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Economic evaluation of health consequences of prenatal methylmercury exposure in France.doc

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Economic evaluation of health consequences of prenatal methylmercury exposure in France

Picheryetal.EnvironmentalHealth2012,11:53 /content/11/1/53 RESEARCH OpenAccess Economicevaluationofhealthconsequencesof prenatalmethylmercuryexposureinFrance CélinePichery1*,MartineBellanger1,DenisZmirou-Navier1,2,3,NadineFréry4,SylvaineCordier3,AnneRoue-LeGall1, PhilippeHartemann2,5andPhilippeGrandjean6,7 Abstract Background:Evidenceofadose–responserelationshipbetweenprenatalexposuretomethylmercury(MeHg)and neurodevelopmentalconsequencesintermsofIQreduction,makesitpossibletoevaluatetheeconomic consequencesofMeHgexposures. Objective:ToperformaneconomicevaluationofannualnationalbenefitsofreductionoftheprenatalMeHg exposureinFrance. Methods:Weuseddataonhair-HgconcentrationsinFrenchwomenofchildbearingage(18–45years)froma nationalsampleof126womenandfromtwostudiesconductedincoastalregions(n=161andn=503).Alinear doseresponsefunctionwithaslopeof0.465IQpointreductionperμg/gincreaseinhair-Hgconcentrationwas used,alongwithalogtransformationoftheexposurescale,whereadoublingofexposurewasassociatedwitha lossof1.5IQpoints.Thecostscalculationsutilizedanupdatedestimateof€2008 17,363perIQpointdecrement, withthreehypotheticalexposurecut-offpoints(hair-Hgof0.58,1.0,and2.5μg/g). Results:Becauseofhigherexposurelevelsofwomenincoastalcommunities,theannualeconomicimpactsbased onthesedataweregreaterthanthoseusingthenationaldata,i.e.€1.62billion(national),and€3.02billionand€ 2.51billion(regional),respectively,withthelinearmodel,and€5.46billion(national),and€9.13billionand€8.17 billion(regional),withthelogmodel,forexposuresabove0.58μg/g. Conclusions:TheseresultsemphasizethateffortstoreduceMeHgexposureswouldhavehighsocialbenefitsby preventingtheseriousandlifelongconsequencesofneurodevelopmentaldeficitsinchildren. Keywords:Economicevaluation,Methylmercury,Prenatalexposure,Neurodevelopmentaldeficits Background difficult to model [1]. Thus, risk assessment must rely Human exposure to methylmercury (MeHg) occurs pri- onbiomarkersoftotalhumanuptakes. marily t