title: Economic impacts of environmentally attributable childhood health outcomes in the European Union.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 School of Geography and the Environment, Oxford University, Oxford, UK.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Bartlett
authors.forename: Leonardo
authors.initials: L
authors.lastname: Trasande
mesh_terms: D001249:Asthma / Q000139:chemically induced / Q000191:economics / Q000453:epidemiology; D002648:Child; D002669:Child Welfare / Q000191:economics / Q000706:statistics & numerical data*; D017281:Cost of Illness; D002658:Developmental Disabilities / Q000139:chemically induced / Q000191:economics / Q000453:epidemiology; D004781:Environmental Exposure / Q000191:economics* / Q000706:statistics & numerical data; D005062:European Union / Q000191:economics / Q000706:statistics & numerical data*; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007855:Lead Poisoning / Q000191:economics / Q000453:epidemiology; D008767:Methylmercury Compounds / Q000009:adverse effects; D009369:Neoplasms / Q000139:chemically induced / Q000191:economics / Q000453:epidemiology
chemical_list: D008767:Methylmercury Compounds