内分泌撹乱物質の疾病負担は巨額

参考:Lancet2016年11月2日 (水)配信

Attina TM et al. Exposure to endocrine-disrupting chemicals in the USA: a population-based disease burden and cost analysis. Lancet Diabetes Endocrinol. 2016 Oct 17. pii: S2213-8587(16)30275-3. doi: 10.1016/S2213-8587(16)30275-3. [Epub ahead of print] 内分泌撹乱化学物質(EDC)への曝露に起因する疾病負担および関連費用を欧米の比較で検証。EDCによる疾病費用は米国で欧州より大幅に高いという結果でした(年間3400億ドル[GDPの2.33%] vs. 2170億ドル[同1.28%])。その差は主にポリ臭化ジフェニルエーテルによる知能指数の低下および知的障害に起因していました。 【原文を読む】 Lancet  

Exposure to endocrine-disrupting chemicals in the USA: a population-based disease burden and cost analysis

Teresa M Attina, MD, Prof Russ Hauser, MD, Sheela Sathyanarayana, MD, Prof Patricia A Hunt, PhD, Prof Jean-Pierre Bourguignon, MD, John Peterson Myers, PhD, Joseph DiGangi, PhD, Prof R Thomas Zoeller, PhD, Dr Leonardo Trasande, MDcorrespondencePress enter key for correspondence informationemailPress enter key to Email the author DOI: http://dx.doi.org/10.1016/S2213-8587(16)30275-3  

Summary

Background Endocrine-disrupting chemicals (EDCs) contribute to disease and dysfunction and incur high associated costs (>1% of the gross domestic product [GDP] in the European Union). Exposure to EDCs varies widely between the USA and Europe because of differences in regulations and, therefore, we aimed to quantify disease burdens and related economic costs to allow comparison. Methods We used existing models for assessing epidemiological and toxicological studies to reach consensus on probabilities of causation for 15 exposure–response relations between substances and disorders. We used Monte Carlo methods to produce realistic probability ranges for costs across the exposure–response relation, taking into account uncertainties. Estimates were made based on population and costs in the USA in 2010. Costs for the European Union were converted to US$ (€1=$1·33). Findings The disease costs of EDCs were much higher in the USA than in Europe ($340 billion [2·33% of GDP] vs$217 billion [1·28%]). The difference was driven mainly by intelligence quotient (IQ) points loss and intellectual disability due to polybrominated diphenyl ethers (11 million IQ points lost and 43 000 cases costing $266 billion in the USA vs 873 000 IQ points lost and 3290 cases costing $12·6 billion in the European Union). Accounting for probability of causation, in the European Union, organophosphate pesticides were the largest contributor to costs associated with EDC exposure ($121 billion), whereas in the USA costs due to pesticides were much lower ($42 billion). Interpretation EDC exposure in the USA contributes to disease and dysfunction, with annual costs taking up more than 2% of the GDP. Differences from the European Union suggest the need for improved screening for chemical disruption to endocrine systems and proactive prevention. Funding Endocrine Society, Ralph S French Charitable Foundation, and Broad Reach Foundation.