Environmental factors are often overshadowed when it comes to issues in health and medical policies but recent analyses put price tags on preventable diseases and disorders. A study in May's Health Affairs issue, examined the environment-health link of numerous disease conditions like toxicity, childhood cancer, asthma, autism, and ADHD.
While it's difficult to pinpoint which of the thousands of chemicals cause which problems, there is a greater emphasis on awareness of patients' environmental exposure. Check out more on the bottom line: environmental illnesses, highly preventable, are a financial burden to the victims and the health system and a damaging burden to kids.
Environmental Illness in Kids Costs Billions
WASHINGTON — Childhood diseases thought to be linked to environmental causes cost the nation nearly $77 billion in medical costs and lost productivity in 2008 alone, a new analysis found.
Building on a 2002 analysis, investigators estimated how much of a role environmental factors play in causing such conditions as childhood cancers, asthma, and attention deficit hyperactivity disorder (ADHD) and then attached a dollar figure to the medical treatment and lost productivity expected to occur because of the preventable disease or disorder.
The study was published in the May issue of Health Affairs, which is devoted entirely to examining the link between the environment and health — an issue that often gets short shrift in health policy and medical circles, although a recent congressional hearing focused on disease clusters and their environmental causes.
“Our principal finding is that chemical factors in the environment continue to contribute greatly to childhood morbidity and to healthcare costs,” Leonardo Trasande, MD, of the Mount Sinai School of Medicine in New York City, and Yinghua Liu, MD, of the National Children's Study New York–Northern New Jersey Center wrote.
Their list of diseases thought to be caused at least in part by the environment include lead poisoning, methylmercury poisoning, childhood cancer, asthma, intellectual disability, ADHD, and autism.
Cerebral palsy was included in the 2002 analysis, but it was removed for the new study because of “limited data supporting the role of chemical factors.”
The priciest environmentally-caused disease is lead poisoning, which, Trasande said at a press briefing, cost the nation $60 billion in 2008.
About 10% of that cost was for medical care, but 90% is attributable to lost economic productivity from “reduced cognitive potential” resulting from preventable exposure to lead during childhood, according to the Trasande and Liu.
Lead exposure in childhood — which has greatly declined since the 1978 passage of a law banning use of lead-based paint in homes — has been linked to permanent brain damage and life-long problems with attention and impulsivity control and has also been linked to criminal activity later in life, they wrote.
Methylmercury poisoning — which can lead to brain and spinal cord damage — accounted for $5 billion in lost productivity in 2008, the study authors said.
The leading source of mercury in the environment is coal-fired power plants, but people can also ingest it by eating contaminated fish, and, in some few cases, from eating animals that were fed grain coated in a preservative that contained methylmercury.
Trasande and Liu said more than $5 billion in productivity costs were lost in 2008 because of intellectual disabilities caused by environmental factors.
A number of studies have drawn a link between air pollution and IQ, including a 2009 study in the journal Pediatrics that found children who were exposed to high levels of a pervasive air pollutant in the womb had significantly lower full-scale and verbal IQ scores at age 5.
Another $5 billion was lost because of ADHD that could ultimately be attributed to chemical factors in the environment.
Meanwhile, asthma cost more than $3 billion in medical costs, such as trips to the hospital and doctors' visits, in 2008, and another $4 billion in lost productivity as parents had to take off work to care for sick kids.
The prevalence of asthma is increasing, which baffles public health experts, because two known triggers — secondhand cigarette smoke and air pollution — have decreased in recent years as a result of anti-smoking and clean air laws.
Trasande and Liu also looked at the costs of autism.
“While we don't know the specific component environmental factors that contribute to autism, there are a number of reports documenting the role of environmental factors, in specific, chemical factors [that contribute to autism],” Trasande told MedPage Today.
Trasande said it's extremely difficult to pinpoint the exact health effects any of the thousands of chemicals that humans are exposed to in daily life. Manufacturers of new compounds are not required to prove their chemicals won't make people sick.
A National Institute of Science report estimated that 28% of developmental disabilities may be caused by environmental factors — that is, they are not caused by genetics alone. Or, as the saying goes, “Genes might load the gun, but the environment pulls the trigger,” Trasande said.
Avoiding chemicals is impossible, but parents can attempt to lessen their children's exposure by monitoring what they eat and airing out rooms when new electronics and furniture are installed.
“That ‘new' smell is actually a chemical smell,” Trasande explained.
In addition, doctors — most of whom likely never received environmental health training — can ask patients about foods they eat, their living conditions, and past exposure to toxins. Ob/gyns can also inform newly pregnant woman that, although they should be getting omega-3 fatty acids, they should avoid fish such as mackerel and some types of tuna that might contain high levels of mercury.
Trasande said he hopes his study will show that environmentally-caused diseases carry a huge financial burden — a dollar figure he hopes will be used in comparisons with the costs of making regulatory changes in the energy industry to prevent pollution.
“This analysis re-emphasizes for policymakers the implications of failing to prevent toxic chemical exposures not only for the health of children but also for the health of our economy,” Trasante and Liu concluded.
By Emily P. Walker, Washington Correspondent, MedPage Today