The social costs of childhood lead exposure in the post-lead regulation era.

摘要

OBJECTIVE: To estimate the benefits that might be realized if all children in the United States had a blood lead level of less than 1 microg/dL. DESIGN: Data were obtained from published and electronic sources. A Markov model was used to project lifetime earnings, reduced crime costs, improvements in health, and reduced welfare costs using 2 scenarios: (1) maintaining the status quo and (2) reducing the blood lead level of all children to less than 1 microg/dL. PARTICIPANTS: The cohort of US children between birth and age 6 years in 2008, with economic and health outcomes projected for 65 years. INTERVENTIONS: Increased primary prevention efforts aimed at reducing lead exposure among children and pregnant women. MAIN OUTCOME MEASURES: Societal costs and quality-adjusted life years (QALYs) gained. RESULTS: Reducing blood lead levels to less than 1 microg/dL among all US children between birth and age 6 years would reduce crime and increase on-time high school graduation rates later in life. The net societal benefits arising from these improvements in high school graduation rates and reductions in crime would amount to Dollars 50 000 (SD, Dollars 14 000) per child annually at a discount rate of 3%. This would result in overall savings of approximately Dollars 1.2 trillion (SD, Dollars 341 billion) and produce an additional 4.8 million QALYs (SD, 2 million QALYs) for US society as a whole. CONCLUSION: More aggressive programs aimed at reducing childhood lead exposure may produce large social benefits.