Costs of fatalities

Cost-benefit analysis also requires a determination of the costs incurred from incident-related fatalities. Reduction in individual risk (fatalities per year) is a key component in risk associated with buildings in process plants. One method of determining the cost of fatal accidents is to estimate the amount of money that society might perceive as reasonable compensation in the event of a fatal accident. 

Gross disproportionate For each fatality, there should be one defined cost. So, when cost to avert the fatality is calculated (CBA), it is compared with the defined cost of fatality. For high-risk value, this factor could be 10, whereas for low risk value it could be 2. There is no gross term definition. This is done by judgment from case-to-case basis. 

In the public arena, other decisions must be made about covering costs associated with automobile accidents, including the cost of fatalities. The basic questions asked include Is requiring varying levels of insurance enough to control the public cost Or should roads be repaired more often Should roads be widened Should more protective features be required for new cars Which combination of interventions makes most sense for society, and at what cost ... 

Fatal accident rate Lost-time injury rate Capital cost of accidents Number of plant/community evacuations Cost of business interruption Cost of workers compensation claims Number of hazardous material spills (in excess of a threshold) Tonnage of hazardous material spilled Tonnage of air, water, liquid and solid effluent Tonnage of polluting materials released into the environment Employee exposure monitoring Number of work related sickness claims Number of regulatory citations and fines Ecological impact of operations (loss or restoration of biodiversity, species, habitats)... 

One useful tool of risk assessment is to compare the risk before and after prevention or mitigation to determine the difference in risk. A cost benefit analysis can be completed that determines the cost of the mitigation versus the amount of risk reduction. All costs need to be calculated to determine a cost per year. These costs would include fire damage, injury or fatality, insurance cost increases, loss of profits, etc. The cost of the mitigation, including capital and maintenance costs, needs to be determined. 

Hull RD, Hirsh J, Sackett DL, et al. Cost-effectiveness of primary and secondary prevention of fatal pulmonary embolism in high-risk surgical patients. CMAf 1982 127 990-5. 

Annual bombings costs over the next 20 years are expected to stay constant if the tagging programs are not implemented. The constant annual direct costs of the projected bombing threat are expected to be 15 million dollars for property damage, 30 million dollars for bombing fatalities... 

The lower estimate by Leger accounted for those vehicle accidents occurring during the maximum hours of sleepiness 02 00-07 00 hr and 14 00-17 00 hr. For 1988, 36.1% of fatal accidents (17,689 deaths) and 41.6% of total accidents (resulting in 769,184 disabling injuries) occurred during the hours of maximum sleepiness. This yielded a cost of 29.2 billion. 

In 1988, the total cost of work-related accidents of 47.1 billion was based on 10,600 deaths and 1,800,000 disabling injuries. Included in the estimate of work-related accidents attributable to sleepiness were (a) motor-vehicle accidents due to shift work and on-the-job motor vehicle accidents (35.0% of total work-related accidents), (b) falls during work caused by sleepiness or inattention (12.6%), and (c) water and transportation accidents (4.8%). Therefore, of all work-related accidents, about 52.5% might potentially be related to sleepiness and then, accounting for 5565 fatalities and 945,000 disabling injuries, resulted in a cost of 24.7 billion. 

Falls accounted for 4100 deaths, or 22.8% (524,400) of the 2,300,000 disabling injuries, or 2.5 billion of the 10.9 billion cost of accidents in public places. Using the lower cost estimate of 41.6% of total accidents (218,150 disabling injuries) that occurred at maximum hours of sleepiness and 36.1% of fatal accidents (1480 fatalities) accounted for a cost total of 1.04 billion. The higher estimate of 54% of total public accidents was due to nocturnal sleepiness, which yielded 283,176 disabling injuries at a total cost of 1.34 billion. 

Therefore, the total estimated cost of accidents related to sleepiness was the sum total of all component costs. Thus, the lower estimate of cost related to sleepiness includes 1,907,072 disabling injuries and 24,318 fatalities, creating a cost of 43.15 billion in 1988. The higher estimate accounted for 2,474,430 disabling injuries, at a total cost of 56.02 billion (rounding would give a total of 43.2 billion and 55.9 billion, respectively). 

Dr. Wilse Webb performed a different analysis from Leger s using the data of fatal and total motor-vehicle accidents as reported by the National Safety Council in 1988 (6). He proposed a conservative estimate of 1225 fatalities, 45,000 disabling injuries, and 1.75 billion in total cost from these accidents. 

Although the creation of shareholder value is becoming the primary target for top management in all kinds of industries, the level of acceptance varies widely. In some more traditional industries, like steel and chemicals, senior managers still tend to run their business with a focus on the Return on Sales or even tons of output. Yet this ratio has a major flaw it fails to judge the company s results in relation to its invested capital and the cost of that capital, which could be fatal in the longer term. However useful ROS may be, it cannot stand alone as a measure of performance. 

The newer preparations approximately triple the cost of diagnostic investigations requiring contrast media. With a fatality rate of -1/50 000 in patients receiving the older agents, hospitals are faced with an interesting cost-benefit equation. 

The frequency of ADRs in the general population is unknown. However, the reported rates of new occurrences for ADRs are noted for selected patient populations. A meta-analysis of 39 prospective studies reported an overall incidence of serious ADRs in hospitalized patients of 6.7% and of fatal ADRs of 0.32% . The fatality rate makes ADRs the fourth to sixth leading cause of death in the United States. Another meta-analysis of 36 studies indicated that approximately 5% of hospital admissions are due to ADRs. The costs of ADRs are estimated to be 1.56- 4 billion in direct hospital costs per year in the United States. ... 

One major class of consequences is the adverse health effects including acute, latent fatalities and injuries. Another class of consequences addresses the so called socioeconomic costs of the ERP including psychological effects on the population subject to the ERP, social and economic effects of disruption of normal, everyday activities, etc. A set of distinct attributes, each measuring the degree to which each area of concern is affected as a result of the established ERP, is thus determined. As a result, each decision leads to a multidimensional consequence. 

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