Incidence of cancer among persons living near a municipal solid waste landfill site in Montreal, Québec

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.

Assessing volatile organic compounds exposure and prostate-specific antigen: National Health and Nutrition Examination Survey, 2001–2010

Background

Volatile organic compounds (VOCs) are a large group of chemicals widely used in people's daily routines. Increasing evidence revealed the VOCs' accumulating toxicity. However, the VOCs toxicity in male prostate has not been reported previously. Thus, we comprehensively evaluated the association between VOCs and prostate-specific antigen (PSA).

Methods

A total of 2016 subjects were included in our study from the National Health and Nutrition Examination Survey with VOCs, PSA, and other variables among U.S. average population. We constructed XGBoost Algorithm Model, Regression Model, and Generalized linear Model (GAM) to analyze the potential association. Stratified analysis was used to identify high-risk populations.

Results

XGBoost Algorithm model identified blood chloroform as the most critical variable in the PSA concentration. Regression analysis suggested that blood chloroform was a positive association with PSA, which showed that environmental chloroform exposure is an independent risk factor that may cause prostate gland changes [β, (95% CI), P = 0.007, (0.003, 0.011), 0.00019]. GAM observed the linear relationship between blood chloroform and PSA concentration. Meanwhile, blood chloroform linear correlated with water chloroform in the lower dose range, indicating that the absorption of water may be the primary origin of chloroform. Stratified associations analysis identified the high-risk group on the chloroform exposures.

Conclusion

This study revealed that blood chloroform was positively and independently associated with total PSA level, suggesting that long-term environmental chloroform exposure may cause changes in the prostate gland.

Quantification and control of gaseous emissions from solid waste landfill surfaces

Landfilling is the most common option for solid waste disposal worldwide. Landfill sites can emit significant quantities of greenhouse gases (GHGs; e.g., methane, carbon dioxide, and nitrous oxide) and release toxic and odorous compounds (e.g., sulfides). Due to the complex composition and characteristics of landfill surface gas emissions, the quantification and control of landfill emissions are challenging. This review attempts to comprehensively understand landfill emission quantification and control options by primarily focusing on GHGs and odor compounds. Landfill emission quantification was highlighted by combining different emissions monitoring approaches to improve the quality of landfill emission data. Also, landfill emission control requires a specific approach that targets emission compounds or a systematic approach that reduces overall emissions by combining different control methods since the diverse factors dominate the emissions of various compounds and their transformation. This integrated knowledge of emission quantification and control options for GHGs and odor compounds is beneficial for establishing field monitoring campaigns and incorporating mitigation strategies to quantify and control multiple landfill emissions.

Climate Justice and California's Methane Superemitters: Environmental Equity Assessment of Community Proximity and Exposure Intensity

Methane superemitters emit non-methane copollutants that are harmful to human health. Yet, no prior studies have assessed disparities in exposure to methane superemitters with respect to race/ethnicity, socioeconomic status, and civic engagement. To do so, we obtained the location, category (e.g., landfill, refinery), and emission rate of California methane superemitters from Next Generation Airborne Visible/Infrared Imaging Spectrometer (AVIRIS-NG) flights conducted between 2016 and 2018. We identified block groups within 2 km of superemitters (exposed) and 5-10 km away (unexposed) using dasymetric mapping and assigned level of exposure among block groups within 2 km (measured via number of superemitter categories and total methane emissions). Analyses included 483 superemitters. The majority were dairy/manure (n = 213) and oil/gas production sites (n = 127). Results from fully adjusted logistic mixed models indicate environmental injustice in methane superemitter locations. For example, for every 10% increase in non-Hispanic Black residents, the odds of exposure increased by 10% (95% confidence interval (CI): 1.04, 1.17). We observed similar disparities for Hispanics and Native Americans but not with indicators of socioeconomic status. Among block groups located within 2 km, increasing proportions of non-White populations and lower voter turnout were associated with higher superemitter emission intensity. Previously unrecognized racial/ethnic disparities in exposure to California methane superemitters should be considered in policies to tackle methane emissions.

Prioritizing health, safety and environmental hazards by integrating risk assessment and analytic hierarchy process techniques in solid waste management facilities

The aim of this research was to assess and prioritize risk levels of health, safety, and environmental (HSE) hazards in solid waste management facilities of Tehran, Iran. The risk of HSE hazards was assessed using Fine-Kinney and environmental failure mode and effects analysis (EFMEA) methods and then the high-risk hazards were prioritized for implementing corrective actions by analytic hierarchy process (AHP) considering six criteria of (1) probability of occurrence, (2) severity of consequences, (3) simultaneous HSE effects, and (4-6) feasibility, effectiveness, and cost of corrective actions. A total number of 485 HSE hazards were identified, of which 78% were health and safety hazards and 22% were environmental hazards. The proportions of the transfer and transport, material recovery and composting facilities and landfill sites in the identified hazards were 21%, 38%, and 41%, respectively. Based on the AHP method, the leading hazards in the transfer and transport, material recovery and composting facilities, and landfill sites were exposure to bioaerosol in carwash facilities, exposure to bioaerosols and odor/volatile organic compounds (VOCs) in manual waste separation, and leachate spills in the former landfill site, respectively. This study showed that the hybrid method was an appropriate and reliable tool to prioritize HSE hazards.

Methodological issues in descriptive environmental epidemiology. The example of study Sentieri

BACKGROUND

Descriptive epidemiology identifies associations between environmental exposures and health effects that require results from methodologically stronger studies before causation can be considered.

OBJECTIVE

To critically review the methodology and results of Sentieri, a descripitive study on residence in areas with one or more industrial source of pollution.

METHODS

We systematically reviewed the literature quoted by Sentieri for the selection of health effects of nine types of pollution sources of a-priori interest. We also reviewed and meta-analyzed the results of the first report of Sentieri, that analyzed mortality in 44 polluted sites (PS), and 17 causes of deaths during 1995-2002.

RESULTS

Among 159 study results quoted by Sentieri, 23.9 % were supportive of an association between residence near a pollution source and a health effect, 30.2 % were partially supportive, 10.7 % were not supportive, and 35.2 % were not relevant. Among 653 standardized mortality ratios for associations between PS-specific pollution sources and causes of death, 14.4% were significantly above 1.02, and 9.0% were significantly below 0.98. Among 48 meta-analysis, seven were significantly above 1.0, including five on exposure to asbestos.

CONCLUSIONS

Sentieri exemplifies the limitations of descriptive environmental epidemiology studies, in which most hypotheses have limited prior support, most results do not show associations, data on potential confounders and other sources of bias are not available. Such studies tend to replicate well-known associations and occasionally can identify critical situations requiring more investigation, but cannot be used to infer causality either in general or in specific circumstances.

Trace gas emissions from municipal solid waste landfills: A review

Trace gas emissions from municipal solid waste (MSW) landfills have received increasing attention in recent years. This paper reviews literature published between 1983 and 2019, focusing on (i) the origin and fate of trace gas in MSW landfills, (ii) sampling and analytical techniques, (iii) quantitative emission measurement techniques, (iv) concentration and surface emission rates of common trace compounds at different landfill units and (v) the environmental and health concerns associated with trace gas emissions from MSW landfills. Trace gases can be produced from waste degradation, direct volatilisation of chemicals in waste products or from conversions/reactions between other compounds. Different chemical groups dominate the different waste decomposition stages. In general, organic sulphur compounds and oxygenated compounds are connected with fresh waste, while abundant hydrogen sulphide, aromatics and aliphatic hydrocarbons are usually found during the methane fermentation stage. Selection of different sampling, analytical and emission rate measurement techniques might generate different results when quantifying trace gas emission from landfills, and validation tests are needed to evaluate the reliability of current methods. The concentrations of trace gases and their surface emission rates vary largely from site to site, and fresh waste dumping areas and uncovered waste surfaces are the most important fugitive emission sources. The adverse effects of trace gas emission are not fully understood, and more emission data are required in future studies to assess quantitatively their environmental impacts as well as health risks.

Contaminant levels and endocrine disruptive effects in Clarias gariepinus exposed to simulated leachate from a solid waste dumpsite in Calabar, Nigeria

Solid waste dumpsites (SWDs) and landfills are significant sources of emerging contaminants to terrestrial and aquatic ecosystems. We have studied the endocrine disruptive effects of simulated leachate from a solid waste dumpsite in Calabar, Nigeria. Juvenile C. gariepinus were exposed to simulated leachate, diluted to 0:0 (control), 1:10, 1:50, 1:100 for 3, 7 and 14 days. In addition, 17β-estradiol (E2: 100 μg/L)-exposed positive control group was included. Hepatic transcripts for the genes encoding vitellogenin (vtg), estrogen receptor-α (er-α), and aromatase (cyp19a1) were analyzed by real-time PCR. Protein expression for Vtg and Cyp19 were measured by immunoblotting and plasma steroid hormones (testosterone: T and E2) were measured using enzyme immunoassay (EIA). Soil samples from the dumpsite were analyzed for selected group of contaminants showing that DEHP was the only detected phthalate ester (PE) at 1300 ± 400 ng/g. Further, perfluoroalkyl substances (PFASs) such as PFBS, PFOS, PFHxA, PFOA, PFNA, PFDA, PFUnDA and PFDoDA were detected in the soil samples from the dumpsite. We observed significant and apparent concentration-dependent increases in mRNA (vtg, er-α, and cyp19a1) and their corresponding functional protein products, after exposure to the simulated leachates. Further, the simulated leachate produced concentration-specific changes in plasma E2 and T levels. In general, the estrogenic endocrine and reproductive alterations in the exposed fish may directly be attributed to the PFASs and DEHP detected at the dumpsites. However, in addition to PFASs and DEHP, there could be other estrogenic contaminants in the leachate. Given the rapid utilization, for residential purposes, and increases in human settlement in areas around the Lemna SWDs, this study provides a direct cause-and-effect evidence of the potential contaminants at the dumpsite with significant environmental and human health consequences.

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.

Lung Cancer Risk and Residence in the Neighborhood of a Sewage Plant in Italy. A Case-Control Study

Aims and background

Environmental pollution originating in sewage and industrial plants can be associated with lung cancer risk, as ecological and case-control studies have indicated. In the present study, the association between lung cancer occurrence and residence near a sewage plant in Prato (Italy) was investigated. A previous geographic study in the same area had shown an increasing trend of lung cancer mortality and incidence with propinquity to the plant.

Methods

A case-control study was carried out in the male population of Prato. Incident cases in the period 1987–1997 were identified from the Tuscan Cancer Registry (no. 918). Controls were randomly extracted from the Registry Office of the Municipality of Prato (no. 1852). For all subjects, the residential history was reconstructed. A weighted average distance from the plant was computed and used as a proxy variable of exposure. Two analyses were performed: on the whole data set and on a subset of subjects for whom information on tobacco exposure and education was obtained through a postal questionnaire (response rate, 41.1%). Logistic regression models were applied to estimate odds ratios and 95% CI.

Results

Both analyses showed a significantly elevated lung cancer risk for subjects living within 1.5 km (ORwhole = 1.56, 1.06–2.28; ORsubset = 2.28, 1.06–4.86) and suggested a risk increase with a decrease of weighted average distance from the plant.

Conclusions

The findings highlight a possible role, in lung cancer occurrence, for environmental pollution spread from the plant. Due to drawbacks of the study, further analyses are needed to evidence a noncontroversial etiological conclusion. When environmental data are not available, results of epidemiological studies using residential histories may be useful in preventive policies regarding point source emissions. Free full text available at www.tumorionline.it

Breast and prostate cancer mortality and industrial pollution

We investigated whether there might be an excess of breast and prostate cancer mortality among the population residing near Spanish industries, according to different categories of industrial groups. An ecologic study was designed to examine breast and prostate cancer mortality at a municipal level (period 1997-2006). Population exposure to pollution was estimated by means of distance from town of residence to industrial facilities. Using Besag-York-Mollié regression models with Integrated Nested Laplace approximations for Bayesian inference, we assessed the relative risk of dying from these tumors in 2-, 3-, 4-, and 5-km zones around installations, and analyzed the effect of category of industrial group. For all sectors combined, no excess risk was detected. However, excess risk of breast cancer mortality (relative risk, 95% credible interval) was detected near mines (1.10, 1.00-1.21 at 4 km), ceramic industries (1.05, 1.00-1.09 at 5 km), and ship building (1.12, 1.00-1.26 at 5 km), and excess risk of prostate cancer was detected near aquaculture for all distances analyzed (from 2.42, 1.53-3.63 at 2 km to 1.63, 1.07-2.36 at 5 km). Our findings do not support that residing in the vicinity of pollutant industries as a whole (all industrial sectors combined) is a risk factor for breast and prostate cancer mortality. However, isolated statistical associations found in our study with respect to specific industrial groups warrant further investigation.

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.

Increased deaths from gastric cancer in communities living close to waste landfills

BACKGROUND

Municipal waste landfills (MWLs) have been linked with some malignancies, but data about gastric cancer (GC) are still uncertain.

METHODS

Number of deaths from GC, death rates, and odds ratios (ORs) were calculated considering all residents in the 258 towns in the Apulia Region (4,099,547 subjects, years 2006-2009), living within 3 km from each of the 16 regional MWLs (n = 716,404) or in control areas (n = 3,383,143).

RESULTS

Males living close to MWLs showed a higher death rate for GC, a twofold higher mean number of GC deaths and higher adjusted ORs of GC, compared with controls areas.

CONCLUSIONS

In a large population and over a wide time period, an increased risk of death from GC has been shown in males living in communities close to MWLs. Primary prevention policies acting through more sustainable waste management might probably partially reduce deaths from GC in areas with MWLs.

Evaluation of genome damage in subjects occupationally exposed to possible carcinogens

In occupational exposures, populations are simultaneously exposed to a mixture of chemicals. We aimed to evaluate DNA damage due to possible carcinogen exposure (phenylhydrazine, ethylene oxide, dichloromethane, and 1,2-dichloroethane) in lymphocytes of pharmaceutical industry workers from the same production line. Population comprised 16 subjects (9 females and 7 males) who were exposed to multiple chemicals for 8 months. Genome damage was assessed using alkaline comet assay, micronucleus assay, and comet assay coupled with fluorescent in situ hybridization (comet-FISH). After 8 months of exposure, the issue of irregular use of all available personal protective equipment (PPE) came into light. To decrease the risk of exposure, strict use of PPE was enforced. After 8 months of strict PPE use, micronuclei frequency and comet assay parameters in lymphocytes of pharmaceutical workers significantly decreased compared with prior period of irregular PPE use. Comet-FISH results indicated a significant shift in distribution of signals for the TP 53 gene toward a more frequent occurrence in the comet tail. Prolonged exposure to possible carcinogens may hinder DNA repair mechanisms and affect structural integrity of TP 53 Two indicators of loss of TP 53 gene integrity have risen, namely, TP 53 fragmentation rate in lymphocytes with persistently elevated primary damage and incidence of TP 53 deletions in undamaged lymphocytes.

A follow-up of cancer incidence among former Finnish dump site residents: 1999-2011

BACKGROUND

In an analysis of the years 1976-1998, a 50% excess in cancer incidence was observed among residents in twelve blockhouses in Helsinki, Finland on a former dump area containing industrial and household waste.

OBJECTIVE

To assess cancer risk over a 13-year period 1999-2011 among residents formerly living in houses built on a dump area.

METHODS

All 1879 persons who ever lived in the former dump area were identified and the number of cancer cases in this population was obtained from the Finnish Cancer Registry.

RESULTS

After 5 years of residence at the dump site, the standardized incidence ratio of cancer (all sites combined) was 1·32 (95% CI: 0·94-1·79) in men and 0·53 (95% CI: 0·33-0·82) for women, in comparison with the general Helsinki population (1999-2011). No significant excess cancer risks were found.

CONCLUSIONS

Residing on a former dump area was not found to result in an increased risk of cancer.

[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.

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.

The potential monetary benefits of reclaiming hazardous waste sites in the Campania region: an economic evaluation

BACKGROUND

Evaluating the economic benefit of reducing negative health outcomes resulting from waste management is of pivotal importance for designing an effective waste policy that takes into account the health consequences for the populations exposed to environmental hazards. Despite the high level of Italian and international media interest in the problem of hazardous waste in Campania little has been done to reclaim the land and the waterways contaminated by hazardous waste.

OBJECTIVE

This study aims to reduce the uncertainty about health damage due to waste exposure by providing for the first time a monetary valuation of health benefits arising from the reclamation of hazardous waste dumps in Campania.

METHODS

First the criteria by which the landfills in the Campania region, in particular in the two provinces of Naples and Caserta, have been classified are described. Then, the annual cases of premature death and fatal cases of cancers attributable to waste exposure are quantified. Finally, the present value of the health benefits from the reclamation of polluted land is estimated for each of the health outcomes (premature mortality, fatal cancer and premature mortality adjusted for the cancer premium). Due to the uncertainty about the time frame of the benefits arising from reclamation, the latency of the effects of toxic waste on human health and the lack of context specific estimates of the Value of Preventing a Fatality (VPF), extensive sensitivity analyses are performed.

RESULTS

There are estimated to be 848 cases of premature mortality and 403 cases of fatal cancer per year as a consequence of exposure to toxic waste. The present value of the benefit of reducing the number of waste associated deaths after adjusting for a cancer premium is euro11.6 billion. This value ranges from euro5.4 to euro20.0 billion assuming a time frame for benefits of 10 and 50 years respectively.

CONCLUSION

This study suggests that there is a strong economic argument for both reclaiming the land contaminated with hazardous waste in the two provinces of Naples and Caserta and increasing the control of the territory in order to avoid the creation of new illegal dump sites.

An examination of cancer epidemiology studies among populations living close to toxic waste sites

BACKGROUND

Toxic waste sites contain a broad range of suspected or confirmed human carcinogens, and remain a source of concern to many people, particularly those living in the vicinity of a site. Despite years of study, a consensus has not emerged regarding the cancer risk associated with such sites.

METHODS

We examined the published, peer-reviewed literature addressing cancer incidence or mortality in the vicinity of toxic waste sites between 1980 and 2006, and catalogued the methods employed by such studies.

RESULTS

Nineteen studies are described with respect to eight methodological criteria. Most were ecological, with minimal utilization of hydrogeological or air pathway modeling. Many did not catalogue whether a potable water supply was contaminated, and very few included contaminant measurements at waste sites or in subjects' homes. Most studies did not appear to be responses to a recognized cancer mortality cluster. Studies were highly variable with respect to handling of competing risk factors and multiple comparisons.

CONCLUSION

We conclude that studies to date have generated hypotheses, but have been of limited utility in determining whether populations living near toxic waste sites are at increased cancer risk.

Race, wealth, and solid waste facilities in North Carolina

BACKGROUND

Concern has been expressed in North Carolina that solid waste facilities may be disproportionately located in poor communities and in communities of color, that this represents an environmental injustice, and that solid waste facilities negatively impact the health of host communities.

OBJECTIVE

Our goal in this study was to conduct a statewide analysis of the location of solid waste facilities in relation to community race and wealth.

METHODS

We used census block groups to obtain racial and economic characteristics, and information on solid waste facilities was abstracted from solid waste facility permit records. We used logistic regression to compute prevalence odds ratios for 2003, and Cox regression to compute hazard ratios of facilities issued permits between 1990 and 2003.

RESULTS

The adjusted prevalence odds of a solid waste facility was 2.8 times greater in block groups with > or = 50% people of color compared with block groups with < 10% people of color, and 1.5 times greater in block groups with median house values < 60,000 dollars compared with block groups with median house values > or = 100,000 dollars. Among block groups that did not have a previously permitted solid waste facility, the adjusted hazard of a new permitted facility was 2.7 times higher in block groups with > or = 50% people of color compared with block groups with < 10% people of color.

CONCLUSION

Solid waste facilities present numerous public health concerns. In North Carolina solid waste facilities are disproportionately located in communities of color and low wealth. In the absence of action to promote environmental justice, the continued need for new facilities could exacerbate this environmental injustice.

Cancer mortality in an area of Campania (Italy) characterized by multiple toxic dumping sites

Several recent studies have documented that a widespread practice of dumping toxic wastes has taken place for many years in the Provinces of Naples and Caserta. Extensive programs of environmental monitoring are currently ongoing in the area. In this frame, the Department of Civil Defence of the Italian Government has appointed an ad hoc study group in order to assess the health status of the population resident in the area of interest. The first investigation performed by the study group has been a geographic study on cancer mortality and occurrence of malformations in 196 municipalities constituting the two Provinces. The study detected an area located in the southeastern part of the Province of Caserta and in the northwestern part of the Province of Naples, where cancer mortality and congenital malformations show significantly increased rates with respect to expected figures derived from the regional population. The area highlighted by the study is, in general terms, overlapping with the area where most illegal dumping of toxic wastes took place. It is now recommended that mortality studies be extended to take into account other health outcomes, to search for correlations with environmental exposures, and consider possible confounding factors.

An investigation of the relationship between air emissions of volatile organic compounds and the incidence of cancer in Indiana counties

Cancer is a health endpoint influenced by a multitude of factors, including genetic history, individual behavior, and environmental insults. The ubiquity of toxicants in the environment has raised questions about the extent of their role in causing cancer in humans. More specifically, it is desirable to understand the cancer incidence due to airborne toxicants in anthropogenic pollution. One particular class of such pollutants is volatile organic compounds (VOCs). This paper reports an epidemiological investigation of the incidence of cancer in the 92 counties of Indiana. We evaluated the relationship between the amount of VOCs released in each county, as reported by the Toxic Release Inventory, and the county-by-county incidence of various types of cancer, especially those of less common organ systems not directly associated with the absorption or distribution of toxicants. Our evaluation considered chlorinated versus nonchlorinated emissions as well as stack versus fugitive emissions. We evaluated three models: linear, quadratic, and polynomial. Of these, the quadratic model appeared to be the best predictor (highest r2) for most endpoints for which there was a positive correlation. However, the linear model was the most sensitive (lowest P-value) for skin, melanoma, and endocrine-related cancers, including female genital system cancers. Our results indicate a relationship between emissions of VOCs and the incidence of some types of cancers. Most notable were strong correlations between VOC emissions and cancers of the brain, nervous system, endocrine system, and skin.

Hospitalization rates for coronary heart disease in relation to residence near areas contaminated with persistent organic pollutants and other pollutants

Exposure to environmental pollutants may contribute to the development of coronary heart disease (CHD). We determined the ZIP codes containing or abutting each of the approximately 900 hazardous waste sites in New York and identified the major contaminants in each. Three categories of ZIP codes were then distinguished: those containing or abutting sites contaminated with persistent organic pollutants (POPs), those containing only other types of wastes ("other waste"), and those not containing any identified hazardous waste site ("clean"). Effects of residence in each of these ZIP codes on CHD and acute myocardial infarction (AMI) hospital discharge rates were assessed with a negative binomial model, adjusting for age, sex, race, income, and health insurance coverage. Patients living in ZIP codes contaminated with POPs had a statistically significant 15.0% elevation in CHD hospital discharge rates and a 20.0% elevation in AMI discharge rates compared with clean ZIP codes. In neither of the comparisons were rates in other-waste sites significantly greater than in clean sites. In a subset of POP ZIP codes along the Hudson River, where average income is higher and there is less smoking, better diet, and more exercise, the rate of hospitalization for CHD was 35.8% greater and for AMI 39.1% greater than in clean sites. Although the cross-sectional design of the study prevents definite conclusions on causal inference, the results indirectly support the hypothesis that living near a POP-contaminated site constitutes a risk of exposure and of development of CHD and AMI.

Current practices in spatial analysis of cancer data: data characteristics and data sources for geographic studies of cancer

The use of spatially referenced data in cancer studies is gaining in prominence, fueled by the development and availability of spatial analytic tools and the broadening recognition of the linkages between geography and health. We provide an overview of some of the unique characteristics of spatial data, followed by an account of the major types and sources of data used in the spatial analysis of cancer, including data from cancer registries, population data, health surveys, environmental data, and remote sensing data. We cite numerous examples of recent studies that have used these data, with a focus on etiological research.

Spatial epidemiology: current approaches and future challenges

Spatial epidemiology is the description and analysis of geographic variations in disease with respect to demographic, environmental, behavioral, socioeconomic, genetic, and infectious risk factors. We focus on small-area analyses, encompassing disease mapping, geographic correlation studies, disease clusters, and clustering. Advances in geographic information systems, statistical methodology, and availability of high-resolution, geographically referenced health and environmental quality data have created unprecedented new opportunities to investigate environmental and other factors in explaining local geographic variations in disease. They also present new challenges. Problems include the large random component that may predominate disease rates across small areas. Though this can be dealt with appropriately using Bayesian statistics to provide smooth estimates of disease risks, sensitivity to detect areas at high risk is limited when expected numbers of cases are small. Potential biases and confounding, particularly due to socioeconomic factors, and a detailed understanding of data quality are important. Data errors can result in large apparent disease excess in a locality. Disease cluster reports often arise nonsystematically because of media, physician, or public concern. One ready means of investigating such concerns is the replication of analyses in different areas based on routine data, as is done in the United Kingdom through the Small Area Health Statistics Unit (and increasingly in other European countries, e.g., through the European Health and Environment Information System collaboration). In the future, developments in exposure modeling and mapping, enhanced study designs, and new methods of surveillance of large health databases promise to improve our ability to understand the complex relationships of environment to health.

Breast Cancer Incidence and Exposure to Environmental Chemicals in 82 Counties in Mississippi

OBJECTIVE

Breast cancer is a major public health problem in the United States and in most industrialized countries. Environmental exposure to several chemicals has been implicated in the cause of breast cancer. However, data are not consistent about the role of the environment in breast cancer incidence. To assess environmental risks for breast cancer, patterns of breast cancer incidence in relation to environmental chemicals in Mississippi counties were mapped.

METHODS

This article presents an analysis of age-adjusted incidence rates of female breast cancer and environmental chemical emissions by county in the state of Mississippi. The incidence data were obtained from the State Department of Health, and emissions data sources included the U.S. Environmental Protection Agency's Air-Data and Toxics Release Inventory Program.

RESULTS

Counties having a significantly higher incidence of breast cancer compared with the state's rate were identified. Also identified were counties with higher levels of chemical emissions. The incidence of breast cancer in 1998 was significantly associated with the amount of ammonia (r = 0.268, P = 0.015), minimum emissions (r = 0.233, P = 0.035), and maximum emissions (r = 0.237, P = 0.032) of the facilities in the county. A linear dose-response relationship was observed between increased amounts of chemical emissions and breast cancer incidence.

CONCLUSIONS

This study found a significant link between breast cancer incidence and maximum emissions of environmental chemicals. However, further research using individual-level data is needed.

Solid waste disposal in urban areas and health--the case of Belo Horizonte, Brazil

The presence of sanitary or controlled landfill in urban areas and its implications for the health of the population that lives in its bordering area has been little investigated. The presence of these deposits, with design or operational problems, can end up providing a likely location for the proliferation of diverse vectors and favouring uncontrolled emissions, which may affect health, both for the people that work and live in these places and those that live nearby. This paper describes a study carried out in the city of Belo Horizonte, Brazil, with the objective of associating the presence of the BR 040 sanitary landfill, located in the urban environment, and the health of the neighbouring population. There were 475 possibilities of occurrences studied, covering 19 different combinations for association between the exposure factor and the groupings of researched diseases (respiratory diseases, diarrhoea and skin diseases). However, of this total only 33 results were shown to be significant in showing the existence of an association. For these results, the variable exposures identified as a risk factor showed an odds ratio ranging between 1.20 and 13.75. Although without an evidenced relationship, respiratory diseases appeared as a relevant outcome in the study, as they were present in 23 of the 33 studied combinations in which the results were significant.

Health hazards and waste management

Different methods of waste management emit a large number of substances, most in small quantities and at extremely low levels. Raised incidence of low birth weight births has been related to residence near landfill sites, as has the occurrence of various congenital malformations. There is little evidence for an association with reproductive or developmental effects with proximity to incinerators. Studies of cancer incidence and mortality in populations around landfill sites or incinerators have been equivocal, with varying results for different cancer sites. Many of these studies lack good individual exposure information and data on potential confounders, such as socio-economic status. The inherent latency of diseases and migration of populations are often ignored. Waste management workers have been shown to have increased incidence of accidents and musculoskeletal problems. The health impacts of new waste management technologies and the increasing use of recycling and composting will require assessment and monitoring.

Cancer risks in populations living near landfill sites in Great Britain

Previous studies have raised concerns about possible excess risks of bladder, brain and hepatobiliary cancers and leukaemias near landfill sites. Several cancers have been implicated, but no consistent pattern has emerged. We present a large nationwide analysis of selected cancers near landfill sites in Great Britain. The base population comprised people living within 2 km of 9565 (from a total of 19 196) landfill sites that were operational at some time from 1982 to 1997, with populations living more than 2 km from a landfill as reference. Risks of cancers at the above sites were computed with adjustment for age, sex, year of diagnosis, region and deprivation. National post-coded registers provided a total of 341 856 640 person-years for the adult cancer analyses and 113 631 443 person-years for childhood leukaemia. There were 89 786 cases of bladder cancer, 36 802 cases of brain cancer, 21 773 cases of hepatobiliary cancer, 37 812 cases of adult leukaemia and 3973 cases of childhood leukaemia. In spite of the very large scale of this national study, we found no excess risks of cancers of the bladder and brain, hepatobiliary cancer or leukaemia, in populations living within 2 km of landfill sites. The results were similar if the analysis were restricted to landfill sites licensed to carry special (hazardous) waste. Our results do not support suggestions of excess risks of cancer associated with landfill sites reported in other studies.

Health effects of residence near hazardous waste landfill sites: a review of epidemiologic literature

This review evaluates current epidemiologic literature on health effects in relation to residence near landfill sites. Increases in risk of adverse health effects (low birth weight, birth defects, certain types of cancers) have been reported near individual landfill sites and in some multisite studies, and although biases and confounding factors cannot be excluded as explanations for these findings, they may indicate real risks associated with residence near certain landfill sites. A general weakness in the reviewed studies is the lack of direct exposure measurement. An increased prevalence of self-reported health symptoms such as fatigue, sleepiness, and headaches among residents near waste sites has consistently been reported in more than 10 of the reviewed papers. It is difficult to conclude whether these symptoms are an effect of direct toxicologic action of chemicals present in waste sites, an effect of stress and fears related to the waste site, or an effect of reporting bias. Although a substantial number of studies have been conducted, risks to health from landfill sites are hard to quantify. There is insufficient exposure information and effects of low-level environmental exposure in the general population are by their nature difficult to establish. More interdisciplinary research can improve levels of knowledge on risks to human health of waste disposal in landfill sites. Research needs include epidemiologic and toxicologic studies on individual chemicals and chemical mixtures, well-designed single- and multisite landfill studies, development of biomarkers, and research on risk perception and sociologic determinants of ill health.

Risks of developing cancer relative to living near a municipal solid waste landfill site in Montreal, Quebec, Canada

In this study, we sought to determine whether men who lived near the Miron Quarry municipal solid waste landfill site in Montreal, Quebec, Canada, were at higher risk for developing cancer than individuals who lived at more remote locations. Subjects were selected from a previously completed population-based, interview, cancer case-control study of men who lived in metropolitan Montreal. Thirteen sites of cancer (n = 2 928 subjects) and a population-based control group (n = 417) were analyzed. We used the exact street address at the time of diagnosis to classify subjects by geographic zones and distance from the site. We used unconditional logistic regression to estimate odds ratios (ORs) and associated 95% confidence intervals (CIs) for each site of cancer, adjusted for key covariates. In the exposure zone nearest to the site, elevated risks were found for cancers of the pancreas (adjusted OR = 1.4 [95% CI = 0.8, 2.6]); liver (OR = 1.8 [95% CI = 0.8, 4.3]); and prostate (OR = 1.5 [95% CI = 1.0, 2.1]). A high risk was also found for pancreatic cancer (OR = 1.7 [95% CI = 0.9, 3.5]) and the non-Hodgkin's lymphomas (OR = 1.5 [95% CI = 0.8, 2.6]) in a subexposure zone approximately downwind from the site. We used distance from the site as another exposure metric, and higher-than-expected risks were found for pancreatic cancer (OR for living within 1.25 km of the site [OR<1.25km] = 2.2 [95% CI = 1.0, 4.6]); liver cancer (OR<1.5km = 2.1 [95% CI = 0.8, 5.3]); kidney cancer (OR<2 km = 1.4 [95% CI = 0.9, 2.3]); and the non-Hodgkin's lymphomas (OR<1km = 2.0 [95% CI = 1.0, 4.0]). Data from this study and from a previous investigation at the same site suggest that men who lived near this landfill site may have been-and may continue to be-at excess risk of cancers of the liver, kidney, pancreas, and non-Hodgkin's lymphomas.

Small area study of mortality among people living near multiple sources of air pollution

OBJECTIVE

In the area of Malagrotta, a suburb of Rome (Italy), a large waste disposal site, a waste incinerator plant, and an oil refinery plant became operational in the early 1960s and have represented three major sources of air pollution. To evaluate the potential health risk due to airborne contamination around these point sources, a small area analysis of mortality was conducted. Cancer of the liver, larynx, lung, kidney, lymphatic, and haematopoietic systems were evaluated.

METHODS

Sex and age specific mortality (1987-93) and population denominators (1991) were available for the census tracts of the metropolitan area of Rome. Standardised mortality ratios (SMRs) were computed separately for males and females in bands of increasing distance from the plants, up to a radius of 10 km. Stone's test for the decline in risk with distance was performed with increments in radius of 1 km; SMRs were also computed after adjusting for a four level index of socioeconomic status.

RESULTS

No overall excess or decline in risk with distance was found for liver, lung, and lymphohaematopoietic cancers in either sex. For laryngeal cancer, an increased but not significant risk was found at 0-3 km and at 3-8 km. A significant decline with distance in mortality from laryngeal cancer was found among men (p = 0.03); the trend remained after adjusting for the socioeconomic index (p = 0.06).

CONCLUSIONS

The study showed no association between proximity to the industrial sites and mortality for most of the several conditions considered. However, mortality from laryngeal cancer declined with distance from the sources of pollution. This result is interesting, as previous findings of an increased risk of laryngeal cancer near incinerators have been controversial.

Environmental risk factors and female breast cancer

The increasing incidence of breast cancer in the United States and the international variation in risk have led to speculation that environmental risk factors are an important cause of breast cancer. We review the epidemiologic evidence on the breast cancer risk associated with ambient environmental exposures experienced passively by the US population, and discuss the difficulties associated with measurement of specific exposures in environmental studies. We review geographic variation of breast cancer rates in the United States, and exposure to organochlorines, ionizing and electromagnetic radiation, and passive smoking. Results are inconclusive but do not support a major role of environmental risk factors in the etiology of breast cancer.

Comparative biomonitoring study of workers at a waste disposal site using cytogenetic tests and the comet (single-cell gel) assay

Workers exposed to environmental pollutants at a waste disposal site were studied for genotoxic effects with cytogenetic tests and the comet (alkaline single-cell gel) assay. Analyses were performed on peripheral blood samples of 44 workers at a waste disposal site (DM) and 47 subjects of a control group (VE) matched for gender, age, and smoking habits. Chromosomal aberrations were evaluated in 1,000 lymphocytes per individual, sister chromatid exchanges in 50 cells, and DNA migration (tail moment) was determined in 100 leukocytes. Structural chromosome aberrations were more frequent in DM than in VE, but only the frequency of acentric fragments and the percentage of aberrant cells (excluding gaps) was significantly increased. No significant difference was found for the mean frequency of SCE. A statistically significant difference was also seen with the comet assay. The mean tail moment was higher in DM than in VE. However, no correlation was found between cytogenetic data and the effects in the comet assay. The results of our study indicate that DNA effects in the comet assay represent an independent endpoint which might be useful for the biomonitoring of genotoxic effects in addition to established tests.