Table 1.Disability weights (95% Uncertainty Interval (UI)) of all health outcomes considered to estimate Disability-Adjusted Life Years attributed to exposure to lead, methylmercury, cadmium and inorganic arsenic through foods in Denmark.
Health outcome
|
Disability weight (95% UI)1
|
Chronic kidney disease – stage 4
|
0.104 (0.070-0.147)
|
Chronic kidney disease – stage 5 (on dialysis)
|
0.571 (0.398-0.725)
|
Borderline intellectual functioning (IQ 70-84)
|
0.011 (0.005-0.020)
|
Mild intellectual disability (IQ 50-69)
|
0.043 (0.026-0.064)
|
Moderate intellectual disability (IQ 35-49)
|
0.100 (0.066-0.142)
|
Severe intellectual disability (IQ 20-34)
|
0.160 (0.107-0.226)
|
Profound intellectual disability (IQ <20)
|
0.200 (0.133-0.283)
|
Cancer diagnosis and primary care
|
0.288 (0.193-0.399)
|
Cancer remission
|
0.18-0.472
|
Metastatic carcinoma
|
0.451 (0.307-0.600)
|
Terminal cancer
|
0.540 (0.377-0.687)
|
Bladder cancer sequelae – impotence
|
0.019 (0.010-0.034)
|
Bladder cancer sequelae – incontinence
|
0.142 (0.094-0.204)
|
1All disability weights are obtained from the Global Burden of Disease 2010 study (Salomon et al. 2015), except when stated otherwise. Pert distributions were applied to propagated uncertainty in disability weights.
2Disability weight obtained from the Australian Burden of Disease Study (Mathers et al. 1999). A uniform distribution is applied to propagate uncertainty for this disability weight.
Table 2. Attributable number of cases and deaths (total and per 100,000 individuals of the general population) of health outcomes associated with exposute to lead, methylmercury, cadmium and inorganic arsenic through foods in Denmark, 2019.
Hazard, Health outcome
|
Total attributable incidence (95% UI)
|
Attributable incidence/100,000 (95% UI)
|
Total attributable mortality (95% UI)
|
Attributable mortality/100,000 (95% UI)
|
Lead1
|
|
|
|
|
Borderline ID
|
LB: 247 (54; 478)
|
LB: 4 (0.9; 8)
|
|
|
70 < IQ < 85
|
UB: 805 (173; 1583)
|
UB: 14 (3; 27)
|
-
|
-
|
Mild ID
|
LB: 56 (12; 108)
|
LB: 1 (0.2; 2)
|
-
|
-
|
50 < IQ < 70
|
UB: 184 (39; 373)
|
UB: 3 (0.7; 6)
|
|
|
Moderate ID
|
LB: 2 (0.3; 3)
|
LB: 0.03 (0.006; 0.05)
|
-
|
-
|
35 < IQ < 50
|
UB: 5 (1; 11)
|
UB: 0.09 (0.02; 0.2)
|
|
|
Severe ID
|
LB: 0.04 (0.007; 0.07)
|
LB: 0.0006 (0.0001; 0.001)
|
-
|
-
|
20 < IQ < 35
|
UB: 0.1 (0.02; 0.3)
|
UB: 0.002 (0.0004; 0.005)
|
|
|
Profound ID
|
LB: 0.0003 (0.00006; 0.0006)
|
LB: 0.000005 (0.000001, 0.00001)
|
-
|
-
|
IQ < 20
|
UB: 0.001 (0.0002; 0.002)
|
UB: 0.00002 (0.000003; 0.00004)
|
|
|
Cadmium2,4
|
|
|
|
|
CKD stage 4
|
0.09
|
0.002
|
4
|
0
|
CKD stage 5
|
0.04
|
0.0006
|
5
|
0.0001
|
Methylmercury3
|
|
|
|
|
Borderline ID
70 < IQ < 85
|
338 (114; 614)
|
5.8 (2.0; 11)
|
-
|
-
|
Mild ID
50 < IQ < 70
|
76 (26; 140)
|
1.3 (0.44; 2.4)
|
-
|
-
|
Moderate ID
35 < IQ < 50
|
2.2 (0.74; 4.1)
|
0.038 (0.013; 0.071)
|
-
|
-
|
Severe ID
20 < IQ < 35
|
0.049 (0.016; 0.091)
|
0.00084 (0.00028; 0.0016)
|
|
|
Profound ID
IQ < 20
|
0.00039 (0.00013; 0.00074)
|
6.7e-06 (2.2e-06; 1.3e-05)
|
-
|
-
|
Inorganic arsenic4
|
|
|
|
|
Lung cancer
|
0.225
|
0.004
|
0.186 (0.185; 0.187)
|
0.00321 (0.00319; 0.00322
|
Bladder cancer
|
0.090
|
0.002
|
0.026 (0.026; 0.027)
|
0.00045 (0.00044; 0.00046
|
Skin cancer
|
0.339
|
0.006
|
0.029 (0.027; 0.03)
|
0.000496 (0.000467; 0.000525
|
1 Borderline intellectual disability (ID), mild ID, moderate ID, severe ID and profound ID due to exposure to Pb in Danish 5 year-olds. Calculations were made using lower bound (LB) and upper bound (UB) estimates for the conversion factor relating dietary Pb exposure (µg/day) to Pb in the blood (µg/dL). Associated 95% Uncertainty Intervals (UI), propagated from the uncertainty around the dose-response relationship, are given in parenthesis.
2 Chronic kidney disease (CKD) stage 4 and stage 5 due to dietary Cd exposure in Denmark. Uncertainty was not quantified.
3 Borderline intellectual disability (ID), mild ID, moderate ID, severe ID and profound ID due to in utero exposure to MeHg of the fetuses of Danish pregnant women. Associated 95% Uncertainty Intervals (UI) are given in parenthesis.
4 Uncertainty was not quantified when estimating incidence, only mortality.
Table 3. Disability adjusted life years (DALYs) attributable to dietary exposure to MeHg, Pb, Cd, and i-As (total and per 100,000 individuals of the general population). Associated 95% Uncertainty Intervals (UI) are given in parenthesis.
|
Total DALY (95% UI)
|
YLD
(95% UI)
|
YLL
(95% UI)
|
DALY/100,000 (95% UI)
|
MeHg – Intellectual Disability
|
592 (200; 1181)
|
592 (200; 1181)
|
0 (0; 0)
|
10 (3.4; 20)
|
Pb – Intellectual Disability
|
LB: 383 (86; 787)
UB: 1261 (277; 2658)
|
LB: 383 (86; 787)
UB: 1261 (277; 2658)
|
0 (0;0)
|
LB: 6.6 (1.5; 14)
UB: 22 (4.8; 46)
|
Cd – Chronic Kidney Disease
|
0.040 (0.035; 0.044)
|
0.029 (0.025; 0.034)
|
0.010 (0.010; 0.010)
|
0.0007 (0.0006; 0.0008)
|
iAs – lung, bladder and skin cancer
|
5.05 (4.72; 5.39)
|
1.12 (0.81; 1.47)
|
3.82 (3.76; 3.88)
|
0.087 (0.081; 0.093)
|