RT Journal Article
T1 Public healthcare costs associated with long-term exposure to mixtures of persistent organic pollutants in two areas of Southern Spain: A longitudinal analysis.
A1 Perez-Carrascosa, Francisco Miguel
A1 Barrios-Rodriguez, Rocio
A1 Gomez-Peña, Celia
A1 Salcedo-Bellido, Inmaculada
A1 Velasco-Garcia, Maria Eugenia
A1 Jimenez-Moleon, Jose Juan
A1 Garcia-Ruiz, Antonio
A1 Navarro-Espigares, Jose Luis
A1 Requena, Pilar
A1 Muñoz-Sanchez, Carmen
A1 Arrebola, Juan Pedro
K1 Biomonitoring
K1 Healthcare expenditure
K1 Organochlorine pesticides
K1 Persistent organic pollutants
K1 Polychlorinated biphenyls
AB Polychlorinated biphenyls and organochlorine pesticides are persistent organic pollutants (POPs) that had been banned or restricted in many countries, including Spain. However, their ubiquity still poses environmental and human health threats. To longitudinally explore public healthcare costs associated with long-term exposure to a mixture of 8 POPs in a cohort of residents of two areas of Granada Province, Southern Spain. Longitudinal study in a subsample (n = 385) of GraMo adult cohort. Exposure assessment was performed by analyzing adipose tissue POP concentrations at recruitment. Average primary care (APC) and average hospital care (AHC) expenditures of each participant over 14 years were estimated using the data from their medical records. Data analyses were performed by robust MM regression, weighted quantile sum regression (WQS) and G-computation analysis. In the adjusted robust MM models for APC, most POPs showed positive beta coefficients, being Hexachlorobenzene (HCB) significantly associated (β: 1.87; 95% Confidence interval (95%CI): 0.17, 3.57). The magnitude of this association increased (β: 3.72; 95%CI: 0.80, 6.64) when the analyses were restricted to semi-rural residents, where β-HCH was also marginally-significantly associated to APC (β: 3.40; 95%CI: -0.10, 6.90). WQS revealed a positive but non-significant mixture association with APC (β: 0.14; 95%CI: -0.06, 0.34), mainly accounted for by β-HCH (54%) and HCB (43%), that was borderline-significant in the semi-rural residents (β: 0.23; 95%CI: -0.01, 0.48). No significant results were observed in G-Computation analyses. Long-term exposure to POP mixtures might represent a modifiable factor increasing healthcare costs, thus affecting the efficiency of the healthcare systems. However, and owing the complexity of the potential causal pathways and the limitations of the present study, further research is warranted to fully elucidate ascertain whether interventions to reduce human exposure should be considered in healthcare policies.
PB Academic Press
YR 2022
FD 2022-06-01
LK http://hdl.handle.net/10668/22210
UL http://hdl.handle.net/10668/22210
LA en
NO Pérez-Carrascosa FM, Barrios-Rodríguez R, Gómez-Peña C, Salcedo-Bellido I, Velasco-García ME, et al. 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.
DS RISalud
RD Apr 10, 2025