Geographic density of landfill sites and risk of congenital anomalies in England

Self-reported symptoms of ocular allergy and its comorbid factors among residents living near a landfill site in Ghana

Residents close to landfill sites may be exposed to long-term emitted toxic compounds that may have effects on their eyes. The aim of this study was to determine the prevalence of symptomatic ocular allergy and its comorbid factors among residents living near a landfill site in Ghana. An exploratory cross-sectional design involving 400 inhabitants living around a landfill site was employed. The prevalence of symptomatic ocular allergy was 59.3%. In a bivariate analysis, comorbid conditions including respiratory disease, coughing, flu, cholera, skin disease, diarrhoea, and hypertension predicted symptomatic ocular allergy. However, only cholera remained a significant predictor of symptomatic ocular allergy in the multivariate analysis. Symptomatic ocular allergy was high among inhabitants around the landfill site in Ghana. While proper design and management of landfills in Ghana is crucial, further longitudinal and clinical studies are required to clinically establish the link between landfill and ocular allergy.

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.

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.

A Geographic Information System-Based Indicator of Waste Risk to Investigate the Health Impact of Landfills and Uncontrolled Dumping Sites

Uncontrolled and poor waste management practices are widespread. The global health impact of hazardous waste exposure is controversial, but the excess of some diseases appears to be consistent. The Geographic Information System (GIS, ESRI Inc., Rome, Italy) method used to estimate the waste risk exposure, in an area with many illegal waste dumps and burning sites, is described. A GIS geodatabase (ESRI ArcGIS format) of waste sites’ data was built. A municipal GIS-based indicator of waste risk (Municipal Risk Index: MRI) has been computed, based on type and quantity of waste, typology of waste disposal, known or potential environmental contamination by waste and population living near waste sites. 2767 waste sites were present in an area 426 km² large. 38% of the population lived near one or more waste sites (100 m). Illegal/uncontrolled waste dumps, including waste burning areas, constituted about 90% of all sites. The 38 investigated municipalities were categorized into 4 classes of MRI. The GIS approach identified a widespread impact of waste sites and the municipalities likely to be most exposed. The highest score of the MRI included the municipalities with the most illegal hazardous waste dumps and burning sites. The GIS-geodatabase provided information to contrast and to prosecute illegal waste trafficking and mismanagements.

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.

Risk of congenital anomalies near municipal waste incinerators in England and Scotland: Retrospective population-based cohort study

BACKGROUND

Few studies have investigated congenital anomalies in relation to municipal waste incinerators (MWIs) and results are inconclusive.

OBJECTIVES

To conduct a national investigation into the risk of congenital anomalies in babies born to mothers living within 10 km of an MWI associated with: i) modelled concentrations of PM₁₀ as a proxy for MWI emissions more generally and; ii) proximity of residential postcode to nearest MWI, in areas in England and Scotland that are covered by a congenital anomaly register.

METHODS

Retrospective population-based cohort study within 10 km of 10 MWIs in England and Scotland operating between 2003 and 2010. Exposure was proximity to MWI and log of daily mean modelled ground-level particulate matter ≤10 μm diameter (PM₁₀) concentrations.

RESULTS

Analysis included 219,486 births, stillbirths and terminations of pregnancy for fetal anomaly of which 5154 were cases of congenital anomalies. Fully adjusted odds ratio (OR) per doubling in PM₁₀ was: 1·00 (95% CI 0·98-1·02) for all congenital anomalies; 0·99 (0·97-1·01) for all congenital anomalies excluding chromosomal anomalies. For every 1 km closer to an MWI adjusted OR was: 1·02 (1·00-1·04) for all congenital anomalies combined; 1·02 (1·00-1·04) for all congenital anomalies excluding chromosomal anomalies; and, for specific anomaly groups, 1·04 (1·01-1·08) for congenital heart defect sand 1·07 (1·02-1·12) for genital anomalies.

DISCUSSION

We found no increased risk of congenital anomalies in relation to modelled PM₁₀ emissions, but there were small excess risks associated with congenital heart defects and genital anomalies in proximity to MWIs. These latter findings may well reflect incomplete control for confounding, but a possible causal effect cannot be excluded.

Do emissions from landfill fires affect pregnancy outcomes? A retrospective study after arson at a solid waste facility in Sicily

OBJECTIVES

In response to public health concern about effects of arson at solid waste management plants in July 2012, we analysed vital statistics data to evaluate any potential effect on pregnancies at different gestational ages of pollutants emitted from the landfill on fire.

SETTING

A community living near the largest landfill plant in Sicily.

PARTICIPANTS

The study group comprised 551 births, live births and stillbirths from pregnancies of mothers residing in the extra-urban exposed area, conceived during a 40 week period during which the highest fire's peak might have influenced pregnancy.

PRIMARY AND SECONDARY OUTCOME MEASURES

Birth outcomes (gestational age <37 and <32 weeks, low birth weight, very low birth weight and small for gestational age) in the study group were compared with the ones of a reference group of women residing in areas of Sicily with similarly low population density and industrial development.

RESULTS

Among singleton live births we observed a three-fold increase in risk of very preterm birth between the extra-urban area and the remaining low inhabitants density and unindustrialised areas for births whose pregnancies were in the third trimester (OR adjusted for maternal age and infant gender=3.41; 95% CI 1.04 to 11.16). There was an excess of very low birth weight singleton infants in the study group as compared with the reference group, which was limited to births to mothers exposed during periconception period (OR adjusted for maternal age and infant gender=4.64; 95% CI 1.04 to 20.6) and first trimester (OR adjusted for maternal age and infant gender=3.66; 95% CI 1.11 to 12.1). The association estimates were imprecise due to the small number of outcomes recorded.

CONCLUSIONS

The study documented an excess of very preterm and very low birth weight among infants born to mothers exposed to the landfill fire emissions during conception or early pregnancy.

European Countries: Does common legislation guarantee better hazardous waste performance for European Union member states?

The study of efficiency in hazardous waste management has been proved to be a driving factor for sustainable development (SD). This study focuses on a performance assessment of European countries, most of them European Union (EU) member states and candidate countries that share a common legislative framework through European regulations, in order to provide a general understanding of hazardous waste performance. In this paper, we use Data Envelopment Analysis (DEA) to examine the efficiency of 32 countries in Europe by using novel input/output environmental parameters to study the efficiency of the different waste management operations from an environmental point of view. This analysis contrasts the efficiency in the management of total waste versus hazardous waste and studies three operations with hazardous wastes: incineration and incineration with energy recovery, disposal and recovery. Results show that there are differences in the achievement of efficiency, not only among countries, but also among the different waste management operations analysed.

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.

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.

Systematic literature review of reproductive outcome associated with residential proximity to polluted sites

This study aims to assess the evidence on adverse pregnancy outcome associated with living close to polluted industrial sites, and identify the strengths and weaknesses of published epidemiological studies. A systematic literature search has been performed on all epidemiological studies published in developed countries since 1990, on the association between residential proximity to industrial sites (hazardous waste sites, industrial facilities and landfill sites) and adverse pregnancy outcome (low birth weight, preterm birth, small for gestational age, intrauterine growth retardation, infant mortality, congenital malformation). Based on 41 papers, our review reveals an excess risk of reproductive morbidity. However, no studies show significant excess risk of mortality including fetal death, neonatal or infant mortality and stillbirth. All published studies tend to show an increased risk of congenital abnormalities, yet not all are statistically significant. All but two of these studies revealed an excess risk of low birth weight. Results for preterm birth, small for gestational age and intrauterine growth retardation show the same pattern. There is suggestive evidence from the post-1990 literature that residential proximity to polluted sites (including landfills, hazardous waste sites and industrial facilities) might contribute to adverse reproductive outcomes, especially congenital malformations and low birth weight-though not mortality. This body of evidence has limitations that impede the formulation of firm conclusions, and new, well-focused studies are called for. The review findings suggest that continued strengthening of rules governing industrial emissions as well as industrial waste management and improved land use planning are needed.

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.

The evidence of toxic wastes dumping in Campania, Italy

The region of Campania (particularly Naples and Caserta) were subjected to extensive illegal dumping operations of toxic and radioactive wastes since the 1980s. The highly toxic wastes (HTW) dumping operations that have taken place both along the coast and the hinterland, have extremely adverse effects on health, livelihoods and the future prospect of sustainable development of the local population. The toxic wastes dumping in Campania is real and it has compromised (irreversibly) the human health, natural environment, food security and the long-term development prospects of the affected population. To reverse this tragic trend, it is necessery the identification, isolation and reclamation of the polluted sites and full assessment of the nature and the scale of the polluting chemicals and other hazardous wastes. The purpose of this review is to contribute significantly to the available evidence of the long-running toxic waste dumping in Campania and its negative impact on the health of population.

Differences in health symptoms among residents living near illegal dump sites in Los Laureles Canyon, Tijuana, Mexico: a cross sectional survey

Living near landfills is a known health hazard prompting recognition of environmental injustice. The study aim was to compare self-reported symptoms of ill health among residents of four neighborhoods, living in haphazardly constructed settlements surrounded by illegal dumpsites in Tijuana, Mexico. One adult from each of 388 households located in Los Laureles Canyon were interviewed about demographics, health status, and symptoms. Distance from each residence to both the nearest dumpsite and the canyon bottom was assessed. The neighborhoods were selected from locations within the canyon, and varied with respect to proximity to dump sites. Residents of San Bernardo reported significantly higher frequencies of ill-health symptoms than the other neighborhoods, including extreme fatigue (OR 3.01 (95% CI 1.6-5.5)), skin problems/irritations (OR 2.73 (95% CI 1.3-5.9)), stomach discomfort (OR 2.47 (1.3-4.8)), eye irritation/tears (OR 2.02 (1.2-3.6)), and confusion/difficulty concentrating (OR 2.39 (1.2-4.8)). Proximity to dumpsites did not explain these results, that varied only slightly when adjusted for distance to nearest dumpsite or distance to the canyon bottom. Because San Bernardo has no paved roads, we hypothesize that dust and the toxicants it carries is a possible explanation for this difference. Studies are needed to further document this association and sources of toxicants.

Evaluating biotoxicity variations of landfill leachate as penetrating through the soil column

Recent studies of leachate-induced ecotoxicity have focused on crude samples, while little attention has been given to changes in biotoxicity resulting from the environmental behavior of landfill leachate. Therefore, we set up a soil column to simulate the underground penetration of leachate into the soil layer, define the rules of migration and transformation of leachate pollutants, and determine the variation in toxicity of landfill leachate during penetration. The results demonstrated that: (1) landfill leachate inhibited the growth and chlorophyll levels, elevated the levels of lipid peroxidation and protein oxidation, and stimulated the antioxidant enzyme activities of barley seedlings. The effects generally displayed a peak value at 12-24 cm, slowly declined at 36-48 cm, and then rapidly decreased with penetrating distance in the column. (2) Statistical correlation analysis of the properties of leachate and the observed biotoxic effects revealed that COD, conductivity and heavy metals (esp. Ni, Mn, Cd) were positively correlated with variations in biotoxicity. (3) The microbial activity of outflowing leachate sampled from the 48 cm port was significantly higher than the activity from succedent ports, and the types of contaminants increased in the leachate outflowing from the same port, implying that microbial behaviors near the 48 cm port could be used to partially evaluate variations in the composition and biotoxicity of landfill leachate. Taken together, the above results illustrate the polluting characteristics of landfill leachate when penetrating a soil column and provide guidance for pollution control and risk assessment of landfill leachate.

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

OBJECTIVES

Potential health hazards for the environment and people living nearby landfills and incinerators are claimed to be related to several methods of waste management. Independent systematic review of the scientific literature is a key procedure to support the lay public and policy makers to achieve informed decisions.

METHODS

The study design and potential biases of papers retrieved in this comprehensive literature search were analyzed.

RESULTS

The most consistent result is that the risks of congenital anomalies and hospitalization due to respiratory disease are likely to be real nearby special waste landfills. From the very little information on exclusively urban waste depots it is reasonable to say that correct management of landfill does not increase the risk of these health effects. It is confirmed that historically incinerators are an important source of pollution and harm for the health of populations living nearby; however, changes in technology are producing more reassuring results.

CONCLUSIONS

A moderate level of confidence is possible in limited areas of knowledge, implying the need to overcome the limitations of current studies about exposure assessment and to control confounders at the individual level.

[Solid urban waste: socio-environmental impacts and prospects for sustainable management with social inclusion]

Strategies to reconcile development with the protection of ecosystems will yet again be discussed at the forthcoming Rio +20 Summit. The management of solid urban waste is an issue which has barely been touched upon in such discussions. Given the institutionalization of the National Solid Waste Policy, this paper seeks to contribute to this debate and to single out alternatives to tackle this issue with an emphasis on social inclusion. For this purpose, specialized scientific literature was consulted as well as information on solid waste management. It is clearly seen that inadequate management of solid waste has immediate impacts on the environment and health, and contributes to climate change. Considering the limitations of the current options for waste disposal, it is essential to minimize the quantities produced by reducing, reusing and recycling. In this context, the role of independent waste gatherers who have been conducting work of great environmental importance is highlighted. Given the vulnerabilities of this population, it is necessary to devise public policies to ensure that waste gathering is a more respected and less risky activity that guarantees an income, so as to move towards more healthy, equitable and sustainable development.

Residential proximity to environmental hazards and adverse health outcomes

How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses.

Health risks in areas close to urban solid waste landfill sites

OBJECTIVE

To evaluate the association between living close to solid waste landfill sites and occurrences of cancer and congenital malformations among populations in their vicinity.

METHODS

Deaths among people living in the municipality of São Paulo, Southeastern Brazil, between 1998 and 2002 were selected and geocoded, according to selected causes. Over the period evaluated, there were 351 deaths due to liver cancer, 160 due to bladder cancer and 224 due to leukemia, among adults, 25 due to childhood leukemia and 299 due to congenital malformation, in areas close to landfill sites. Buffer zones of radius 2 km around the 15 sites delimited the areas exposed. Standardized mortality ratios for each outcome were analyzed in Bayesian spatial models.

RESULTS

In a general manner, the highest values for the standardized mortality ratios were found in more central areas of the municipality, while the landfill sites were located in more peripheral areas. The standardized mortality ratios did not indicate any excess risk for people living in areas close to solid waste landfill sites in the municipality of São Paulo. For landfill sites in operation, there was a greater risk of bladder and liver cancer, and death due to congenital malformation, but without statistical significance.

CONCLUSIONS

No increase in the risk of cancer or congenital malformations was found in areas in the vicinity of urban waste dumps in the municipality of São Paulo. The weak associations and the imprecision of the estimates obtained did not allow any causal relationship to be established.

Inequalities, inequities, environmental justice in waste management and health

BACKGROUND

The scientific evidence on the health effects of waste-related exposure is not conclusive. Differential exposure to waste by socio-economic status (SES) is often documented, but the interplay between environmental and social factors, crucial for policy making, is not well known. This review aims at investigating the role of health inequalities and inequities in waste management.

METHODS

Grey and peer-reviewed literature, published after 1983, was reviewed from Europe and the USA.

RESULTS

Available data provide consistent indications that waste facilities are often disproportionally more located in areas with more deprived residents, or from ethnical minorities. This applies to waste incinerators, landfills, hazardous waste sites, legal and illegal. In studies considering health effects (mainly from Europe), risks are estimated with standardization for SES. Such standardization almost always decreases risk estimates for several cancers and reproductive outcomes. However, effect modification is not investigated in these studies.

CONCLUSIONS

The patterns of association between waste-related environmental pressures and SES suggest that some of the observed inequalities in exposure and health represent a case of environmental injustice as they are the result of social processes and may be prevented, at least partly. Disentangling the possible health effects remains difficult, due to limitations in the methodology. It seems important to investigate if disadvantaged people are more vulnerable, i.e. risks differ in different social groups living in the same area. Notwithstanding these open questions, public health officers and decision makers should identify waste management policies to minimize their potential health impacts and their unequal distribution.

Systematic review of epidemiological studies on health effects associated with management of solid waste

BACKGROUND

Management of solid waste (mainly landfills and incineration) releases a number of toxic substances, most in small quantities and at extremely low levels. Because of the wide range of pollutants, the different pathways of exposure, long-term low-level exposure, and the potential for synergism among the pollutants, concerns remain about potential health effects but there are many uncertainties involved in the assessment. Our aim was to systematically review the available epidemiological literature on the health effects in the vicinity of landfills and incinerators and among workers at waste processing plants to derive usable excess risk estimates for health impact assessment.

METHODS

We examined the published, peer-reviewed literature addressing health effects of waste management between 1983 and 2008. For each paper, we examined the study design and assessed potential biases in the effect estimates. We evaluated the overall evidence and graded the associated uncertainties.

RESULTS

In most cases the overall evidence was inadequate to establish a relationship between a specific waste process and health effects; the evidence from occupational studies was not sufficient to make an overall assessment. For community studies, at least for some processes, there was limited evidence of a causal relationship and a few studies were selected for a quantitative evaluation. In particular, for populations living within two kilometres of landfills there was limited evidence of congenital anomalies and low birth weight with excess risk of 2 percent and 6 percent, respectively. The excess risk tended to be higher when sites dealing with toxic wastes were considered. For populations living within three kilometres of old incinerators, there was limited evidence of an increased risk of cancer, with an estimated excess risk of 3.5 percent. The confidence in the evaluation and in the estimated excess risk tended to be higher for specific cancer forms such as non-Hodgkin's lymphoma and soft tissue sarcoma than for other cancers.

CONCLUSIONS

The studies we have reviewed suffer from many limitations due to poor exposure assessment, ecological level of analysis, and lack of information on relevant confounders. With a moderate level confidence, however, we have derived some effect estimates that could be used for health impact assessment of old landfill and incineration plants. The uncertainties surrounding these numbers should be considered carefully when health effects are estimated. It is clear that future research into the health risks of waste management needs to overcome current limitations.