A First Environmental Burden Of Disease Assessment For Children And Adolescents In Germany

Abstract

Introduction: Environmental Burden of Disease (EBD) estimates are increasingly used by scientists to inform policy decision-makers about major environmental drivers causing ill-health. Currently no up-to-date national estimates of the EBD are available for Germany and existing estimates have not been generated with current state of the Global Burden of Disease methodology. Especially children and adolescents represent a group strongly vulnerable to environmental hazards. Consequently, the aim of the study is to estimate the EBD for 16 risk factors in children, aged 3-17 years, in Germany. Methods: The study is based on the standardized EBD methodology and its core measure, the disability-adjusted life year (DALY). The current exposure of children and adolescents will be quantified by human biomonitoring and environmental measurement data gathered in the currently ongoing, population-representative German Environmental Survey (GerES 2014-2017). For risk factors with cumulative chronic effects and long lag periods, probabilistic models, based on past trends, will be set up to estimate the future exposure and associated health outcomes. Results: Earlier studies identified particulate matter and second-hand-smoke as important risk factors for the German population. In this study we will update and reevaluate existing estimates and add new information on e.g. ultrafine particles, environmental noise, introduce evidence about newly identified carcinogenic effects of lead and include endocrine disruptors. Further, the study will also evaluate the economic burden caused by particulate matter pollution. Discussion: Even though children and adolescents presently seem to be a quite healthy segment of the society, they are particularly susceptible for the effects of environmental pollutants which can cause disease burden in their future life. The tailored methods and assumptions will shed additional light on the disease burden of one of the most vulnerable population groups.