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Conditions linked to everyday chemicals—used in cosmetics, plastics and common household items like sofas—lead to $340 billion in treatment and lost productivity costs annually in the U.S., according to a new study.

Researchers behind the paper, published in The Lancet, evaluated a set of chemicals that have been shown to disrupt normal functioning of the endocrine system using data on the levels of the chemicals in blood and urine of subjects of a Centers for Disease Control and Prevention (CDC) study. Flame retardants like PBDEs, phthalates, which are widely used in cosmetics and scented products, plastic component DEHP and organophosphate pesticides are among the chemicals linked to health issues in the U.S., according to the research.

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The study contributes to a growing debate about how best to assess and manage the safety of common chemicals. Improved regulation could reduce exposure to some of the most damaging chemicals, the report’s authors say. Previous research has shown that Europe—where regulations require manufacturers to prove household chemicals are safe before they hit shelves—loses a significantly smaller share of its GDP as a result of endocrine disrupting diseases than the U.S.

Diseases related to household chemicals cost $217 billion, or 1.28% of GDP, in Europe, compared to $340 billion, or 2.33% of GDP, in the U.S. These chemicals have been linked to obesity, intellectual disabilities, endometriosis, autism and heart disease.

“Exposures in the United States are similar in some ways, but they also differ,” says study author Leonardo Trasande, a New York University professor who studies environmental health. “That’s in large part to differences in regulation between Europe and the U.S.”

The U.S. relies on a law known as at the Toxic Substances Control Act (TSCA) to regulate household chemicals, a decades-old law that was updated earlier this year, and thousands of chemicals on the market remain untested. Improvements passed this year give the Environmental Protection Agency (EPA) more authority to test and ban hazardous chemicals, but Trasande and many others say the law does not go far enough. The EPA has announced five chemicals the agency plans to “fast track,” but tens of thousands more will remain untested for the foreseeable future, including many included in the study. Trasande says Congress should provide additional funding to allow the agency to move faster with review of a broader array of chemicals.

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The American Chemistry Council, a lobbying group for chemical manufacturers, criticized the paper for using research that shows links between certain household chemicals and endocrine disruption rather than causation. The paper does “virtually nothing to advance the protection of public health,” the ACC said in a statement.

But while research showing the connection between many chemicals and endocrine disruption remains correlational, many scientists say the burden should still rest on manufacturers to prove a substance is safe before selling it to the public.

“What we need here is a reform that tests chemicals proactively before they’re used on the open market,” Trasande said last year.

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