Health Outcomes

• Metabolic outcomes, Neurological/Cognitive outcomes

Health Outcome List:

• Reviewed publications that examined — metabolic outcomes (diabetes)
• neurological/cognitive outcomes (Parkinson's disease, IQ deficits, ADHD, autism)
• hypothyroidism

Environmental Agents

List of Environmental Agents:

• Reviewed publications that examined persistent toxic substances

Source of Environmental Agents:

• Not available

Economic Evaluation / Methods and Source

Type:

• Cost analysis (CA)

Cost Measures:

• Reviewed publications that examined the following costs — healthcare costs/expenditures (e.g., inpatient, outpatient, nursing home, hospice, home-health provider/assisted living, prescription drugs, treatment/therapy)
• costs of disability income subsidies
• lost productivity/earnings
• costs of special education
• costs related to justice system (e.g., juvenile delinquency and prison)
• impacts on lifetime earnings and labor force participation
• social impact costs (e.g., welfare)
• costs of low-weight births

Potential Cost Measures:

• Not available

Benefits Measures:

• Not available

Potential Benefits Measures:

• Not available

Location:

• Not available

Models Used:

• Not available

Models References:

• Not available

Methods Used:

• The authors reviewed literature to determine the evidence that exposure to environmental agents (particularly persistent toxic substances) are plausible risk factors for the chosen health outcomes. The authors — 1) evaluated literature to assess the extent to which approaches and methodologies to measure economic costs and impacts of the chosen health outcomes are developed; and 2) used primary data sources in cases where no existing studies were found that evaluated costs for the selected effects/outcomes.

Sources Used:

• Economic consequences of diabetes mellitus in the US in 1997 (American Diabetes Association, 1999); US Consumer Price Index (US Census Bureau); Diabetes in Canada: national statistics and opportunities for improved surveillance, prevention and control (Health Canada, 1999); Canadian Consumer Price Index (Ontario Ministry of Finance, 2000); Ontario Ministry of Health (2000); The impact of Parkinson's disease on health status, health expenditures, and productivity: estimates from the National Medical Expenditure Survey (Rubenstein et al., 1997); Parkinson's Action Network: cost of illness and disease severity in a cohort of French patients with Parkinson's disease (LePen et al., 1999); The economic impact of Parkinson's disease: an estimate based on a 3-month prospective analysis (Dodel et al., 1998); In harm's way: toxic threats to child development (Schettler et al., 2000); Canadian Institute of Child Health (2000); Ontario Ministry of Correctional Services (2000); Societal benefits of reducing lead exposure (Schwartz, 1994); Updated estimates of earnings benefits from reduced exposure to children to environmental lead (Salkever, 1995); additional sources cited in publication

Economic Citation / Fundings

Citation:

• Muir T and Zegarac M. Societal costs of exposure to toxic substances: economic and health costs of four case studies that are candidates for environmental causation. Environmental Health Perspectives. 2001. 109; Suppl 6.
• Pubmed

NIEHS Funding:

• Not available

Other Funding: Not available