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Burden and cost of chemical exposure

Calculating the burden and cost of chemical exposure

First PARC report on environmental burden of disease (EBD) and health impact assessment (HIA) of chemical substances is published. Twenty-five institutes from ten countries joined forces to get the work done.

The report Inventory of existing EBD, HIA, exposure and exposure-effect data for chemicals prioritized in PARC’ aims to push forward the calculation of the burden and cost associated with chemical exposure for PARC prioritized chemical substances using indicators such as deaths, DALYs (Disability Adjusted Life Years) and costs (euros). Four subtasks were defined going from data availability, methodological improvements, case studies and indicators to help translating science to policy in this domain. Twenty-five institutes from ten countries joined forces to improve EBD and HIA for chemical substances.

There is a large gap in EBD calculations between stressors like air pollution, noise and chemical substances. For air pollution a framework with selected exposure-response curves is proposed by WHO and environmental agencies and applied in calculated EDB for air and noise pollution in Europe, whereas such a widely accepted framework nor applications are not yet available for chemical substances. Starting from methods from other domains (air pollution and noise) and pioneer work on EBD for chemical substances published in scientific literature, this project aims to establish and apply an EBD and HIA framework for exposure to chemicals.

Methodology  

The method under development for EBD and HIA for chemicals considers  

  • exposure data,  
  • exposure effect-associations and weight of evidence,  
  • population data (demographics and socio-economic status, SES) and
  • health data (incidence/prevalence of diseases and life expectancy).  

For the aspect of exposure data, we make use of human biomonitoring (HBM) data from the HBM4EU project since HBM data have the great advantage of reflecting aggregate exposure, covering all relevant routes and sources of exposure to chemicals.  

For the aspect of exposure-effect associations, some hurdles to be taken are that

  • for subclinical health effects (e.g. change in hormone levels related to chemical exposure) these are not always easily translated into a clinical effect necessary for burden of disease estimates and  
  • the uncertainty on causality of exposure-response relationships.  

These are challenges addressed in the methodological subtask.

In view of population data and health data, availability and accessibility of European and national demographics and health data registries was assessed, with emphasis on stratification according to SES.  Exposure and exposure response curves may differ for people of different SES leading to health inequalities. Reducing these health inequalities is the first flagship under the Zero Pollution Ambition and therefore in the case studies exposure data will be searched for stratified by SES. In this way burden of disease estimates will cover differences by SES.

Case studies

Several case studies have been initiated for which the health burden will be calculated, according to the methodological framework and data gathering for the four above mentions key aspects of EBD. The cases studies selected to start in 2023/2024 include PARC prioritized chemicals and health effects. More specific, the following case studies are under development:  

  1.  Pyrethroids exposure and association with attention deficit hyperactivity disorder (ADHD),
  2.  Environmental burden of a mixture of heavy metals on cancer and cardiovascular related mortality in adults living close to waste incinerators,  
  3. EBD of arsenic exposure and cancers (lung, bladder & skin),
  4. HIA of lead exposure and cardiovascular diseases and chronic kidney disease,  
  5. Influence of waste co-incineration in a cement plant on cancer burden,  
  6. Lead (Pb) and methylmercury (meHg) exposure and IQ loss in children in Europe. Additional case studies will start next year (e.g. PFAS exposure and immune suppression effects).

Based on the case studies, indicators will be developed to translate science into policy and assist policy makers. 

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