Childhood lead exposure in France: benefit estimation and partial cost-benefit analysis of lead hazard control.
Childhood lead exposure in France: benefit estimation and partial cost-benefit analysis of lead hazard control.
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法国儿童铅暴露：铅危害控制的效益估计和部分成本效益分析。
DOI：
10.1186/1476-069x-10-44
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发表时间：
2011-05-20
期刊：
影响因子：
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通讯作者：
Grandjean P
中科院分区：
文献类型：
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作者：
Pichery C;Bellanger M;Zmirou-Navier D;Glorennec P;Hartemann P;Grandjean P
铅暴露仍然是一个公共卫生问题，因为它具有严重的不利影响，如认知和行为障碍：6岁以下的儿童是最脆弱的人群。在欧洲，尚未详细审查与铅有关的经济影响。我们估计在法国由于儿童暴露的年度成本，并通过成本效益分析（CBA），旨在评估预期的社会和经济效益的暴露减少。货币效益是根据避免的国家成本来评估的。我们使用了2008年法国1至6岁儿童血铅（B-Pb）浓度调查的结果。由于没有确定阈值浓度，我们进行了敏感性分析，假设毒性高于15 μg/L、24 μg/L和100 μg/L的不同假设阈值。基于文献数据，将铅暴露的不良健康后果转化为社会负担和经济成本。包括直接的健康效益、社会效益和无形的避免成本。污染物接触控制的成本部分估算涉及家庭铅基油漆去污、旨在减少工业铅排放的投资和拆除所有铅饮用水管道。2008年三个假设阈值的年度总效益分别为：227.2亿欧元、107.2亿欧元和4.4亿欧元。减排成本从9亿欧元到29.5亿欧元不等。最后，根据土壤和灰尘中铅控制的部分CBA，三个假设的B-Pb效应值的总净效益估计分别为37.8亿欧元、18.8亿欧元和2.5亿欧元。预防儿童铅暴露具有很高的社会效益，因为B-Pb浓度分别降低到15 μg/L或24 μg/L以下。仅减少100微克/升以上的硼-铅接触量几乎没有经济影响，因为现在表现出如此高接触水平的儿童人数很少。审慎的公共政策将有助于避免未来的医疗干预，限制对特殊教育的需求，提高未来的生产力，从而增加接触铅的儿童的终身收入。
Lead exposure remains a public health concern due to its serious adverse effects, such as cognitive and behavioral impairment: children younger than six years of age being the most vulnerable population. In Europe, the lead-related economic impacts have not been examined in detail. We estimate the annual costs in France due to childhood exposure and, through a cost benefit analysis (CBA), aim to assess the expected social and economic benefits of exposure abatement. Monetary benefits were assessed in terms of avoided national costs. We used results from a 2008 survey on blood-lead (B-Pb) concentrations in French children aged one to six years old. Given the absence of a threshold concentration being established, we performed a sensitivity analysis assuming different hypothetical threshold values for toxicity above 15 μg/L, 24 μg/L and 100 μg/L. Adverse health outcomes of lead exposure were translated into social burden and economic costs based on literature data from literature. Direct health benefits, social benefits and intangible avoided costs were included. Costs of pollutant exposure control were partially estimated in regard to homes lead-based paint decontamination, investments aiming at reducing industrial lead emissions and removal of all lead drinking water pipes. The following overall annual benefits for the three hypothetical thresholds values in 2008 are: €22.72 billion, €10.72 billion and €0.44 billion, respectively. Costs from abatement ranged from €0.9 billion to 2.95 billion/year. Finally, from a partial CBA of lead control in soils and dust the estimates of total net benefits were € 3.78 billion, € 1.88 billion and €0.25 billion respectively for the three hypothesized B-Pb effect values. Prevention of childhood lead exposure has a high social benefit, due to reduction of B-Pb concentrations to levels below 15 μg/L or 24 μg/L, respectively. Reducing only exposures above 100 μg/L B-Pb has little economic impact due to the small number of children who now exhibit such high exposure levels. Prudent public policies would help avoiding future medical interventions, limit the need for special education and increase future productivity, and hence lifetime income for children exposed to lead.