John Libbey Eurotext

Environnement, Risques & Santé


Advantages, limitations, and perspectives of cost-benefit analysis in environmental health, assessed from two case studies Volume 12, issue 4, Juillet-Août 2013

EHESP (École des hautes études en santé publique) Avenue du Professeur-Léon-Bernard CS 74312 35043 Rennes cedex France

In France, public policy rarely uses economic approaches as a tool for decision support. The consequences of lead and mercury exposure on children's health highlight the validity of integrating economic evaluations into the public-policy decision-making process. Such exposure impairs children's health and may cause serious side effects, such as cognitive and behavioural disorders. Nonetheless, blood levels, especially of lead, are weak health signals, because they are visible only during screenings by testing blood samples or in cases of severe poisoning, even though no threshold effects have been demonstrated. We used cost-benefit analysis, which included a cost optimization assessment, to examine the economic impact of the exposure of the population of children in France to these pollutants and of exposure reduction. The first results of the evaluation show that public policy focused on reducing exposure to these pollutants would achieve monetary benefits of several billion euros per year. These benefits include a reduction in future medical expenses and special education of young children, and, most importantly, their increased productivity during adult life. Assessing the costs of investments in programs to reduce emissions of pollutants is useful for public decision making, so that costs of intervention and the benefits of this reduction can be weighed. Following the empirical work, this article discusses the advantages, limitations and perspectives of integrating economic evaluation into the development of policies to prevent the environmental risks of neurotoxic effects on children.