Exposure to Hormone-Disrupting Chemicals Results in Huge Cost for EU

A recent series of studies published in the Endocrine Society’s Journal of Clinical Endocrinology and Metabolism found human exposure to endocrine disrupting chemicals (EDCs) contributes to adverse health effects and disabilities, costing the European Union (EU) an estimated €157 billion (US$209 billion) in actual health costs and lost earnings per year. The high-end cost estimate of the disease burden from EDCs is €270 billion (US$359 billion) per year, or two percent of Europe’s GDP.

The research concluded thirteen chronic conditions have strong evidence for causation by EDCs, which interfere, mimic, or block natural hormones. Links to infertility, birth defects, obesity, diabetes, cardiovascular disease, and neurological disorders including autism and Attention Deficit Hyperactivity Disorder (ADHD) were established; other conditions such as endometriosis, breast cancer, and fibroids were not included but will be the subject of future research.

Limiting exposure to hormone disrupting chemicals could reduce economic cost, according to the authors. The highest economic impact was from pesticides (€120 billion; US$132.3 billion), followed by chemicals found in plastics (€26 billion; US$28.7 billion) and flame-retardants (€9 billion; US$9.9 billion). Flame-retardants can cause intellectual disabilities, testicular cancer, and undescended testis in children, and are often found in electronics, furniture, and mattresses.


The largest estimated cost driver was mental disabilities caused by prenatal exposure to organophosphates from pesticides; 13 million lost IQ points and 59,300 additional cases of intellectual disability cost society between €46.8 billion (US$62.2 billion) and €195 billion (US$259.3 billion) a year.

The cost analysis approach “has the potential to inform decision-making in the environmental health arena. We are hoping to bring the latest endocrine science to the attention of policymakers as they weigh how to regulate these toxic chemicals,” said  Phillipe Grandjean, MD, PhD, Professor of Environmental Medicine at the University of Southern Denmark, Adjunct Professor at the Harvard T.H. Chan School of Public Health, and co-author of the study. In Europe, 2009 and 2011 laws placed limits on pesticides and biocides with endocrine-disrupting properties that may have harmful health and environmental effects.

Adult obesity linked to phthalate exposure represented the second-highest total cost, generating €15.6 billion (US$20.7 billion) a year. Phthalates are commonly found in food packaging and other plastics. Obesogens in plastics, such as bisphenol A (BPA), can migrate into foods in small amounts and trigger weight gain. The EU banned the use of BPA in baby bottles and children’s toys in 2011, but the chemical is still used in other products to manufacture plastics and resin, and persists in the environment due to disposal of high volumes of plastic products.

The study linked at least five percent of autism cases in Europe to EDC exposure.

However, measuring fetal exposure to chemicals after birth is difficult and that figure could be underestimating the true association, according to Grandjean. “I would recommend that pregnant women and children eat organic fruits and vegetables and avoid using plastic containers and canned food, especially in the microwave, because containers are usually treated on the inside with substances and compounds that can leak into the tomato soup and may act as endocrine disruptors,” he said. “The shocking thing is that the major component of [the total cost burden] is related to the loss of brain function in the next generation.”

Study co-author Martine Bellanger, PhD, Professor of Health Economics at the EHESP French School of Public Health, presented the findings with Dr. Grandjean in March at the Endocrine Society’s 97th Annual Meeting & Expo in San Diego, CA, via webcast from Brussels, Belgium.Obesity and diabetes topped the clinical agenda of the meeting, which featured cutting-edge research from different sectors. "For many of us in the field, it's the premier meeting for both science and clinical reviews and new science presentations and networking," said steering committee chair Matthew Ringel, MD, from the Wexner Medical Center at Ohio State University.

The findings have global implications for disease burden and public health policy. “Although this analysis was limited to the European Union, the disease and cost burden of exposure is likely to be on the same order of magnitude in the United States and elsewhere in the world,” said Leonardo Trasande, MD, MPP, Associate Professor of Pediatrics, Environmental Medicine & Population Health at NYU Langone Medical Center. Data from the Centers for Disease Control and Prevention suggest the costs could be even higher in the United States.

The studies involved 18 of the world’s foremost experts on endocrines science. For more information, the series includes:

• “Estimating Burden and Disease Costs of Exposure to Endocrine Disrupting Chemicals in the European Union

• “Male Reproductive Disorders, Diseases and Costs of Exposure to Endocrine Disrupting Chemicals in the European Union

• “Obesity, Diabetes and Associated Costs of Exposure to Endocrine Disrupting Chemicals in the European Union

• “Neurobehavioral Deficits, Diseases and Associated Costs of Exposure to Endocrine Disrupting Chemicals in the European Union