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

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.

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.

Toxic Site Identification Program in Azerbaijan

The need to protect communities from hazardous waste is an important agenda for any nation. Although pollutant management and policy development are attempted in many developing countries, it is not always successful due to limited funds, project resources, and access to trained experts to conduct toxic site identification projects. For this reason, Pure Earth created the Toxic Site Identification Program (TSIP). The goal of the TSIP program is to provide reliable information and data that identifies location of toxic sites and the level of toxic severity. TSIP is significant because it provides developing countries a database of ranked toxic sites identified as hazardous risk to human health. For example, Azerbaijan is one of the most polluted post-Soviet nations, but has limited resources to address and manage its polluted sites. The Azerbaijani TSIP database is the first reliable data source that identifies hazardous pollutants in the country. Our study is significant because it discusses how the TSIP labels and ranks the level of toxic severity to human health. It is also the first data source in Azerbaijan that identifies which Soviet legacy toxic sites are affecting local communities. Although our study is specific to Azerbaijan, the TSIP method can be applied to nations with similar data limitations and the need for a database that identifies country specific environmental and hazardous locations. The data sampling method and results are mapped and accompanied by tables of the collected pollutant types to identify communities at greatest health-risk to legacy toxic sites.

Incidence and mortality trends and geographic patterns of follicular lymphoma in Canada

Background

Follicular lymphoma (fl) is the most common indolent lymphoma and the 2nd most common non-Hodgkin lymphoma, accounting for 10%-20% of all lymphomas in the Western world. Epidemiologic and geographic trends of fl in Canada have not been investigated. Our study's objective was to analyze incidence and mortality rates and the geographic distribution of fl patients in Canada for 1992-2010.

Methods

Demographic and geographic patient data for fl cases were obtained using the Canadian Cancer Registry, the Registre québécois du cancer, and the Canadian Vital Statistics database. Incidence and mortality rates and 95% confidence intervals were calculated per year and per geographic area. Rates were plotted using linear regression models to assess trends over time. Overall data were mapped using Microsoft Excel mapping software (Redmond, WA, U.S.A.) to identify case clusters across Canada.

Results

Approximately 22,625 patients were diagnosed with fl during 1992-2010. The age-standardized incidence rate of this malignancy in Canada was 38.3 cases per million individuals per year. Geographic analysis demonstrated that a number of Maritime provinces and Manitoba had the highest incidence rates, and that the provinces of Nova Scotia and Quebec had the highest mortality rates in the nation. Regional data demonstrated clustering of fl within cities or regions with high herbicide use, primary mining, and a strong manufacturing presence.

Conclusions

Our study provides a comprehensive overview of the fl burden and its geographic distribution in Canada. Regional clustering of this disease in concentrated industrial zones strongly suggests that multiple environmental factors might play a crucial role in the development of this lymphoma.

Detection and Geometrical Characterization of a Buried Landfill Site by Integrating Land Use Historical Analysis, Digital Photogrammetry and Airborne Lidar Data

Abandoned quarries are frequently used as sites of illegal dumping of solid urban waste. These sites often occur nearby or within urban areas so that their detection may turn out to be quite difficult from the surface. This study focuses on the detection and geometrical characterization of a hidden landfill site located along the coastline of the Campi Flegrei, near Naples, Italy. Our approach is based on the analysis of historical topographic maps and aerial photographs, coupled with quantitative comparison of multitemporal digital elevation models obtained by digital photogrammetry and lidar techniques. The comparative analysis of topographic maps and aerial photos clearly shows modifications of the landscape associated with the urban development and quarrying activity, as well as the later filling of the quarry. The change detection analysis reveals that remarkable elevation changes occurred in the study area between 1956 and 2008. The average thickness of the landfill deposits is ca. 8 m, whereas the average volume is ca. 100,000 m3. The results of this work confirm the suitability of the used methodological approach that combines both qualitative and quantitative techniques for the detection of buried landfill sites. The geometric characterization of a landfill represents a fitting starting point for the further planning of geophysical site surveys and direct investigations aimed at the assessment of environmental hazards.

Prostate-specific antigen and its derivatives in young adults occupationally exposed to quarry pollutants in southeastern Nigeria

To evaluate the level of total prostate-specific antigen (PSA) and effect of duration of exposure to pollutants in quarry workers, 5 mls of blood sample was collected from participants: 72 male quarry workers exposed to quarry pollutants and 72 unexposed controls. PSA estimations were done using the principle of ELISA. Mean total PSA, free PSA, and free-total PSA ratio levels of quarry workers did not differ from those of controls and was below the cutoff for the risk of prostate diseases. Higher mean total PSA and free PSA were observed in workers exposed for > 3 years compared to the unexposed control and workers exposed for ≤ 3 years. Age-adjusted linear regression indicated significant association (R = 0.515; p < .001) between the duration of exposure and total PSA level in quarry workers. This study suggests that longer duration of exposure to the quarry pollutants may elevate PSA level if precautions are not taken to minimize dose of exposure.

A systematic critical review of epidemiological studies on public health concerns of municipal solid waste handling

AIMS

The ultimate aim of this review was to summarise the epidemiological evidence on the association between municipal solid waste management operations and health risks to populations residing near landfills and incinerators, waste workers and recyclers. To accomplish this, the sub-aims of this review article were to (1) examine the health risks posed by municipal solid waste management activities, (2) determine the strengths and gaps of available literature on health risks from municipal waste management operations and (3) suggest possible research needs for future studies.

METHODS

The article reviewed epidemiological literature on public health concerns of municipal solid waste handling published in the period 1995-2014. The PubMed and MEDLINE computerised literature searches were employed to identify the relevant papers using the keywords solid waste, waste management, health risks, recycling, landfills and incinerators. Additionally, all references of potential papers were examined to determine more articles that met the inclusion criteria.

RESULTS

A total of 379 papers were identified, but after intensive screening only 72 met the inclusion criteria and were reviewed. Of these studies, 33 were on adverse health effects in communities living near waste dumpsites or incinerators, 24 on municipal solid waste workers and 15 on informal waste recyclers. Reviewed studies were unable to demonstrate a causal or non-causal relationship due to various limitations.

CONCLUSION

In light of the above findings, our review concludes that overall epidemiological evidence in reviewed articles is inadequate mainly due to methodological limitations and future research needs to develop tools capable of demonstrating causal or non-causal relationships between specific waste management operations and adverse health endpoints.

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.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.

Analysis of Environmental Chemical Mixtures and Non-Hodgkin Lymphoma Risk in the NCI-SEER NHL Study

BACKGROUND

There are several suspected environmental risk factors for non-Hodgkin lymphoma (NHL). The associations between NHL and environmental chemical exposures have typically been evaluated for individual chemicals (i.e., one-by-one).

OBJECTIVES

We determined the association between a mixture of 27 correlated chemicals measured in house dust and NHL risk.

METHODS

We conducted a population-based case-control study of NHL in four National Cancer Institute-Surveillance, Epidemiology, and End Results centers--Detroit, Michigan; Iowa; Los Angeles County, California; and Seattle, Washington--from 1998 to 2000. We used weighted quantile sum (WQS) regression to model the association of a mixture of chemicals and risk of NHL. The WQS index was a sum of weighted quartiles for 5 polychlorinated biphenyls (PCBs), 7 polycyclic aromatic hydrocarbons (PAHs), and 15 pesticides. We estimated chemical mixture weights and effects for study sites combined and for each site individually, and also for histologic subtypes of NHL.

RESULTS

The WQS index was statistically significantly associated with NHL overall [odds ratio (OR) = 1.30; 95% CI: 1.08, 1.56; p = 0.006; for one quartile increase] and in the study sites of Detroit (OR = 1.71; 95% CI: 1.02, 2.92; p = 0.045), Los Angeles (OR = 1.44; 95% CI: 1.00, 2.08; p = 0.049), and Iowa (OR = 1.76; 95% CI: 1.23, 2.53; p = 0.002). The index was marginally statistically significant in Seattle (OR = 1.39; 95% CI: 0.97, 1.99; p = 0.071). The most highly weighted chemicals for predicting risk overall were PCB congener 180 and propoxur. Highly weighted chemicals varied by study site; PCBs were more highly weighted in Detroit, and pesticides were more highly weighted in Iowa.

CONCLUSIONS

An index of chemical mixtures was significantly associated with NHL. Our results show the importance of evaluating chemical mixtures when studying cancer risk.

Mortality and morbidity in a population exposed to multiple sources of air pollution: A retrospective cohort study using air dispersion models

BACKGROUND AND AIMS

A landfill, an incinerator, and a refinery plant have been operating since the early 1960s in a contaminated site located in the suburb of Rome (Italy). To evaluate their potential health effects, a population-based retrospective cohort study was conducted using dispersion modeling for exposure assessment.

METHODS

A fixed cohort was enrolled in the Rome Longitudinal Study in 2001, mortality and hospitalizations were followed-up until 2010. Exposure assessments to the landfill (H2S), the incinerator (PM10), and the refinery plant (SOX) were performed for each subject using a Lagrangian dispersion model. Individual and small-area variables were available (including exposures levels to NO2 from traffic and diesel trucks). Cox regression analysis was performed (hazard ratios, HRs, 95% CI) using linear terms for the exposures (5th-95th percentiles difference). Single and bi-pollutant models were run.

RESULTS

The cohort included 85,559 individuals. The estimated annual average exposures levels were correlated. H2S from the landfill was associated with cardiovascular hospital admissions in both genders (HR 1.04 95% CI 1.00-1.09 in women); PM10 from the incinerator was associated with pancreatic cancer mortality in both genders (HR 1.40 95% CI 1.03-1.90 in men, HR 1.47 95% CI 1.12-1.93 in women) and with breast morbidity in women (HR 1.13 95% CI 1.00-1.27). SOx from the refinery was associated with laryngeal cancer mortality in women (HR 4.99 95% CI 1.64-15.9) and respiratory hospital admissions (HR 1.13 95% CI 1.01-1.27).

CONCLUSIONS

We found an association of the pollution sources with some cancer forms and cardio-respiratory diseases. Although there was a high correlation between the estimated exposures, an indication of specific effects from the different sources emerged.

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.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

Spatial-temporal analysis of non-Hodgkin lymphoma in the NCI-SEER NHL case-control study

BACKGROUND

Exploring spatial-temporal patterns of disease incidence through cluster analysis identifies areas of significantly elevated or decreased risk, providing potential clues about disease risk factors. Little is known about the etiology of non-Hodgkin lymphoma (NHL), or the latency period that might be relevant for environmental exposures, and there are no published spatial-temporal cluster studies of NHL.

METHODS

We conducted a population-based case-control study of NHL in four National Cancer Institute (NCI)-Surveillance, Epidemiology, and End Results (SEER) centers: Detroit, Iowa, Los Angeles, and Seattle during 1998-2000. Using 20-year residential histories, we used generalized additive models adjusted for known risk factors to model spatially the probability that an individual had NHL and to identify clusters of elevated or decreased NHL risk. We evaluated models at five different time periods to explore the presence of clusters in a time frame of etiologic relevance.

RESULTS

The best model fit was for residential locations 20 years prior to diagnosis in Detroit, Iowa, and Los Angeles. We found statistically significant areas of elevated risk of NHL in three of the four study areas (Detroit, Iowa, and Los Angeles) at a lag time of 20 years. The two areas of significantly elevated risk in the Los Angeles study area were detected only at a time lag of 20 years. Clusters in Detroit and Iowa were detected at several time points.

CONCLUSIONS

We found significant spatial clusters of NHL after allowing for disease latency and residential mobility. Our results show the importance of evaluating residential histories when studying spatial patterns of cancer.

Analysis of microbiological and chemical quality of poultry meat in the vicinity of the Mbeubeuss landfill in Malika (Senegal)

A total of 100 samples of poultry meat were collected in poultry farms in the vicinity of the Mbeubeuss landfill in the Niayes (Senegal) for microbiological and chemical analysis. Fifty-four (54) samples were collected in farms located less than 1 km from the landfill and 46 samples were collected in farms located a bit further (more than 1 km from the landfill). Microbiological quality was determined using techniques recommended by Association Française de Normalisation (AFNOR). Lead and cadmium concentration in poultry meat was measured by flame spectrometry while total mercury was determined by atomic absorption spectrometry. Three percent (3%) of the samples' quality were unsatisfactory for E. coli, 1% for Staphylococci and 7% for Salmonella spp. Poor meat quality was found either in farms located less than 1 km of the landfill or in farms located at more than 1 km of the landfill. Except for Salmonella, only meat samples from poultry receiving drinking water from well showed unsatisfactory microbiological quality. The samples were free of cadmium and lead but were contaminated by mercury. Sixty-eight percent (68%) of the samples contained mercury with a high contamination level (>0.011 mg/kg) in 20% of the samples. No significant difference was found between the farms that were nearest to and further away from the landfill while the source of drinking water seemed to be the main cause of contamination of poultry meat by mercury.

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.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.

Asthma symptoms among adolescents who attend public schools that are located near confined swine feeding operations

OBJECTIVES

Little is known about the health effects of living in close proximity to industrial swine operations. We assessed the relationship between estimated exposure to airborne effluent from confined swine feeding operations and asthma symptoms among adolescents who were aged 12 to 14 years.

METHODS

During the 1999-2000 school year, 58169 adolescents in North Carolina answered questions about their respiratory symptoms, allergies, medications, socioeconomic status, and household environments. To estimate the extent to which these students may have been exposed during the school day to air pollution from confined swine feeding operations, we used publicly available data about schools (n = 265) and swine operations (n = 2343) to generate estimates of exposure for each public school. Prevalence ratios and 95% confidence intervals for wheezing within the past year were estimated using random-intercepts binary regression models, adjusting for potential confounders, including age, race, socioeconomic status, smoking, school exposures, and household exposures.

RESULTS

The prevalence of wheezing during the past year was slightly higher at schools that were estimated to be exposed to airborne effluent from confined swine feeding operations. For students who reported allergies, the prevalence of wheezing within the past year was 5% higher at schools that were located within 3 miles of an operation relative to those beyond 3 miles and 24% higher at schools in which livestock odor was noticeable indoors twice per month or more relative to those with no odor.

CONCLUSIONS

Estimated exposure to airborne pollution from confined swine feeding operations is associated with adolescents' wheezing symptoms.

Race, poverty, and potential exposure of middle-school students to air emissions from confined swine feeding operations

Previous studies suggest that airborne effluent from swine confined animal feeding operations (CAFOs) may affect the health and quality of life of adults and the prevalence of asthma symptoms among children. To investigate the extent to which public school students may be exposed to airborne effluent from swine CAFOs and to evaluate the association between schools' demographic characteristics and swine CAFO exposures, we assessed the proximity of 226 schools to the nearest swine CAFO and conducted a survey of school employees to identify schools with noticeable livestock odor. We used publicly available information describing the enrollment of each school to assess the association between race and socioeconomic status (SES) and swine CAFO exposure. Odor from livestock was noticeable outside (n = 47, 21%) and inside (n = 19, 8%) school buildings. Schools with < 63% enrollment of white students and > or = 47% of students receiving subsidized lunches at school were located closer to swine CAFOs (mean = 4.9 miles) than were the remaining schools (mean = 10.8 miles) and were more likely to be located within 3 miles of an operation than were schools with high-white/high-SES enrollment (prevalence ratio = 2.63; 95% confidence interval, 1.59-4.33). The prevalence of reported livestock odor varied with SES (low SES, 25%; high SES, 17%). These analyses indicate that the potential for in-school exposure to pollution arising from swine CAFOs in North Carolina and the environmental health risks associated with such exposures vary according to the racial and economic characteristics of enrolled students.

Diarrhoea and garbage disposal in Salvador, Brazil

The association of infantile diarrhoea with the presence of garbage in the environment was investigated in Canabrava, a peripheral neighbourhood of Salvador, northeast of Brazil. A cross-sectional study was conducted with all the 184 children aged less than two years residing in Canabrava, which is located close to the city garbage dump. Variables selected for study included the method used for the disposal of excrement, type of floor, mother's education, unemployment of the head of the family, regularity of the water supply, presence of toilet, storage of garbage inside the house, age, gender, duration of breastfeeding, and the number of people per room. The estimated prevalence of diarrhoea was 21.2%. Exposure to garbage in the environment was found to be the most important factor associated with diarrhoea (adjusted odds ratio [AOR] = 3.98, 95% CI 1.56-10.13). Other important variables were the mother's education (AOR = 2.79, 95% CI 1.09-7.13), maternal breastfeeding (AOR = 2.30, 95% CI 1.05-5.04), and unemployment of the head of the family (AOR = 2.09, 95% CI 0.93-4.69). These findings indicate the necessity of adopting solutions in the public domain and of intersectorial policies for the reduction of diarrhoea.

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.