Connecting the dots between BPA and U.S. health care costs

The incidence of chronic disease, use of synthetic chemicals, and evidence that many of them have human health impacts have grown during the past few decades.  So has U.S. health care spending (an eightfold increase since the 1960s).   As Philip Landrigan, BPA sourcesChairman of the Department of Preventative Medicine at Mount Sinai School of Medicine observes in a recent Huffington Post article, “We know that these chemicals are reaching people.  We know that chemicals can cause disease.  Those diseases cost money.”

A new study published in this month’s Health Affairs calculates the medical costs for BPA- associated disease and is the opening salvo in connecting the dots between environmental exposures and U.S. health care costs.  Here’s the abstract:

BPA sippy cupThere is mounting evidence that bisphenol A (BPA), a chemical used in the production of polycarbonate plastics and the linings of aluminum cans, may have adverse health consequences. The Food and Drug Administration has banned BPA from baby bottles and sippy cups but has deferred further action on other food uses—that is, uses in metal-based food and beverage containers. This article quantifies the potential social costs of childhood obesity and adult coronary heart disease attributable to BPA exposure in the United States in 2008 and models the potential health and economic benefits associated with replacing BPA in all food uses. BPA exposure was estimated to be associated with 12,404 cases of childhood obesity and 33,863 cases of newly incident coronary heart disease, with estimated social costs of $2.98 billion in 2008. Removing BPA from food uses might prevent 6,236 cases of childhood obesity and 22,350 cases of newly incident coronary heart disease per year, with potential annual economic benefits of $1.74 billion (sensitivity analysis: $889 million–$13.8 billion per year). Although more data are needed, these potentially large health and economic benefits could outweigh the costs of using a safer substitute for BPA.

Read here for reaction by the FDA (which currently bans BPA from baby bottles and children’s sippy cups) and industry.

Meanwhile, on the “mounting evidence” score, more study results have been reported how to avoid BPAlinking BPA to specific diseases.  For example, this study concluded that exposure to low levels of BPA during early development may make men more susceptible to prostate cancer later in life.  It is the first one to link early-life BPA exposure to human prostate cancer, but is among a growing number that suggest exposure to even small amounts of the chemical alters cells and thereby leads to disease as people age.  The National Cancer Institute estimates that prostate cancer is the second leading cause of cancer-related death in U.S. men, with about 15% percent of all men at risk of being diagnosed with it.  “Overall I think this is some of the strongest and most convincing evidence to date linking early-life BPA exposure and cancer,” said Heather Patisaul, a researcher at North Carolina State University who was not involved in the study, noting that the researchers paid careful attention to making “the exposures human relevant, [and] used cells derived from healthy humans and replicated physiological conditions seen in aging men.”  For industry’s response to this study (in particular, its methods), read this edition of Environmental Health News.

An Environmental Health News link cites to over 60 studies it reported in 2013 and thus far in 2014 covering a range of environmental health topics, from a study concluding that women exposed to low levels of lead are more likely to experience early menopause, to one that estimates 6% of lung cancer deaths in the United States and the United Kingdom – 11,000 deaths per year – may result from diesel exhaust.  BPA was the focus of 8 of those 61 reports.

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