Health officials said yesterday people were worrying themselves sick over quality-of-life issues which had been ignored by governments and the medical establishment for too long.
The costs to the NHS of treating people with infectious diseases, accidental injuries, falls or poisoning incidents were far outweighed by the as yet unquantified costs to society through absence from work, general anxiety and depression.
The Health Protection Agency has begun to assess some of the economic cost of illnesses through GP consultations and hospital admissions. But officials say they must also listen to what people think about their communities.
Patrick Saunders, one of the compilers of a report to be published this month, said: "If you ask communities what is important to them about the environment, they largely tell you it is quality of life issues [such as] dog messing, graffiti, worry about crime, kids who have got nowhere to play.
"These things are really important to them. If they are telling us they feel rubbish about where they live, then we have to take that on board properly."
Another compiler, Professor Stephen Palmer, provided another example. He said nurses in hospitals worried "hugely" when they had been exposed to possible hepatitis via an infected needle, when the chances of catching infection were small. "Whenever a nurse jabs herself with a needle she worries about getting hepatitis. The chances of her getting that are very small. The worry is huge.
Professor Palmer said the same could be applied to residents who lived near landfill sites. "People are measurably worrying themselves ill," he said. "There is a community wide anxiety as a result of these fear."
Dr Elaine Farmery, another official working on the report, said the costs were extremely high: "When we talk of 100s of millions of pounds cost for the NHS, we can talk in billions for society."
Pat Troop, the chief executive of the agency, said measuring disease was often extremely complex.
Underlying causes of illness did not always appear in diagnoses, many sexually transmitted diseases were dealt with in outpatients clinics, and the long-term implications of chemical exposures in the home, especially in children, were unrecognised.
Yet, she added: "It really is the case, the same groups are exposed to the infections, indoor air pollution and the passive effects of smoking.
"It is usually the poor. So far, the agency has estimated that the cost of treating infectious diseases such as flu and respiratory illnesses in England alone is £4.4bn a year. They account for a third of all GP consultations and 4% of hospital admissions," she said.
About 17,000 people a year die from injuries, mainly from accidental falls or traffic accidents, while treating those who survive costs the NHS in England about £2bn a year.
In Britain as a whole, 7,500 people a year die from poisoning, including suicides. Just providing hospital beds for those who are ill as a result of poisoning costs £100m.
