PARC has published a new deliverable exploring how chemical exposure affects population health and how this evidence can support policy decisions. Bringing together 24 research institutes from seven Member States, the work focuses on environmental burden of disease (EBD) and health impact assessment (HIA), two approaches that help quantify the effects of chemicals in terms of disease cases, disability-adjusted life years, mortality and health-related economic losses.

Though EBD and HIA are powerful tools that allow scientists and policy makers to get quantitative insights into the impact of environmental stressors (such as chemicals), figures on EBD and HIA for chemicals remain to this day (in contrast to noise and air pollution) rather scarce (in contrast to noise and air pollution). T6.2.4 of PARC attempts to bridge these gaps by focusing on various case studies in which the EBD and/or HIA of various chemical stressors – health outcome pairs are researched.

To this end, the project focuses on advancing different aspects of EBD and HIA, notably methodological improvements, data generation, and development of health indicators; these aspects are applied in the different case studies.

This PARC project was initiated with the launch of six case studies, these included:

1. The impact of pyrethroid insecticides on ADHD in Europe, where a preliminary EBD estimation was provided. For Germany, France, Switzerland, Iceland, and Israel, it was estimated that in individuals aged 0 – 19 years, pyrethroids were on average responsible for 18% of all ADHD cases; further causing 3 – 27 DALYs, 209 – 2189 cases, and 0.3 – 2.5 million EUR (EUR2019) on a yearly basis and per million inhabitants. Yet, these figures should be interpreted with caution given the uncertainty of the estimation, predominately due to uncertainties in population representative exposure data and the exposure-response association.
2. The impact of lead exposure on cardiovascular diseases (CVD) in European adults. The case study initially focused on updating the exposure-response function (ERF) for the association between lead and CVD. This was done via a systematic review, and a burden-of-proof meta-analysis and meta-regression in collaboration with the Institute for Health Metrics and Evaluation (IHME). This case study is still in progress.
3. The impact of lead and methylmercury exposure on IQ-loss in European children – a mixture EBD approach. The case study also conducted a systematic review and meta-analysis to select the ERFs. This case study is being finalized.
4. Burden of disease study on arsenic exposure and lung, bladder, and skin cancer in Belgium, Portugal and Denmark. In this study, it was found that, per 100,000 inhabitants, arsenic is associated with 0.35 – 0.4 DALYs for bladder cancer, about 2 DALYs for lung cancer, and about 0.15 DALYs for skin cancer in Belgium across different socio-economic status (SES) categories. The findings of this case study underscore the importance of addressing socio-economic disparities in environmental health risks, and the challenges arising from the lack of harmonized, SES-stratified data collection (including exposure and, especially, ERF data) across countries, which can potentially lead to burden of disease underestimation for certain subpopulations.
5. Impact of municipal solid waste incineration (MSCI) emissions on cancer-related mortality in a Portuguese region (Great Lisbon Area) in the neighborhood of a MSCI. The study performed a systematic review and meta-analysis; based on which a potential increase in lung cancer mortality attributable to municipal solid waste incineration emissions is suggested; solid waste incineration estimated to be associated with 14.5% of lung cancer mortality and 6.2 deaths per 100,000 inhabitants in the Great Lisbon Area (based on ERF information from the conducted meta-analysis). However, relevant uncertainties remain due to limitations in exposure data assessment and study designs, highlighting the need for robust, individual level longitudinal studies to quantify this association better.
6. Influence of waste co-incineration in a cement plant on cancer burden in the Western Slovenia, in the neighourhood of the Salonit Anhova cement plant. In this case study, no increased cancer risk was identified in the population living in areas potentially affected by pollution from co-incineration at the Anhovo cement plant.

Aside from the six initial case studies, other case studies have been launched in PARC Y3. These include (I) EBD related to exposure to glyphosate and associated health effects, (II) EBD of PFAS related to immune effects, (III) EBD of Cd and nephrotoxicity, (IV) as well as the EBD of Cd/Pb-mixtures and nephrotoxicity, and finally, (V) a methodological improvements case study on the integration of probability modelling in the EBD – with lead and IQ-loss as a test case. Moreover, steps have also been undertaken to develop and integrate an EBD module in the MCRA tool of PARC Model Network (in collaboration with T8.3) The pyrethroids and PFAS case studies have served as pilot cases for the development and validation of the EBD module in MCRA.

Overall, the T6.2.4 task has provided insights the methodological understanding of the EBD and HIA methods, while also – via the different case studies – having provided quantitative health information on the impact of various chemical stressors. In the following years, the new case studies will be further developed, giving quantitative insights into the effects of chemicals. In the coming years, there will also be an increased focus on the harmonisation of methods, and the development of EBD/HIA modules in existing risk assessment tools, and in developments of tools assessing impact of source control to burden of disease. This way, the T6.2.4 task will provide PARC, research agencies, and government agencies with the necessary tools prioritise chemical risks, and tools for risk management.