Health-adjusted person-years

Although the QALY is the most commonly used health outcome summary measure, it is not the only one. Other conceptually equivalentoutcomes include years of healthy lifeiYHl), well years (WYs), health-adjusted person-years (HAPYs), and health-adjusted life expectancy (HALE). An alternative concept called healthy year equivalents (HYEs) has been proposed as theoretically superior to QALYs, but its practi-cai significance has been iimited. 

Comparisons between Enropean stndies are also difficult. Tolley and Gyldmark (1993) reviewed costs of treatment, care, and support for HIV-positive and AIDS patients in eleven Enropean conntries, which were based on data from the second half of the eighties. The anthors inflated cost fignres to 1990 prices and converted them from local currency to US by using national healthcare-specific price indices and health-specific purchasing power parities. The standardized cost estimates ranged between US 1,700 (social care per HIV-positive) and US 28,200 (hospital care per AIDS person-year), with the exception of a Greek study, which produced an adjusted cost estimate for the hospital treatment and care of AIDS patients of US 70,400 per person-year. 

Despite the high prevalence of the use of minor analgesics (aspirin and paracetamol) there is little information available on the association between the use of these analgesics and the risk of hypertension. A prospective cohort study in 80 020 women aged 31-50 years has provided some useful information (5). The women had participated in the Nurses Health Study II and had no previous history of hypertension. The frequency of use of paracetamol, aspirin, and NSAIDs was collected by mailed questionnaires and cases of physician-diagnosed hypertension were identified by self-report. During 164 000 person-years of follow-up, 1650 incident cases of hypertension were identified. Overall, 73% of the cohort had used paracetamol at least 1-4 days/month, 51% had used aspirin, and 77% had used an NS AID. Compared with non-users of paracetamol the age-adjusted relative risk... 

The social pillar of sustainabihty, nevertheless, requires creating a unit system to convert qualitative data into quantitative data. The human health impact is measured on the number of healthy life years lost because of premature mortality and disability/ person/year, or so-called disabihty-adjusted hfe year (DALY)/person/year [15]. For social weU-being, the result is obtained based on 11 midpoint impacts, which are divided... 

Epilepsy is a disorder that afflicts approximately 2 million individuals in the United States, with an age-adjusted prevalence of approximately 4 to 7 cases per 1000 persons.1 The incidence of epilepsy in the United States is estimated at 35 to 75 cases per 100,000 persons per year, which is similar to that of other developed countries.2,3 In developing countries, the incidence is higher at 100 to 190 cases per 100,000 persons per year, possibly related to poor health care and prenatal care, increased risk of neurologic trauma, and increased rates of infections. About 8% of the United States population will experience a seizure during their lifetime. New-onset seizures occur most frequently in infants below 1 year of age and in adults after age 55.4 However, the largest number of patients suffering from epilepsy is between the ages of 15 and 64 years. 

In 1956 a chemist synthesized a powerful chloracnegic agent, 2,3,7,8-tetrabromodibenzo-p-dioxin (TBDD). He initially contracted chloracne, a chemically induced acne, after an initial synthesis. The toxicity of this compound was unknown but the chemist did not use a chemical hood or personal protective equipment during this work. Later that same year he synthesized 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and this work resulted in a very severe case of chloracne—he was hospitalized for evaluation and later released. He recovered from the two incidents and was in good health in 1991. At that time the chemist volunteered to have his blood sampled for the measurement of TBDD in the blood sample itself and also in the blood adjusted for its lipid content—an indication of the compound in his fat tissues. The analysis revealed that the concentration of TBDD in blood lipids in 1991 was 625 parts per trillion. The concentration of TCDD in blood lipids was 16 parts per trillion. Based on this observation as well as other measurements, the initial body burden of halogenated dioxins in 1956 was estimated to have been between 13,000 and 150,000 parts per trillion. 

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