Perfluorooctanoic acid and low birth weight: Estimates of US attributable burden and economic costs from 2003 through 2014

Julia Malits, Janice Blustein, Leonardo Trasande, Teresa M. Attina

Research output: Contribution to journalArticle

Abstract

Background and objective: In utero exposure to perfluorooctanoic acid (PFOA) has been associated with decreases in birth weight. We aimed to estimate the proportion of PFOA-attributable low birth weight (LBW) births and associated costs in the US from 2003 to 2014, a period during which there were industry-initiated and regulatory activities aimed at reducing exposure. Methods: Serum PFOA levels among women 18-49 years were obtained from the National Health and Nutrition Examination Survey (NHANES) for 2003-2014; birth weight distributions were obtained from the Vital Statistics Natality Birth Data. The exposure-response relationship identified in a previous meta-analysis (18.9. g decrease in birth weight per 1. ng/mL of PFOA) was applied to quantify PFOA-attributable LBW (reference level of 3.1. ng/mL for our base case, 1 and 3.9. ng/mL for sensitivity analyses). Hospitalization costs and lost economic productivity were also estimated. Results: Serum PFOA levels remained approximately constant from 2003-2004 (median: 3.3. ng/mL) to 2007-2008 (3.5. ng/mL), and declined from 2009-2010 (2.8. ng/mL) to 2013-2014 (1.6. ng/mL). In 2003-2004, an estimated 12,764 LBW cases (4% of total for those years) were potentially preventable if PFOA exposure were reduced to the base case reference level (10,203 cases in 2009-2010 and 1,491 in 2013-2014). The total cost of PFOA-attributable LBW for 2003 through 2014 was estimated at $13.7 billion, with $2.97 billion in 2003-2004, $2.4 billion in 2009-2010 and $347 million in 2013-2014. Conclusions: Serum PFOA levels began to decline in women of childbearing age in 2009-2010. Declines were of a magnitude expected to meaningfully reduce the estimated incidence of PFOA-attributable LBW and associated costs.

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perfluorooctanoic acid
Low Birth Weight Infant
Economics
Costs and Cost Analysis
Birth Weight
Serum
Parturition
Vital Statistics

Keywords

  • Economic costs
  • Low birth weight
  • NHANES
  • PFOA exposure

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

@article{d78488059f714b1091f474766fc4fbb7,
title = "Perfluorooctanoic acid and low birth weight: Estimates of US attributable burden and economic costs from 2003 through 2014",
abstract = "Background and objective: In utero exposure to perfluorooctanoic acid (PFOA) has been associated with decreases in birth weight. We aimed to estimate the proportion of PFOA-attributable low birth weight (LBW) births and associated costs in the US from 2003 to 2014, a period during which there were industry-initiated and regulatory activities aimed at reducing exposure. Methods: Serum PFOA levels among women 18-49 years were obtained from the National Health and Nutrition Examination Survey (NHANES) for 2003-2014; birth weight distributions were obtained from the Vital Statistics Natality Birth Data. The exposure-response relationship identified in a previous meta-analysis (18.9. g decrease in birth weight per 1. ng/mL of PFOA) was applied to quantify PFOA-attributable LBW (reference level of 3.1. ng/mL for our base case, 1 and 3.9. ng/mL for sensitivity analyses). Hospitalization costs and lost economic productivity were also estimated. Results: Serum PFOA levels remained approximately constant from 2003-2004 (median: 3.3. ng/mL) to 2007-2008 (3.5. ng/mL), and declined from 2009-2010 (2.8. ng/mL) to 2013-2014 (1.6. ng/mL). In 2003-2004, an estimated 12,764 LBW cases (4{\%} of total for those years) were potentially preventable if PFOA exposure were reduced to the base case reference level (10,203 cases in 2009-2010 and 1,491 in 2013-2014). The total cost of PFOA-attributable LBW for 2003 through 2014 was estimated at $13.7 billion, with $2.97 billion in 2003-2004, $2.4 billion in 2009-2010 and $347 million in 2013-2014. Conclusions: Serum PFOA levels began to decline in women of childbearing age in 2009-2010. Declines were of a magnitude expected to meaningfully reduce the estimated incidence of PFOA-attributable LBW and associated costs.",
keywords = "Economic costs, Low birth weight, NHANES, PFOA exposure",
author = "Julia Malits and Janice Blustein and Leonardo Trasande and Attina, {Teresa M.}",
year = "2018",
month = "3",
doi = "10.1016/j.ijheh.2017.11.004",
language = "English (US)",
journal = "International Journal of Hygiene and Environmental Health",
issn = "1438-4639",
publisher = "Urban und Fischer Verlag Jena",

}

TY - JOUR

T1 - Perfluorooctanoic acid and low birth weight

T2 - Estimates of US attributable burden and economic costs from 2003 through 2014

AU - Malits, Julia

AU - Blustein, Janice

AU - Trasande, Leonardo

AU - Attina, Teresa M.

PY - 2018/3

Y1 - 2018/3

N2 - Background and objective: In utero exposure to perfluorooctanoic acid (PFOA) has been associated with decreases in birth weight. We aimed to estimate the proportion of PFOA-attributable low birth weight (LBW) births and associated costs in the US from 2003 to 2014, a period during which there were industry-initiated and regulatory activities aimed at reducing exposure. Methods: Serum PFOA levels among women 18-49 years were obtained from the National Health and Nutrition Examination Survey (NHANES) for 2003-2014; birth weight distributions were obtained from the Vital Statistics Natality Birth Data. The exposure-response relationship identified in a previous meta-analysis (18.9. g decrease in birth weight per 1. ng/mL of PFOA) was applied to quantify PFOA-attributable LBW (reference level of 3.1. ng/mL for our base case, 1 and 3.9. ng/mL for sensitivity analyses). Hospitalization costs and lost economic productivity were also estimated. Results: Serum PFOA levels remained approximately constant from 2003-2004 (median: 3.3. ng/mL) to 2007-2008 (3.5. ng/mL), and declined from 2009-2010 (2.8. ng/mL) to 2013-2014 (1.6. ng/mL). In 2003-2004, an estimated 12,764 LBW cases (4% of total for those years) were potentially preventable if PFOA exposure were reduced to the base case reference level (10,203 cases in 2009-2010 and 1,491 in 2013-2014). The total cost of PFOA-attributable LBW for 2003 through 2014 was estimated at $13.7 billion, with $2.97 billion in 2003-2004, $2.4 billion in 2009-2010 and $347 million in 2013-2014. Conclusions: Serum PFOA levels began to decline in women of childbearing age in 2009-2010. Declines were of a magnitude expected to meaningfully reduce the estimated incidence of PFOA-attributable LBW and associated costs.

AB - Background and objective: In utero exposure to perfluorooctanoic acid (PFOA) has been associated with decreases in birth weight. We aimed to estimate the proportion of PFOA-attributable low birth weight (LBW) births and associated costs in the US from 2003 to 2014, a period during which there were industry-initiated and regulatory activities aimed at reducing exposure. Methods: Serum PFOA levels among women 18-49 years were obtained from the National Health and Nutrition Examination Survey (NHANES) for 2003-2014; birth weight distributions were obtained from the Vital Statistics Natality Birth Data. The exposure-response relationship identified in a previous meta-analysis (18.9. g decrease in birth weight per 1. ng/mL of PFOA) was applied to quantify PFOA-attributable LBW (reference level of 3.1. ng/mL for our base case, 1 and 3.9. ng/mL for sensitivity analyses). Hospitalization costs and lost economic productivity were also estimated. Results: Serum PFOA levels remained approximately constant from 2003-2004 (median: 3.3. ng/mL) to 2007-2008 (3.5. ng/mL), and declined from 2009-2010 (2.8. ng/mL) to 2013-2014 (1.6. ng/mL). In 2003-2004, an estimated 12,764 LBW cases (4% of total for those years) were potentially preventable if PFOA exposure were reduced to the base case reference level (10,203 cases in 2009-2010 and 1,491 in 2013-2014). The total cost of PFOA-attributable LBW for 2003 through 2014 was estimated at $13.7 billion, with $2.97 billion in 2003-2004, $2.4 billion in 2009-2010 and $347 million in 2013-2014. Conclusions: Serum PFOA levels began to decline in women of childbearing age in 2009-2010. Declines were of a magnitude expected to meaningfully reduce the estimated incidence of PFOA-attributable LBW and associated costs.

KW - Economic costs

KW - Low birth weight

KW - NHANES

KW - PFOA exposure

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