A study by ibs.GRANADA quantifies for the first time the cost of exposure to chemical contaminants for the health system
Subjects with high levels in their body of a compound called Hexachlorobenzene (HCB) spend an average of 65 euros more annually on primary care than people with low concentrations
Scientists from the Biosanitary Research Institute (ibs.GRANADA) and the University of Granada warn that, although the cost per contaminant may not seem very high, exposure could have enormous repercussions at the population level due to the large number of substances to which to which most of the population is exposed and to the high prevalence of potentially related diseases
Scientists from the Group of Preventive Medicine and Public Health of the Biosanitary Research Institute (ibs.GRANADA) and the University of Granada have quantified for the first time the individual cost for the Spanish public health system associated with long-term exposure to environmental pollutants. The study analyzed the levels of pollutants accumulated in the body of 385 adults residing in the province of Granada, as well as the cost derived from the healthcare received in the Andalusian public healthcare system over the 14 years after the start of the study.
The researchers found that primary care health spending was significantly higher in people who had accumulated higher levels of chemical contaminants in their bodies, regardless of their age, sex, degree of obesity, or residence. This expense was represented above all by medical prescriptions, consultations and diagnostic tests.
Interestingly, participants with high levels of a compound called Hexachlorobenzene (HCB) spent an average of 65 euros more annually on primary care than people with low concentrations. HCB was used as a fungicide in Spain until the 80s and is also generated unintentionally in combustion processes. However, HCB and other pollutants studied belong to the family of Persistent Organic Pollutants, which are highly resistant to degradation and accumulate in living beings. In fact, "it should be noted that practically all of us have detectable levels of Persistent Organic Pollutants in our bodies, but the internal concentrations vary greatly between people depending on their lifestyle, which once again highlights the importance lifestyle," says Juan Pedro Arrebola, a researcher at the Department of Preventive Medicine and Public Health at the University of Granada and principal investigator of the study.
Although, at first glance, the health expenditure associated with an individual pollutant may not seem very high, the authors point out that the entire population is exposed daily to hundreds of chemicals with similar mechanisms of action, so the implications at the population level could be very high.
The importance of this finding lies not only in the fact that primary care costs are very useful for resource planning and health policies, but also that they are global indicators of the burden of highly prevalent diseases that are usually monitored at this level. such as diabetes or cardiovascular disease, which imply a high cost for primary care. "In fact, this study corroborates the previous results of our research group in which we observed that exposure to these compounds was associated with an increased risk of diabetes or hypertension," says Arrebola.
Being the first study of its kind, the results require confirmation in subsequent studies, but they highlight the importance of integrating health economics as a tool in the context of epidemiological studies. This work is part of the larger study called GraMo, financed by research funds from the Carlos III Health Institute, and whose objective is to investigate exposure to environmental pollutants and their influence on the development of chronic diseases. The research team is currently working on quantifying the cost associated with other very ubiquitous pollutants, such as those derived from plastics, cosmetics and phytosanitary products, among others, as well as carrying out health examinations on all participants.
Researchers from many different disciplines have contributed to the GraMo study, belonging to the institute itself, the UGR and other institutions, such as the Andalusian School of Public Health, University of Malaga, as well as the Santa Ana de Motril hospitals and the San Cecilio and Virgen University Hospitals. of the Snows of Granada, among others.
The research is directed by Juan Pedro Arrebola Moreno, researcher and professor in the Department of Preventive Medicine and Public Health of the UGR, and has given rise to the doctoral thesis of the researcher of the same Department, Francisco Miguel Pérez Carrascosa.
Bibliographic reference:
Pérez-Carrascosa FM, Barrios-Rodríguez R, Gómez-Peña C, Salcedo-Bellido I, Velasco-García ME, Jiménez-Moleón JJ, García-Ruiz A, Navarro-Espigares JL, Requena P, Muñoz-Sánchez C, Arrebola JP . Public healthcare costs associated with long-term exposure to mixtures of persistent organic pollutants in two areas of Southern Spain: A longitudinal analysis. Environ Res. 2022 Oct;213:113609. doi: 10.1016/j.envres.2022.113609.