The attributable annual health costs of U.S. occupational lead poisoning

Abstract

Background: U.S. occupational lead standards have not changed for decades, while knowledge about lead’s health effects has grown substantially.

Objective: The objective of this analysis was twofold: to estimate the attributable annual societal costs of health damages associated with occupationally lead-exposed U.S. workers and, more broadly, to develop methods for a fuller valuation of health damages.

Methods: I combined data voluntarily reported to NIOSH on the number of highly exposed workers with published literature on the health effects of lead in adults to estimate the potential health benefits of lowering the U.S. occupational limit. I developed simple algorithms for monetizing more fully both the direct medical and indirect (productivity) damages associated with those high lead exposures.

Results: I estimated direct medical costs of $141 million (2014US$) per year for 16 categories of health endpoints, and combined direct and indirect costs of over $392 million (2014US$) per year for the 10,000 or so U.S. workers with high occupational lead exposures.

Conclusions: Reducing allowable occupational lead limits produces annual societal benefits of almost $40,000 per highly exposed worker. Given underreporting of actual exposures and the omission of important health effects, this is likely a severe underestimate.

Keywords:

• Lead exposure
• Occupational exposures
• Occupational attributable health costs
• Costs of illness

Acknowledgments

I appreciate the support of D Michaels, F Forastiere, and S H; the assistance of J Schwartz and JW Reyes; and the insights of my reviewers.