Introduction
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In contrast to many infectious diseases, many chronic diseases are increasing in prevalence. Chronic diseases are those not caused by microbial agents such as viruses, bacteria, protozoan, and fungi. The increased incidence of chronic diseases is evidenced by rising rates of asthma, developmental problems, birth defects and some types of cancer (EPA, 2003). While the causes of these diseases are complex and multi-factorial, a growing body of research confirms that environmental factors are important contributors (Schettler, Stein, Reich, Valenti, & Wallinga, 2000). Environmental contributors are chemicals, frequently made by man or introduced by man into unintended parts of the environment, which are linked to negative health impacts. Examples of environmental contributors include lead, mercury, pesticides, diesel and gasoline exhaust, and PCBs.
The growing burden of chronic diseases is imposing a significant economic cost on society. These costs include expenditures for health care and costs associated with lost productivity and diminished earning potential. Landrigan et al.(2002) conservatively estimate that certain childhood environmental diseases cost the U.S. an estimated $54.9 billion per year in 1997 dollars. This number does not include the emotional or social tolls that environmentally attributable diseases, such as childhood cancer or learning disabilities, have on individuals, families, and society as a whole.
The purpose of this study is to estimate how much money is spent in Oregon annually to pay for environmentally attributable diseases, which are largely preventable. The estimates in this study are based on conservative assumptions, providing a low end approximation of the actual economic impact of pollution-related disease and disability. Implementing policies that reduce exposures to environmental pollutants would lead to reduced healthcare costs in Oregon and significantly benefit the economy and the health of current and future Oregonians. It is up to us to leave a legacy of health to Oregon’s children.
Previous Studies
In 2002, Landrigan et al. published a study estimating annual costs for childhood lead poisoning, asthma, and cancer. As part of this study, the authors established “environmentally attributable fractions” (EAFs), the proportion or fraction of each disease or disability that can be reasonably attributed to exposure to environmental contaminants. These EAFs were then used to estimate the cost burden of these diseases and disabilities attributable to toxins in the environment. The EAFs used in the Landrigan et al. study were developed by a panel of experts using data from the National Academy of Sciences. Utilizing these EAFs, Landrigan et al. estimated the total national environmentally attributable fractional costs for lead poisoning, asthma, cancer and developmental disabilities in children to be $54.9 billion/year in 1997 dollars.
Massey and Ackerman (2003) used the Landrigan model to evaluate the environmentally attributable costs of childhood cancer, asthma, neurobehavioral disorders, lead poisoning, and birth defects in Massachusetts. While both Landrigan et al. and Massey & Ackerman used similar methodology, they differed in the sources of health information and economic assumptions used.
Several other studies have utilized the methodology of both Landrigan et al. and Massey & Ackerman to evaluate the environmentally attributable costs of childhood and adult disease and disability in Washington (Davis & Hauge, 2005), Montana (Seninger, 2005), and for children only in Minnesota (Schuler et al., 2006).