O3C.2 A 30-year impact analysis of best practices for silica dust exposure reduction in construction: costs, benefits and hrql

Crystalline silica dust exposure is common in the construction sector. In fact, it is the industry with the largest number of people exposed in Canada. Inhalation of silica dust is known to cause lung cancer, silicosis, chronic obstructive pulmonary diseases, rheumatoid arthritis, and tuberculosis. The hierarchy of controls provide a range of prevention options for reducing or eliminating exposure. In this study we undertake an impact analysis of the implementation of two exposure reduction approaches—use of personal protective equipment by all exposed individuals and use of engineering controls wherever and whenever feasible. We estimated the intervention costs over a 30 year time period (2020–2050) of each exposure reduction approach implemented across the entire sector in Ontario, Canada, and considered equipment, maintenance, training, and productivity costs of each approach over the time period. The economic impacts from lung cancer cases averted due to exposure reduction included three broad categories of impacts—direct, indirect and intangible. We took a societal-level perspective in the analysis. All costs and benefits were discounted to the beginning of the exposure reduction period. Various sensitivity analyses were undertaken with key parameters. Findings suggest the net benefit is positive from 2055 onward for both reduction approaches, i.e., there is a positive return on investment at the societal level. The largest component of benefits is from health-related quality of life gains, with productivity/output gains accounting for the second largest component. Healthcare savings is the smallest component, primarily because cancer cases incur relatively modest health costs due to their short life-expectancy following diagnosis. Promoting the use of personal protective equipment and engineering controls across the construction sector can substantially reduce exposures to silica dust and give rise to net benefits at the societal level in terms of improvements in health-related quality of life, increased productivity/output, and reduce healthcare costs.