Reducing Chemical Exposure Could Save Americans Hundreds of Billions of Dollars in Healthcare Costs

Recent studies agree: Chemical exposures have become a serious public health threat. While chemicals such as plasticizers make life more convenient, they’re a major contributor to ill health, costing the U.S. more than $340 billion each year in health care costs and lost productivity.1,2,3

Impaired brain development, lower IQs, behavior problems, infertility, birth defects, obesity, diabetes, uterine fibroids, endometriosis and precocious puberty are just a sampling of the many health problems linked to exposure to endocrine-disrupting chemicals (EDCs).

As noted by Dr. Leonardo Trasande, an associate professor at NYU Langone in New York City and co-author of the study:4

“Our research adds to the growing evidence on the tremendous economic as well as human health costs of endocrine-disrupting chemicals. This has the potential to develop into a much larger health and economic issue if no policy action is taken.”

Americans Are at Greater Risk of Toxic Exposures Than Europeans

In the European Union (EU) — where regulations are more stringent and exposure is less severe than in the U.S. — medical expenses associated with EDC exposure still amounts to a whopping $177.5 billion (€163 billion) annually, according to the most recent estimates.5

Women’s health problems alone, caused by EDCs, were recently found to cost the EU $1.5 billion (€1.4 billion) each year.6,7,8,9,10

The discrepancy between the U.S. and the EU suggests regulating endocrine-disrupting chemicals can indeed have a very significant and beneficial impact on health.

After all, the EU has a population of more than 510 million,11 whereas the U.S. has just under 325 million,12 yet the healthcare costs associated with chemical exposures in the U.S. is nearly double that of the EU.

Hazards and Costs of EDCs Are Likely Vastly Underestimated

Even more sobering: These costs are likely VASTLY underestimated, as only 5 percent of known endocrine disruptors were included in the cost analysis!

Already banned substances were also overlooked. This includes DDT and PCBs, even though these chemicals are known to persist in the environment and the human body for years if not decades, so that’s another source of underestimation of the problem.

For example, DDE, a breakdown product of the insecticide DDT has been linked to obesity and diabetes, both of which are at epidemic levels worldwide. Another case in point: A 2005 landmark study13 found a total of 287 chemicals — including PCBs and DDT — in the umbilical cord blood of infants born in the U.S.

Prenatal exposure to chemicals such as those identified in that study have been linked to everything from abnormal fetal development, diminished intelligence, behavior problems, infertility, abnormal sexual maturation, metabolic dysfunction and cancers later in life.14,15

Flame Retardants Account for Two-Thirds of Estimated Health Problems From EDCs

In Europe, where pesticide regulations are a bit laxer, pesticides were found to be the primary driver of disease. In the U.S. flame retardant chemicals are thought to be the primary culprits, accounting for as much as two-thirds of the health problems attributed to EDC exposure. As reported by Tech Times:16

“The difference in costs is largely attributed to the widespread use in the U.S. of a chemical mixture in furniture that make them less flammable.

This chemical blend called polybrominated diphenyl ethers [PBDE], which has been restricted in Europe since 2008, caused about 43,000 cases of intellectual disability in the U.S per year. In Europe, the cases were only 3,290.

PBDEs are also linked to a loss of 11 million IQ points in the U.S. per year and 873,000 lost IQ points in Europe.

‘EDC exposure in the USA contributes to disease and dysfunction, with annual costs taking up more than 2 percent of the GDP. Differences from the European Union suggest the need for improved screening for chemical disruption to endocrine systems and proactive prevention,’ the researchers wrote …”

In the U.S., the widespread use of flame retardants causes the loss of 11 million IQ points among the population, costing the country $268 billion annually.

Pesticide exposure claims another 1.8 million IQ points, adds 7,500 disability cases and another $44.7 billion in associated costs each year. As reported by Environmental Health News:17

“[Study co-author, Dr. Leonardo] Trasande said the study highlights the need to address endocrine disruptor exposure in the United States, especially as the country updates the federal Toxic Substances Control Act.

The 2016 updates to the act, which regulates both existing and new chemicals, contained no mention of endocrine disruption, Trasande said. Chemicals should be screened for any potential impacts to human hormones before they hit the marketplace, he added.

‘The cost of required testing is likely to be small when weighed against the $340 billion in costs we have identified as being related to exposure to [endocrine disrupting compounds],’ the authors wrote.”

Other Common EDCs: Bisphenol A and Bisphenol S

While flame retardants and pesticides topped the list in terms of their contribution to health problems — primarily through their impact on children’s developing brains, as they have the strongest neurological effects — many others pose serious health risks as well. Among the most pervasive are bisphenol A (BPA) and phthalates.

BPA is found in hard plastics such as reusable bottles and food containers, the lining of canned goods, cashier’s receipts, dental sealants and more. BPA is strongly associated with female health concerns, including polycystic ovarian syndrome (PCOS),18 a leading cause of infertility in women.

In response to consumer demand for BPA-free products, many manufacturers have switched to bisphenol S (BPS). But BPS appears to be just as toxic, if not more so, than BPA.19

In 2013, researchers at the University of Texas Medical Branch discovered that even minute concentrations — less than one part per trillion — of BPS can disrupt cellular functioning.20

Metabolic disorders like obesity, diabetes, and even cancer, are potential ramifications of such disruptions. BPS also appears to be significantly less biodegradable, and more heat-stable and photo-resistant, than BPA.

The Many Hazards of Phthalates

Phthalates are found in disposable water bottles, shower curtains, food packaging, vinyl gloves used during medical procedures and food preparation, vinyl flooring, household cleaners, cosmetics, personal care products and more.

The prevalence of phthalates in personal care products is thought to be the reason why women tend to have higher levels of phthalates in their system than men. Furniture, upholstery, mattresses and wall coverings can also contain phthalates. They’ve even been detected in infant formula and baby food (likely because they migrated from the packaging materials). They are also used as “inert” ingredients in pesticides.21

Phthalates are remarkably powerful hormone disruptors that have been linked to a wide array of adverse effects,22,23,24 including the feminization of males,25,26,27 reduced IQ in children,28,29 birth defects, PCOS, early or delayed puberty, miscarriage30 and preterm birth, neurodevelopmental delays, inattention, hyperactivity and symptoms of autism,31 asthma,32 allergies and respiratory problems.33

During pregnancy, an increased exposure to phthalates may alter the production of thyroid hormones in your unborn child,34 which are crucial for the proper development of your baby during your first trimester. Recent research has also linked higher levels of phthalates in your body to low vitamin D levels,35 which in turn increases your risk for depression,36,37 mental decline in older adults38 and chronic migraine headaches,39 to name just a few.

The Centers for Disease Control and Prevention (CDC) acknowledges that your risk of exposure comes from eating and drinking foods exposed to plastics and breathing phthalates in dust particles. Recent research confirms fast food is a significant source of phthalates,40 largely because restaurant workers use plastic gloves, drinks are poured through PVC tubing, and the food is served in paper or plastic containers or wrappers that contain phthalates.

Those who got at least 35 percent of their calories from fast food had nearly 24 percent higher levels of the phthalate DEHP and 39 percent higher DiNP in their urine compared to those who had not consumed any fast food in that time frame. Health effects associated with the two phthalates identified in this study include liver, kidney, lung and reproductive system damage and insulin resistance in adolescents.41

According to the National Toxicology Program (NTP), phthalates are also “reasonably considered to be a human carcinogen.” Despite that, they continue to be used in everyday products.42 Also, while not typically associated with clothing, a recent pilot study found that cotton and polyester fabrics pick up both flame retardant chemicals and phthalates from indoor air.43 When clothing carrying the chemicals are washed, the chemicals enter wastewater and are released into the environment.44

Toxic Burden Is Evident in Health Statistics

Health statistics suggest the toxic burden is becoming too great for children and adults alike, and warnings have been issued by a number of different organizations, agencies and health experts around the world in recent years.

According to Dr. Joseph E. Pizzorno, founding president of Bastyr University, toxins in the modern food supply are now “a major contributor to, and in some cases the cause of, virtually all chronic diseases.”45

David Bellinger, Ph.D., a professor of Neurology at Harvard Medical School, estimates Americans have lost a total of 16.9 million IQ points due to exposure to organophosphate pesticides.46

A recent report by the International Federation of Gynecology and Obstetrics warns that chemical exposures now represent a major threat to human health and reproduction.47,48,49

An Endocrine Society task force also recently issued a new scientific statement on endocrine-disrupting chemicals, noting that the health effects of hormone-disrupting chemicals are such that everyone needs to take proactive steps to avoid them.50,51

One in 5 cancers are thought to be due to environmental chemicals, and according to recent studies, miniscule amounts of chemicals amplify each other’s adverse effects when combined. Even more disturbing, the analysis found that the cumulative effects of non-carcinogenic chemicals can act in concert to synergistically produce carcinogenic activity — a finding that overturns and more or less nullifies conventional testing for carcinogens.52,53

The High Cost of Plastic Packaging

As noted in a recent cover story by C&EN,54 food manufacturers are using more plastic than ever, thereby generating an ever-increasing amount of plastic garbage. For example, some vegetables and many meats are individually sealed in polyethylene plastic nowadays — a practice that extends shelf-life.

Individually sealing cucumbers in plastic extends shelf life from three to 14 days, by retaining moisture. Individually vacuum-sealed steaks last for nearly a month, compared to about four days when packaged in polystyrene foam trays covered by a plastic film.

“Many industry critics think all these plastics are a bit much. ‘It’s so immensely curious how stupid modern packaging is,’ William McDonough, a designer and sustainability guru, told a greenbiz.com reporter a few years back.55

To McDonough and like-minded critics, flexible plastics, especially the newer multilayered films, are another excess of a throwaway society. They are much harder to recycle than the simpler metal, paper, and glass containers they replace. Too many of the new materials end up in landfills or bobbing around the ocean,” Alexander H. Tullo writes.

“The packaging industry, though, doesn’t think its products are so stupid. It sees plastics as a solution to another big environmental problem: food waste.”

The Economy of Plastics

While it’s hard to argue with the benefits, the use of plastic wrapping on food has significant environmental ramifications that simply cannot be ignored. In a recent report called “The New Plastics Economy: Rethinking the Future of Plastics,”56 the plastic waste problem is laid bare. In 2013:

78 million metric tons of plastic packaging was produced worldwide

Of that, 40 percent ended up in landfills

32 percent ended up in the environment, polluting land and sea. An estimated 150 million metric tons of plastics currently contaminate the world’s oceans. “Without significant action, there may be more plastic than fish in the ocean, by weight, by 2050,” the report warns

Only 28 percent of the plastic garbage was collected; half of which was recycled and the other half burned for energy

A mere 2 percent of the 78 million metric tons of plastic packaging was recycled into plastic food packaging

Another report, “Valuing Plastic: The Business Case for Measuring, Managing and Disclosing Plastic Use in the Consumer Goods Industry,”57,58 published in 2014, calculated the cost of plastic waste disposal and greenhouse gas emissions at $75 billion annually. As noted by Conrad MacKerron, senior vice president of As You Sow, a corporate responsibility group:59

“You have this highly engineered package that is used for maybe a few weeks, and then it sits for hundreds of years at a landfill. Whether you are an environmental advocate or not, it is a waste of materials that have significant value. That’s not good business.”

Leaked Emails Reveal Coca-Cola’s Plan to Fight Environmentally-Conscious Restrictions on Plastics and Plastic Chemicals

The food and beverage industries are the two primary contributors to the plastic waste problem, and evidence suggests at least some of these global leaders are far from amenable to making changes that might benefit our environment and health. In fact, emails that emerged during a recent Wikileaks dump reveal the extent to which Coca-Cola Europe is fighting, or preparing to fight, legislation that either protects human health or the environment, and that includes opposing:60

• BPA labeling and BPA restrictions or ban
• Regulations on plastic packaging
• Restrictions on use of plastic packaging
• Increased collection and recycling targets
• Environmental impact fees

What You Can Do to Avoid Toxic Chemicals

While the World Health Organization estimates that 1 in 4 deaths is related to living and working in a toxic environment,61,62,63,64your diet, personal care and common household products likely pose the most immediate risk to your and your family’s health. This is particularly true when it comes to EDCs such as plasticizers and flame retardant chemicals. As reported by Tech Times:65

“Researchers said that there are ways for people to limit exposure to endocrine-disrupting chemicals such as by eating organic food products, avoiding the use of pesticides at home, limiting the use of aluminum canned food as well as avoiding microwaving and dishwashing plastic.”

Indeed, repeated tests have confirmed that those who eat primarily organic foods tend to have far lower levels of toxins in their system. To limit your exposure to EDCs like PBDEs, phthalates and BPA/BPS, keep the following guidelines in mind when shopping for food, personal care and household products.

Avoid fast-food restaurant fare and processed goods. Eating a diet focused on locally grown, ideally organic and whole foods cooked from scratch will significantly limit your exposure to not only phthalates and BPA but also a wide array of other chemicals, including synthetic food additives and pesticides.	Use natural cleaning products or make your own. Besides phthalates, avoid those containing 2-butoxyethanol (EGBE) and methoxydiglycol (DEGME) — two toxic glycol ethers that can compromise your fertility and cause fetal harm.
Buy products that come in glass bottles rather than plastic or cans; be aware that even “BPA-free” plastics typically leach other endocrine-disrupting chemicals that are just as bad for you as BPA.	Switch to organic toiletries, including shampoo, toothpaste, antiperspirants and cosmetics. EWG’s Skin Deep database66 can help you find personal care products that are free of phthalates and other potentially dangerous chemicals.
Store your food and beverages in glass rather than plastic, and avoid using plastic wrap as it too contains phthalates that can migrate into your food (especially if you microwave food wrapped in plastic).	Replace your vinyl shower curtain with a fabric one or glass doors.
Use glass baby bottles and drinking bottles.	Replace feminine hygiene products (tampons and sanitary pads) with safer alternatives.
Filter your tap water for both drinking and bathing. If you can only afford to do one, filtering your bathing water may be more important, as your skin absorbs contaminants. Under the 1974 Safe Drinking Water Act, the EPA set a maximum contaminant level (MCL) for DEHP of 0.006 mg/dL, or 6 ppb.67 Note that the Safe Drinking Water Act regulates DEHP levels only for public water supplies, not for well water. Filtering your water is also important to limit exposure to atrazine and fluorinated firefighting chemicals,68 both of which are common drinking water contaminants in the U.S.	Look for fragrance-free products. One artificial fragrance can contain dozens of potentially toxic chemicals, including phthalates. Avoid fabric softeners and dryer sheets, which contain a mishmash of synthetic chemicals and fragrances.
If you have PVC pipes, you may have DEHP leaching into your water supply. If you have PVC pipe from before 1977, you will definitely want to upgrade to a newer material. This “early-era” PVC pipe can leach a carcinogenic compound called vinyl chloride monomer into your water. Alternatives to PVC for water piping include ductile iron, high-density polyethylene, concrete, copper and PEX.69	Consider replacing vinyl flooring with a “greener” material. Also avoid soft, flexible plastic flooring, such as those padded play-mat floors for kids (often used in day cares and kindergartens), as there’s a good chance it is made from phthalate-containing PVC.
Read the labels and avoid anything containing phthalates. Besides DEHP, also look for DBP (di-n-butyl phthalate), DEP (diethyl phthalate), BzBP (benzyl butyl phthlate) and DMP (dimethyl phthalate). Also be wary of anything listing a “fragrance,” which often includes phthalates.	Make sure your baby’s toys are BPA-free, such as pacifiers, teething rings and anything your child may be prone to suck or chew on — even books, which are often plasticized. It’s advisable to avoid all plastic, especially flexible varieties