Cancer values of prevented fatalities (VPFs), one size does not fit all: The benefits of contaminated site cleanups in Italy

The authors conducted a survey based on conjoint choice experiments in Milan, Italy, about mortality risk reductions delivered by hypothetical private behaviors and public programs, and used it to estimate the value of a prevented fatality (VPF) when the cause of death is cancer. Their estimate of the VPF is (sic)4.2 million. The VPF is about (sic)1 million larger when the risk reduction is delivered by a public program, but further analyses reveal that it is so only when the respondent believes that public programs are effective at reducing this particular type of mortality risk. This estimate of the VPF is higher than generic European Union-wide figures recommended by the European Commission Directorate-General for Environment (DG Environment) for environmental policy analyses, and is comparable to other VPFs that are appropriate for Italy, hazardous waste regulations, and enforcement-based cleanup programs. The authors use their VPF to compute the benefits of addressing leaking landfills, illegal disposal of hazardous wastes, and poor hazardous waste management practices in the provinces of Naples and Caserta in southern Italy. The authors also examine the importance of the discount rates, since the mortality benefits of remediation begin in 20 yr and are assumed to continue over 30 yr.

Implications: Cost-benefit analysis that includes monetized nonmarket goods and services such as adverse health and premature mortality effects has become a standard tool in project appraisal and policy decision-making. The authors' estimates of the mortality benefits of cleaning up hazardous waste sites in a region of southern Italy are much larger than previous calculations that relied on the guidelines by DG Environment, raising concerns that using one VPF for all member countries of the European Union, and/ or VPF figures estimated in a private risk reduction setting, might considerably underestimate the benefits of cleanup policies.