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Your Environment. Your Health.

Economics of children's environmental health

Environmental Health Economic Analysis Annotated Bibliography


Review Cost analysis (CA), Cost-benefit analysis (CBA), Cost-effectiveness analysis (CEA)
Trasande L
The Mount Sinai Journal of Medicine
This review article presented a selection of articles that used cost analyses, cost-effectiveness analyses, and cost-benefit analyses, and compared the relative merits of each approach as they apply to children's environmental health. The authors concluded that economic analyses in children’s environmental health are highly important to inform public-health policy, and further attention and training in their appropriate use are needed.

Health Outcomes

  • Reviewed publications that examined — respiratory outcomes (asthma)
  • metabolic outcomes (obesity)
  • neurodevelopmental outcomes (mental retardation)

Environmental Agents

List of Environmental Agents:

  • Reviewed publications that examined — metals (lead, methyl mercury)

Source of Environmental Agents:

  • Reviewed publications that examined — lead in gasoline
  • lead in paint
  • mercury from coal-fired power plants

Economic Evaluation / Methods and Source


  • Cost analysis (CA)
  • Cost-benefit analysis (CBA)
  • Cost-effectiveness analysis (CEA)

Cost Measured:

  • Reviewed publications that examined costs related to the following — healthcare expenses
  • hospitalizations
  • prescription drugs
  • outpatient visits and emergency room visits
  • lost economic productivity
  • QALYs lost
  • cost of implementing interventions

Potential Cost Measures: (Not available)

Benefits Measures:

  • Reviewed publications that assessed benefits of reducing children's exposure to environmental agents, such as — quality adjusted life years (QALYs) or disability adjusted life years (DALYs) saved/gained
  • savings in healthcare expenses and educational costs
  • increased economic productivity
  • reduced incidence/prevention of illness (e.g., obesity, childhood lead poisoning, mental retardation)

Potential Benefits: (Not available)

Location: (Not available)

Models Used:

  • Review described the environmentally attributable fraction (EAF) model

Methods Used:

  • This review article compared three types of economic evaluations, described the strengths and weaknesses, and provided examples of each. The authors discussed data sources commonly used in economic health analyses and methodological gaps and issues.

Sources Used:

  • Authors recommended several data sources for conducting environmental health economic analyses, such as — NHANES (to quantify environmental exposures); National Health Interview Survey (for disease prevalence and incidence attributable to environmental exposures); Nationwide Inpatient Sample or National Hospital Discharge Survey (to quantify hospitalizations); Nationwide Emergency Department Sample or the National Hospital Ambulatory Medical Care Survey (to quantify emergency room visits); National Ambulatory Medical Care Survey or the Medical Expenditure Panel Survey (to quantify outpatient utilization)

Economic Evaluation / Methods and Source


  • Trasande L. 2011. Economics of children's environmental health. The Mount Sinai Journal of Medicine.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding: (Not available)

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