Burden of disease from toxic waste sites in India, Indonesia, and the Philippines in 2010

Ecotoxicological impacts of landfill sites: Towards risk assessment, mitigation policies and the role of artificial intelligence

Waste disposal in landfills remains a global concern. Despite technological developments, landfill leachate poses a hazard to ecosystems and human health since it acts as a secondary reservoir for legacy and emerging pollutants. This study provides a systematic and scientometric review of the nature and toxicity of pollutants generated by landfills and means of assessing their potential risks. Regarding human health, unregulated waste disposal and pathogens in leachate are the leading causes of diseases reported in local populations. Both in vitro and in vivo approaches have been employed in the ecotoxicological risk assessment of landfill leachate, with model organisms ranging from bacteria to birds. These studies demonstrate a wide range of toxic effects that reflect the complex composition of leachate and geographical variations in climate, resource availability and management practices. Based on bioassay (and other) evidence, categories of persistent chemicals of most concern include brominated flame retardants, per- and polyfluorinated chemicals, pharmaceuticals and alkyl phenol ethoxylates. However, the emerging and more general literature on microplastic toxicity suggests that these particles might also be problematic in leachate. Various mitigation strategies have been identified, with most focussing on improving landfill design or leachate treatment, developing alternative disposal methods and reducing waste volume through recycling or using more sustainable materials. The success of these efforts will rely on policies and practices and their enforcement, which is seen as a particular challenge in developing nations and at the international (and transboundary) level. Artificial intelligence and machine learning afford a wide range of options for evaluating and reducing the risks associated with leachates and gaseous emissions from landfills, and various approaches tested or having potential are discussed. However, addressing the limitations in data collection, model accuracy, real-time monitoring and our understanding of environmental impacts will be critical for realising this potential.

Environmental pitfalls and associated human health risks and ecological impacts from landfill leachate contaminants: Current evidence, recommended interventions and future directions

The improper management of solid waste, particularly the dumping of untreated municipal solid waste, poses a growing global challenge in both developed and developing nations. The generation of leachate is one of the significant issues that arise from this practice, and it can have harmful impacts on both the environment and public health. This paper presents an overview of the primary waste types that generate landfill leachate and their characteristics. This includes examining the distribution of waste types in landfills globally and how they have changed over time, which can provide valuable insights into potential pollutants in a given area and their trends. With a lack of specific regulations and growing concerns regarding environmental and health impacts, the paper also focuses on emerging contaminants. Furthermore, the environmental and ecological impacts of leachate, along with associated health risks, are analyzed. The potential applications of landfill leachate, suggested interventions and future directions are also discussed in the manuscript. Finally, this work addresses future research directions in landfill leachate studies, with attention, for the first time to the potentialities that artificial intelligence can offer for landfill leachate management, studies, and applications.

Burden of lung cancer and predicted costs of occupational exposure to hexavalent chromium in the EU - The impact of different occupational exposure limits

BACKGROUND

Exposure to hexavalent chromium [Cr(VI)] occurs widely in occupational settings across the EU and is associated with lung cancer. In 2025, the occupational exposure limit is set to change to 5 μg/m³. Current exposure limits are higher, with 10 μg/m³ as a general limit and 25 μg/m³ for the welding industry. We aimed to assess the current burden of lung cancer caused by occupational exposure to Cr(VI) and to evaluate the impact of the recently established EU regulation by analysing different occupational exposure limits.

METHODS

Data were extracted from the literature, the Global Burden of Disease 2019) study, and Eurostat. We estimated the cases of cancer attributable to workplace exposure to Cr(VI) by combining exposure-effect relationships with exposure data, and calculated related DALYs and health costs in scenarios with different occupational exposure limits.

RESULTS

With current EU regulations, 253 cases (95%UI 250.96-255.71) of lung cancer were estimated to be caused by Cr(VI) in 2019, resulting in 4684 DALYs (95%UI 4683.57-4704.08). In case the welding industry adopted 10 μg/m³, a decrease of 43 cases and 797 DALYs from current values is expected. The predicted application of a 5 μg/m³ limit would cause a decrease of 148 cases and 2746 DALYs. Current costs are estimated to amount to 12.47 million euros/year (95%UI 10.19-453.82), corresponding to 39.97 million euros (95%UI 22.75-70.10) when considering costs per DALY. The limits implemented in 2025 would lead to a decrease of 23.35 million euros when considering DALYs, with benefits of introducing a limit value occurring after many decades. Adopting a 1 μg/m³ limit would lower costs to 1.04 million euros (95%UI 0.85-37.67) and to 3.33 million euros for DALYs (95%UI 1.89-5.84).

DISCUSSION

Assessing different scenarios with different Cr(VI) occupational exposure limits allowed to understand the impact of EU regulatory actions. These findings make a strong case for adapting even stricter exposure limits to protect workers' health and avoid associated costs.

Re-assessing global municipal solid waste generation

This study contributes to estimate the total waste generated at global level. A few studies have provided an efficient and comprehensive global estimate. However, data reporting is globally inconsistent due to varying interpretation of terminology, lacking standardised categories and varying methodologies used to observe and measure waste amounts. This study employs regression analysis and material flow analysis approaches to ensure a cross-comparability of waste generation data. The result implies that total global waste arisings are around 20 billion tonnes in 2017. This corresponds to 2.63 tonnes of total waste per capita (cap) per year. The total global waste generated is expected to grow to 46 billion tonnes by 2050 under a business-as-usual scenario. Municipal solid waste (MSW) is a much smaller amount, ranging from 2.3 to 3.1 billion tonnes (average of 2.7 billion tonnes) in 2019. This figure reflects an increase of between 30% and 50% in MSW generated during the last 15 years (2004-2019). MSW generated is expected to grow to 2.89-4.54 billion tonnes by 2050, depending on which assumptions are used. This represents a 26%-45% increase compared to 2019. The overall assessment in this study reveals that almost one-third of the total MSW generated is not collected, and most of what is collected is not treated accordingly to current ideas of sound management. Moreover, almost 42% of MSW goes to open dumping or uncontrolled burning. The finding provides valuable insight for policymakers to design and assess circular economy policy instruments towards achieving sustainable development goals.

Unlocking India's Potential in Managing Endocrine-Disrupting Chemicals (EDCs): Importance, Challenges, and Opportunities

Endocrine-disrupting chemicals (EDCs) are a prime concern for the environment and health globally. Research shows that in developing countries such as India both the environment and human populations are severely exposed to EDCs and consequently experience rising incidents of adverse health effects such as diabetes and cancers. In this paper, we discuss the current EDC management approach in India, critically assess its limitations, and describe opportunities for potential improvements. Foremost, current EDC management actions and interventions in India are fragmented and outdated, and far behind the modern and comprehensive approaches adopted in the European Union and other developed countries. Strong and well-planned actions are required on various fronts of science, policy, commerce, and public engagement. These actions include the adoption of a dedicated and modern regulatory framework for managing EDCs, enhancing capacity and infrastructure for EDC monitoring in the environment and human population, employing public-private partnership programs for not only managing EDCs but also in the sectors that indirectly contribute toward the mismanagement of EDCs in the country, and raising awareness on EDCs and promoting health-preserving consumption habits among the public. As India hosts a large proportion of the global human population and biodiversity, the success or failure of its actions will substantially affect the direction of global efforts to manage EDCs and set an example for other developing countries.

Environmental monitoring and health assessment in an industrial town in central India: A cross-sectional study protocol

Background

Textile industry has been widely implicated in environmental pollution. The health effects of residing near manufacturing industries are not well documented in India, especially in central India. Hence, a cross-sectional environmental monitoring and health assessment study was initiated as per directions of the local authorities.

Methods

Comprehensive exposure data about the concentrations of relevant pollutants in the ambient air and ground water samples in the study area will be collected over one year. Using stratified random sampling, 3003 apparently healthy adults will be selected from the study area. Sociodemographic and anthropometric information, relevant medical and family history, and investigations including spirometry, electrocardiogram, neurobehavioral tests, and laboratory investigations (complete blood count, lipid profile and random blood glucose) will be conducted. Finally Iodine azide test and heavy metal level detection in urine and blood samples respectively will be conducted in a subset of selected participants to assess individual pollution exposure. Ethics approval has been obtained from the Institutional Ethics Committee of the National Institute for Research in Environmental Health (No: NIREH/IEC-7-II/1027, dated 07/01/2021).

Discussion

This manuscript describes the protocol for a multi-disciplinary study that aims to conduct environmental monitoring and health assessment in residential areas near viscose rayon and associated chemical manufacturing industries. Although India is the second largest manufacturer of rayon, next only to China, and viscose rayon manufacturing has been documented to be a source of multiple toxic pollutants, there is a lack of comprehensive information about the health effects of residing near such manufacturing units in India. Therefore implementing this study protocol will aid in filling in this knowledge gap.

Risk Analysis Approaches to Evaluating Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries

Risk analysis offers a useful framework for evaluating and managing environmental health risks across different settings. In this Perspective, we question whether the principles and practice of risk analysis could be beneficial in the context of land-based pollution in low- and middle-income countries (LMICs) to better support risk-based decision making. Specifically, potential health and economic impacts from land-based pollution in LMICs has become an increasing issue of concern due to widespread environmental contamination from active and legacy operations, particularly informal activities that are becoming increasingly dispersed throughout communities, such as used lead acid battery recycling, artisanal and small-scale gold mining, and small-scale tanneries. However, the overall magnitude and scale of the public health problem arising from these sources remains highly uncertain and poorly characterized and cannot be compared to land-based pollution in high-income countries due to unique factors. This lack of knowledge has negatively affected the political priority and level of funding for risk mitigation actions targeting land-based pollution in these countries. Our primary objective is to raise further awareness of this emerging issue among risk analysts and decisionmakers and to advocate for more robust and focused research. Here, we highlight the types of industries and activities contributing to land-based pollution in LMICs and describe key findings and knowledge and data gaps that have hindered a fuller understanding of this issue. We also discuss how several risk assessment and risk management approaches might be useful in this resource-constrained context. We conclude that a combination of risk analysis approaches may be worthwhile, but more work is needed to determine which methods or tools will be most informative, technically feasible, and cost-effective for identifying, prioritizing, and mitigating land-based pollution in LMICs. Affected researchers, funding agencies, and local or national governments will need to work together to develop improved study designs and risk mitigation strategies.

Global municipal solid waste infrastructure: Delivery and forecast of uncontrolled disposal

Proper management and treatment of municipal solid waste (MSW) plays a central role towards the reduction or elimination of uncontrolled disposal and the achievement of United Nations (UN) Sustainable Development Goals (SDGs) with the reduction of its vast adverse environmental and health impacts. Despite that, till now, there has never been a quantitative analysis of the progress in waste management infrastructure delivery worldwide. In this paper, we provide valuable insights regarding the progress in new MSW infrastructure delivery based on a dataset of 1764 projects from 156 countries, for the period 2014-2019. We also estimate the magnitude of uncontrolled waste disposal practices worldwide by estimating the gap between the current MSW infrastructure delivery and actual changes in MSW generation. Our results show that the new capacity delivered during the six years period amounted to 243 million metric tonnes (Mt) (40 million Mt per year), out of which 45% was delivered in high-income countries, 37.5% in the People's Republic of China and 17.5% in the rest of the world, mainly through thermal treatment (~57%) and landfilling (8%). The average allocated per capita budget of these projects during this period is about US$14, equivalent to US$2.33 (cap*year)^-1. Our main conclusion is that the share of uncontrolled disposal will continue to rise at least until 2028, reaching almost 730 million Mt per year. Evidently, the global community continues to face a serious challenge towards the implementation of the UN SDG 12, target 12.4 by 2020. The analysis demonstrates that infrastructure delivery must increase by four folds to eliminate uncontrolled disposal practices.

Enhanced biogeogenic controls on dichromate speciation in subsoil containment

In general, lab-based Cr (VI) reduction studies do not often corroborate the prevailing biogeochemical controls for on-site pollution abatement. To promulgate its importance, herein, we investigate the existing biogeogenic parameters of a contaminated site to attenuate the underground Cr (VI) toxicity. This study significantly assesses the speciation of dichromate by biogenic agents that are inherent and self-sustaining to treat the contaminated soil. Herein, a group of bacteria exposed to high concentrations of chromium (≥3500 mg/L) plays a vital role as an enhanced biogeogenic control for the detoxification of toxic Cr (VI). All identified bacteria were screened based on their ability to differentiate from extracellular speciation and harvested in a Cr (VI)-enriched molasses to achieve dichromate concentrations as low as 0.05 mg/L in 168 h. Under low O₂ condition, the bacterial growth rate and doubling time were monitored to establish the half-life period of Cr (VI) for adequate containment treatment. Furthermore, to understand the soil decontamination, Cr (VI) reactive transport was demonstrated to facilitate the contaminant reduction under both saturated and unsaturated groundwater conditions. Herein, Cr (VI) speciation to Cr (III) by the influence of abiogenic factors are unlikely or less probable as studied in existing geogenic conditions. Moreover, the evidence of biogenic reduction of Cr (VI) in microcosm suggests its effectiveness in enhanced detoxification of Cr (VI) up to ≤ 0.1 mg/L, within the reaction period of 144 h and 192 h, for saturated and unsaturated flow conditions, respectively.

Probabilistic estimates of prenatal lead exposure at 195 toxic hotspots in low- and middle-income countries

BACKGROUND

Prior estimates of pediatric lead-related disease burden in low- and middle-income countries (LMICs) used population estimates of maternal blood lead levels (BLLs). This approach may underestimate fetal BLLs by not considering potentially high prenatal lead exposure from toxic hotspots. OBJECTIVES: We developed a probabilistic approach to using the Adult Lead Methodology (ALM) to estimate fetal BLLs from prenatal exposure to lead-contaminated soil at hotspots in the Toxic Site Identification Program (TSIP).

METHODS

We created distributions for each ALM parameter using published literature and extracted soil lead measurements from the TSIP database. Each iteration of the probabilistic ALM randomly selected values from the input distributions to generate a site-specific fetal BLL estimate. For each site, we ran 5000 model iterations, producing a site-specific fetal BLL distribution.

RESULTS

195 TSIP sites, in 33 LMICs, met our study inclusion criteria; an estimated 820,000 women of childbearing age are at risk for lead exposure at these sites. The predicted geometric means (GM) for site-specific fetal BLLs ranged from 3.3 μg/dL to 534 μg/dL, and 98% of sites had estimated GM fetal BLLs >5 μg/dL, the current reference level of the United States Centers for Disease Control and Prevention (CDC), while 11 sites had estimated GM fetal BLLs above the CDC chelation threshold of 45 μg/dL.

DISCUSSION

The TSIP soil lead data and this probabilistic approach to the ALM show that pregnant women living near TSIP sites may have BLLs that put their fetus at risk for neurologic damage and other sequelae, underscoring the need for interventions to reduce lead exposure at toxic hotspots.

Cr(VI) reduction by Fe(II) sorbed to silica surfaces

The reaction kinetics of groundwater contaminants are integral to evaluating the fate and transport of toxic metals in the environment. For redox sensitive contaminants, such as chromium, the kinetics of different reaction pathways can vary by orders of magnitude. Species-specific rate constants for iron-chromium oxidation-reduction reactions are unknown for many systems, especially in the presence of sorbing surfaces. We investigate the role of quartz and amorphous silica (SiO_2(am)) surfaces in mediating abiotic reduction of Cr(VI)_aq by aqueous and sorbed Fe(II) using batch sorption and redox experiments. Sorption edges indicate outer-sphere (Fe(II)_ads,OS) and inner-sphere (Fe(II)_ads,IS) complexes are present on both silica surfaces, and their abundance depends on pH, ionic strength, and surface disorder. The rate constants for Cr(VI)_aq reduction by Fe(II) species increase in the following order: k_aq ≪ k_{ads,OS,quartz} < k_{ads,OS,SiO2(am)} < k_{ads,IS,quartz} < k_{ads,IS,SiO2(am)}, suggesting that increasing proximity of Fe(II) to the negatively charged silica surface enhances the rate of reduction of Cr(VI)_aq. However, we observe that experiments with larger amounts of sorbed Fe(II) reduce less total Cr(VI)_aq over time, which we attribute to a portion of the sorbed Fe(II) being sequestered into the Cr(III)-Fe(III)-oxyhydroxide precipitates forming on the silica surface. Therefore, the balance between increases in the rate and decreases in the total amount of Cr(VI)_aq reduction by various sorbed Fe(II) species must be considered when devising remediation strategies.

A Field Procedure To Screen Soil for Hazardous Lead

Soils retain lead contamination from possible sources such as mining, smelting, battery recycling, waste incineration, leaded gasoline, and crumbling paint. Such contamination is often concentrated in toxic hot spots that need to be identified locally. To address this need, a simple field procedure was designed to screen soil for hazardous Pb for use by the general public. The procedure is a modification of the in vitro soil Pb extraction described by Drexler and Brattin ( Hum. Ecol. Risk Assess. 2007, 13, 383 ) and EPA Method 1340, and uses a 0.4 M glycine solution at pH 1.5. A higher soil-to-solution ratio of 1:10 allows for classifying soil samples based on extractable Pb concentrations of <200 mg/kg (low), 200-400 mg/kg (medium), and >400 mg/kg (high) using sodium rhodizonate as a color indicator. The 1:10 soil-to-solution ratio also makes it possible to measure Pb concentrations in the glycine extract solutions on a continuous scale using a portable X-ray fluorescence analyzer. The procedure rather consistently extracts about one-third of the Pb extracted by the standard method across a wide range of Pb concentrations. Manufacturing the kit in larger quantities could reduce the cost of the materials well below the current $5/test.

Comparative effectiveness of different biochars and conventional organic materials on growth, photosynthesis and cadmium accumulation in cereals

Although biochar and conventional organic materials have been widely studied for lowering cadmium (Cd) uptake by plants but information regarding their comparative effectiveness is lacking. In this study, biochars from different feedstocks viz. rice husk biochar (RHB), cotton sticks biochar (CSB) and wheat straw biochar (WSB) were compared with conventional organic materials viz. farm manure (FM), poultry manure (PM) and press mud (PrMd) for their effectiveness to promote plant growth and to reduce Cd uptake by wheat and rice plants grown rotationally in a Cd-spiked (50 mg kg^-1) soil. Each amendment was applied at the rate of 2% (w/w) in three replicates. Results showed that the application of amendments improved the soil properties and plant growth, by retaining Cd in the soil and restricting its uptake by plants. The amendments decreased the ammonium bicarbonate diethylene penta acetic acid extractable soil Cd, and improved soil organic carbon (SOC) and cation exchange capacity (CEC) as compared to only Cd-contaminated soil. The highest SOC content of 2.68 and 1.68% and CEC of 8.77 and 9.39 cmol_c kg^-1 were found in RHB treated post-wheat and post-rice soil, respectively. Amendments treated soil showed lower concentrations of bioavailable Cd and the maximum reduction was recorded in RHB and PrMd amended soil. Similarly, bioaccumulation of Cd was decreased with the application of all amendments; the maximum decrease was recorded in RHB and PrMd treated soil. Our results suggested that RHB and PrMd could be used for reducing the bioaccumulation of Cd in cereal grains in alkaline soils.

A meta-analysis of blood lead levels in India and the attributable burden of disease

Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38-9.35) in children and 7.52 μg/dL (95% CI: 5.28-9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9-5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.

Cost Effectiveness of Environmental Lead Risk Mitigation in Low- and Middle-Income Countries

Environmental remediation efforts in low- and middle-income countries have yet to be evaluated for their cost effectiveness. To address this gap we calculate a cost per Disability Adjusted Life Year (DALY) averted following the environmental remediation of the former lead smelter and adjoining residential areas in Paraiso de Dios, Haina, the Dominican Republic, executed from 2009 to 2010. The remediation had the effect of lowering surface soil lead concentrations to below 100 mg/kg and measured geometric mean blood lead levels (BLLs) from 20.6 μg/dL to 5.34 ug/dL. Because BLLs for the entire impacted population were not available, we use environmental data to calculate the resulting disease burden. We find that before the intervention 176 people were exposed to elevated environmental lead levels at Paraiso de Dios resulting in mean BLLs of 24.97 (95% CI: 24.45-25.5) in children (0-7 years old) and 13.98 μg/dL (95% CI: 13.03-15) in adults. We calculate that without the intervention these exposures would have resulted in 133 to 1,096 DALYs and that all of these were averted at a cost of USD 392 to 3,238, depending on assumptions made. We use a societal perspective, meaning that we include all costs regardless of by whom they were incurred and estimate costs in 2009 USD. Lead remediation in low- and middle-income countries is cost effective according to World Health Organization thresholds. Further research is required to compare the approach detailed here with other public health interventions.

Improving human health outcomes with a low-cost intervention to reduce exposures from lead acid battery recycling: Dong Mai, Vietnam

This study details the first comprehensive evaluation of the efficacy of a soil lead mitigation project in Dong Mai village, Vietnam. The village's population had been subject to severe lead poisoning for at least a decade as a result of informal Used Lead Acid Battery (ULAB) recycling. Between July 2013 to February 2015, Pure Earth and the Centre for Environment and Community Development (Hanoi, Vietnam) implemented a multi-faceted environmental and human health intervention. The intervention consisted of a series of institutional and low-cost engineering controls including the capping of lead contaminated surface soils, cleaning of home interiors, an education campaign and the construction of a work-clothes changing and bathing facility. The mitigation project resulted in substantial declines in human and environmental lead levels. Remediated home yard and garden areas decreased from an average surface soil concentration of 3940mg/kg to <100mg/kg. One year after the intervention, blood lead levels in children (<6 years old) were reduced by an average of 67%-from a median of 40.4μg/dL to 13.3μg/dL. The Dong Mai project resulted in significantly decreased environmental and biological lead levels demonstrating that low-cost, rapid and well-coordinated interventions could be readily applied elsewhere to significantly reduce preventable human health harm.

Calculation of the disease burden associated with environmental chemical exposures: application of toxicological information in health economic estimation

Calculation of costs and the Burden of Disease (BoD) is useful in developing resource allocation and prioritization strategies in public and environmental health. While useful, the Disability-Adjusted Life Year (DALY) metric disregards subclinical dysfunctions, adheres to stringent causal criteria, and is hampered by gaps in environmental exposure data, especially from industrializing countries. For these reasons, a recently calculated environmental BoD of 5.18% of the total DALYs is likely underestimated. We combined and extended cost calculations for exposures to environmental chemicals, including neurotoxicants, air pollution, and endocrine disrupting chemicals, where sufficient data were available to determine dose-dependent adverse effects. Environmental exposure information allowed cost estimates for the U.S. and the EU, for OECD countries, though less comprehensive for industrializing countries. As a complement to these health economic estimations, we used attributable risk valuations from expert elicitations to as a third approach to assessing the environmental BoD. For comparison of the different estimates, we used country-specific monetary values of each DALY. The main limitation of DALY calculations is that they are available for few environmental chemicals and primarily based on mortality and impact and duration of clinical morbidity, while less serious conditions are mostly disregarded. Our economic estimates based on available exposure information and dose-response data on environmental risk factors need to be seen in conjunction with other assessments of the total cost for these environmental risk factors, as our estimate overlaps only slightly with the previously estimated environmental DALY costs and crude calculations relying on attributable risks for environmental risk factors. The three approaches complement one another and suggest that environmental chemical exposures contribute costs that may exceed 10% of the global domestic product and that current DALY calculations substantially underestimate the economic costs associated with preventable environmental risk factors. By including toxicological and epidemiological information and data on exposure distributions, more representative results can be obtained from utilizing health economic analyses of the adverse effects associated with environmental chemicals.

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.

Disability Weights for Chronic Mercury Intoxication Resulting from Gold Mining Activities: Results from an Online Pairwise Comparisons Survey

In artisanal small-scale gold mining, mercury is used for gold-extraction, putting miners and nearby residents at risk of chronic metallic mercury vapor intoxication (CMMVI). Burden of disease (BoD) analyses allow the estimation of the public health relevance of CMMVI, but until now there have been no specific CMMVI disability weights (DWs). The objective is to derive DWs for moderate and severe CMMVI. Disease-specific and generic health state descriptions of 18 diseases were used in a pairwise comparison survey. Mercury and BoD experts were invited to participate in an online survey. Data were analyzed using probit regression. Local regression was used to make the DWs comparable to the Global Burden of Disease (GBD) study. Alternative survey (visual analogue scale) and data analyses approaches (linear interpolation) were evaluated in scenario analyses. A total of 105 participants completed the questionnaire. DWs for moderate and severe CMMVI were 0.368 (0.261-0.484) and 0.588 (0.193-0.907), respectively. Scenario analyses resulted in higher mean values. The results are limited by the sample size, group of interviewees, questionnaire extent, and lack of generally accepted health state descriptions. DWs were derived to improve the data basis of mercury-related BoD estimates, providing useful information for policy-making. Integration of the results into the GBD DWs enhances comparability.

Burden of disease resulting from lead exposure at toxic waste sites in Argentina, Mexico and Uruguay

BACKGROUND

Though lead contaminated waste sites have been widely researched in many high-income countries, their prevalence and associated health outcomes have not been well documented in low- and middle-income countries.

METHODS

Using the well-established health metric disability-adjusted life year (DALY) and an exposure assessment method developed by Chatham-Stephens et al., we estimated the burden of disease resulting from exposure to lead at toxic waste sites in three Latin American countries in 2012: Argentina, Mexico and Uruguay. Toxic waste sites identified through Pure Earth's Toxic Sites Identification Program (TSIP) were screened for lead in both biological and environmental sample media. Estimates of cardiovascular disease incidence and other outcomes resulting from exposure to lead were utilized to estimate DALYs for each population at risk.

RESULTS

Approximately 316,703 persons in three countries were at risk of exposure to pollutants at 129 unique sites identified through the TSIP database. Exposure to lead was estimated to result in between 51,432 and 115,042 DALYs, depending on the weighting factor used. The estimated burden of disease caused by exposure to lead in this analysis is comparable to that estimated for Parkinson's disease and bladder cancer in these countries.

CONCLUSIONS

Lead continues to pose a significant public health risk in Argentina, Mexico, and Uruguay. The burden of disease in these three countries is comparable with other widely recognized public health challenges. Knowledge of the relatively high number of DALYs associated with lead exposure may be used to generate support and funding for the remediation of toxic waste sites in these countries and others.

Pollution, health and development: the need for a new paradigm

BACKGROUND

Pollution is the largest cause of death in low- and middle-income countries. WHO estimates that 8.9 million persons die each year of diseases caused by pollution - 94% of them in poor countries. By comparison, HIV/AIDS causes 1.5 million deaths per year, and malaria and tuberculosis cause fewer than 1 million each. Diseases caused by pollution are very costly.

PREVENTION

Pollution can be prevented. In high-income countries, legal and technical control strategies have been developed and yielded great health and economic benefits. The removal of lead from gasoline increased the mean IQ of all American children and has generated an annual economic benefit of $213 billion. Unmet need: Despite its enormous human and economic costs, pollution has been overlooked in the international development agenda. Pollution control currently receives <0.5% of development spending.

SOLUTION

We have formed The Lancet-GAHP-Mount Sinai Commission on Pollution, Health and Development. This Commission will develop robust analyses of the impacts of pollution on health, economics, and development. It will inform heads of state and global funders about the enormous scale pollution's effects. The ultimate goal is to raise the priority of pollution and increase the resources allocated to control of this urgent public health problem.

Disease profile and health-related quality of life (HRQoL) using the EuroQol (EQ-5D + C) questionnaire for chronic metallic mercury vapor intoxication

Background

Toxic mercury is still being used today for example by workers mining gold, resulting in diverse health symptoms in users and individuals in proximity. A considerable burden of disease (BoD) can be assumed, while previous analyses were limited by data scarcity. Besides limited epidemiological data, neither data about the health-related quality of life (HRQoL) nor about the disease severity (disability weight, DW) is available. The aim of the project was to develop disease profiles of chronic metallic mercury vapor intoxication (CMMVI) by including the HRQoL to improve the data basis for BoD analyses of gold miners exposed to mercury.

Methods

Disease profiles comprising the disease label [a], differentiation into disease stages [b], description of the cause of exposure [c], a list of common symptoms [d], and an assessment of the HRQoL [e] were developed using expert elicitation and literature search. The HRQoL was assessed by experts using the five EuroQol dimensions accompanied by the cognition add-on questionnaire (EQ-5D + C).

Results

The ten sources used for the analyses (interview transcript, presentation, and eight literature reviews) identified more than 250 terms describing 85 distinguishable health effects of CMMVI. The analysis revealed 29 common symptoms that were frequently mentioned. Moderate and severe CMMVI cases differ regarding their symptoms and/or symptom severity and HRQoL, resulting in the EQ-5D + C-3L codes 121222 and 233333, respectively.

Conclusions

The profiles should be used to facilitate the ascertainment of CMMVI cases, to compare the HRQoL with other diseases, to derive DWs for improving BoD estimates, and to foster discussions about how to reduce the associated burden.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-015-0388-0) contains supplementary material, which is available to authorized users.

Spatial Associations Between Contaminated Land and Socio Demographics in Ghana

Associations between contaminated land and socio demographics are well documented in high-income countries. In low- and middle-income countries, however, little is known about the extent of contaminated land and possible demographic correlations. This is an important yet sparsely researched topic with potentially significant public health implications as exposure to pollution remains a leading source of morbidity and mortality in low-income countries. In this study, we review the associations between several socio demographic factors (population, population density, unemployment, education, and literacy) and contaminated sites in Ghana. Within this context, both correlation and association intend to show the relationship between two variables, namely contaminated sites and socio demographics. Aggregated district level 2010 census data from Ghana Statistical Service and contaminated site location data from Pure Earth’s Toxic Sites Identification Program (TSIP) were spatially evaluated using the number of sites per kilometer squared within districts as the unit of measurement. We found a low to medium positive correlation (ρ range: 0.285 to 0.478) between contaminated sites and the following socio demographics: higher population density, higher unemployment, greater education, and higher literacy rate. These results support previous studies and suggest that several socio demographic factors may be reasonably accurate predictors of contaminated site locations. More research and targeted data collection is needed to better understand these associations with the ultimate goal of developing a predictive model.

The NIEHS Superfund Research Program: 25 Years of Translational Research for Public Health

BACKGROUND

The Superfund Research Program (SRP) is an academically based, multidisciplinary, translational research program that for 25 years has sought scientific solutions to health and environmental problems associated with hazardous waste sites. SRP is coordinated by the National Institute of Environmental Health Sciences (NIEHS). It supports multi-project grants, undergraduate and postdoctoral training programs, individual research grants, and Small Business Innovation Research (SBIR) and Technology Transfer Research (STTR) grants.

RESULTS

SRP has had many successes: discovery of arsenic's toxicity to the developing human central nervous system; documentation of benzene toxicity to hematologic progenitor cells in human bone marrow; development of novel analytic techniques such as the luciferase expression assay and laser fragmentation fluorescence spectroscopy; demonstration that PCBs can cause developmental neurotoxicity at low levels and alter the genomic characteristics of sentinel animals; elucidation of the neurodevelopmental toxicity of organophosphate insecticides; documentation of links between antimicrobial agents and alterations in hormone response; discovery of biological mechanisms through which environmental chemicals may contribute to obesity, atherosclerosis, diabetes, and cancer; tracking the health and environmental effects of the attacks on the World Trade Center and Hurricane Katrina; and development of novel biological and engineering techniques to facilitate more efficient and lower-cost remediation of hazardous waste sites.

CONCLUSION

SRP must continue to address the legacy of hazardous waste in the United States, respond to new issues caused by rapid advances in technology, and train the next generation of leaders in environmental health science while recognizing that most of the world's worst toxic hot spots are now located in low- and middle-income countries.

International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals

Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice.

Children's health in Latin America: the influence of environmental exposures

BACKGROUND

Chronic diseases are increasing among children in Latin America.

OBJECTIVE AND METHODS

To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data.

RESULTS

Industrial development and urbanization are proceeding rapidly in Latin America, and environmental pollution has become widespread. Environmental threats to children's health include traditional hazards such as indoor air pollution and drinking-water contamination; the newer hazards of urban air pollution; toxic chemicals such as lead, asbestos, mercury, arsenic, and pesticides; hazardous and electronic waste; and climate change. The mix of traditional and modern hazards varies greatly across and within countries reflecting industrialization, urbanization, and socioeconomic forces.

CONCLUSIONS

To control environmental threats to children's health in Latin America, WHO, including PAHO, will focus on the most highly prevalent and serious hazards-indoor and outdoor air pollution, water pollution, and toxic chemicals. Strategies for controlling these hazards include developing tracking data on regional trends in children's environmental health (CEH), building a network of Collaborating Centres, promoting biomedical research in CEH, building regional capacity, supporting development of evidence-based prevention policies, studying the economic costs of chronic diseases in children, and developing platforms for dialogue with relevant stakeholders.

The burden of chronic mercury intoxication in artisanal small-scale gold mining in Zimbabwe: data availability and preliminary estimates

BACKGROUND

Artisanal small-scale gold mining (ASGM) is a poverty-driven activity practiced in over 70 countries worldwide. Zimbabwe is amongst the top ten countries using large quantities of mercury to extract gold from ore. This analysis was performed to check data availability and derive a preliminary estimate of disability-adjusted life years (DALYs) due to mercury use in ASGM in Zimbabwe.

METHODS

Cases of chronic mercury intoxication were identified following an algorithm using mercury-related health effects and mercury in human specimens. The sample prevalence amongst miners and controls (surveyed by the United Nations Industrial Development Organization in 2004 and the University of Munich in 2006) was determined and extrapolated to the entire population of Zimbabwe. Further epidemiological and demographic data were taken from the literature and missing data modeled with DisMod II to quantify DALYs using the methods from the Global Burden of Disease (GBD) 2004 update published by the World Health Organization (WHO). While there was no disability weight (DW) available indicating the relative disease severity of chronic mercury intoxication, the DW of a comparable disease was assigned by following the criteria 1) chronic condition, 2) triggered by a substance, and 3) causing similar health symptoms.

RESULTS

Miners showed a sample prevalence of 72% while controls showed no cases of chronic mercury intoxication. Data availability is very limited why it was necessary to model data and make assumptions about the number of exposed population, the definition of chronic mercury intoxication, DW, and epidemiology. If these assumptions hold, the extrapolation would result in around 95,400 DALYs in Zimbabwe's total population in 2004.

CONCLUSIONS

This analysis provides a preliminary quantification of the mercury-related health burden from ASGM based on the limited data available. If the determined assumptions hold, chronic mercury intoxication is likely to have been one of the top 20 hazards for population health in Zimbabwe in 2004 when comparing with more than 130 categories of diseases and injuries quantified in the WHO's GBD 2004 update. Improving data quality would allow more accurate estimates. However, the results highlight the need to reduce a burden which could be entirely avoided.

MiRNA profiling provides insights on adverse effects of Cr(VI) in the midgut tissues of Drosophila melanogaster

Cr(VI), a well-known environmental chemical, is reported to cause various adverse effects on exposed organisms including genomic instability and carcinogenesis. Despite available information on the underlying mechanism of Cr(VI) induced toxicity, studies regarding toxicity modulation by epigenetic mechanisms are limited. It was therefore, hypothesized that the global miRNA profiling in Cr(VI) exposed Drosophila, a genetically tractable model organism, will provide information about mis-regulated miRNAs along with their targeted genes and relevant processes. Third instar larvae of Drosophila melanogaster (Oregon R(+)) were exposed to 5.0-20.0 μg/ml of Cr(VI) for 24 and 48 h. Following miRNA profile analysis on an Agilent platform, 28 of the 36 differentially expressed miRNAs were found to be significantly mis-regulated targeting major biological processes viz., DNA damage repair, oxidation-reduction processes, development and differentiation. Down-regulation of mus309 and mus312 under DNA repair, acon to oxidation-reduction and pyd to stress activated MAPK cascade respectively belonging to these gene ontology classes concurrent with up-regulation of dme-miR-314-3p, dme-miR-79-3p and dme-miR-12-5p confirm their functional involvement against Cr(VI) exposure. These findings assume significance since majority of the target genes in Drosophila have functional homologues in humans. The study further recommends Drosophila as a model to explore the role of miRNAs in xenobiotic induced toxicity.

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.

Influence of seasonal variation on water quality in tropical water distribution system: is the disease burden significant?

Recent evidence shows that water distribution system (WDS) is a major risk factor in piped water supply system and the degree of contamination of water in WDS is usually influenced by seasonal variation. Risk assessment studies eliminate the effect of seasonality whenever annualized estimate of concentration of contaminants in water is used to determine the risk to health. In tropical climate where strong seasonal variation prevails, the excess risk during dry and hot season, above the annualized risk can be significant. This study investigates what impact seasonal adjustment may have on health improvement targets for WDS. Water quality data of two Nigerian water supply schemes were used to estimate the impact of WDS on water quality. Seasonal deviation from the annualized impact was quantified as the latent risk in disability-adjusted life years (DALYs). The hazards identified in both WDSs were cadmium and lead, and the estimated 95th-percentile risk of the metals, over the course of dry season was about 31-38%, and 1-3% higher than the estimated yearly average risk, respectively. Wilcoxon signed-rank test showed that the risk distributions during the dry season was significantly higher (p < 0.05) than the yearly average. The median latent risks (5th, 95th-percentiles), for both WDS were 0.014 (7.6 × 10(-3), 0.023) and 4.8 × 10(-3) (-, 7.6 × 10(-3)) DALYs/person/year for cadmium and 0.87 × 10(-3) (0, 0.1 × 10(-3)) and 0.16 × 10(-3) (0, 0.031 × 10(-3)) DALYs/person/year, respectively, for lead. These risks are substantially higher than the WHO limit (1 × 10(-6) DALYs/person/year). Therefore, to achieve effective health improvement target, mitigation measures should be planned and executed by season.