Leonardo Trasande, MD, and team set out to determine what the national toll might be for childhood exposure to toxic chemicals, and their impact on lead poisoning, autism, asthma, ADHD (attention deficit hyperactivity disorder), and cancer rates among children. They also calculated the annual direct medical care costs, as well as other (indirect) costs, such as productivity loss by parents caring for their children, etc.
The authors found that:
- $76.6 billion is spent annually dealing with the consequences of childhood exposure to environmental chemicals
- This represents 3.5% of the country's health costs in 2008
- $50.9 billion was spent dealing with lead poisoning
- $7.9 billion was spent on autism
- $5.4 billion was spent on intellectual disability
- $5.1 billion was spent on mercury pollution
- $5 billion was spent on ADHD
- $2.2 billion was spent on asthma
- $95 million was spent on childhood cancer
"Our findings show that, despite previous efforts to curb their use, toxic chemicals have a major impact on health care costs and childhood morbidity. New policy mandates are necessary to reduce the burden of disease associated with environmental toxins. The prevalence of chronic childhood conditions and costs associated with them may continue to rise if this issue is not addressed."
The team examined a 1997 study which revealed a yearly cost of $54.9 billion for childhood diseases linked to environmental toxins in the USA. This earlier study had been carried out by Dr. Philip J. Landrigan, MD, currently Dean for Global Health, and Professor and Chair of Preventive Medicine, and Professor of Pediatrics, at Mount Sinai School of Medicine.
Although lead exposure and asthma related costs had dropped, new chemicals and diseases likely caused by their arrival, such as ADHD have increased the overall costs of childhood disease.
In another report in the same journal, Dr. Landrigan from Mount Sinai and Lynn R. Goldman, MD, from George Washington University, propose the following three-pronged approach to bring down the burden of disease and reduce the impact of toxic chemicals in the environment:
- Carefully analyze and evaluate those chemicals that are already on the market for possible toxicity, starting with the most widely used ones, using modern, efficient toxicity testing technologies
- Test and evaluate any new chemical for toxicity before it is allowed to enter the market. Maintain strict and well-enforced regulations on these chemicals.
- More funds should be directed towards epidemiologic monitoring so that scientists and health care professionals are better able to understand and prevent some of the impacts that chemicals have on children.
"Implementing these proposals would have a significant impact in preventing childhood disease and reducing health costs. Scant legislation has been passed to reduce the risks associated with childhood exposure to toxic chemicals in the environment. Even though only six chemicals have been banned, we have seen dramatic benefits from that action alone. The removal of lead from gasoline and paint is an example of the importance of this type of regulation."
In another report in the same journal, Dr. Perry Sheffield set out to determine whether there might be a link between air pollution and childhood respiratory illness, and the subsequent health care costs.
Dr. Sheffield and colleagues gathered hospitalization data between 1999 and 2007 for infants aged between 1 and 12 months who developed bronchiolitis - an asthma-like viral lung infection. They monitored the air quality around the hospitals where the infants had been hospitalized. There was a clear link between total charges and costs for infant bronchiolitis hospitalizations and levels of fine particulate matter pollutant surrounding those hospitals.
There was a $127 average increase per infant in bronchiolitis hospitalization costs as air pollutant levels increased. They worked out that US health care costs could be reduced by $15 million per year if fine particulate levels went down by just 7%.
Dr. Sheffield said:
"While more research is required to understand the full effect of air pollutants on infectious disease severity and health care costs, our findings are indicative of the tremendous impact new legislation on air quality control standards could have on the health of our children."
"Reducing The Staggering Costs Of Environmental Disease In Children, Estimated At $76.6 Billion In 2008"
Leonardo Trasande, and Yinghua Liu
Health Aff May 2011 10.1377/hlthaff.2010.1239