title: The costs of respiratory illnesses arising from Florida gulf coast Karenia brevis blooms.
abstract: BACKGROUND
  Algal blooms of Karenia brevis, a harmful marine algae, occur almost annually off the west coast of Florida. At high concentrations, K. brevis blooms can cause harm through the release of potent toxins, known as brevetoxins, to the atmosphere. Epidemiologic studies suggest that aerosolized brevetoxins are linked to respiratory illnesses in humans.
  
  
  OBJECTIVE
  We hypothesized a relationship between K. brevis blooms and respiratory illness visits to hospital emergency departments (EDs) while controlling for environmental factors, disease, and tourism. We sought to use this relationship to estimate the costs of illness associated with aerosolized brevetoxins.
  
  
  METHODS
  We developed a statistical exposure-response model to express hypotheses about the relationship between respiratory illnesses and bloom events. We estimated the model with data on ED visits, K. brevis cell densities, and measures of pollen, pollutants, respiratory disease, and intra-annual population changes.
  
  
  RESULTS
  We found that lagged K. brevis cell counts, low air temperatures, influenza outbreaks, high pollen counts, and tourist visits helped explain the number of respiratory-specific ED diagnoses. The capitalized estimated marginal costs of illness for ED respiratory illnesses associated with K. brevis blooms in Sarasota County, Florida, alone ranged from $0.5 to $4 million, depending on bloom severity.
  
  
  CONCLUSIONS
  Blooms of K. brevis lead to significant economic impacts. The costs of illness of ED visits are a conservative estimate of the total economic impacts. It will become increasingly necessary to understand the scale of the economic losses associated with K. brevis blooms to make rational choices about appropriate mitigation.
authors: Marine Policy Center, Woods Hole Oceanographic Institution, Woods Hole, Massachusetts 02543, USA. phoagland@whoi.edu
authors: Porter
authors: P
authors: Hoagland
authors: Di
authors: D
authors: Jin
authors: Lara Y
authors: LY
authors: Polansky
authors: Barbara
authors: B
authors: Kirkpatrick
authors: Gary
authors: G
authors: Kirkpatrick
authors: Lora E
authors: LE
authors: Fleming
authors: Andrew
authors: A
authors: Reich
authors: Sharon M
authors: SM
authors: Watkins
authors: Steven G
authors: SG
authors: Ullmann
authors: Lorraine C
authors: LC
authors: Backer
mesh_terms: D004782:Environmental Health / Q000191:economics*; D004784:Environmental Monitoring; D005068:Eutrophication; D005431:Florida; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D019570:Inhalation Exposure / Q000191:economics*; D008387:Marine Toxins / Q000191:economics / Q000633:toxicity; D035964:Oxocins / Q000191:economics / Q000633:toxicity; D012140:Respiratory Tract Diseases / Q000139:chemically induced* / Q000191:economics*; D000095702:Polyether Toxins
chemical_list: D008387:Marine Toxins; D035964:Oxocins; C053342:brevetoxin; D000095702:Polyether Toxins