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Knowns and unknowns on burden of disease due to chemicals: a systematic review.

Prüss-Ustün A, Vickers C, Haefliger P, Bertollini R - Environ Health (2011)

Bottom Line: These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively.The known burden due to chemicals is considerable.These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden.

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Affiliation: Department of Public Health and Environment, World Health Organization, av. Appia 20, 1211 Geneva 27, Geneva, Switzerland. pruessa@who.int

ABSTRACT

Background: Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed.

Methods: A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease.

Results: In total, 4.9 million deaths (8.3% of total) and 86 million Disability-Adjusted Life Years (DALYs) (5.7% of total) were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively.

Conclusions: The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels.

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Human exposure to chemicals throughout their life-cycle and selected programmes relevant to their prevention
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Figure 1: Human exposure to chemicals throughout their life-cycle and selected programmes relevant to their prevention

Mentions: Their chemical, physical and toxicological properties vary greatly - while many are not hazardous or persistent, some are life-threatening on contact and some persist in the environment, accumulate in the food chain, travel large distances from where they are released, and are harmful to human health in small amounts. Human exposure can occur at different stages of the life-cycle of a chemical, including through occupational exposure during manufacture, use and disposal, consumer exposure, exposure to contaminated products, or environmental exposure to toxic waste (Figure 1). Exposure can occur via various pathways, including inhalation of contaminated air and dust, ingestion of contaminated water and food, dermal exposure to chemical or contaminated products, or fetal exposure during pregnancy (Table 1). Further information on human exposure to chemicals is available from a variety of documents [1-4]. As illustrated in Figure 1, several sectors and programmes have a role to play in preventing human exposure to chemicals and promoting their sound management throughout their life cycle, including health, environment, agriculture, energy and transport sectors, and water, food and chemical safety programmes.


Knowns and unknowns on burden of disease due to chemicals: a systematic review.

Prüss-Ustün A, Vickers C, Haefliger P, Bertollini R - Environ Health (2011)

Human exposure to chemicals throughout their life-cycle and selected programmes relevant to their prevention
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3037292&req=5

Figure 1: Human exposure to chemicals throughout their life-cycle and selected programmes relevant to their prevention
Mentions: Their chemical, physical and toxicological properties vary greatly - while many are not hazardous or persistent, some are life-threatening on contact and some persist in the environment, accumulate in the food chain, travel large distances from where they are released, and are harmful to human health in small amounts. Human exposure can occur at different stages of the life-cycle of a chemical, including through occupational exposure during manufacture, use and disposal, consumer exposure, exposure to contaminated products, or environmental exposure to toxic waste (Figure 1). Exposure can occur via various pathways, including inhalation of contaminated air and dust, ingestion of contaminated water and food, dermal exposure to chemical or contaminated products, or fetal exposure during pregnancy (Table 1). Further information on human exposure to chemicals is available from a variety of documents [1-4]. As illustrated in Figure 1, several sectors and programmes have a role to play in preventing human exposure to chemicals and promoting their sound management throughout their life cycle, including health, environment, agriculture, energy and transport sectors, and water, food and chemical safety programmes.

Bottom Line: These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively.The known burden due to chemicals is considerable.These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Public Health and Environment, World Health Organization, av. Appia 20, 1211 Geneva 27, Geneva, Switzerland. pruessa@who.int

ABSTRACT

Background: Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed.

Methods: A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease.

Results: In total, 4.9 million deaths (8.3% of total) and 86 million Disability-Adjusted Life Years (DALYs) (5.7% of total) were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively.

Conclusions: The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels.

Show MeSH
Related in: MedlinePlus