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Your Environment. Your Health.

Economic impacts of environmentally attributable childhood health outcomes in the European Union

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost analysis (CA)
Bartlett ES and Trasande L
European Journal of Public Health
This report is the first cost analysis of impacts of childhood environmental chemical exposures in the European Union (EU). The researchers estimated the combined environmentally attributable costs of lead exposure, methyl mercury exposure, developmental disabilities, asthma, and cancer to be $70.9 billion in 2008. Estimation of these costs was important for evaluating the impact of the implementation of the EU's chemical policy (REACH). These findings also highlight the importance of specifically considering the health effects in children when conducting analyses of the costs or benefits of environmental, health, and safety policies.
Children and adolescents (< 18 years)

Health Outcomes

  • Lead poisoning
  • methyl mercury poisoning
  • developmental disabilities (autism spectrum disorder, ADHD, conduct disorders, mental retardation)
  • respiratory outcomes (asthma)
  • pediatric cancer

Environmental Agents

List of Environmental Agents:

  • Environmental pollutants ("chemical substances of human origin in air, food water, and communities")
  • metals (lead, methyl mercury)

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source


  • Cost analysis (CA)

Cost Measured:

  • Direct health care system costs
  • costs of rehabilitation
  • lost productivity

Potential Cost Measures: (Not available)

Benefits Measures: (Not available)

Potential Benefits: (Not available)


  • European Union

Models Used:

  • Environmentally Attributable Fraction (EAF) model

Methods Used:

  • The authors evaluated the economic impacts of childhood environmental chemical exposures in the European Union. The authors — 1) used a cost-of-illness approach to estimate health care system costs; 2) used environmentally attributable fraction (EAF) modeling to estimate the proportion of childhood disease due to environmental exposures; and 3) analyzed data on exposures, disease prevalence, and costs at a country level, and then aggregated costs across EU member states to estimate overall economic impacts within the EU.

Sources Used:

  • European Community Health Indicators (European Commission, 2008); Eurostat Harmonized Index of Consumer Prices; Global Burden of Asthma (Global Health Initiative for Asthma); GLOBOCAN database (WHO, 2008); additional sources cited in publication

Economic Evaluation / Methods and Source


  • Bartlett ES and Trasande L. 2014. Economic impacts of environmentally attributable childhood health outcomes in the European Union. European Journal of Public Health.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding: (Not available)

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