Toward an economic analysis of the environmental burden of disease among Canadian children.

There have been calls for increased investments in research in Canada to determine the extent of exposure and the associated health effects of environmental risks to child health. When allocating scare public health resources, decision makers often rely on cost-benefit analysis to determine whether specific expenditures will yield significant economic benefits by reducing adverse health outcomes. This article describes the elements required for an economic analysis of the environmental burden of disease among Canadian children. Such analysis would require reviewing the strength of the association between environmental exposures and specific adverse pregnancy outcomes and childhood diseases. Second, it would determine the prevalence of childhood diseases and conditions in order to estimate the total economic and social costs associated with the overall burden of childhood diseases in Canada. The next step is to determine how much of the overall burden of disease among Canadian children can be attributed to environmental exposures. Recent environmental burden of disease analyses in other jurisdictions have led to advancement in methodologies that could support this work in Canada. Finally, the economic and social costs attributable to the environmental burden of childhood diseases in Canada could be estimated. Estimates of the economic costs of environmentally related diseases can then be used to determine the appropriate level of investments in scientific research. This article argues for initial investments in establishing a biomonitoring program of children's and pregnant women's exposure to environmental chemicals, as well as a Canadian longitudinal cohort study on the environmental influences on child health and development.