Estimating Burden and Disease Costs of Exposure to Endocrine-Disrupting Chemicals in the European Union

Leonardo Trasande, R. Thomas Zoeller, Ulla Hass, Andreas Kortenkamp, Philippe Grandjean (), John Peterson Myers, Joseph Digangi, Martine Bellanger (), Russ Hauser, Juliette Legler, Niels E. Skakkebaek and Jerrold J. Heindel
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Leonardo Trasande: Dpt of Population Health [New York] - New York University School of Medicine - NYU - NYU System, College of Global Public Health [New York] - NYU - New York University [New York] - NYU - NYU System, Departments of Pediatrics and Environmental Medicine [New York] - New York University School of Medicine - NYU - NYU System
R. Thomas Zoeller: Department of Biology - UMASS - University of Massachusetts System
Philippe Grandjean: LGL-TPE - Laboratoire de Géologie de Lyon - Terre, Planètes, Environnement - ENS de Lyon - École normale supérieure de Lyon - Université de Lyon - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - INSU - CNRS - Institut national des sciences de l'Univers - UJM - Université Jean Monnet - Saint-Étienne - CNRS - Centre National de la Recherche Scientifique
John Peterson Myers: Psychopharmacology Unit - University of Bristol [Bristol]
Martine Bellanger: EHESP - École des Hautes Études en Santé Publique [EHESP], EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité

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Abstract: Context: Rapidly increasing evidence has documented that endocrine-disrupting chemicals (EDCs) contribute substantially to disease and disability. Objective: The objective was to quantify a range of health and economic costs that can be reasonably attributed to EDC exposures in the European Union (EU). Design: A Steering Committee of scientists adapted the Intergovernmental Panel on Climate Change weight-of-evidence characterization for probability of causation based upon levels of available epidemiological and toxicological evidence for one or more chemicals contributing to disease by an endocrine disruptor mechanism. To evaluate the epidemiological evidence, the Steering Committee adapted the World Health Organization Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group criteria, whereas the Steering Committee adapted definitions recently promulgated by the Danish Environmental Protection Agency for evaluating laboratory and animal evidence of endocrine disruption. Expert panels used the Delphi method to make decisions on the strength of the data. Results: Expert panels achieved consensus at least for probable (>20%) EDC causation for IQ loss and associated intellectual disability, autism, attention-deficit hyperactivity disorder, childhood obesity, adult obesity, adult diabetes, cryptorchidism, male infertility, and mortality associated with reduced testosterone. Accounting for probability of causation and using the midpoint of each range for probability of causation, Monte Carlo simulations produced a median cost of €157 billion (or $209 billion, corresponding to 1.23% of EU gross domestic product) annually across 1000 simulations. Notably, using the lowest end of the probability range for each relationship in the Monte Carlo simulations produced a median range of €109 billion that differed modestly from base case probability inputs. Conclusions: EDC exposures in the EU are likely to contribute substantially to disease and dysfunction across the life course with costs in the hundreds of billions of Euros per year. These estimates represent only those EDCs with the highest probability of causation; a broader analysis would have produced greater estimates of burden of disease and costs.

Keywords: obesity; steering committee; testosterone; diabetes mellitus; type 2; cryptorchidism; exposure; adult; attention-deficit/hyperactivity disorder; autistic disorder; cost of illness; european union; male infertility; intellectual disability; united states environmental protection agency; world health organization; economics; mortality; disability; endocrine disruptors; childhood obesity; climate change; consensus (search for similar items in EconPapers)
Date: 2015-04-01
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Citations: View citations in EconPapers (5)

Published in Journal of Clinical Endocrinology and Metabolism, 2015, 100 (4), pp.1245 - 1255. ⟨10.1210/jc.2014-4324⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01505537

DOI: 10.1210/jc.2014-4324

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