Environmental pollutants and disease in American children

Estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities

Philip J. Landrigan, Clyde B. Schechter, Jeffrey M. Lipton, Marianne C. Fahs, Joel Schwartz

Research output: Contribution to journalArticle

320 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)721-728
Number of pages8
JournalEnvironmental Health Perspectives
Volume110
Issue number7
StatePublished - 2002
Externally publishedYes

Fingerprint

Industrial poisons
Environmental Pollutants
Lead Poisoning
Developmental Disabilities
asthma
disability
morbidity
poisoning
cancer
Asthma
Morbidity
Costs and Cost Analysis
mortality
Mortality
pollutant
cost
Costs
Neoplasms
Pediatrics
National Center for Health Statistics (U.S.)

Keywords

  • Asthma
  • Cancer
  • Developmental disabilities
  • Environmental pediarics
  • Health economics
  • Lead poisoning

ASJC Scopus subject areas

  • Environmental Science(all)
  • Environmental Chemistry
  • Public Health, Environmental and Occupational Health

Cite this

Environmental pollutants and disease in American children : Estimates of morbidity, mortality, and costs for lead poisoning, asthma, cancer, and developmental disabilities. / Landrigan, Philip J.; Schechter, Clyde B.; Lipton, Jeffrey M.; Fahs, Marianne C.; Schwartz, Joel.

In: Environmental Health Perspectives, Vol. 110, No. 7, 2002, p. 721-728.

Research output: Contribution to journalArticle

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