Health Outcomes

• Cardiovascular outcomes, Metabolic outcomes

Health Outcome List:

• Cardiovascular outcomes (coronary artery disease)
• metabolic outcomes (obesity/aberrant body weight)

Environmental Agents

List of Environmental Agents:

• Hormonal mimics (bisphenol A (BPA))

Source of Environmental Agents:

• Metal-based food containers
• beverage containers

Economic Evaluation / Methods and Source

Type:

• Cost-benefit analysis (CBA)

Cost Measures:

• Healthcare costs/expenditures associated with additional cases of obesity (during childhood and adulthood)
• healthcare costs/expenditures associated with additional cases of incident coronary heart disease
• cost of QALYs lost

Potential Cost Measures:

• Cost for use of alternative lining for containers (e.g., oleoresin) or replacing BPA
• costs for removing BPA from food uses (e.g., costs for premarket testing to rule out toxicity)

Benefits Measures:

• Cases of BPA-attributable childhood obesity prevented
• costs of BPA-associated childhood obesity saved
• cases of BPA-attributable adult coronary heart disease prevented
• costs of BPA-associated adult coronary heart disease saved

Potential Benefits Measures:

• Not available

Location:

• Not available

Models Used:

• Environmentally Attributable Fraction (EAF) model

Models References:

• References cited in publication — Institute of Medicine, 1981

Methods Used:

• The author quantified the potential social costs of childhood obesity and adult coronary heart disease attributable to BPA exposure in the United States in 2008 and models the potential health and economic benefits associated with replacing BPA in all food uses. The author — 1) quantified both increased rates of coronary heart disease in adults and increases in children’s BMIs attributable to BPA exposure; 2) used pre-existing burden of disease cost-estimates to quantify costs from exposure; and 3) used data from previous BPA intervention study to estimate reductions in both disease and costs if BPA was removed from food uses.

Sources Used:

• NHANES (2003-2008); Incidence and prevalence: 2006 chart book on cardiovascular and lung diseases (National Heart, Lung and Blood Institute); Center for Disease Control and Prevention; American Heart Association (Heidenreich et al., 2011; Russell et al., 1998); Nationwide Inpatient Sample and Medical Expenditure Panel Survey; How much should we invest in preventing childhood obesity? (Trasande, 2010); The impact of obesity on health service utilization and costs in childhood (Trasande et al., 2009); Effects of childhood obesity on hospital care and costs (Trasande et al., 2009); Urinary bisphenol A concentration and risk of future coronary artery disease in apparently healthy men and women (Melzer et al., 2012); Consumer Price Index (Bureau of Labor Statistics); A simulation of affordability and effectiveness of childhood obesity interventions (Ma et al., 2011); additional sources cited in publication

Economic Citation / Fundings

Citation:

• Trasande L. Further limiting bisphenol a in food uses could provide health and economic benefits. Health Affairs. 2014. 33; 2.
• Pubmed
• DOI

NIEHS Funding:

• Not available

Other Funding: Not available