EDC disease burdens result in substantial costs in the US

PERSPECTIVE

Andrea C. Gore

This is an important study because it adds to a previous analysis of the economic costs of EDCs on human health in the European Union, extending that analysis to the United States. The results indicate that there are societal benefits to minimizing chemical exposures, both for the health of the population and the health of the economy. This type of analysis also underscores the importance of considering effects of EDCs across populations. Each of us, as individuals, should be concerned about long-term health consequences of EDCs. However, a few IQ points for an individual may not seem like much. For the population, though, the cumulative effect of shifting the bell curve of IQ to the left means that many more people with intellectual disabilities and that many fewer people in the genius range.

Endocrine-disrupting chemicals are pervasive and global, and at the level of the individual, they appear to be present in our bodies at very low levels with little or no measurable impact on our health and physiology.
We make such a statement because traditionally we are used to assessing such substances using classical toxicologic paradigms, such as acute physiological tests in laboratory rodents, or in vitro cell-based tests, where often a substance needs to be present at a concentration many hundreds of times greater than that found in humans before a significant effect is seen. We are thus lulled into a sense of security. However, many large epidemiologic studies are showing that even the concentrations of EDCs we previously thought of as safe are having significant impacts at a population level — and these impacts do not simply concern the health of a few individuals.
In a new study by Attina and colleagues that builds on previous research looking at the European population, this low-level exposure to EDCs is costing the U.S. population an estimated $340 billion, which is more than 2.3% of GDP.  
The authors are using a statistical approach which was pioneered by scientists looking at climate change and is based on very realistic estimates of disease incidence and disease burden which can be attributed to EDC exposures. They have limited themselves to only 15 of the best-described and documented EDCs — a small fraction of the many hundreds of potential EDC substances known to be in the environment — and have similarly applied only very conservative estimates of how much a particular EDC might contribute to a disease.
What is particularly interesting is the comparison to the previous studies which focused on the countries of the European Union. Overall, the costs are quite similar: $340 billion for the U.S., compared with $217 billion for the EU. On both continents, the major costs are associated with neurodevelopmental impairment, illustrated by loss of IQ points or attention deficit hyperactivity disorder, both attributed to prenatal or early childhood exposures, though other conditions are also significant (eg, infertility, diabetes, fibroids, etc). But there are also obvious differences largely due to the prevalence of different kinds of EDCs in the U.S. environment compared with the EU, or sometimes the different medical costs associated with a certain condition.
The new study also highlights another important feature, namely, that with all of the potential EDCs in the environment, it is very difficult to imagine how they can all be tested appropriately within a relatively short period of time, and consequently how such substances can be fairly regulated to keep us safe. Even if a harmful substance is replaced by a new compound, it does not imply that the new compound will be necessarily safer, but simply that we know less about it. What this new study has done is to put a price tag on inaction and a realistic cost-pressure to develop more effective ways of managing and regulating such substances.

Disclosure: Ivell reports no relevant financial disclosures.