Economic evaluation of health consequences of prenatal methylmercury exposure in France

Céline Pichery,Anne Roue-Legall,Nadine Fréry,Martine Bellanger,Denis Zmirou-Navier,Philippe Grandjean,Sylvaine Cordier,Philippe Hartemann

doi:10.1186/1476-069x-11-53

Abstract

BackgroundEvidence of a dose–response relationship between prenatal exposure to methylmercury (MeHg) and neurodevelopmental consequences in terms of IQ reduction, makes it possible to evaluate the economic consequences of MeHg exposures.ObjectiveTo perform an economic evaluation of annual national benefits of reduction of the prenatal MeHg exposure in France.MethodsWe used data on hair-Hg concentrations in French women of childbearing age (18–45 years) from a national sample of 126 women and from two studies conducted in coastal regions (n = 161and n = 503). A linear dose response function with a slope of 0.465 IQ point reduction per μg/g increase in hair-Hg concentration was used, along with a log transformation of the exposure scale, where a doubling of exposure was associated with a loss of 1.5 IQ points. The costs calculations utilized an updated estimate of €2008 17,363 per IQ point decrement, with three hypothetical exposure cut-off points (hair-Hg of 0.58, 1.0, and 2.5 μg/g).ResultsBecause of higher exposure levels of women in coastal communities, the annual economic impacts based on these data were greater than those using the national data, i.e. € 1.62 billion (national), and € 3.02 billion and € 2.51 billion (regional), respectively, with the linear model, and € 5.46 billion (national), and € 9.13 billion and € 8.17 billion (regional), with the log model, for exposures above 0.58 μg/g.ConclusionsThese results emphasize that efforts to reduce MeHg exposures would have high social benefits by preventing the serious and lifelong consequences of neurodevelopmental deficits in children.

Highlights

Evidence of a dose–response relationship between prenatal exposure to methylmercury (MeHg) and neurodevelopmental consequences in terms of Intelligence Quotient (IQ) reduction, makes it possible to evaluate the economic consequences of MeHg exposures
These results emphasize that efforts to reduce MeHg exposures would have high social benefits by preventing the serious and lifelong consequences of neurodevelopmental deficits in children
We considered a third value based on updated findings from the prospective studies in the Faroes [36], which resulted in an exposure limit about 50% below the level recommended by the U.S National Research Council (NRC), corresponding to 0.58 μg/g hair, the lowest of the three reference values

Summary

Introduction

Evidence of a dose–response relationship between prenatal exposure to methylmercury (MeHg) and neurodevelopmental consequences in terms of IQ reduction, makes it possible to evaluate the economic consequences of MeHg exposures. Human exposure to methylmercury (MeHg) occurs primarily through ingestion of seafood and freshwater fish [1]. The first two concluded that chronic low-dose prenatal MeHg exposure from maternal consumption of fish was associated with subtle end points of neurotoxicity in children [15]. Support for the notion of seafood-mediated MeHg neurotoxicity later emerged from the Seychelles [16]. Faroes investigators provided extended evidence of a dose–response relationship between prenatal MeHg exposure and lasting neurodevelopmental deficits [15,17,18]. Epidemiological studies in French Guiana [19,20,21] and in other parts of the world [2224] showed the effects of MeHg on childhood neurodevelopmental disorders. This research has prompted further studies focused on French populations, especially in coastal regions of western France [3,25]

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