Should I discount the health incidence as well as the valuation?

You should not discount the health incidence for any of the scenarios mentioned above. Changes

in the lag assumptions do not change the total number of estimated deaths, for example, but

rather the timing of those deaths. If you discounted the health incidence along with valuation, you

would essentially be discounting twice. In contrast, the process for conducting cost-effectiveness

analyses and calculating QALYs involves discounting life years. See Appendix G of the PM RIA

for more information on cost-effectiveness analyses (


Which health endpoints do not occur in the same year as exposure?

In many cases, the health effect from exposure to air pollution occurs shortly after exposure, but

there can be a significant lag between exposure and the health effect. The cession lag can be a

matter of hours or days in duration, but some health effects may lag exposure by much longer. If

exposure and the health effect do not occur within the same year, it is necessary to discount those

benefits back to the analysis year. The only health function currently in BenMAP that falls into

this category is PM2.5–related premature mortality. Discounting PM-related premature mortality

is controversial because the lag structure is unknown, but scientific literature on similar adverse

health effects and new intervention studies suggest that premature mortality probably would not

occur in the same year as the exposure. (See: Roosli M, Kunzli N, Braun-Fahrlander C, Egger

M. 2005. “Years of life lost attributable to air pollution in Switzerland: dynamic exposureresponse

model.” International Journal of Epidemiology 34[5]:1029-35.)

EPA’s Science Advisory Board recommends future research to support the development


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