Plastic chemicals linked to $249 billion in US health care costs in 2018 alone, study finds

By Sandee LaMotte, CNN

(CNN) — By contributing to the development of chronic disease and death, a group of hormone-disruptive plastic chemicals is costing the US health care system billions — over $249 billion in 2018 alone, a new study found.

“The real contribution of this work is helping the public understand how much of the human health threat of endocrine-disrupting chemicals is due to plastics,” said lead author Dr. Leonardo Trasande, a professor of pediatrics and population health at NYU Langone Health in New York City.

“We’re talking about cancer. We’re talking about brain damage in young children. We’re talking about obesity and diabetes, heart disease and early deaths in adults,” Trasande said. “Right now, the United States is not considering the costs to its own population of industries which continue to produce and consume plastic in the US.”

While estimates of the health costs of plastics have been done in the past, the new study provides a “a better understanding of both potential exposure routes but also potential targets for solutions,” said researcher Bethanie Carney Almroth, professor of ecotoxicology and environmental science at the University of Gothenburg in Sweden.

“And since money talks, this could be a powerful tool in helping people, from consumers to policy makers, in understanding the importance of regulating these chemicals,” said Carney Almroth in an email. She was not involved in the research.

Hopefully the new study can initiate a societal discussion about the use of plastics and the related health risks, said Jane Muncke, managing director and chief scientific officer at the Food Packaging Forum, a nonprofit foundation based in Zurich focused on science communication and research. She, too, was not involved with the new study.

“These health costs are currently paid for by society and by the individuals who suffer from the diseases, while the plastics manufacturers and businesses that use plastics for their products make handsome profits,” Muncke said.

“This seems very unjust, and hopefully this study can initiate a discussion about true cost accounting — according to ‘the polluter pays’ principle,” she said in an email.

CNN reached out to the American Chemistry Council for comment. The council, which represents US chemical, plastics and chlorine industries, told CNN that companies are dedicated to protecting “public health and our environment.”

“We have not had the chance to thoroughly review this new report, but we consistently advocate for the use of sound scientific and economic research and data when discussing the business, use, and regulation of chemistry. Establishing a causal relationship between chemical exposure and human disease and thoroughly characterizing human exposures from plastics are challenging (but necessary) elements to any health cost analysis, as are quantifications of health benefits to provide context.”

A handful of chemicals

The new research analyzed the impact of four groups of chemicals used in the production of plastic products: Flame retardants called polybrominated diphenyl ethers, or PBDE; phthalates, which are used to make plastic more durable; bisphenols such as BPA and BPS used to create hard plastics and resins; and per- and polyfluoroalkyl substances, also known as PFAS.

However, these are just a fraction of the chemicals used to make plastics. A United Nations report published in May found more than 13,000 chemicals are used in plastics production.

“There are over 16 thousand chemicals used to make plastics or present in finished plastic products, as a new report will show that we are publishing in the next couple of months,” Muncke said via email. “If there were data available on all of these 16 thousand plastic chemicals, I am convinced that the actual associated health costs would be far higher.”

Of those 16,000 chemicals, more than 3,000 are known to have hazardous properties, but close to 10,000 lack data, Carney Almroth said.

“To my mind, that is absolutely insane,” she said. “We don’t know what is in these products, we don’t know who is being exposed to what, we don’t know the implications of those exposures.”

Decades of research

The four chemicals measured in the new study, however, have been widely studied over years and decades, experts say. All are thought to interfere with the body’s mechanism for hormone production, known as the endocrine system, and cause damage to developmental, reproductive, immune and cognitive systems, the report said.

“The biggest impact of endocrine-disrupting chemicals is on children’s brain development because they disrupt thyroid hormones in pregnancy, which is crucial to that development,” Trasande said.

Flame retardants: Most of the health cost burden in the report — $159 billion — was from exposure to PBDE flame retardants, which scientists say can settle and remain for long periods in fat and other tissues in the body. The US Environmental Protection Agency is “concerned” that certain flame retardants “are persistent, bioaccumulative, and toxic to both humans and the environment.”

“The critical endpoint of concern for human health is neurobehavioral effects,” the agency said. “Because these chemicals are not chemically bound to plastics, foam, fabrics, or other products in which they are used, making them more likely to leach out of these products.”

Phthalates: This family of chemicals accounted for $67 billion of the health care costs in 2018, according to the study. Phthalates have been connected in studies with reproductive problems, such as genital malformations and undescended testes in baby boys and lower sperm counts and testosterone levels in adult males. Other studies have linked phthalates to childhood obesity, asthma, cardiovascular issues and cancer.

Phthalates are found in hundreds of consumer products, including food storage containers, shampoo, makeup, perfume and children’s toys. The synthetic chemicals may contribute to some 91,000 to 107,000 premature deaths a year among people ages 55 to 64 in the US, according to an October 2021 study.

Bisphenols: Exposure to bisphenols accounted for $1 billion in 2018 health care costs, the study found. These chemicals are found in eyewear and water bottles, and they may coat some metal food cans, bottle tops and water supply pipes.

The chemical BPA has been linked to fetal abnormalities, low birth weight, and brain and behavior disorders in infants and children. In adults, BPA has been linked to diabetes, heart disease, cancer, obesity and erectile dysfunction.

Premature death was also associated with BPA exposure, a 2020 study found. People who had higher levels of bisphenol A in their urine were about 49% more likely to die during a 10-year period.

Per- and polyfluoroalkyl substances: Exposure to PFAS chemicals was associated in the study with $22 billion in health care costs. Carpets, couches, nonstick cookware, stain-resistant clothes, cell phones, cosmetics, the lining of fast-food wrappers — the list of popular products that contain PFAS are numerous and nearly impossible to avoid.

In a 300-plus-page report, the prestigious National Academies of Sciences, Engineering, and Medicine found “sufficient” scientific evidence of an association between PFAS and an increased risk of adult kidney cancer and abnormally high cholesterol levels. Exposure to PFAS was also associated with decreased infant and fetal growth as well as decreased antibody response to vaccines in both adults and children, according to the 2022 report.

The report recommended blood tests for people at high risk such as firefighters, workers in fluorochemical manufacturing plants, and those who live near commercial airports, military bases, landfills, incinerators, wastewater treatment plants and farms where contaminated sewage sludge is used.

People in “vulnerable life stages” — such as during fetal development in pregnancy, early childhood and old age — are at high risk, the report said.

Depending on the levels found in blood, doctors should look for signs of testicular cancer and ulcerative colitis and test thyroid and kidney function at all wellness visits, the report said. In addition, doctors should prioritize screening for cholesterol, breast cancer and hypertension during pregnancy.

“The authors (of the new study) chose to focus on the endocrine disrupting effects of the selected plastic chemicals — these are undoubtedly important, but I am also very concerned about the presence of MANY known carcinogens that are used to make plastics and that leach from plastics,” Muncke said.

“Our own work has shown that most of the plastic chemicals with hazard data available (about 25% of the 16 thousand) are … carcinogenic, mutagenic or toxic for reproduction,” Muncke said in an email. “Hopefully this study can be used as stepping stone to also develop cost estimates for the incidence of cancers.”

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