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Your Environment. Your Health.

Reducing the staggering costs of environmental disease in children, estimated at $76.6 billion in 2008

Environmental Health Economic Analysis Annotated Bibliography


Research article Cost analysis (CA)
Trasande L and Liu Y
Health Affairs
This cost analysis found that diseases of environmental origin in US children cost $76.6 billion in 2008. The authors concluded that to prevent further increases in these costs, efforts are needed to institute premarket testing of new chemicals, conduct toxicity testing on chemicals already in use, reduce lead-based paint hazards, and curb mercury emissions from coal-fired power plants.

Health Outcomes

  • Cancer outcomes (childhood cancer)
  • respiratory outcomes (asthma)
  • neurological/cognitive outcomes (intellectual disability, autism, ADHD, developmental disabilities)
  • lead poisoning
  • methyl mercury toxicity

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:

  • Medical care costs for lead poisoning
  • lost economic productivity due to reduced cognitive ability from lead exposure and methyl mercury toxicity
  • intellectual disability costs
  • autism costs
  • ADHD costs
  • economic costs of developmental disabilities
  • medical costs of asthma
  • work days lost caring for child with asthma
  • medical costs for children with malignancies (inpatient emergency room costs, prescription drug costs, outpatient costs)

Potential Cost Measures:

  • Medical costs of obesity due to exposure to endocrine-disrupting chemicals
  • cardiovascular risks due to perinatal exposure to methyl mercury
  • criminal activity due to childhood lead exposure

Benefits Measures: (Not available)

Potential Benefits:

  • Economic savings achieved by preventing methyl mercury contamination of fish

Location: (Not available)

Models Used:

  • Environmentally Attributable Fraction (EAF) model

Methods Used:

  • To update and expand a previous analysis of the costs of environmental disease in children, the study authors multiplied the environmentally attributable fraction by the prevalence or incidence of each condition examined, the population at risk, and the cost per case.

Sources Used:

  • US Census Bureau (2008); National Survey of Children's Health (2007-2008); National Health and Nutrition Examination Survey (1999-2004); Medical Expenditure Panel Surveys; Nationwide Inpatient Sample; Nationwide Emergency Department Survey; National Hospital Ambulatory Medical Care Survey; Medical Care Consumer Price Index; National Vital Statistics Reports (2007); additional sources cited in publication

Economic Evaluation / Methods and Source


  • Trasande L and Liu Y. 2011. Reducing the staggering costs of environmental disease in children, estimated at $76.6 billion in 2008. Health Affairs.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding: (Not available)

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