Several chemical families are linked to a loss of intellectual quotient (IQ) points in children. This may lead to reduced working productivity and/or lower wages in adulthood and contribute to increasing the substantial socio-economic burden worldwide. The Adverse Outcome Pathway (AOP) concept, that leverages existing data to formalize knowledge, is a well-accepted concept in risk assessment although it does not handle the socio-economic impact that environment-induced diseases may generate. Here, we propose to extend the AOP framework by bridging an adverse outcome (AO) to a cost outcome (CO) creating so-called Cost Outcome Pathways (COPs) for including the socio-economic costs of exposure to chemicals. As a case study, a COP related to neurodevelopmental toxicity was designed, with a connection between the AO decreased, IQ and the CO increased, socio-economic burden. For support to policymaking in the public health sector, this framework might also hold great potential for environmental exposure-related diseases such as cancer or obesity which are diseases with known detrimental socio-economic impacts.

The authors have declared no competing interest.

French Ministries for an Ecological Transition, for Agriculture and Food, for Solidarity and Health and of Higher Education, Research and Innovation (Ecophyto II+ plan)

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