Evidence map›Paper›PMID 27430869›Full record

ArticleEnvironmental health : a global access science source2016

Public health and chronic low chlordecone exposures in Guadeloupe; Part 2: Health impacts, and benefits of prevention.

Vincent Nedellec, Ari Rabl, William Dab

Abstract read
In one paragraph

Article in Environmental health : a global access science source, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Vincent NedellecDirector of Vincent Nedellec Conseil, 23, rue André Masséna-83000, Toulon, France. vincent.nedellec3@gmail.com.ORCID 0000-0001-8177-4777
Ari RablRetired from Ecole des Mines/ARMINES, Paris, Consultant on Environmental Impacts, 6 av. Faidherbe, 91440, Bures sur Yvette, France.
William DabConservatoire National des Arts et Métiers (CNAM), Laboratoire MESuRS (Modélisation, épidémiologie et surveillance des risques sanitaires EA 4628), 292, rue Saint Martin-75141, Paris cedex 03, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInhabitants of Guadeloupe are chronically exposed to low doses of chlordecone via local food due to its past use in banana plantations. The corresponding health impacts have not been quantified. We develop a quantitative method and present the results in two articles: 1. Hazard identification, exposure-response functions, and exposure, 2. Health impacts, and benefits of a program to reduce the exposure of the population. Here is the second article.

methodsThe exposure-response functions derived in Part 1 (for liver and prostate cancer, renal dysfunction and cognitive development) are combined with the exposure data to calculate the impacts. The corresponding costs are calculated via DALY's and VOLY. A no-effect threshold is included via the marginal fraction of the collective exposure above the reference dose. The health benefits are the impacts in 2002 (before the exposure reduction program) minus the impacts in 2006 (since the program). They are compared to the costs, namely the public annual expenditures for reducing the population exposure.

resultsWithout threshold, estimated annual cases of liver cancer, prostate cancer and renal dysfunction are respectively 5.4, 2.8, 0.10 in 2002; and 2.0, 1.0, 0.04 in 2006. Annual IQ points lost (cognitive development) are respectively: 1 173 and 1 003. The annual cost of total impacts is 38.3 Million Euros (M€) in 2002 and 23.7 M€ in 2006. Comparing the benefit of 14.6 M€ with the 3.25 M€ spent for prevention, the program appears well justified. With threshold, the costs of the impacts are lower, respectively: 26.5 M€ in 2002 and 12.8 M€ in 2006, but the benefit is not very different: 13.7 M€.

conclusionThis is the first study that quantified chronic non genotoxic effects of chlordecone exposures in Guadeloupe. According to our results, preventive actions should be focused on pregnant women because of the high social cost of development impairment and also because their exposures decreased less rapidly than others. Prevention effort should be sustained as long as chlordecone remains in soils. Additional toxicological and epidemiological research would also be required for health endpoints that could not be taken into account (neurotoxicity of adults, autoimmune diseases and other developmental effects).

Indexed as

Environmental ExposureAdolescentAdultChlordeconeCognition DisordersFemaleGuadeloupeHumansInfant, NewbornInsecticidesKidney DiseasesLiver NeoplasmsMaleMiddle AgedProstatic NeoplasmsPublic HealthChlordeconeInsecticidesSoil PollutantsChlordeconeEndocrine disrupterExposure reduction programLow-doseNon-mutagen agentRisk assessmentRisk managementThreshold

Identifiers

PMID27430869
PMCPMC4950608

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.