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Utilities were calculated using the Dutch value set.
Data on exceedance of 25 mg/L NO3 for the other 11 member states were not available and estimated using the Dutch value and the ratio of exceedance of 25 mg/L NO3 in untreated groundwater.
QALYs based on the EuroQol-5D (EQ-5D) utility values using the Dutch value set; 13 14 Proportion of patients with a minimal clinical important difference MCID) (ie, improvement ≥0.4) on the CCQ; 15 16 Proportion of patients with an MCID (ie, improvement ≥4) on St . Georges Respiratory Questionnaire (SGRQ); 17 18 Total number of COPD exacerbations (moderate and severe).
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Resource use was valued using the Dutch guidelines on pharmacoeconomic research [ 17] where possible.
The costs are valued using the Dutch guidelines for cost analysis in healthcare (Health Care Insurance Board).> Productivity costs: The productivity costs are defined as the costs of absence from paid work due to CRPS, including the impact of compensation mechanisms, the cost of efficiency losses (productivity costs while working at a slower pace) and the costs of hindrance at unpaid work.
Risk of bias assessment was performed by using the Dutch EBRO checklist for case-control studies.
IQ was estimated using the Dutch version of the National Adult Reading Test.
Utilities were determined using the Dutch tariff [ 14].
Eating behaviour is assessed using the Dutch Eating Behaviour Questionnaire.
Physical work demands using the Dutch Musculoskeletal Questionnaire.
This study will use the Dutch tariff and the original UK tariff to value generic quality of life [ 58- 60].
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