title: Applying cost analyses to drive policy that protects children: mercury as a case study.
abstract: Exposure in prenatal life to methylmercury (MeHg) has become the topic of intense debate in the United States after the Environmental Protection Agency (EPA) announced a proposal in 2004 to reverse strict controls on emissions of mercury from coal-fired power plants that had been in effect for the preceding 15 years. This proposal failed to incorporate any consideration of the health impacts on children that would result from increased mercury emissions. We assessed the impact on children's health of industrial mercury emissions and found that between 316,588 and 637,233 babies are born with mercury-related losses of cognitive function ranging from 0.2 to 5.13 points. We calculated that decreased economic productivity resulting from diminished intelligence over a lifetime results in an aggregate economic cost in each annual birth cohort of $8.7 billion annually (range: $0.7-$13.9 billion, 2000 dollars). $1.3 billion (range: $51 million-$2.0 billion) of this cost is attributable to mercury emitted from American coal-fired power plants. Downward shifts in intellectual quotient (IQ) are also associated with 1566 (range: 115-2675) excess cases of mental retardation (MR defined as IQ < 70) annually. This number accounts for 3.2% (range: 0.2-5.4%) of MR cases in the United States. If the lifetime excess cost of a case of MR (excluding individual productivity losses) is $1,248,648 in 2000 dollars, then the cost of these excess cases of MR is $2.0 billion annually (range: $143 million-$3.3 billion). Preliminary data suggest that more stringent mercury policy options would prevent thousands of cases of MR and billions of dollars over the next 25 years.
authors.affiliation: Center for Children's Health and the Environment, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. leo.trasande@mssm.edu
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
authors.forename: Clyde
authors.initials: C
authors.lastname: Schechter
authors.forename: Karla A
authors.initials: KA
authors.lastname: Haynes
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Landrigan
mesh_terms: D002648:Child; D002669:Child Welfare; D003365:Costs and Cost Analysis; D006291:Health Policy; D006801:Humans; D008607:Intellectual Disability / Q000139:chemically induced; D008628:Mercury / Q000633:toxicity*; D014481:United States
chemical_list: D008628:Mercury