Skip Navigation
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Your Environment. Your Health.

Societal costs of exposure to toxic substances: economic and health costs of four case studies that are candidates for environmental causation

Environmental Health Economic Analysis Annotated Bibliography


Review Cost analysis (CA)
Muir T and Zegarac M
Environmental Health Perspectives
This review article estimated that 10-50% of the social and economic costs of four health outcomes (diabetes, Parkinson's disease, neurodevelopmental effects, and IQ deficits) are environmentally induced. The authors concluded that accounting for the economic and social costs can contribute to a better understanding of the real scope of the many issues raised by polluted environments.
Not available

Health Outcomes

  • 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


  • Cost analysis (CA)

Cost Measured:

  • 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: (Not available)

Location: (Not available)

Models Used: (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 Evaluation / Methods and Source


  • Muir T and Zegarac M. 2001. Societal costs of exposure to toxic substances: economic and health costs of four case studies that are candidates for environmental causation. Environmental Health Perspectives.
  • Pubmed
  • DOI: (Not available)

NIEHS Funding: (Not available)

Other Funding: (Not available)

to Top