1 School of Geography and the Environment, Oxford University, Oxford, UK.
Eur J Public Health. 2014 Feb;24(1):21-6. doi: 10.1093/eurpub/ckt063. Epub 2013 Jun 6.
There is increasing evidence of the role that exposure to industrial chemicals plays in the development of childhood disease. The USA and the European Union (EU) have taken divergent policy approaches to managing this issue, and economic estimates of disease costs attributable to environmental exposures in children are available in the USA but not the EU. We undertook the first economic evaluation of the impacts of childhood environmental chemical exposures in the EU.
We used a cost-of-illness approach to estimate health care system costs, and used environmentally attributable fraction modelling to estimate the proportion of childhood disease due to environmental exposures. We analysed data on exposures, disease prevalence and costs at a country level, and then aggregated costs across EU member states to estimate overall economic impacts within the EU.
We found the combined environmentally attributable costs of lead exposure, methylmercury exposure, developmental disabilities, asthma and cancer to be $70.9 billion in 2008 (range: $58.9-$90.6 billion). These costs amounted to ~0.480% of the gross domestic product of the EU in 2008.
Childhood chemical exposures present a significant economic burden to the EU. Our study offers an important baseline of disease costs before the implementation of Registration, Evaluation and Authorization of Chemicals, which is important for studying the impacts of this policy regime.
越来越多的证据表明,接触工业化学品在儿童疾病的发展中起着重要作用。美国和欧盟(EU)在管理这一问题上采取了不同的政策方法,并且可以在美国获得与儿童环境暴露相关的疾病成本的经济估算,但欧盟没有。我们对欧盟儿童环境化学暴露的影响进行了首次经济评估。
我们使用疾病成本法来估算医疗保健系统的成本,并使用环境归因分数模型来估算因环境暴露而导致的儿童疾病的比例。我们在国家层面分析了暴露、疾病流行率和成本数据,然后将成本汇总到欧盟成员国,以估算欧盟内部的总体经济影响。
我们发现,2008 年铅暴露、甲基汞暴露、发育障碍、哮喘和癌症的综合环境归因成本为 709 亿美元(范围:589 亿至 906 亿美元)。这些成本相当于欧盟 2008 年国内生产总值的 0.480%左右。
儿童期的化学暴露对欧盟造成了重大的经济负担。我们的研究在实施化学品注册、评估和授权之前提供了疾病成本的重要基准,这对于研究这一政策制度的影响非常重要。