Suchergebnisse

Context: Obesityanddiabetes are epidemic in the European Union(EU). Exposure to endocrine-disrupting chemicals (EDCs) is increasingly recognized as a contributor, independent of diet and physical activity. Objective: The objective was to estimate obesity, diabetes, and associated costs that can be reasonably attributed to EDC exposures in the EU. Design: An expert panel evaluated evidence for probability of causation using weight-of-evidence characterization adapted from that applied by the Intergovernmental Panel on Climate Change. Exposureresponse relationships and reference levels were evaluated for relevant EDCs, and biomarker data were organized from peer-reviewed studies to represent European exposure and burden of disease. Cost estimationas of2010utilized published cost estimates for childhood obesity, adult obesity, and adult diabetes. Setting, Patients and Participants, and Intervention: Cost estimation was performed from the societal perspective. Results: The panel identified a 40% to 69% probability of dichlorodiphenyldichloroethylene causing 1555 cases of overweight atage10 (sensitivity analysis: 1555-5463) in 2010 with associated costs of£24.6 million (sensitivity analysis:£24.6-86.4 million). A 20% to 39% probability was identified for dichlorodiphenyldichloroethylene causing 28 200 cases of adult diabetes (sensitivity analysis: 28 200-56 400) with associated costs of£835million (sensitivity analysis:£835million-16.6 billion).Thepanel also identifieda40%to69% probability of phthalate exposure causing 53 900 cases of obesity in older women and £15.6 billion in associated costs. Phthalate exposure was also found to have a 40% to 69% probability of causing 20 500 new-onset cases of diabetes in older women with £607 million in associated costs. Prenatal bisphenol A exposure was identified to have a 20% to 69% probability of causing 42 400 cases of childhoodobesity, with associated lifetime costs of £1.54 billion. Conclusions: EDC exposures in the EU contribute substantially to obesity and diabetes, with a moderate probability of >£18 billion costs per year. This is a conservative estimate; the results emphasize the need to control EDC exposures.

Copyright © 2015 by the Endocrine Society. Context: Obesityanddiabetes are epidemic in the European Union(EU). Exposure to endocrine-disrupting chemicals (EDCs) is increasingly recognized as a contributor, independent of diet and physical activity. Objective: The objective was to estimate obesity, diabetes, and associated costs that can be reasonably attributed to EDC exposures in the EU. Design: An expert panel evaluated evidence for probability of causation using weight-of-evidence characterization adapted from that applied by the Intergovernmental Panel on Climate Change. Exposureresponse relationships and reference levels were evaluated for relevant EDCs, and biomarker data were organized from peer-reviewed studies to represent European exposure and burden of disease. Cost estimationas of2010utilized published cost estimates for childhood obesity, adult obesity, and adult diabetes. Setting, Patients and Participants, and Intervention: Cost estimation was performed from the societal perspective. Results: The panel identified a 40% to 69% probability of dichlorodiphenyldichloroethylene causing 1555 cases of overweight atage10 (sensitivity analysis: 1555-5463) in 2010 with associated costs of£24.6 million (sensitivity analysis:£24.6-86.4 million). A 20% to 39% probability was identified for dichlorodiphenyldichloroethylene causing 28 200 cases of adult diabetes (sensitivity analysis: 28 200-56 400) with associated costs of£835million (sensitivity analysis:£835million-16.6 billion).Thepanel also identifieda40%to69% probability of phthalate exposure causing 53 900 cases of obesity in older women and £15.6 billion in associated costs. Phthalate exposure was also found to have a 40% to 69% probability of causing 20 500 new-onset cases of diabetes in older women with £607 million in associated costs. Prenatal bisphenol A exposure was identified to have a 20% to 69% probability of causing 42 400 cases of childhoodobesity, with associated lifetime costs of £1.54 billion. Conclusions: EDC exposures in the EU contribute substantially to obesity and diabetes, with a moderate probability of >£18 billion costs per year. This is a conservative estimate; the results emphasize the need to control EDC exposures.

Human biomonitoring (HBM) monitors levels of environmental pollutants in human samples, which often is a topic of concern for residents near industrially contaminated sites (ICSs). Around an ICS area in Menen (Belgium), including a (former) municipal waste incinerator and a metal recovery plant, increasing environmental concentrations of dioxins and polychlorinated biphenyls (PCBs) were observed, causing growing concern among residents and authorities. The local community succeeded in convincing the responsible authorities to investigate the problem and offer research funding. Persistent organic pollutants (POPs) were measured in two consecutive HBM studies (2002-2006 and 2010-2011), in the context of the Flemish Environment and Health Study (FLEHS), as well as in soil and locally produced food. Meanwhile, local authorities discouraged consumption of locally produced food in a delineated area of higher exposure risk. Ultimately, HBM and environmental data enabled tailored dietary recommendations. This article demonstrates the usefulness of HBM in documenting the body burdens of residents near the ICS, identifying exposure routes, evaluating remediating actions and providing information for tailored policy strategies aiding to further exposure reduction. It also highlights the role of the local stakeholders as an example of community-based participatory research and how such an approach can create societal support for research and policy. ; Funding: The HBM studies were conducted within the framework of the Flemish Center of Expertise on Environment and Health (FLEHS 2002–2006 and 2007–2011), funded by the Flemish Government, Department of Environment & Spatial Development, Flemish Planning Bureau for the Environment and Spatial Development (formally: Department of Environment, Nature & Energy); Department of Economics, Science and Innovation and the Flemish Agency for Care and Health. The scienceto-policy process of the HBM results was funded by the Department of Environment & Spatial Development, Flemish Planning Bureau for the Environment and Spatial Development (formally: Department of Environment, Nature & Energy) and the Flemish Agency for Care and Health. The egg study was funded by the Government of Flanders, Department of Environment & Spatial Development, Flemish Planning Bureau for the Environment and Spatial Development (formally: Department of Environment, Nature & Energy); the Flemish Agency for Care and Health and the Flanders Environment Agency. The views expressed herein are those of the author(s) and are not necessarily endorsed by the Flemish Government. Acknowledgments: The authors wish to express their gratitude to the participants of the studies for their cooperation and to the study nurses and study fieldworkers for their contribution to the study. We also thank the SGS laboratory for collection and analysis of the egg samples and Josworld for designing the leaflet on dietary recommendations for consumption of home-produced eggs.