Medical costs of asbestos-related diseases in Spain between 2004 and 2011

Our plain-English summary of Medical costs of asbestos-related diseases in Spain between 2004 and 2011, by M. García-Gómez, R.U. Garrido, R.C. López, et al (Industrial Health, 2017).

The study

• Authors: M. García-Gómez, R.U. Garrido, R.C. López, A. Menéndez-Navarro
• Journal: Industrial Health
• Published: 2017;55(1):3-12
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The objective of this article was to estimate the medical costs derived from malignant ARD treatment in the Spanish National Health System (NHS) between 2004 and 2011. Estimation of direct healthcare costs was based on national primary data on the cost of specialized care for inpatients and outpatients treated at NHS hospitals and on national and regional secondary data on costs of primary healthcare and pharmaceutical prescriptions. A prevalence approach was used to estimate the overall burden of ARDs. Direct medical costs of 37,557 ARDs attended in Spanish NHS facilities in 2004-2011 were estimated at 464 million euros; specialist care accounted for 50.9% of total costs, primary healthcare 10.15%, and drug prescription 38.9%. The cost was 27.8-fold higher in males than in females. Bronchopulmonary cancers represented the greatest healthcare cost, 281 million euros. The cost of delivering healthcare to ARDs victims in Spain has a negative economic impact on the NHS due to the gross under-recognition of occupational victims under the Spanish National Insurance System.

In plain English

This cost study estimated the direct medical costs to Spain's National Health System (NHS) of treating asbestos-related diseases from 2004 to 2011. The authors used national hospital and outpatient records and applied published estimates of the share of each disease due to occupational asbestos exposure, covering asbestosis, mesothelioma, and lung, larynx, ovary, colon and rectum cancers. Primary care and prescription costs were estimated from one Catalonian health district. They estimated 37,557 public hospital admissions attributable to asbestos and a total cost of 463,983,511 euros, 30.4-fold higher for men than for women. Specialist care made up 50.9% of costs, prescriptions 38.95% and primary care 10.15%. Tracheal and bronchopulmonary (lung) cancers accounted for 60.5% of costs overall. Among women, mesothelioma accounted for 77.9%. Total costs rose 27.8% between 2004 and 2011. Only 490 cases were recognized as occupational diseases by the National Insurance System over the period. The authors concluded that this under-recognition has a negative economic impact on the NHS. They considered their figure an underestimate, because indirect costs and pharynx and stomach cancers were excluded.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cost-of-illness study estimating direct healthcare costs to the Spanish NHS, using a prevalence approach and attributable fractions applied to national health system records
• Who was studied: Patients treated in Spanish public (NHS) hospitals and specialist outpatient services, 2004–2011, aged over 25 (over 40 for mesothelioma). The 37,557 hospital admissions are an estimate of admissions attributable to occupational asbestos exposure. They are not counted individual patients.
• Exposure: Occupational asbestos exposure (fiber types not specified). Diseases covered: asbestosis (100% attributed), mesothelioma, and the attributable fraction of lung, laryngeal, ovarian, colon and rectum cancers. For example, 14% of lung cancer in males and 0.6% in females was attributed.
• Main results:
  • Total estimated direct healthcare cost over 2004–2011 was 463,983,511 euros, 30.4-fold higher for male than female cases
  • Specialist healthcare made up 50.9% of the total cost
  • Pharmaceutical care made up 38.95% of the total cost
  • Primary healthcare made up 10.15% of the total cost
  • Tracheal and bronchopulmonary cancers incurred the highest costs overall (60.5%) and among men (62.1%); mesothelioma incurred the highest costs among women (77.9% of female total)
  • Total cost rose by 27.8% between 2004 and 2011 (26.7% for males, 68.9% for females)
  • Total public hospital cost was 234,153,370.71 euros, 96.8% for male patients
  • Occupation-related mesothelioma admissions in males rose from 350 in 2004 to 449 in 2011; asbestosis admissions fell from 39 to 31
  • By comparison, over the same period only 490 cases were recognized as occupational diseases under the Spanish National Insurance System: 81 mesotheliomas, 66 bronchopulmonary cancers, 280 asbestosis and 63 pleural plaques
• The authors' conclusion: The authors concluded that gross under-recognition of asbestos-related diseases as occupational diseases shows deficiencies in the Spanish National Insurance System. They also concluded that it has a negative economic impact on the NHS, which they estimated bears about 58 million euros a year that should be paid by the compensation scheme.
• Limitations the authors state:
  • The estimate is an underestimate because the asbestos-attributable fraction of pharynx and stomach cancers was not included
  • Only direct costs were counted. Indirect costs such as lost productivity were not.
  • Primary care and prescription costs were derived from one area that cannot be considered representative of Spain
  • Information system coverage of outpatient day hospital activity was only 46.7%
  • Using whole-period cost ratios assumes no substantial change in treatment over 2004–2011; some bias cannot be ruled out
  • Long-stay hospital costs were not included
  • No primary care or prescription data existed for asbestosis or mesothelioma in the district, so the lung cancer cost factor was used for these diseases

Related studies

• Medical costs of cancer attributable to work in the Basque Country (Spain) in 2008 — M. García Gómez, R. Castañeda López, et al. (2013)
• Treatment patterns and humanistic burden of malignant pleural mesothelioma in Spain — S. Cedres, J. Calvete, et al. (2025)
• Potential years of life lost (PYLL) caused by asbestos-related diseases in the world — R. Diandini, K. Takahashi, et al. (2013)
• Estimating the social cost of respiratory cancer cases attributable to occupational exposures in France — H. Serrier, H. Sultan-Taieb, et al. (2014)
• Evaluation of the national health surveillance program of workers previously exposed to asbestos in Spain (2008) — M.G. Gómez, R. Castañeda, et al. (2012)
• Pleural cancer mortality in Spain: time-trends and updating of predictions up to 2020 — G. López-Abente, M. García-Gómez, et al. (2013)

Browse more research in Industrial Health, or return to medical research.