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.

Https

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.

Comparison of methods for calculating the health costs of endocrine disrupters: a case study on triclosan

Environmental Health Economic Analysis Annotated Bibliography

Details

Research article Cost analysis (CA)
Authors
Prichystalova R, Fini JB, Trasande L, Bellanger M, Demeneix B, Maxim L
Journal
Environmental Health
Summary
This study compared two methods for calculating health costs associated with environmental exposures and health outcomes using triclosan as an example. The authors compared the integrated probabilistic risk assessment (IPRA) method based on rat toxicology data, and Population Attributable Fraction (PAF) method using human epidemiological data. The results between the two methods were very different for the two outcomes for which direct comparisons were possible. The IRPA method estimated zero cases of increased T3 (thyroid-related) hormone levels and zero cases of early pubertal development, whereas the PAF method estimated 88,957–303,759 cases of increased T3 levels and 281,923 cases of early pubertal development. The authors concluded that selection of the analysis method significantly affected the socioeconomic estimates, and additional work should be done to understand the reasons for the different results. The authors also estimated the economic costs associated with increased body mass index (BMI) to be €5.8 billion per year for adult men and women in Europe.
Population
US populations in five epidemiological studies including boys ages 5-10 years, girls ages 6-8 years, boys and girls ages 12-19 years, adolescents, and adults ages 20-85 years

Health Outcomes

  • Endocrine outcomes (T3 hormone levels)
  • Reproductive outcomes (vas deferens weight, testicular function, female onset of puberty)
  • Metabolic outcomes (obesity, elevated BMI)

Environmental Agents

List of Environmental Agents:

  • Hormonal mimics (triclosan)

Source of Environmental Agents: (Not available)

Economic Evaluation / Methods and Source

Type:

  • Cost analysis (CA)

Cost Measured:

  • Cost per individual case from published articles for specific health outcomes
  • Variable being tested was method used to determine the percentage of the exposed population that shows a health effect

Potential Cost Measures: (Not available)

Benefits Measures: (Not available)

Potential Benefits: (Not available)

Location:

  • United States

Models Used: (Not available)

Methods Used:

  • The authors compared two methods for calculating health costs of endocrine disruptors: integrated probabilistic risk assessment (IPRA) based on rat toxicology data, and Population Attributable Fraction (PAF) using human epidemiological data. The authors: — 1) for the first method, performed an extensive literature review for triclosan toxicological, epidemiological, and biomonitoring studies; 2) used the IPRA model using rat toxicological data and the PROAST software tool to calculate a human dose-response function and Critical Effect Dose (CED) for specific health outcomes; 3) applied interspecies and intraspecies extrapolation factors to account for toxicology differences between animals and humans; 4) converted the calculated human CED to internal dose to align with published biomonitoring data of urine concentrations as exposure data; 5) calculated the share of exposed human population at risk based on the rat toxicological data and the other calculated values above; 6) for the second method using the PAF, selected epidemiological studies with exposure-response data for the same selected health outcomes that were analyzed for the rat toxicology studies; 7) applied exposure data from the biomonitoring studies and the exposure-response relationship data to calculate the PAF; 8) and only for the obesity outcome, calculated costs of obesity based on a published direct annual health cost of €811 per case.

Sources Used:

  • Biomonitoring data from publicly available triclosan biomonitoring studies (Additional file 1); Five epidemiological studies from the US (Koeppe et al., 2013; Lankester et al., 2013; Li et al., 2015; Wolff et al., 2010; Wolff et al., 2015); Integrated Probabilistic Risk Assessment (IPRA) method (Voet and Slob, 2007); Calculation of the attributable fraction approach (Bellanger et al., 2015; Legler et al., 2015); EUROSTAT data source to apply exposure-response relationship to EU population; additional sources cited in the publication

Economic Evaluation / Methods and Source

Citation:

  • Prichystalova R, Fini JB, Trasande L, Bellanger M, Demeneix B, Maxim L. 2017. Comparison of methods for calculating the health costs of endocrine disrupters: a case study on triclosan. Environmental Health.
  • Pubmed
  • DOI

NIEHS Funding: (Not available)

Other Funding:

  • Idex Sorbonne Universites Pour l'Enseignement et la Recherche (SUPER)
Back
to Top