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Research Article
1 July 2002

Environmental pollutants and disease in American children: estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities.

Publication: Environmental Health Perspectives
Volume 110, Issue 7
Pages 721 - 728

Abstract

In this study, we aimed to estimate the contribution of environmental pollutants to the incidence, prevalence, mortality, and costs of pediatric disease in American children. We examined four categories of illness: lead poisoning, asthma, cancer, and neurobehavioral disorders. To estimate the proportion of each attributable to toxins in the environment, we used an environmentally attributable fraction (EAF) model. EAFs for lead poisoning, asthma, and cancer were developed by panels of experts through a Delphi process, whereas that for neurobehavioral disorders was based on data from the National Academy of Sciences. We define environmental pollutants as toxic chemicals of human origin in air, food, water, and communities. To develop estimates of costs, we relied on data from the U.S. Environmental Protection Agency, Centers for Disease Control and Prevention, National Center for Health Statistics, the Bureau of Labor Statistics, the Health Care Financing Agency, and the Practice Management Information Corporation. EAFs were judged to be 100% for lead poisoning, 30% for asthma (range, 10-35%), 5% for cancer (range, 2-10%), and 10% for neurobehavioral disorders (range, 5-20%). Total annual costs are estimated to be $54.9 billion (range $48.8-64.8 billion): $43.4 billion for lead poisoning, $2.0 billion for asthma, $0.3 billion for childhood cancer, and $9.2 billion for neurobehavioral disorders. This sum amounts to 2.8 percent of total U.S. health care costs. This estimate is likely low because it considers only four categories of illness, incorporates conservative assumptions, ignores costs of pain and suffering, and does not include late complications for which etiologic associations are poorly quantified. The costs of pediatric environmental disease are high, in contrast with the limited resources directed to research, tracking, and prevention.

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Information

Published In

Environmental Health Perspectives
Volume 110Issue 7July 2002
Pages: 721 - 728
PubMed: 12117650

History

Published online: 1 July 2002

Authors

Affiliations

Philip J Landrigan
The Center for Children's Health and the Environment and The Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. [email protected]
Clyde B Schechter
The Center for Children's Health and the Environment and The Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. [email protected]
Jeffrey M Lipton
The Center for Children's Health and the Environment and The Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. [email protected]
Marianne C Fahs
The Center for Children's Health and the Environment and The Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. [email protected]
Joel Schwartz
The Center for Children's Health and the Environment and The Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. [email protected]

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