What Is the Economic Impact of Endocrine-Disrupting Chemical Exposure?

Doctor holding a piggy bank
Doctor holding a piggy bank
Health care costs associated with endocrine-disrupting chemicals exceed €1 billion in the European Union.

Reproductive problems related to endocrine-disrupting chemical (EDC) exposure in women appear to be contributing substantially to health care expenditures and lost earning potential in Europe, according to study results published in the Journal of Clinical Endocrinology & Metabolism.

For this analysis, an expert panel adapted existing health care cost models to evaluate the economic impact of EDC exposure. Direct costs of hospital stays, physician services, and other medical costs, as well as indirect costs such as lost work productivity associated with the disorders, were included in the evaluation.

The researchers evaluated assessed probability of causation and exposure-response relationships and reference levels. They also organized biomarker data from peer-reviewed literature to delineate exposure and approximate burden of disease in Europe in 2010.

Due to the robust evidence linking diphenyldichloroethene (DDE) — a byproduct of the pesticide dichlorodiphenyltrichloroethane (DDT) — to uterine fibroids and phthalates — commonly found in plastics and cosmetics — to endometriosis, the panel limited the scope of its analysis to these conditions.

For causation of uterine fibroids by DDE exposure, the epidemiological and toxicological evidence supports a probability of causation of 20% to 39%, according to the researchers. The same probability was noted for causation of endometriosis by phthalate exposure.

Results revealed that an estimated 56 700 cases of uterine fibroids and 145 000 cases of endometriosis were attributable to EDCs across the European Union in 2010. Associated economic and health care costs were €163 million and €1.25 billion, respectively.

“The data shows that protecting women from exposure to endocrine-disrupting chemicals could substantially reduce rates of disease and lower health care and other social costs of these conditions,” study researcher Leonardo Trasande, MD, MPP, associate professor of pediatrics, environmental medicine, and population health at NYU Langone Medical Center, said in a press release.

This analysis was part of a series of economic analyses showing that EDC exposure may be costing the European Union more than €157 billion annually. Earlier studies looked at costs associated with infertility and male reproductive dysfunctions, birth defects, obesity, diabetes, cardiovascular disease, and neurobehavioral and learning disorders, according to the release.

“Although these two gynecological conditions affect millions of women worldwide, we recognize that this analysis only reflects the tip of the iceberg,” Dr Trasande said. “A growing body of evidence suggests EDC exposure is linked to a broader range of female reproductive problems, including polycystic ovary syndrome, infertility, and pregnancy complications. These disorders also place a significant cost burden on women, their families and society as a whole.”


  1. Hunt PA, Sathyanarayana S, Fowler PA, Trasande L. Female Reproductive Disorders, Diseases, and Costs of Exposure to Endocrine Disrupting Chemicals in the European Union. J Clin Endocrinol Metab. 2016. doi:10.1210/jc.2015-2873.