New study blames chemicals in plastics for $250B in US health care costs

Four endocrine-disrupting chemicals commonly used in plastics cost the U.S. an estimated $250 billion a year in increased medical bills from treating diseases like cancer and diabetes, according to a new study published by the Endocrine Society.

The study, from academics and the group Defend Our Health and funded in part by the U.S. National Institutes of Health, said that amounts to a little more than 1 percent of U.S. gross domestic product.

The paper was published Jan. 11 in the Journal of the Endocrine Society and said it's one of the first to break out the plastics share of health costs from exposure to flame retardants, bisphenol A, phthalates and perfluoroalkyl substances used in plastics.

The researchers argued that the results show the need for the ongoing talks to write a global plastics treaty to put more attention on reducing the use of those endocrine disrupting chemicals, or EDCs.

"Our study found plastics contribute substantially to disease and associated social costs in the U.S., about $250 billion in 2018 alone," said Leonardo Trasande, a medical doctor and professor at New York University who researches the disease costs of EDCs. "These costs are equivalent to 1.22 percent of the gross domestic product. The diseases due to plastics run the entire life course from preterm birth to obesity, heart disease and cancers."

In an email, Trasande, who has represented the endocrine society at the plastics treaty talks, said researchers were not surprised by the $250 billion in medical costs.

"The magnitudes are unfortunately not surprising given the broad scope and impact of chemicals used in plastic materials," he said.

The American Chemistry Council did not provide comment before an embargo on publication of the report lifted but has in the past criticized similar studies attributing premature death of U.S. residents to factors like phthalate exposure, saying that plastics must meet scientific standards to be used in medical devices, food packaging and other applications.

The Trasande study said the biggest share of the cost of the EDCs in plastic, about $160 billion, comes from polybrominated diphenyl ethers used as flame retardant additives in plastic products, with the health impact being mostly from cancers.

The study, Chemicals Used in Plastic Materials: An Estimate of the Attributable Disease Burden and Costs in the United States, used data from 2018.

The research said phthalates ranked second, accounting for $65 billion in medical costs, mostly linked to preterm birth, reduced sperm count and childhood obesity. PFAS chemicals can be traced to about $22 billion in medical costs, largely associated with kidney failure and gestational diabetes, while BPA was linked to about $1 billion in costs, the study estimated.

Trasande said the study "drives home the need" for the ongoing plastics treaty talks to address chemical health issues.

"In order to make an impact, we need support for policies such as the global plastics treaty and to educate consumers on the importance of reducing their use of plastics and other products containing harmful chemicals," said co-author Michael Belliveau, executive director at Defend Our Health.

"We can reduce these health costs and the prevalence of chronic endocrine diseases such as diabetes and obesity if governments and companies enact policies that minimize exposure to EDCs to protect public health and the environment," he said.

The researchers looked at the health care costs associated with the chemicals, and then broke down how much of their use went to plastics.

In some cases, like for penta-PBDEs, it said plastics accounted for more than 95 percent of uses in applications like furniture foam.

For other chemicals like the PFAS material perfluorooctane sulfonic acid, it said about 33 percent went to paper production and coatings and three percent went to firefighting foams, which are not counted as plastics related.

But it said about half of PFOS went to surface treatments for plastic-related synthetic textiles, which it counted, estimating that PFOS uses were about 32 percent plastics-related.

For some phthalates, it estimated the uses were mostly plastic, with 97 percent of DEHP and 100 percent of benzylbutylphthalate used in PVC flooring and polyvinyl acetate caulks, sealants and adhesives.

The study ended by saying that plastics treaty negotiators should focus on reducing those four chemicals to achieve "substantial" benefits from reducing disease burdens and health care costs.

"We conclude that the global plastics treaty should reduce the use of chemicals of concern, particularly PFAS, bisphenols, flame retardants, and phthalates," the report said. "The benefits to these reductions are substantial, as reduced exposures will lead to savings in health-care costs due to lower disease burdens. These benefits in the United States alone are likely to be in the billions of dollars and accrue annually as sustained reductions in exposures are achieved."

The study also criticized an earlier estimate of medical costs from EDCs in plastics by the Minderoo Foundation as too high.

A March 2023 report from the Minderoo-Monaco Commission on Plastics and Human Health estimated the price tag in the U.S. at $900 billion a year, but Trasande's study said that group made a mathematical error in phthalate exposure and it assumed all uses of the EDCs were in plastics.

"The commission mistakenly assumes that PBDEs, phthalates, and bisphenols are used only in plastic materials, when these chemicals are also used in nonplastic applications, including solvents and ceramics," the Trasande study said.