Health effects associated with the disposal of solid waste in landfills and incinerators in populations living in surrounding areas: a systematic review

Biological and chemical contamination of illegal, uncontrolled refuse storage areas in Poland

This study focused on assessing the microbiological and chemical contamination of air, soil and leachate in uncontrolled refuse storage areas in central Poland. The research included an analysis of the number of microorganisms (culture method), endotoxin concentration (gas chromatography-mass spectrometry), heavy metals level (atomic absorption spectrometry), elemental characteristics (elemental analyser), cytotoxicity assessment against A-549 (human lung) and Caco-2 (human colon adenocarcinoma) cell lines (PrestoBlue™ test) and toxic compound identification (ultra-high-performance liquid chromatography-quadrupole time-of-flight ultrahigh-resolution mass spectrometry). Microbial contamination differed depending on the dump and the group of tested microorganisms. The number of bacteria was: 4.3 × 10² - 1.8 × 10³ CFU m^-3 (air); 1.1 × 10³ - 1.2 × 10⁶ CFU mL^-1 (leachate); 1.0 × 10⁶ - 3.9 × 10⁶ CFU g^-1 (soil). Respectively, for air and soil the number of fungi was: 2.2 × 10² - 4.6 × 10² CFU m^-3; 1.8 × 10² - 3.9 × 10³ CFU g^-1. Metal levels (Fe, Mn, Pb, Zn, Al, Hg, Cd, Cu, Cr) were higher than in the control sample; however, the average concentrations did not exceed the permissible standards. The cytotoxicity of soil and leachate samples depended on the dump, sample and cell line tested. The leachates were more cytotoxic than soil extracts. Compounds belonging to pesticides, surfactants and biocides, chemicals and/or polymer degradation products, medicinal drugs and insect repellents were found. The detection of potential pathogens in the air, soil and leachate, the presence of toxic compounds and the confirmation of the cytotoxic effect of leachate and soil on human cell lines justify the need for further research on the risks posed by illegal dumps. These studies should aim at developing a unified assessment method and a method to minimise the risk of contaminants spreading in the environment, including harmful biological agents.

Characterization of the microbiological effects of pomegranate, banana, and mandarin peels on water under laboratory conditions

The protection of natural resources, especially water resources, is attracting international attention by researchers in order to achieve sustainable development. Inadequate treatment of waste from the food industry leads to pollution of ground and surface water through leachate or direct discharge of waste. To understand the impact of inappropriate discharge of these wastes, the microbial groups (bacteria, yeasts, and moulds) of pomegranate peel (PP), banana peel (BP), mandarin peel (MP) and the water in which each waste is decomposed were studied. The microbial groups were isolated, quantified, and purified by elective media at 30 °C. The fungal microbial isolates were identified by their macro and microscopic characteristics. The findings show that the highest density of bacteria (3.95 ± 0.48 × 10⁵ CFU/ml) was obtained in the water in which the BP is decomposed, the highest density of yeasts (4.59 ± 0.52 × 10⁵ CFU/ml) and moulds (4.10 ± 0.34 × 10⁵ CFU/ml) was recorded in the water in which the PP is decomposed compared to the microbial density of the initial and the final control water. The fungal microbial groups were more diverse between the decomposition waters; the waters in which PP and BP are decomposed showed a higher diversity with 9 and 8 species respectively, compared to the water in which MP is decomposed with 7 species, and compared to the initial and the final control water with 3 and 5 species respectively. Conclusively, direct dumping or landfilling of food waste in general, PP, BP, and MP in particular can cause pollution of surface and groundwater by microorganisms that can be harmful.

Along the energy justice continuum: An examination of energy disposal through the lens of feminist community based participatory action research

Energy justice research tends to focus on inequalities that result from energy systems, including from fossil fuel extraction to production, distribution, and consumption. However, little research has investigated local effects of the disposal of waste products from fossil fuel extraction. To better understand these impacts, we employed a case study approach with qualitative interviews of residents of Kettleman City, a rural community in California's Central Valley (USA) that hosts a hazardous waste landfill which accepts predominantly waste from fossil fuel production. Informed by a novel feminist community-based participatory action research approach (CBPAR), interview data were collected from residents in the Summer of 2019 and analyzed using deductive and inductive coding strategies. Resident interviews highlighted the disproportionate distribution of pollution and environmental degradation shouldered by the community along with their experiences of adverse health and social impacts. Our analysis revealed the importance of incorporating an intersectional perspective to frame resident experiences of energy injustice. Our research highlights the untapped potential of feminist-informed CBPAR to catalyze change and challenge the production of energy injustice from energy waste disposal.

Health risks of solid waste management practices in rural Ghana: A semi-quantitative approach toward a solid waste safety plan

Inadequate solid waste management (SWM) can lead to environmental contamination and human health risks. The health risks from poor SWM can vary based on specific practices and exposure pathways. Thus, it is necessary to adequately understand the local context. This information, however, is rarely available in low-resource settings, particularly in rural areas. A solid waste safety plan could be helpful in these settings for gathering necessary data to assess and minimize health risks. As a step in developing such a tool, a semi-quantitative health risk analysis of SWM practices in nine Ghanaian rural villages was undertaken. Data on SWM in each village were collected through qualitative field observations and semi-structured interviews with local stakeholders. SWM-related health risks were assessed using the collected data, similar case studies in the scientific literature and dialogue among an assembled team of experts. The analysis identified context-specific practices and exposure pathways that may present the most substantial health risks as well as targeted solutions for mitigation risks. A risk assessment matrix was developed to quantify SWM risks as low, medium, high, or very high based on the likelihood and severity of identified hazards. The highest SWM risks were identified from dumpsites and uncontrolled burying of solid waste. More specifically, a very high or high risk of infectious and vector-borne diseases from SWM in the villages was identified, both in the disposal of solid waste in dumpsites and uncontrolled burying of solid waste. Additionally, a very high or high risk of inhalation, ingestion or dermal contact with contaminants was found in the disposal of solid waste in dumpsites, open burning of waste and reuse of waste from dumpsites as compost. The results demonstrate the potential value of a solid waste safety plan and a parsimonious approach to collect key local data to inform its contents.

Aging in Rural Communities

Purpose of Review

Population aging is occurring worldwide, particularly in developed countries such as the United States (US). However, in the US, the population is aging more rapidly in rural areas than in urban areas. Healthy aging in rural areas presents unique challenges. Understanding and addressing those challenges is essential to ensure healthy aging and promote health equity across the lifespan and all geographies. This review aims to present findings and evaluate recent literature (2019-2022) on rural aging and highlight future directions and opportunities to improve population health in rural communities.

Recent Findings

The review first addresses several methodological considerations in measuring rurality, including the choice of measure used, the composition of each measure, and the limitations and drawbacks of each measure. Next, the review considers important concepts and context when describing what it means to be rural, including social, cultural, economic, and environmental conditions. The review assesses several key epidemiologic studies addressing rural-urban differences in population health among older adults. Health and social services in rural areas are then discussed in the context of healthy aging in rural areas. Racial and ethnic minorities, indigenous peoples, and informal caregivers are considered as special populations in the discussion of rural older adults and healthy aging. Lastly, the review provides evidence to support critical longitudinal, place-based research to promote healthy aging across the rural-urban divide is highlighted.

Summary

Policies, programs, and interventions to reduce rural-urban differences in population health and to promote health equity and healthy aging necessitate a context-specific approach. Considering the cultural context and root causes of rural-urban differences in population health and healthy aging is essential to support the real-world effectiveness of such programs, policies, and interventions.

Biohydrogen in a circular bioeconomy: A critical review

Hydrogen produced from biomass feedstocks is considered an effective solution in moving toward a decarbonized economy. Biohydrogen is a clean energy source that has gained global attention for adoption as it promises to mitigate climate change and human environmental damage. Through the circular economy framework, sustainable biohydrogen production with other bioproducts while addressing issues such as waste management is possible. This study presents a comprehensive review of the various biomass feedstocks and processing technologies associated with biohydrogen generation, as well as the possible integration of existing industries into a circular bioeconomy framework. The currently standing challenges and future perspectives are also discussed.

Mitochondrial dysfunctions elicited by solid waste leachates provide insights into mechanisms of leachates induced cell death and pathophysiological disorders

Emissions (mainly leachates and landfill gases) from solid waste facilities are laden with mixtures of dangerous xenobiotics implicated with significant increase in various pathophysiological disorders including cancer, and eventual mortality of exposed wildlife and humans. However, the molecular mechanisms of solid waste leachates induce pathophysiological disorders and cell death are still largely unknown. Although, evolving evidence implicated generation of reactive oxygen species and oxidative stress as the possible mechanism. Recent scientific reports are linking reactive oxygen species and mitochondrial dysfunctions as the player mechanism in pathophysiological disorder and apoptosis induced by xenobiotics in solid waste leachates. This systematic review presents an explicit discussion of recent scientific findings on the structural and functional alterations in mitochondria induced by solid waste leachates as the molecular mechanisms plausibly responsible for the pathophysiological disorders, cancer and cell death reported in landfill toxicology and epidemiological studies. This review aims to increase scientific understanding on solid waste leachate induced mitochondria dysfunctions as the key player in molecular mechanisms of solid waste induced toxicity. The findings in this review were mainly from using primary cells, cell lines, Drosophila and fish. Whether the findings will similarly be observed in mammalian test systems in vivo and particularly in exposed humans, remained to be investigated. Improvement in technological advancements, enforcement of legislation and regulations, and creation of sophisticated health surveillance against exposure to solid waste leachates, will expectedly mitigate human exposure to solid waste emissions and contamination of the environment.

An overview of the environmental pollution and health effects associated with waste landfilling and open dumping

Landfilling is one of the most common waste management methods employed in all countries alike, irrespective of their developmental status. The most commonly used types of landfills are (a) municipal solid waste landfill, (b) industrial waste landfill, and (c) hazardous waste landfill. There is, also, an emerging landfill type called "green waste landfill" that is, occasionally, being used. Most landfills, including those discussed in this review article, are controlled and engineered establishments, wherein the waste ought to abide with certain regulations regarding their quality and quantity. However, illegal and uncontrolled "landfills" (mostly known as open dumpsites) are, unfortunately, prevalent in many developing countries. Due to the widespread use of landfilling, even as of today, it is imperative to examine any environmental- and/or health-related issues that have emerged. The present study seeks to determine the environmental pollution and health effects associated with waste landfilling by adopting a desk review design. It is revealed that landfilling is associated with various environmental pollution problems, namely, (a) underground water pollution due to the leaching of organic, inorganic, and various other substances of concern (SoC) contained in the waste, (b) air pollution due to suspension of particles, (c) odor pollution from the deposition of municipal solid waste (MSW), and (d) even marine pollution from any potential run-offs. Furthermore, health impacts may occur through the pollution of the underground water and the emissions of gases, leading to carcinogenic and non-carcinogenic effects of the exposed population living in their vicinity.

Metal Bioaccumulation, Cytogenetic and Clinico-Biochemical Alterations in Rattus norvegicus Exposed In Situ to a Municipal Solid Waste Landfill in Lagos, Nigeria

This study aimed at determining in animal model the health effects of in situ exposure to landfill chemicals. We evaluated metal concentrations in tissues and cytogenetic and clinico-biochemical effects in Wistar rats (Rattus norvegicus) exposed in situ at Olusosun landfill in Lagos, Nigeria. Male rats (n = 30/point) were exposed at three different points to ambient air and underground water (via drinking) at the landfill for 4-, 8-, 12-, 16-, 20- and 24-week periods. Rats concurrently sited at a residential area, 17.3 km from the landfill site served as control. There was significantly (p < 0.05) time-dependent: accumulation of lead, cadmium, chromium, copper and zinc in the liver and kidney and increase in body weight gain, in exposed rats compared to control. There was significant induction of micronuclei and cytotoxicity (reduced PCE/NCE ratios) in exposed rats. Haematological parameters (RBC, PCV, Hb and WBC) and serum biomarkers of hepato-renal damage [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) activities; creatinine and urea levels] revealed significant increases. There was significant increase in hepatic levels of reduced glutathione, malondialdehyde, catalase activities, and decrease in superoxide dismutase, at all periods. Chromium and copper concentrations in the liver and kidney revealed significant positive correlations with either one or more of AST, ALT, LDH and urea. Significant metal concentrations in the underground water and tissues suggest that heavy metals are responsible for the observed alterations, and this may have been via oxidative stress. These findings suggest potential health risk due to occupational and residential exposure to landfill pollutants.

Current Status and Review of Waste-to-Biogas Conversion for Selected European Countries and Worldwide

Growing world population and increasing population density are leading to increasing waste production with biological waste amounting to several billion tonnes annually. Together with the increasing need for renewable energy sources, waste-to-biogas conversion as a prime example of waste-to-energy technology represents a facile way of solving two problems simultaneously. This review aims to address the recent progress in the field of waste-to-biogas technology, which is lately facing intensive research and development, and present the current status of this waste treatment method both in technological and legislative terms. The first part provides an overview of waste and waste management issues. This is followed by a detailed description of applicable waste-to-energy (WtE) technologies and their current implementation in selected European countries. Moreover, national energy and climate plans (NECPs) of selected EU Member States are reviewed and compared with a focus on implementation of WtE technologies. In a further section, biogas production from waste around the world is reviewed and compared country wise. Finally, an outlook into the future of WtE technologies is provided alongside the conclusions based upon the reviewed data.

Assessment of Awareness and Practices of Biomedical Waste Management among Health Care Professionals at a Teaching Hospital in Uttar Pradesh

Improper waste management practices are a serious problem that involves not only the hospital staff but society at large. To improve biomedical waste (BMW) management, it is important to evaluate the current practices in BMW management (BMWM), identify the gaps, and address them. With this backdrop, this research was done to assess the awareness of BMW management practices among the healthcare professionals in a teaching hospital. This is a hospital-based observational study with assessment of 112 doctors, 230 nurses, and 158 waste handlers. The healthcare workers (HCW) were evaluated regarding awareness, and different practices of BMWM with a self-structured questionnaire. An overall score of ≥50% in each section was considered satisfactory regarding awareness and practices for BMWM. Data were analyzed statistically using SPSS Ver.21 software. Regarding the awareness on various aspects of BMWM, doctors had maximum level of awareness at 68.6% (60.0% – 77.2%), followed by nurses at 69.3% (63.3%-75.3%) and waste handlers at 55.9% (48.2% – 63.6%). Overall nurses showed maximum awareness of existing practices at 74.0% followed by doctors at 70.2% and waste handlers were at 53.8%. To optimize BMWM, it is important to raise awareness on best practices while evaluating the current practices. Gaps in knowledge and skills need to be identified and closed. Ongoing information, education and communication for health care professionals are pivotal in improving BMWM practices.

Campania and cancer mortality: An inseparable pair? The role of environmental quality and socio-economic deprivation

The region of Campania in Southern Italy features high levels of socio-economic deprivation and low levels of environmental quality. A vast strand of the scientific literature has tried to verify whether poor environmental quality and widespread socio-economic deprivation might explain the high cancer mortality rates (CMRs) observed, especially in the municipalities - infamously labelled as the 'Land of Fires' - that were hit most severely by the crisis. While some studies managed to identify links between these two confounding factors and cancer mortality, the evidence is overall mixed. Interesting information may be drawn from the observation of municipal data: in spite of previous claims, some municipalities featuring high environmental quality and low socio-economic deprivation also display high CMRs, while other Campanian municipalities facing disastrous environmental and socio-economic conditions are characterised by low CMRs. These figures, in contrast to common sentiment and previous studies, need to be investigated thoroughly in order to assess the exact role of the confounding factors. In this work, we aim to identify the municipalities where confounding factors act as driving forces in the determination of high CMRs through an original multi-step analysis based on frequentist and Bayesian analysis. Pinpointing these municipalities could allow policymakers to design targeted and effective policy measures aimed at reducing cancer mortality.

Population awareness and attitudes toward waste-related health risks in Accra, Ghana

Despite significant knowledge about the potential health hazards of waste, there are few studies in African cities that investigate awareness of health issues related to waste management, although such research is needed to lower population exposure. This paper examines the case study of Accra in Ghana, a city dealing with serious health and pollution problems. Three focus groups and 157 households in Accra were surveyed on household waste disposal and awareness of waste-related health hazards. Surveyed households had limited knowledge of waste-related health hazards in their neighbourhoods. Although the households reported diseases that could be associated with environmental factors linked to waste management, 87% of all surveyed households did not think that someone in their household could have fallen ill of a disease that can be related to waste. In middle- and high-income neighbourhoods, waste burning increases substantially when waste is not collected.

Biomonitoring of the adult population living near the waste incinerator of Turin: Serum concentrations of PCDDs, PCDFs, and PCBs after three years from the plant start-up

In September 2013 a waste-to-energy (WTE) incinerator located in the Turin area (Piedmont, Northern Italy) started to produce energy by the incineration of municipal solid wastes. The plant, one of the largest WTE incinerator in Europe, burns up to 490,000 tons of waste per year. A health surveillance program was implemented in order to evaluate the potential health effects on the population living near the plant. This program included a biomonitoring study aimed at assessing levels of several environmental contaminants including, among others, PCDDs, PCDFs, and PCBs. Before the WTE incinerator start-up (T₀), a group of 85 subjects (41 "exposed" and 44 "not exposed" subjects) was randomly selected for enrollment by the local health units among individuals aged 36-50 years who had been living in the same area for at least five years prior to the study. Subjects were balanced by exposure area, sex and five-year age classes. As from the study design, the same cohort was re-evaluated after three years of incinerator activity (T₂). A parallel study was conducted on a group of 12 farmers living and/or working in farms located in an area in the range of 5 km around the incinerator. Results of this study did not evidence any impact of the WTE plant on human exposure to PCDDs, PCDFs, and PCBs. In fact, no significant differences were found in the concentrations of PCDDs + PCDFs, DL-PCBs, and NDL-PCBs measured in the population group residing near the plant after three years of activity (T₂) with respect to the control group. A significant decrease of serum concentrations of all the analytes was observed at T₂ in both groups compared to T₀. Serum concentrations of PCDDs, PCDFs, and PCBs in the group of farmers were higher than those observed in the adult population under study.

Challenges in handling COVID-19 waste and its management mechanism: A Review

COVID-19, the novel corona virus has become a household name. The global COVID-19 outbreak, become a pandemic in early 2020, and spurred millions of life across the world. The pandemic is spreading extremely and its impacts upon human health and environment intensifying day-by-day. Biomedical waste generated daily due to COVID-19 are about the major environmental health concern and its critical management becomes a global challenge. Tones of COVID-19 contaminated wastes are generated every day worldwide and its sound management is very essential to break the disease transmission. The safe and sustainable management of COVID-19 contaminated biomedical waste (BMW) is a social and legal responsibility of all people during this critical period of disease transmission. Unsound management of this waste could cause unforeseen "knock-on" effects on human health and the environment. Health workers, municipal workers, rag-pickers and other persons who are involved directly or indirectly in the COVID -19 war are at high risk and needs to be careful while discharging their responsibility with an efficient and effective waste disposal mechanism.

Influence of environmental policies on waste treatment

Countries' growth along with the need to protect the environment has made waste management a major global concern. In this study, a detailed analysis is carried out of the current situation in 41 countries belonging to the OECD and/or the European Union, in order to identify the most sustainable practices that could be successfully implemented in other nations with similar characteristics. Cluster analysis is used to detect homogeneous groups, shedding light on the possible connection between environmental policies and waste treatment. Contingency tables are employed to determine the relationship between the effectiveness of the policies adopted and two indicators of sustainable practices: material recycling and waste generation. The study is conducted using statistical information from the Sustainable Governance Indicators project and the OECD, with data referring to 2018. Five internally homogeneous groups of countries have been identified, where Israel, Turkey and USA have the lowest participation and compliance in environmental policies. Also, the results show that countries with a high degree of participation in environmental treaties (Croatia, Denmark, Finland, France, Germany, Japan, Luxembourg, the Netherlands, Norway, Spain, Sweden, Switzerland) are making great progress, reducing the use of landfills in favour of other, more environmentally friendly options. Moreover, the contingency tables confirm that the effectiveness of policies translates into a clear trend towards recycling and, to some extent, reduces waste generation.

Municipal Solid Waste Management and Adverse Health Outcomes: A Systematic Review

Municipal solid waste (MSW) can pose a threat to public health if it is not safely managed. Despite prior research, uncertainties remain and refurbished evidence is needed along with new approaches. We conducted a systematic review of recently published literature to update and expand the epidemiological evidence on the association between MSW management practices and resident populations' health risks. Studies published from January 2005 to January 2020 were searched and reviewed following PRISMA guidelines. Eligible MSW treatment or disposal sites were defined as landfills, dumpsites, incinerators, waste open burning, transfer stations, recycling sites, composting plants, and anaerobic digesters. Occupational risks were not assessed. Health effects investigated included mortality, adverse birth and neonatal outcomes, cancer, respiratory conditions, gastroenteritis, vector-borne diseases, mental health conditions, and cardiovascular diseases. Studies reporting on human biomonitoring for exposure were eligible as well. Twenty-nine studies were identified that met the inclusion criteria of our protocol, assessing health effects only associated with proximity to landfills, incinerators, and dumpsites/open burning sites. There was some evidence of an increased risk of adverse birth and neonatal outcomes for residents near each type of MSW site. There was also some evidence of an increased risk of mortality, respiratory diseases, and negative mental health effects associated with residing near landfills. Additionally, there was some evidence of increased risk of mortality associated with residing near incinerators. However, in many cases, the evidence was inadequate to establish a strong relationship between a specific exposure and outcomes, and the studies rarely assessed new generation technologies. Evidence gaps remain, and recommendations for future research are discussed.

Urban Municipal Solid Waste management: Modeling air pollution scenarios and health impacts in the case of Accra, Ghana

Despite the clear link between air pollution and health, research to investigate the relationship between municipal solid waste management and air pollution and health has not been prioritized. Such research may generate scientific information that would help reduce population exposure to air pollutants. This paper examines the case study of Accra in Ghana, a city dealing with serious waste management problems. The paper proposes a methodology to estimate the impact of waste management on urban air pollution and health. The analysis is described in the following four steps: (1) collecting data on the waste sector; (2) modeling the emissions arising from waste management; (3) transforming emissions to concentration values and (4) estimating the burdens on health. The assessment has been conducted using the CCAC SWEET tool and WHO AirQ+. The method presented can be used in different locations, depending on data availability, when analyzing the impact of and potential changes to waste sector policies. The results of this health impact assessment indicate that, based on the emissions of PM_2.5 from the waste sector in Accra, a change from the business-as-usual to more sustainable options would reduce air pollutants emissions and avert 120 premature deaths in 2030. Levels of air pollution in Accra are significant and interventions to reduce PM_2.5 exposure should be promoted. The detailed analysis of the current situation provides suggestions for waste management policies in terms of impacts on health and ideas to reconsider the waste policies in Accra.

Tangerine, banana and pomegranate peels valorisation for sustainable environment: A review

Over the last decade the world has been generating a high quantity of tangerine peel waste (TPW), pomegranate peel waste (PPW) and banana peel waste (BPW). These peels have several economic benefits but there is mismanagement or inappropriate valorisation that could present risks to environment and public health. In the current review, we discussed the use of TPW, PPW and BPW directly for animal feed, soil fertilization, specific compost production and bio-adsorbent. We also discussed the valorisation of these peels for manufacturing the value-added products including enzymes, essential oil and other products that can be used in human food, in medical and cosmetic industry. Additionally, recent studies concerning the valorisation of these peels by biorefinery for bioethanol, biogas and biohydrogen production have been discussed. In the same context some other recent studies about valorisation of microorganisms isolated from these peels for medical, agronomic and industrial interests have been also discussed.

Challenges and actions to the environmental management of Bio-Medical Waste during COVID-19 pandemic in India

The outbreak of COVID-19 has engendered a global health crisis along with diverse impacts on economy, society and environment. Efforts to combat this pandemic have also significantly shot-up the quantity of Bio-medical Waste (BMW) generation. Safe disposal of large quantity of BMW has been gradually posing a major challenge. BMW management is mostly implemented at municipal level following regulatory guidelines defined by respective states and the Union. This article is a narrative of the status of BMW generation, management and regulation in India in the context of COVID-19 crisis. The article is based on comparative analysis of data on BMW generation and management from authentic sources, a systematic literature review and review of news reports. In the current pandemic situation where media has been playing a significant role in highlighting all the concerns related to COVID-19 spread and management. Assessing the ground situation regarding effectiveness of prevailing BMW management facilities, requirement and suggestions can provide insights to the subject with policy implications for India and countries as well. The discussion has been built on different dimensions of BMW management during the pandemic including existing infrastructures, capacity utilisation, policy guidelines, operational practices and waste-handlers aspects. The results on state-wise analysis of reported BMW quantity and active COVID-19 patients also reveal some non-linear relationship between the two variables. Delhi, the National Capital is situated at a better position in terms of BMW management as compared to other studied states. The findings are expected to provide valuable insights to the policy makers and other relevant authorities to evaluate adequateness as well as efficiency quotients of entire BMW management landscape. Some of the critical observations of this article are also expected to offer impetus for enhancing national disaster preparedness in future.

Life cycle assessment of municipal waste management options

To date, landfilling remains the most common waste management practice in Greece in spite of enforced regulations aiming at increasing recycling, pre-selection of waste and energy and material recovery. In this study, selected alternative scenarios aiming at minimizing the unused material fraction to be disposed of in landfills are analyzed, using the life cycle assessment methodology. The methodology was applied in the case of municipal solid waste (MSW) management in Athens and Thessaloniki, with a special focus on energy and material balance, including potential global and local scale airborne emissions. Results are given in the form of indices efficiency, effectiveness, environmental and public health impacts. Material flow accounting, gross energy requirement, emergy intensity, emission and release intensity and morbidity or mortality indicators have been used to support the comparative assessment. However, not all options are equally benign to the local environment and to the health of the local population, since both the former and the latter are still affected by non-negligible local emissions. With regard to public health impacts, adverse effects on respiratory health, congenital malformations, low birth weight and cancer incidence were estimated. A significant and not intuitive result is the fact that life cycle analysis produces different conclusions than a simple environmental impact assessment based only on estimated or measured emissions. Taking into account the overall life cycle of both the waste streams and of the technological systems and facilities envisaged alters the relative attractiveness of the solutions considered.

Nanoparticles impact in biomedical waste management

Effectual management of biomedical waste is obligatory for healthy human beings and for a safe environment. Mismanagement of biomedical waste is a community health problem. Safe and persistent methods for the management of biomedical waste are of vital importance. This article reviews the classification of biomedical waste, sources, colour-coding system of biomedical waste and salient features of biomedical waste rules in 2016, and the future prospective of nanoparticles. The untreated disposal of biomedical waste is associated with a huge amount of risk, so the efficient treatment for biomedical waste is most imperative. The review also highlights the current methods for disposal of biomedical waste, biological treatments given to biomedical waste water in the effluent treatment plant, and impacts due to the current method. Management of biomedical waste is a great challenge in developed and developing countries. To manage the biomedical waste there is a need for cost-effective, ecofriendly and less contaminating approaches for a greener and safe environment. The awareness regarding waste management is of great interest not only for the community but also for associated employees.

Narrative Review on Health-EDRM Primary Prevention Measures for Vector-Borne Diseases

Climate change is expanding the global at-risk population for vector-borne diseases (VBDs). The World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework emphasises the importance of primary prevention of biological hazards and its value in protecting against VBDs. The framework encourages stakeholder coordination and information sharing, though there is still a need to reinforce prevention and recovery within disaster management. This keyword-search based narrative literature review searched databases PubMed, Google Scholar, Embase and Medline between January 2000 and May 2020, and identified 134 publications. In total, 10 health-EDRM primary prevention measures are summarised at three levels (personal, environmental and household). Enabling factor, limiting factors, co-benefits and strength of evidence were identified. Current studies on primary prevention measures for VBDs focus on health risk-reduction, with minimal evaluation of actual disease reduction. Although prevention against mosquito-borne diseases, notably malaria, has been well-studied, research on other vectors and VBDs remains limited. Other gaps included the limited evidence pertaining to prevention in resource-poor settings and the efficacy of alternatives, discrepancies amongst agencies' recommendations, and limited studies on the impact of technological advancements and habitat change on VBD prevalence. Health-EDRM primary prevention measures for VBDs require high-priority research to facilitate multifaceted, multi-sectoral, coordinated responses that will enable effective risk mitigation.

Adverse health effects for populations living near waste incinerators with special attention to hazardous waste incinerators. A review of the scientific literature

Incinerators of municipal, hazardous and medical wastes are sources of emissions of toxic pollutants, being polychlorinated dibenzo-p-dioxins and dibenzofurans, as well as a number of heavy metals of special concern. Moreover, waste incineration also generates ashes that must be properly disposed. In all countries, waste management is currently being an issue of tremendous importance. While the treatment and disposal of municipal solid waste (MSW) is a problem in the entire world, in industrialized countries, the management of hazardous waste (HW) is an additional issue of important concern. While the available scientific information on the environmental impact and the health risks of MSWIs is quite considerable, that related with the potential adverse health effects for the populations living near HWIs is much more reduced. In this paper, we have reviewed the information on health effects-including the incidence of cancer and cancer mortality-for the people residing in the vicinity of HWIs. For a better understanding of the problem, some studies on cancer and other adverse health effects near MSWIs have been also reviewed. Special attention has been paid to the HWI of Constantí (Catalonia, Spain) on which the most complete information among all HWIs in the entire world is available. In our conclusions, a series of important issues/questions are raised: is really safe the limit value of 0.1 ng TEQ/Nm³ for PCDD/Fs to protect human health? Where are the evidences on this? On the other hand, to date, risk assessment studies have been only focused on certain substances; heavy metals and PCDD/Fs. Studies have not included those chemicals that are not routinely analyzed, being even some of them probably unknown right now. Moreover, what about potential interactions among chemicals in order to estimate the carcinogenic and non-carcinogenic risks for the population living near incinerators? Complete epidemiological studies are clearly necessary.

Exposure to waste sites and their impact on health: a panel and geospatial analysis of nationally representative data from South Africa, 2008-2015

BACKGROUND

Rapid population growth, urbanisation, and economic development have led to an unprecedented number of waste sites in developing countries. This challenge has become a contentious international relations issue, with an unsustainable amount of waste and its health consequences often being borne by developing countries. However, little national-level evidence is available in sub-Saharan Africa to quantify the association between exposure to waste sites and health.

METHODS

We used panel data from the South African National Income Dynamics Study (SA-NIDS) to investigate the association between exposure to waste sites and asthma, tuberculosis, diabetes, and depression. The SA-NIDS is a panel survey of a nationally representative sample in South Africa, which includes data reporting the health status of 32 255 individuals between 2008 and 2015. The study exposure was distance of households, in km, to the nearest waste site, derived from waste site geospatial locations from the South Africa Waste Information System.

FINDINGS

We observed a substantial increase in exposure of households to waste sites between 2008 and 2015. The median distance between study households and waste sites decreased from 68·3 km (IQR 31·1-111·7) to 8·5 km (3·0-23·7). Residing within 5 km of a waste site was significantly associated with asthma (adjusted relative risk 1·41; 95% CI 1·20-1·64), tuberculosis (1·18; 1·02-1·36), diabetes (1·25; 1·05-1·49), and depression (1·08; 1·03-1·14). The association persisted even after controlling for multiple socioeconomic factors.

INTERPRETATION

We identified multiple adverse health outcomes in individuals living close to waste sites at a national level in South Africa, suggesting the need to reduce the number and size of waste sites to diminish harmful effects on health and wellbeing for communities living in close proximity to such sites.

FUNDING

South African Medical Research Council, South African National Treasury, and Wellcome Trust.

Health effects of living near an incinerator: A systematic review of epidemiological studies, with focus on last generation plants

Huge reductions in incinerators' emissions occurred over time, and results of older studies cannot be directly generalized to modern plants. We conducted a systematic review of the epidemiologic evidence of the health effects of incinerators, classifying plants in three generations, according to emission limits. A systematic search identified 63 epidemiologic studies, published in English, investigating health effects of incinerators on humans. We focused on cancer, cardio-cerebrovascular diseases (CVD) and respiratory diseases, pregnancy outcomes and congenital anomalies. Only six studies in the general population were on third generation incinerators providing data on pregnancy outcomes and congenital anomalies. Given the heterogeneity of methods, the abundance of ecological/semi-ecological studies and the lack of reliable quantitative measures of exposure in several studies we did not perform any meta-analysis. No excesses emerged concerning all cancers and lung cancer. An excess of non-Hodgkin lymphoma was reported in some earlier studies, but not for second generation plants. Possible excesses of soft tissue sarcomas were confined to earlier incinerators and the areas closer to the plants. No clear association emerged for CVD and diseases of the respiratory system. Several different pregnancy outcomes were considered, and no consistent association emerged, in spite of a few positive results. Studies were negative for congenital anomalies as a whole. Sporadic excesses were reported in a few studies for specific types of anomalies, but no consistent pattern emerged. Evaluation of the evidence was hindered by heterogeneity in reporting and classification of outcomes across studies. Direct evidence from third generation plants is scarce. Methodological issues in study design (mainly related to exposure assessment, confounding and ecological design) and analysis make interpretation of results complex. In spite of this, the overall evidence suggests that, if there were any excesses at all for older incinerators, they were modest at most. Additional monitoring of third generation plants needs to overcome methodological weaknesses.

Assessment of the environmental impact of sanitary and unsanitary parts of a municipal solid waste landfill

Only seven regional MSWLF in Serbia are considered sanitary, while about 3500 landfills operate without proper pollution control. This paper presents a unique opportunity to evaluate the impact of a closed landfill, and a new sanitary landfill, which are located next to each other. The following methodologies for the landfill impact assessment were applied, based on data from 2012 to 2017: Landfill water pollution index (LWPI) and Nemerow index (PI_GW) for groundwater, and the geo-accumulation (I_geo) and ecological risk (ERⁱ) indices and several PAH ratios for soil. The performance of the leachate control system was evaluated using two adapted pollution indices: LPI and the Nemerow index (PI_L). According to the obtained LWPI and PI_GW values, the quality of groundwater at the new landfill is improving (LWPI = 1.05-2.62; PI_GW = 0.52-1.29), while no significant changes were observed for the old landfill (LWPI = 3.06-5.13; PI_GW = 2.03-4.78). High concentrations of ammonia nitrogen (1.01-22.74 mg/l), Fe (0.76-57.11 mg/l), Ni (5.80-230.09 μg/l), Pb (4.2-202.4 μg/l) and ∑PAH₁₆ (150.93-189.55 ng/l) show the strong influence of the landfill on the groundwater quality at the old landfill, indicating the need for additional remediation action. High concentrations of Ni (21.9-133.0 mg/kg) and Cr (8.5-277.0 mg/kg) in the analyzed soil compared to other studies, as well as moderate I_geo values (I_geoNi = 0.36-1.88; I_geoCr = -1.20-1.52), raise concern and suggest the need for further monitoring. The high ERⁱ (158.6-295.0) and I_geo values (0.91-2.30) of Hg show significant potential ecological risk. LPI and PI_L values for early methanogenic phase leachate demonstrates the need to improve the leachate treatment system. The monitoring data and applied pollution indices indicate that Cr and As should be added to the EU Watch List of emerging substances, at least regarding EU potential candidate countries.

Biomedical waste management in India: Critical appraisal

The safe and sustainable management of biomedical waste (BMW) is social and legal responsibility of all people supporting and financing health-care activities. Effective BMW management (BMWM) is mandatory for healthy humans and cleaner environment. This article reviews the recent 2016 BMWM rules, practical problems for its effective implementation, the major drawback of conventional techniques, and the latest eco-friendly methods for BMW disposal. The new rules are meant to improve the segregation, transportation, and disposal methods, to decrease environmental pollution so as to change the dynamic of BMW disposal and treatment in India. For effective disposal of BMWM, there should be a collective teamwork with committed government support in terms of finance and infrastructure development, dedicated health-care workers and health-care facilities, continuous monitoring of BMW practices, tough legislature, and strong regulatory bodies. The basic principle of BMWM is segregation at source and waste reduction. Besides, a lot of research and development need to be in the field of developing environmental friendly medical devices and BMW disposal systems for a greener and cleaner environment.

Solid Wastes Provide Breeding Sites, Burrows, and Food for Biological Disease Vectors, and Urban Zoonotic Reservoirs: A Call to Action for Solutions-Based Research

Background: Infectious disease epidemiology and planetary health literature often cite solid waste and plastic pollution as risk factors for vector-borne diseases and urban zoonoses; however, no rigorous reviews of the risks to human health have been published since 1994. This paper aims to identify research gaps and outline potential solutions to interrupt the vicious cycle of solid wastes; disease vectors and reservoirs; infection and disease; and poverty.

Methods: We searched peer-reviewed publications from PubMed, Google Scholar, and Stanford Searchworks, and references from relevant articles using the search terms (“disease” OR “epidemiology”) AND (“plastic pollution,” “garbage,” and “trash,” “rubbish,” “refuse,” OR “solid waste”). Abstracts and reports from meetings were included only when they related directly to previously published work. Only articles published in English, Spanish, or Portuguese through 2018 were included, with a focus on post-1994, after the last comprehensive review was published. Cancer, diabetes, and food chain-specific articles were outside the scope and excluded. After completing the literature review, we further limited the literature to “urban zoonotic and biological vector-borne diseases” or to “zoonotic and biological vector-borne diseases of the urban environment.”

Results: Urban biological vector-borne diseases, especially Aedes-borne diseases, are associated with solid waste accumulation but vector preferences vary over season and region. Urban zoonosis, especially rodent and canine disease reservoirs, are associated with solid waste in urban settings, especially when garbage accumulates over time, creating burrowing sites and food for reservoirs. Although evidence suggests the link between plastic pollution/solid waste and human disease, measurements are not standardized, confounders are not rigorously controlled, and the quality of evidence varies. Here we propose a framework for solutions-based research in three areas: innovation, education, and policy.

Conclusions: Disease epidemics are increasing in scope and scale with urban populations growing, climate change providing newly suitable vector climates, and immunologically naïve populations becoming newly exposed. Sustainable solid waste management is crucial to prevention, specifically in urban environments that favor urban vectors such as Aedes species. We propose that next steps should include more robust epidemiological measurements and propose a framework for solutions-based research.

Community Health Survey of Residents Living Near a Solid Waste Open Dumpsite in Sabak, Kelantan, Malaysia

The management of waste materials is a serious problem worldwide, especially in urbanizing countries like Malaysia. This study was conducted to compare the prevalence of health symptoms and diseases diagnosed among residents exposed to the solid waste open dumpsite in the suburb of Sabak with the non-exposed community. Research related to exposure to solid waste dumping with complete health problems has never been combined in one study. A comparative cross-sectional study was conducted. The exposed group included residents within a 1 km radius and the non-exposed group included residents between a 2.5 and 4.0 km radius from the dumpsite. The selected residents were interviewed using validated, structured questionnaires. A total of 170 residents from the exposed group and 119 residents from the non-exposed group were selected. The mean (SD) duration time of residence was 22.6 (18.9) years for the exposed group and 15.0 (12.0) years for the non-exposed group. Dumpsite exposure was significantly associated with sore throat (adjusted odd ratio (AOR) 1.88; 95% confidence interval (CI): 1.05, 3.38; p = 0.031), diabetes mellitus (AOR 2.84; 95% CI: 1.10, 7.30; p = 0.021) and hypertension (AOR 2.56; 95% CI: 1.27, 5.13; p = 0.006). This study provides evidence that the unsanitary solid waste disposal in Malaysia is hazardous to the health of residents in the surrounding 1 km, and efforts are needed to minimize the hazards.

Environmental and health risks related to waste incineration

The article presents a mini review of the published research focused on understanding environmental and human health impacts nearby waste incineration plants. We found no studies indicating that modern-technology waste incineration plants, which comply with the legislation on emissions, are a cancer risk factor or have adverse effects on reproduction or development. There are several factors in favor of this affirmation: (a) the emission levels of the plants currently built in the developed countries are several orders of magnitude lower than those of the plants in whose environments epidemiological studies have been carried out and which have found some kind of negative association in terms of health; (b) risk assessment studies indicate that most of the exposure is produced through the diet and not by a direct route; and (c) monitoring dioxin level studies in the population resident in the environment of incineration plants did not reveal increases of these levels when compared with a population living in reference areas. A necessary condition for the development of a waste incineration plant is to generate the conditions to prevent any impact that activates or potentially carries damage or risks to the environment and, in particular, to health. This makes it imperative to use a preventive strategy through the implementation of a previous environmental impact assessment and the establishment of emissions standards and an emissions monitoring program in order to ensure the prevention of environmental damage.

Mortality and Morbidity in a Population Exposed to Emission from a Municipal Waste Incinerator. A Retrospective Cohort Study

In the present research, we evaluated the health effects of exposure to the municipal waste incinerator (MWI) in Pisa, Italy, through a population-based cohort design. The individual exposure pattern in the area was estimated through CALPUFF dispersion models of NO_χ (developed by Atmospheric Studies Group Earth Tech, Lowell, Massachusetts), used as pollution proxies of the MWI and the relevant industrial plant, and through land-use regression for NO_χ due to traffic pollution. Using Cox regression analysis, hazard ratios (HR) were estimated adjusting for exposure to other sources of pollution, age, and socioeconomic deprivation. An adjusted linear trend of HR (HRt) over the categories of exposure, with the relative 95% CI and p-value, was also calculated. Mortality and hospital discharge were studied as impact outcomes. Mortality analysis on males showed increased trends of mortality due to natural causes (HRt p < 0.05), the tumor of the lymphohematopoietic system (HRt p = 0.01), cardiovascular diseases (HRt p < 0.01); in females, increased trends for acute respiratory diseases (HRt p = 0.04). Morbidity analysis showed a HRt for lymphohematopoietic system tumor in males (HRt p = 0.04). Some of the excesses are in agreement with previous evidence on the health effects of MWIs, although the observation in males but not in females, suggests a cautious interpretation. Confounding due to other sources of exposure cannot be ruled out. The evidence was considered important in the decision-making process of the waste cycle.

Birth defects in Tarnaveni area, Romania - preliminary study results

Background and aims

In the development of any human body, defects may occur, resulting in the occurrence of congenital malformations, also referred to as birth defects. The aim of this preliminary study was to assess the prevalence of birth defects registered during a period of 5 years in Tarnaveni area. As Tarnaveni is located in close proximity to a former chemical plant, a recognized hazardous waste site, we conducted this pilot study to assess the prevalence of birth defects, in order to evaluate the need for a more comprehensive investigation of a potential relation between the exposure to toxic metals contaminating the environmental media as a result of the past industrial activities, and the prevalence of the birth defects in this area.

Methods

We abstracted birth information (gestational age at delivery (GA), birth weight (BW), birth length (BL), head circumference (HC), and major structural birth defects), from medical records at “Dr. Gheorghe Marinescu“ Tarnaveni Municipal Hospital, of the 2010–2014 period. We expressed BW as Z-scores relative to expected mean values at each gestational age for a reference population, calculated the ponderal index, and determined the 5 years birth defects prevalence among live births during the study interval.

Results

The 5 years (2010–2014) prevalence of birth defects, was 3.3% (95% confidence interval (CI): 2.47, 4.09). There were n = 163 (8.7%) preterm deliveries (less than 37 weeks of gestation at delivery), mean birth weight was 3108.3 g (standard deviation (SD) = 517.1), ranging from 450–4600 g, and n = 187 (10%) were low birth weight (LBW) (less than 2500 g). The ponderal index was 2.2 g/cm³ on average (SD = 0.5), with range 1.2–20.7 g/cm³.

Conclusions

While preliminary, our data show a 5 years (2010–2014) prevalence of major structural birth defects among newborns from Tarnaveni area of 3.3%. These pilot results indicate the need for a more comprehensive investigation of a potential relation between the exposure to toxic metals contaminating the environmental media as a result of the past industrial activities and the prevalence of the birth defects in Tarnaveni area.

Landfills and preterm birth in the Guadeloupe archipelago (French West Indies): a spatial cluster analysis

Background

A high rate of preterm birth is observed in the Guadeloupe archipelago (French West Indies), raising the hypothesis of harmful environmental exposures, including landfilling. Our aim was to evaluate whether preterm births cluster around the three main open landfills located in this area.

Methods

The study population consisted of 911 women enrolled in the Timoun mother-child cohort (2004–2007). Home addresses during pregnancy and locations of landfills were geocoded. To test for the presence of preterm birth clusters around each dumpsite, we used a focused cluster test specifically designed to detect spatial clustering around point sources.

Results

A total of 144 (15.8%) preterm births were observed among 911 births. Using the term births (n = 767) as controls, a significant cluster was identified within 2 km around the Saint-François landfill with a relative risk (RR) of 4.82 (p = 0.04). No clusters were found around the other two landfills (RR = 2.01, p = 0.26 and RR = 1.06, p = 0.64, for La Gabarre and Baillif, respectively).

Conclusion

The paucity of data available on open landfill sites regarding waste quantities, composition, and changes over time precludes any site-specific interpretation because of the variable degree of possible emissions. This result has to be confirmed in other tropical island environments where waste management has become a major concern with the potential to negatively impact the environment and public health.

A respiratory health survey of a subsurface smoldering landfill

In late 2010, a subsurface smoldering event was detected in the Bridgeton Sanitary Landfill in St. Louis County, Missouri. This was followed by complaints from nearby residents of foul odors emanating from the landfill. In 2016 a health survey was conducted of residents near the landfill and, as a comparison, other regions of St. Louis County. The survey was a two-stage cluster sample, where the first stage was census blocks, and the second stage was households within the census blocks. The health survey, which was conducted by face-to-face interviews of residents both near the landfill and away from the landfill, focused mainly on respiratory symptoms and diseases such as asthma and chronic obstructive pulmonary disease. The differences in the prevalence of asthma (26.7%, 95% CI 19.8-34.1 landfill vs 24.7%, 95% CI 15.7-33.6 comparison) and COPD (13.7%, 95% CI 7.2-20.3 landfill vs 12.5%, 95% CI 6.4-18.7 comparison) between the two groups were not statistically significant. Landfill households reported significantly more "other respiratory conditions," (17.6%, 95% CI 11.1-24.1 landfill vs 9.5%, 95% CI 4.8-14.3 comparison) and attacks of shortness of breath (33.9%, 95% CI 25.1-42.8 landfill vs 17.9%, 95% CI 12.3-23.5). Frequency of odor perceptions and level of worry about neighborhood environmental issues was higher among landfill households (p < 0.001). We conclude that the results do not support the hypothesis that people living near the Bridgeton Landfill have elevated respiratory or related illness compared to those people who live beyond the vicinity of the landfill.

Management of municipal solid waste in Croatia: Analysis of current practices with performance benchmarking against other European Union member states

The European Commission has adopted a very ambitious circular economy package and has consequently revised many legislative proposals on waste. The new targets include achieving a recycling rate of 65% by 2030 and imposing a cap on landfilled waste to no more than 10% (as a percentage of weight). Using available European and national databases on municipal solid waste indicators, we have analysed municipal solid waste production trends for Croatia and have benchmarked the indicators against other EU member states and EU averages. Our analysis points out that the production of municipal solid waste has steadily risen over the last two decades. Although Croatia produces a relatively low amount of municipal solid waste compared with other EU countries and EU averages, gross domestic product adjusted waste production reveals that for every euro of gross domestic product Croatia produces substantial amounts of municipal solid waste. As a matter of fact, among all the EU member states, only Bulgaria had a worse performance than Croatia. Regarding recycling rates, Croatia recycles 15% of its municipal solid waste and incinerates approximately 3% (by weight). The rest (82% by weight) is currently being landfilled. Regarding the treatment of waste, Croatia has implemented mechanical-biological treatment technology, but our analysis reveals that the initial number of mechanical-biological treatment plants will likely have to be scaled down taking into consideration the new EU waste management targets.

Adverse pregnancy outcomes in women with changing patterns of exposure to the emissions of a municipal waste incinerator

Municipal solid waste incinerators emissions contain pollutants that, despite their low concentration, might adversely affect reproductive health. In the present study, we examined rates of miscarriage and birth defects among women who resided or were employed in the vicinity of a municipal solid waste incinerator plant from 2003 to 2013. In 2009, a progressive shutdown of the old incineration lines and operation of a new line caused considerably higher atmospheric release of polycyclic aromatic hydrocarbons, particularly of dioxins, due to these irregular operating conditions, technological renovation, and increased capacity. We used dioxin emission levels, based on a dispersion model, to define exposure status of the residing population to air pollutants emitted by the waste incinerator. In women who resided in areas characterized by higher emission exposures compared with a referent area, the relative risk (RR) of miscarriage was 1.04 (95% confidence interval (CI) 0.80-1.32) based on 62 cases overall, with little evidence of a dose-response relation. RRs were similarly null for both 2003-2008 and 2010-2013 periods (RR 1.12 (95% CI 0.80-1.53) and 0.98 (95% CI 0.63-1.48), respectively). Concerning birth defects in the offspring of women residing in the exposed area, no evidence of increased risk emerged, since the prevalence ratio at birth was 0.64 (95% CI 0.29-1.26), with comparable results in the 2003-2008 and 2010-2013 period. Corresponding analyses carried out in municipal residents who worked in the exposed area confirmed these findings. We also did not detect abnormally high rates of miscarriage and birth defects in the exposed cohorts in the single year 2009. Overall, these results do not suggest an effect of exposure to the emissions of the municipal solid waste incinerator we investigated on two indicators of reproductive health. However, the limited statistical stability of the estimates and the absence of individual-based information on some potential confounders suggest caution in the interpretation of study findings.

Preremedial assessment of the municipal landfill pollution impact on soil and shallow groundwater in Subotica, Serbia

Most regional municipal solid waste landfills in Serbia are operated without control of landfill leachate and gas or with no regard for implementation of national and European legislation. For the first time in Serbia, groundwater and soil at a landfill were subject to systematic annual monitoring according to national, European legislation and adopted methodologies. Characterisation of the groundwater and soil samples from the landfill included ten metals (Fe, Mn, As, Zn, Cd, Pb, Ni, Cr, Cu and Hg), 16 EPA PAHs, nutrients and certain physicochemical parameters, in order to assess the risks such poorly controlled landfills pose to the environment. This impact assessment was performed using specially adapted pollution indices: LWPI, the Single factor pollution index and the Nemerow index for groundwater, and geo-accumulation index, ecological risk factor and selected rations of PAHs for soil. The data analysis included multivariate statistical methods (factor analysis of principal component analysis (PCA/FA)) in order to assess the extent of the contaminants detected in the groundwater and soil samples. The pollution indices (LWPI: 3.56-8.89; Nemerow index: 2.02-3.78) indicate the quality of the groundwater at the landfill is degrading over time, with PAH₁₆, TOC, Cr, Cu, Pb and Zn as the substances of greatest concern. Heavy metals Hg (I_geo≤3.14), Pb (I_geo≤2.22), Cr (I_geo≤3.31) and Cu (I_geo≤2.16) represent the worst soil contamination. Hg has moderate (52.9) to very high (530.0) potential ecological risk, demonstrating the long-term potential effects of bioaccumulation and biomagnification. The results of this work indicate that Cr and Cu should possibly be added to the EU Watch List of emerging substances. This proposition is substantiated by relevant state and alike environmental information from nations in the region. This study demonstrates the need to develop a model for prioritization of landfill closure and remediation based on environmental risk assessment.

Heavy Environmental Pressure in Campania and Other Italian Regions: A Short Review of Available Evidence

The area of Naples and Campania region, in Italy, are experiencing the dramatic consequences of diffuse and illegal waste dumping, resulting in possible threats to human health. This area has been referred to as the “Land of Fires” because of the common practice of waste burning. International interest in the Campania “waste emergency” has triggered several epidemiological studies. This article is aimed at highlighting the body of evidence available concerning human and environmental contamination in the Campania region, and considers the possible lack of comparable knowledge about the situation in other areas suffering from high environmental pollution. We analyzed the results of studies addressing environmental pollution and population health in the Campania region, starting from the most recent reviews on this topic, and compared their findings with those concerning other regions. We reviewed 18 studies of epidemiological/cancer surveillance and human or animal biomonitoring. These studies show worrying results, which could be considered comparable to those available for other Italian areas impacted by heavy industrial activities. The release of environmental contaminants associated with waste incineration and waste disposal in landfills poses a risk to public health, as shown by a number of studies (although not conclusively). The current knowledge available for the Campania region is better than that available for other areas which are facing similar problems due to anthropic activities, including illegal waste trafficking. Thus, Naples and Campania could represent a valuable setting to develop general models for studies of environmental and human contamination.

Socio-demographic predictors of health and environmental co-benefit behaviours for climate change mitigation in urban China

Objective

This study aims to examine the patterns and socio-demographic predictors of health and environmental co-benefit behaviours that support climate change mitigation in a densely populated Asian metropolis—Hong Kong.

Methods

A population-based, stratified and cross-sectional random digit dialling telephone survey study was conducted between January and February 2016, among the Cantonese-speaking population aged 15 and above in Hong Kong. Socio-demographic data and the self-reported practice of 10 different co-benefit behaviours were solicited. Ethics approval and participant’s verbal consent were sought.

Findings

The study sample consisted of 1,017 respondents (response rate: 63.6%) were comparable to the age, gender and geographical distributions of the Hong Kong population found in the latest 2011 Hong Kong Population Census. Among the co-benefit behaviours, using less packaging and disposable shopping bags were practiced in the highest frequency (70.1%). However, four behaviours were found to have never been practiced by more than half of the respondents, including bringing personal eating utensils when dining in restaurants or small eateries, showering less than five minutes, having one vegetarian meal a week, and buying more organic food. Results of multivariable logistic regression showed that frequency of practicing co-benefit behaviours were consistently associated with gender and age.

Conclusion

Urban residents in Hong Kong do not engage in the practice of co-benefit behaviours in a uniform way. In general, females and older people are more likely to adopt co-benefit behaviours in their daily lives. Further research to assess the knowledge and attitudes of the population towards these co-benefit behaviours will provide support to relevant climate change mitigation policies and education programmes.

Hazardous waste and health impact: a systematic review of the scientific literature

Waste is part of the agenda of the European Environment and Health Process and included among the topics of the Sixth Ministerial Conference on Environment and Health. Disposal and management of hazardous waste are worldwide challenges. We performed a systematic review to evaluate the evidence of the health impact of hazardous waste exposure, applying transparent and a priori defined methods. The following five steps, based on pre-defined systematic criteria, were applied. 1. Specify the research question, in terms of "Population-Exposure-Comparators-Outcomes" (PECO).

POPULATION

people living near hazardous waste sites; Exposure: exposure to hazardous waste; Comparators: all comparators; Outcomes: all diseases/health disorders. 2. Carry out the literature search, in Medline and EMBASE. 3. Select studies for inclusion: original epidemiological studies, published between 1999 and 2015, on populations residentially exposed to hazardous waste. 4. Assess the quality of selected studies, taking into account study design, exposure and outcome assessment, confounding control. 5. Rate the confidence in the body of evidence for each outcome taking into account the reliability of each study, the strength of the association and concordance of results.Fifty-seven papers of epidemiological investigations on the health status of populations living near hazardous waste sites were selected for the evidence evaluation. The association between 95 health outcomes (diseases and disorders) and residential exposure to hazardous waste sites was evaluated. Health effects of residential hazardous waste exposure, previously partially unrecognized, were highlighted. Sufficient evidence was found of association between exposure to oil industry waste that releases high concentrations of hydrogen sulphide and acute symptoms. The evidence of causal relationship with hazardous waste was defined as limited for: liver, bladder, breast and testis cancers, non-Hodgkin lymphoma, asthma, congenital anomalies overall and anomalies of the neural tube, urogenital, connective and musculoskeletal systems, low birth weight and pre-term birth; evidence was defined as inadequate for the other health outcomes. The results, although not conclusive, provide indications that more effective public health policies on hazardous waste management are urgently needed. International, national and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, including illegal transboundary trade, and increase support regulation and its enforcement.

Changes in serum dioxin and PCB levels in residents around a municipal waste incinerator in Bilbao, Spain

There is a great concern in the Basque Country regarding emissions from waste incineration, in particular that of organochlorines (OCs), including dioxins, furans and polychlorinated biphenyls (PCBs), and their potential effect on human health. In 2005, a municipal solid waste plant (MSWP) started to operate in Bilbao, representing an opportunity to assess the exposure to the aforementioned pollutants among people living at various distances from the plant. In 2006 and 2008, we carried out two cross-sectional studies to quantify and assess changes in levels of these pollutants. The objective of this study was to describe the levels of OCs in the blood serum in 2013 of 127 adults of this prospective cohort, in four centres of population, near to and further away from the MSWP, and to study trends over time since it started to operate. This study shows the levels of OCs have decreased significantly, from 37.2% to 80.1%. Further, levels of OCs in areas near to the MSWP were not found to be higher than those in areas further afield.

Congenital Anomalies in Contaminated Sites: A Multisite Study in Italy

The health impact on populations residing in industrially contaminated sites (CSs) is recognized as a public health concern especially in relation to more vulnerable population subgroups. The aim of this study was to estimate the risk of congenital anomalies (CAs) in Italian CSs. Thirteen CSs covered by regional CA registries were investigated in an ecological study. The observed/expected ratios (O/E) with 90% confidence intervals (CI) for the total and specific subgroups of CAs were calculated using the regional areas as references. For the CSs with waste landfills, petrochemicals, and refineries, pooled estimates were calculated. The total number of observed cases of CAs was 7085 out of 288,184 births (prevalence 245.8 per 10,000). For some CSs, excesses for several CA subgroups were observed, in particular for genital and heart defects. The excess of genital CAs observed in Gela (O/E 2.36; 90% CI 1.73–3.15) is consistent with findings from other studies. For CSs including petrochemical and landfills, the pooled risk estimates were 1.10 (90% CI 1.01–1.19) and 1.07 (90% CI 1.02–1.13), respectively. The results are useful in identifying priority areas for analytical investigations and in supporting the promotion of policies for the primary prevention of CAs. The use of short-latency effect indicators is recommended for the health surveillance of the populations residing in CSs.

Biomonitoring and exposure assessment of people living near or working at an Italian waste incinerator: methodology of the SPoTT study

Only few studies on the health effect of waste incinerators were focused on human biomonitoring (HBM). Our aim is to describe a protocol for assessing early variation of selected items in a population group living close to a waste incinerator in Turin, Italy. A cohort of 394 subjects was randomly selected, among residents near the incinerator and residents far from it. To achieve this sample size, 765 subjects were contacted. The cohort was monitored before the start-up of the plant and will be followed up 1 and 3 years after, with measurements of respiratory function, selected blood and urine parameters including 19 metals, 17 congeners of PCDDs/Fs, 12 congeners of DL-PCBs, 30 congeners of NDL-PCBs, 11 OH-PAHs, specific hormones (T3, T4, TSH, cortisol and ACTH) and common health parameters. The same protocol is applied for plant workers and breeders living near the plant. Individual exposure to urban pollution and waste incinerator fallout were assessed through the use of mathematical models. Information on individual habits was assessed using a specific questionnaire. SPoTT is the first Italian study that adopts a longitudinal design of appropriate statistical power to assess health impacts of waste incinerator plants' emission. The initial results comparing the baseline to the first follow-up are due at the end of 2016.

Morbidity and mortality of people who live close to municipal waste landfills: a multisite cohort study

BACKGROUND

The evidence on the health effects related to residing close to landfills is controversial. Nine landfills for municipal waste have been operating in the Lazio region (Central Italy) for several decades. We evaluated the potential health effects associated with contamination from landfills using the estimated concentration of hydrogen sulphide (H2S) as exposure.

METHODS

A cohort of residents within 5 km of landfills was enrolled (subjects resident on 1 January 1996 and those who subsequently moved into the areas until 2008) and followed for mortality and hospitalizations until 31 December 2012. Assessment of exposure to the landfill (H2S as a tracer) was performed for each subject at enrolment, using a Lagrangian dispersion model. Information on several confounders was available (gender, age, socioeconomic position, outdoor PM10 concentration, and distance from busy roads and industries). Cox regression analysis was performed [Hazard Ratios (HRs), 95% confidence intervals (CIs)].

RESULTS

The cohort included 242 409 individuals. H2S exposure was associated with mortality from lung cancer and respiratory diseases (e.g. HR for increment of 1 ng/m(3) H2S: 1.10, 95% CI 1.02-1.19; HR 1.09, 95% CI 1.00-1.19, respectively). There were also associations between H2S and hospitalization for respiratory diseases (HR = 1.02, 95% CI 1.00-1.03), especially acute respiratory infections among children (0-14 years) (HR = 1.06, 95% CI 1.02-1.11).

CONCLUSIONS

Exposure to H2S, a tracer of airborne contamination from landfills, was associated with lung cancer mortality as well as with mortality and morbidity for respiratory diseases. The link with respiratory disease is plausible and coherent with previous studies, whereas the association with lung cancer deserves confirmation.

Environmental pollution from illegal waste disposal and health effects: a review on the "triangle of death"

The term “triangle of death” was used for the first time by Senior and Mazza in the journal The Lancet Oncology referring to the eastern area of the Campania Region (Southern Italy) which has one of the worst records of illegal waste dumping practices. In the past decades, many studies have focused on the potential of illegal waste disposal to cause adverse effects on human health in this area. The great heterogeneity in the findings, and the bias in media communication has generated great healthcare doubts, anxieties and alarm. This paper addresses a review of the up-to-date literature on the “triangle of death”, bringing together the available information on the occurrence and severity of health effects related to illegal waste disposal. The Scopus database was searched using the search terms “waste”, “Campania”, “Naples”, “triangle of death” and “human biomonitoring”. Despite the methodological and sampling heterogeneity between the studies, this review examines the evidence from published data concerning cancer incidence, childhood mortality and birth defects, so that the current situation, knowledge gaps and research priorities can be established. The review aims to provide a contribution to the scientific community, and to respond to the concerns of the general population.

Cross-species toxicogenomic analyses and phenotypic anchoring in response to groundwater low-level pollution

Background

Comparison of toxicogenomic data facilitates the identification of deregulated gene patterns and maximizes health risk prediction in human.

Results

Here, we performed phenotypic anchoring on the effects of acute exposure to low-grade polluted groundwater using mouse and zebrafish. Also, we evaluated two windows of chronic exposure in mouse, starting in utero and at the end of lactation. Bioinformatic analysis of livers microarray data showed that the number of deregulated biofunctions and pathways is higher after acute exposure, compared to the chronic one. It also revealed specific profiles of altered gene expression in all treatments, pointing to stress response/mitochondrial pathways as major players of environmental toxicity. Of note, dysfunction of steroid hormones was also predicted by bioinformatic analysis and verified in both models by traditional approaches, serum estrogens measurement and vitellogenin mRNA determination in mice and zebrafish, respectively.

Conclusions

In our report, phenotypic anchoring in two vertebrate model organisms highlights the toxicity of low-grade pollution, with varying susceptibility based on exposure window. The overlay of zebrafish and mice deregulated pathways, more than single genes, is useful in risk identification from chemicals implicated in the observed effects.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2164-15-1067) contains supplementary material, which is available to authorized users.