Study: Replacing BPA in food products could save billions in health costs

In a first-of-its-kind study, a researcher has estimated that the health-related economic savings of removing bisphenol A from our food supply is a whopping $1.74 billion annually. And that’s a conservative estimate.

“This study is a case in point of the economic burden borne by society due to the failure to regulate environmental chemicals in a proactive way,” study author Leonardo Trasande told me.

With evidence mounting that bisphenol A (BPA) exposure is a serious health risk, Trasande, an associate professor in pediatrics, environmental medicine and health policy at New York University, wanted to examine the economic trade-offs of replacing BPA with a safer alternative. BPA, a synthetic compound used in plastics and found in the lining of food and beverage containers, has been identified as an endocrine disruptor and linked to cancer, asthma, fertility outcomes, adverse neurobehavioral development, obesity promotion and cardiovascular risks.

While the U.S. Food and Drug Administration has banned the chemical in baby bottles and sippy cups, it’s still used in food cans and drink packaging. According to Trasande’s study, which was published in the February issue of Health Affairs, more than a million pounds of BPA is produced every year. The chemical is so common that “exposure to BPA in the United States is nearly ubiquitous: In a nationally representative sample, 92.6 percent of people ages six and older had detectable BPA in their urine,” he wrote. Trasande also cited a 2011 study that found that eating one serving of canned soup a day over five days was associated with a more than 1000 percent increase in urinary BPA.

To uncover the economic benefit of replacing BPA, Trasande zeroed in on the social costs of childhood obesity and adult coronary heart disease attributable to food-related BPA exposure in the United States in 2008. Based on BPA research findings, he estimated that BPA exposure was associated with 12,404 cases of childhood obesity and more than 33,800 cases of new coronary heart disease that year, totaling $2.98 billion in social costs. Removing BPA from food packaging, the study estimated, could prevent about 6,200 cases of childhood obesity and 22,350 cases of coronary heart disease each year, totaling an economic yearly benefit of $1.74 billion.

Also, of the 12,404 obese children, more than 9,400 were estimated to remain obese into adulthood, which creates an additional $489 million in health care costs and $972 million in lost quality-adjusted life years, which is way of measuring the impact of disease burden. In all, $2.98 billion in annual costs are attributable to BPA-related childhood obesity and heart disease.

Trasande’s study also weighed the cost savings of removing BPA from food items against the cost of replacing the chemical with oleoresin, a plant-based mixture of oil and resin that might be safer than BPA. He found that replacing BPA in aluminum cans would cost about $2.2 billion each year, which would be borne by manufacturers and consumers via higher prices, “whereas the costs of obesity and coronary heart disease attributable to BPA are borne by multiple sectors of society.” Trasande emphasized that premarket testing of a BPA substitute is necessary to avoid additional, or even worse, health outcomes. He wrote:

Newer economic models are also needed to account for uncertainty in disease causation, so that trade-offs involved in decisions such as whether to remove BPA from food uses can be weighed more carefully in spite of incomplete understanding of the health consequences. These newer approaches will be especially important in informing regulations of endocrine-disrupting chemicals. Information on the costs of their ongoing use, however incomplete, is needed because of the broad public health effects of these chemicals.

Unfortunately, the true economic health cost of BPA is probably much higher, Trasande said, as his study only examined two of the health impacts to which BPA has been linked.

“Our findings suggest that further regulation by FDA may produce substantial economic benefits to society,” he told me. “In addition to promoting diet and behavioral change, which can be difficult to implement and make persistent, regulatory action can be done by government agencies without much in the way of additional economic investment.”

Right now, FDA considers BPA safe at the “very low levels that occur in some foods,” though Trasande noted that the assumed safety threshold for BPA has not been documented in any study. The agency has initiated a number of studies examining the safety of BPA, but it’s hard to say if FDA even has all the information it needs to really determine safe exposure levels. According to FDA's own website, “today there exist hundreds of different formulations for BPA-containing epoxy linings, which have varying characteristics. As currently regulated, manufacturers are not required to disclose to FDA the existence or nature of these formulations.” (Just this month across the proverbial pond, the European Food Safety Authority recommended lowering current tolerable daily intakes of BPA.)

Trasande said the findings of his study weren’t surprising considering the costs of child obesity and cardiovascular disease, “but what is surprising is to hear the counter-arguments that replacing BPA could introduce increases in food-borne illnesses, which is simply not true. …that’s an unscientific claim.” (That food-borne illness argument is from the North American Metal Packaging Alliance, which addressed Trasande’s study in a Jan. 23 news release.)

While policy changes would have the biggest impact on BPA exposure, people can take individual action, too. Trasande noted that some studies have suggested that eliminating aluminum canned-food in favor of fresh food can reduce urinary BPA levels between 66 and 92 percent. He said that while many factors contribute to childhood obesity and cardiovascular disease, stricter BPA regulation could offer the opportunity for “rapid and substantial reductions” in disease burden.

“There is great potential for health benefits through changing behaviors to reduce ongoing BPA exposure,” Trasande said. “But it may actually be quite beneficial to society to replace BPA and institute a more pervasive ban on its use in foods.”

To read Trasande’s full BPA study, visit Health Affairs.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.