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      Long-term health and human capital effects of in utero exposure to an industrial disaster: a spatial difference-in-differences analysis of the Bhopal gas tragedy

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          Abstract

          Objectives

          Globalisation and industrialisation can increase economic opportunity for low/middle-income nations, but these processes may also increase industrial accidents and harm workers. This paper examines the long-term, cohort-based health effects of the Bhopal gas disaster (BGD), one of the most serious industrial accidents in history.

          Design

          This retrospective analysis uses geolocated data on health and education from India’s National Family Health Survey-4 (NFHS-4) and the 1999 Indian Socio-Economic Survey by the National Sample Survey Organization (NSSO-1999) to examine the health effects of exposure to the BGD among men and women aged 15–49 years living in Madhya Pradesh in 2015–2016 (women n=40 786; men n=7031 (NFHS-4) and n=13 369 (NSSO-1999)), as well as their children (n=1260). A spatial difference-in-differences strategy estimated the relative effect of being in utero near Bhopal relative to other cohorts and to those further from Bhopal separately for each dataset.

          Results

          We document long-term, intergenerational impacts of the BGD, showing that men who were in utero at the time were more likely to have a disability that affected their employment 15 years later, and had higher rates of cancer and lower educational attainment over 30 years later. Changes in the sex ratio among children born in 1985 suggest an effect of the BGD up to 100 km from the accident.

          Conclusions

          These results indicate social costs stemming from the BGD that extend far beyond the mortality and morbidity experienced in the immediate aftermath. Quantifying these multigenerational impacts is important for policy consideration. Moreover, our results suggest that the BGD affected people across a substantially more widespread area than has previously been demonstrated.

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          The fragile male

          S. Kraemer (2000)
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            Health Capital and the Prenatal Environment: The Effect of Ramadan Observance During Pregnancy

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              The Bhopal disaster and its aftermath: a review

              On December 3 1984, more than 40 tons of methyl isocyanate gas leaked from a pesticide plant in Bhopal, India, immediately killing at least 3,800 people and causing significant morbidity and premature death for many thousands more. The company involved in what became the worst industrial accident in history immediately tried to dissociate itself from legal responsibility. Eventually it reached a settlement with the Indian Government through mediation of that country's Supreme Court and accepted moral responsibility. It paid $470 million in compensation, a relatively small amount of based on significant underestimations of the long-term health consequences of exposure and the number of people exposed. The disaster indicated a need for enforceable international standards for environmental safety, preventative strategies to avoid similar accidents and industrial disaster preparedness. Since the disaster, India has experienced rapid industrialization. While some positive changes in government policy and behavior of a few industries have taken place, major threats to the environment from rapid and poorly regulated industrial growth remain. Widespread environmental degradation with significant adverse human health consequences continues to occur throughout India.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2023
                9 May 2023
                : 13
                : 6
                : e066733
                Affiliations
                [1 ] departmentSchool of Global Policy and Strategy , Ringgold_8784University of California San Diego , La Jolla, California, USA
                [2 ] departmentDepartment of Economics , Ringgold_8784University of California San Diego , La Jolla, California, USA
                [3 ] departmentCenter on Gender Equity and Health, Department of Medicine , Ringgold_8784University of California San Diego , La Jolla, California, USA
                Author notes
                [Correspondence to ] Dr Gordon C McCord; gmccord@ 123456ucsd.edu
                Author information
                http://orcid.org/0000-0001-5042-9225
                http://orcid.org/0000-0002-3002-0489
                Article
                bmjopen-2022-066733
                10.1136/bmjopen-2022-066733
                10335451
                37311631
                9291da19-0481-40e5-b526-7bf2ea4a347e
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/.

                History
                : 18 July 2022
                : 12 April 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000865, Bill and Melinda Gates Foundation;
                Award ID: INV-008648
                Categories
                Public Health
                1506
                1724
                Original research
                Custom metadata
                unlocked

                Medicine
                public health,epidemiology,health economics
                Medicine
                public health, epidemiology, health economics

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