality rates served as a basis for the length of working life span estimation. Once the number of working years lost to premature deaths was derived, productivity losses were computed.
Results
It was estimated that in total 327 individuals with FASD aged 20 to 69 (almost twice as many men as women) died in Canada in 2011. As a result, there were 2,877 years of potential employment lost, which translated to a loss ranging from $88 million to $126 million. This amount represents the increase in national income, had there been no premature mortality from FASD and the workers with FASD had been typical members of the labour force (without compromised productivity due to FASD).
Conclusions
The estimates of productivity losses further reinforce the value of FASD prevention as a primary strategy.
References
2. Paintner A, Williams AD, Burd L. Fetal Alcohol Spectrum disorders -implications for child neurology, Part 2: Diagnosis and management. J Child Neurol 2012;27(3):355- 362.
3. Substance Abuse and Mental Health Services Administration (SAMHSA), Fetal Alcohol Spectrum Disorders Center for Excellence. Fact Sheet: The Language of Fetal Alcohol Spectrum Disorders, 2004. Available from: http://www.fasdcenter.samhsa.gov/documents/W YNKLanguageFASD2.pdf
4. May PA, Gossage P, Kalberg WO, Robinson LK, Buckley D, Manning M, et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Developmental Disabilities Research Reviews 2009;15:176- 192.
5. Barry KL, Caetano R, Chang G, et al. Reducing Alcohol -Exposed Pregnancies: A Report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect. U. S. Department of Heal Human Services, 2009. Available from: http://www.cdc.gov/ncbddd/fasd/documents/redal cohpreg.pdf
6. Nelson DE, Naimi TS, Brewer RD, Bolen J, Wells HE. Metropolitan -area estimates of binge drinking in the United States. Am J Public Health 2004;94:663– 671.
7. Astley SJ, Clarren SK. Diagnostic Guide for Fetal Alcohol Syndrome and related conditions: The 4 - digit D iagnostic Code. 2nd edition. Seattle, WA: University of Washington, 1999.
8. Burd L, Klug MG, Martsolf JT. Increased sibling mortality in children with fetal alcohol syndrome. Addict Biol 2004;9:179– 86.
9. Burd L, Klug MG, Bueling R, et al. Mortality rates in su bjects with fetal alcohol spectrum disorders and their siblings. Birth Defects Res Part A 2008;82:217– 23.
10. Habbick BF, Nanson JL, Snyder RE, Casey RE. Mortality in f etal alcohol syndrome. Can J Public Health 1997;88:181– 83.
11. Iyasu S, Randall LL, Welty TK, Hs ia J, Mandell F, et al. Risk factors for sudden infant death syndrome among northern plains Indians. J Am Med Assoc 2002;288:2717– 23.
12. Lemoine P, Harousseau H, Borteryu JP, Menuet JC. Les enfants de parents alcooliques: Anomalies observee a propos de 127 ca s [The children of alcoholic parents: a nomalies observed in 127 cases]. Quest Med 1968;21:476– 82.
13. Stratton K, Howe C, Battaglia F. Fetal Alcohol Syndrome: Diagnosis, Epidemiology, Prevention, and Treatment. Washington, DC: National Academy Press, 1996.
14. Tho mpson A, Hackman D, Burd L. Mortality in fetal alcohol s pectrum disorders. Journal of Pediatrics 2014;4:21 -33.
15. Dubovsky D, Whitney N. Modifying approaches to improve outcomes for women in treatment who have Fetal Alcohol Spectrum Disorder. Paper presented at the 4th National Conference on Women, Addiction and Recovery, Chicago, IL, 2010.
16. Single E, Collins D, Easton B. Harwood H, Lapsley H, Kopp P, et al. International Guidelines for Estimating the Costs of Substance Abuse (2nd ed.). Geneva, Switzerland: World Health Organization, 2003. Available from: http://apps.who.int/bookorders/anglais/detart1.jsp ?codlan=1&codcol=15&codcch=561
17. Statistics Canada. Causes of deaths, 2008. CANSIM tables. Ottawa, Canada: Statistics Canada, 2008.
18. Popova S, Lange S, Shield K, Mihic A, Mukherjee RAS, Chudley AE, Bekmuradov D, Rehm J. Comorbidity of Fetal Alcohol Spectrum Disorder: A systematic literature review and meta-analysis. Presented to the 3rd European Conference on FASD. Rome, Italy, October 20- 22, 2014.
19. Easton B, Burd L, Sarnocinska -Hart A, Rehm J, Popova S. Productivity losses because of morbidity attributable to fetal alcohol spectrum disorder in Canada: a demographic approach. J Stud Alcohol Drugs 2014;75(6):1011- 7.
20. Statistics Canada. Perspectives on labour and income (Cat. no. 75 -001- X). Ottawa, Canada: Statistics Canada, 2010.
21. Statistics Canada. Canada at a glance 2012: Population. CANSIM table 051- 0005 (Cat. no. 89- 645- X). Ottawa, Canada: Statistics Canada, 2012a. Available from: http://www.statcan.gc.ca/pub/12 -581- x/12 -581- x2012000- eng.htm
22. Statistics Canada. Canada at a glance 2012: Labour force characteristics, by sex (Table 18). CANSIM table 282- 0002 . Ottawa, Canada: Statistics Canada, 2012b. Available from: http://www.statcan.gc.ca/pub/12 -581- x/2012000/l -t-eng.htm#t18
23. Statistics Canada. Canada at a glance 2012. Unemployment rate (Chart 11). CANSIM table 282- 0002. Ottawa, Canada: Statistics Canada, 2012c. Available from: http://www.statcan.gc.ca/pub/12 -581- x/2012000/c -g/desc/desc -c-g11 -eng.htm
24. Statistics Canada. Canada at a glance 2012. Average weekly wage rate, by industry (Table 19). CANSIM table 282- 0002. Ottawa, Canada: Statistics Canada, 2012d. Available from: http://www.statcan.gc.ca/pub/12 -581- x/2012000/c -g/desc /desc -c-g11 -eng.htm
25. Lupton C, Burd L, Harwood R. Cost of f etal alcohol s pectrum disorders. Am J Med Genet C Semin Med Genet 2004;127C: 42– 50.
26. Popova S, Stade B, Bekmuradov D, Lange S, Rehm J. What do we know about the economic impact of fetal alcohol syndrome and f etal alcohol spectrum disorders?: a systematic literature review. Alcohol and Alcoholism 2011;46(4):490- 497.
27. Popova S, Lange S, Burd L, Rehm J. Health care burden and cost associated with fetal alcohol syndrome: based on official Canadian data. PLoS ONE 2012;7(8):e43024. Available from http://www.plosone.org/article/info%3Adoi%2F1 0.1371%2Fjournal.pone.0043024#close
28. Popova S, Lange S, Burd L, Chudley AE, Clarren SK, Rehm J. Cost of Fetal Alcohol Spectrum Disorder diagnosis in Canada. PLoS ONE 2013a;8(4):e60434. Available from: http://www.plosone.org/article/inf o%3Adoi %2F10.1371%2Fjournal.pone.0060434 .
29. Popova S, Lange S, Burd L, Urbanoski K, Rehm J. Cost of specialized addiction treatment of clients with Fetal Alcohol Spectrum Disorder in Canada. BioMed Central Public Health 2013b;13:570. Available from: http://www.biomedcentral.com/content/pdf/1471 - 2458- 13- 570.pdf .
30. Popova S, Lange S, Burd L, Rehm J. Canadian children and youth in care: The cost of Fetal Alcohol Spectrum Disorder. Child Youth Care Forum 2014a;43:83 -96. Available from: http://link.springer.com/article/10.1007%2Fs1056 6-013- 9226- x .
31. Popova S, Lang e S, Burd L, Shield K, Rehm J. Cost of speech -lang uage interventions for children and youth with Fetal Alcohol Spectrum Disorder in Canada. Int J Speech Lang Pathol 2014b;43:83- 96. Available from: http://ww w.ncbi.nlm.nih.gov/pmc/articles/PMC39 05182/pdf/10566_2013_Article_9226.pdf
32. Burd L, Klug MG, Martsolf JT, Kerbeshian J. Fetal alcohol syndrome: neuropsychiatric phenomics. Neurotoxical Teratol 2003b;25(6):697- 705.
33. Burd L, Wilson H. Fetal, infant and child mortalit y in a context of alcohol use. Am J Med Genet C Semin Med Genet 2004;127C:51- 58.