Table 3.
Overview of available disease burden estimates attributable to chemicals
| Chemicals/Groups of chemicals | Disease outcomes considered (attributable fraction) | Deaths | DALYs‡ | Main limitations¤ | Data year/method§ |
|---|---|---|---|---|---|
| Chemicals in acute poisonings | 526,000 (sub-total) | 9,666,000 (sub-total) | |||
| Chemicals (including drugs) involved in unintentional acute poisonings (methanol, diethylene glycol, kerosene, pesticides etc.) | Unintentional poisonings (71%) | 240,000a | 5,246,000a | Limited to preventable poisonings. Total unintentional poisonings would amount to 346,000 deaths and 7,445,000 DALYs[12] | 2004; C [13]b |
| Chemicals involved in unintentional occupational poisonings | Unintentional poisonings (occupational) (8.6%) | 30,000c | 643,000c | - | 2004; A [14] |
| Pesticides pesticides involved in self-inflicted injuries | Self-inflicted injuries (23%) | 186,000 | 4,420,000 | Limited to preventable self inflicted injuries. Impact of accidental and chronic exposures not considered. | 2002; C [13] |
| Chemicals in occupational exposures (longer term effects) | 581,000 (sub-total) | 6,763,000 (sub-total) | |||
| Asbestos | Malignant mesothelioma (NA); trachea, bronchus, lung cancer (0.3%); asbestosis (NA) | 107,000d | 1,523,000d | - | 2004; A [14], [50] |
| Occupational lung carcinogens (arsenic, asbestos, beryllium, cadmium, chromium, diesel exhaust, nickel, silica) | Trachea, bronchus, lung cancer (8.6%) | 111,000 | 1,011,000 | Only 8 of the chemicals or chemical mixtures classified as carcinogenic or probably carcinogenic to humans taken into account | 2004; A [14] |
| Occupational leukaemogens (benzene, ethylene oxide, ionizing radiation) | Leukaemia (2.3%) | 7,400e | 113,000e | Only 2 of the chemicals or chemical mixtures classified as carcinogenic or probably carcinogenic to humans taken into account | 2004; A [14] |
| Occupational particulates - causing COPD (dusts, fumes/gas) | COPD (13%) | 375,000f | 3,804,000f | - | 2004; A [14] |
| Occupational particulates - other respiratory diseases than COPD (silica, asbestos and coal mine dust) | Asbestosis (NA); silicosis (NA); pneumoconiosis (NA) | 29,000 | 1,062,000 | - | 2004; A [14] |
| Air pollutant mixtures | 3,720,000 (sub-total) | 60,669,000 (sub-total) | |||
| Outdoor air pollutants (particulate matter, sulfur dioxide, nitrogen oxides, benzo[a]pyrene, benzene, others) | Lung cancer (7.9%); acute respiratory infections (1.6%); selected cardiopulmonary diseases (3.4%) | 1,152,000 | 8,747,000 | Only urban air pollution in cities with >100 000 inhabitants taken into account. Health impact from rural air pollution unknown. | 2004; A [14] |
| Outdoor air pollutants emitted from ships (particulate matter, sulfur dioxide, nitrogen oxides, benzo[a]pyrene, benzene, others) | Lung cancer (0.3%); selected cardiopulmonary diseases (0.4%) | 60,000g | NA | - | 2002; B [95] |
| Indoor air pollutants from solid fuel combustion (carbon monoxide, nitrogen oxides, sulfur oxides, benzene, formaldehyde, polyaromatic compounds, particulates, others) | Lung cancer (2.9%); acute respiratory infections (33%); COPD (33%) | 1,965,000 | 41,009,000 | Disease burden from emissions from building materials and household products is not know. BoD from second hand smoke has been evaluated separately. | 2004; A [14] |
| Second-hand smoke (nicotine, formaldehyde, carbon monoxide, phenols, nitrogen oxides, naphthalenes, tar, nitrosamine, PAHs, vinyl chloride, various metals, hydrogen cyanide, ammonia, others) | Lower respiratory infections (6.3%); otitis (1.7%); asthma (11%); lung cancer (1.8%); ischaemic heart disease (4.5%) | 603,000 | 10,913,000 | - | 2004; B [29] |
| Single chemicals with mostly longer term effects | 152,000 (sub-total) | 9,102,000 (sub-total) | |||
| Lead | Mild mental retardation; Cardiovascular diseases | 143,000 | 8,977,000 | - | 2004; A [14] |
| Arsenic in drinking-water | Diabetes mellitus (0.04%) ischemic heart disease (0,11%); lung cancer (0.25%); bladder cancer (1.2%); kidney cancer (NA); skin cancer (0.30%) | 9,100a | 125,000a | Limited to exposure through drinking water. Limited to Bangladesh. | 2001; B [11] |
| Total #,h Total in children <15 years | All considered diseases | 4,879,000 (8.3%) 1,073,000 (22%) | 86,200,000 (5.7%) 46,627,000 (54%) | Mainly 2004; A | |
‡ DALYs are "Disability-adjusted life years", a weighted measure of years of life lost due to premature death, and years lived with disability. ¤ Only outcomes qualified as strong evidence were considered. § Methods: A: Comparative Risk Assessment (CRA); B: Based on exposure and exposure-response (similar to CRA); C: Evidence synthesis and expert evaluation. # The estimates were developed within three years and their pooling is unlikely to introduce a significant error. NA: not available. -: none.
a Estimate not compared to counterfactual exposure, which is however estimated to be negligible using a theoretical minimum exposure given available management options for concerned chemicals.
b Values updated for 2004 based on original reference.
c Already included in total unintentional acute poisonings and therefore not included again in the total.
d Lung cancer and asbestosis caused by asbestos are also considered in occupational lung carcinogens and particulates and this part of the burden is therefore not counted twice in the total.
e Also includes a small fraction of leukaemia caused by ionizing radiation.
f Parts of the particulates are organic in nature, and the estimate therefore includes a small fraction that is not or not directly related to chemicals
g Overlaps with the burden from outdoor air pollution and is therefore not included in the total.
h Total is corrected for double counting (chemicals considered in more than one estimate); not all disease burdens are however additive, and joint exposures could lead to slight overestimate (see Methods section).