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

Respiratory and nervous system effects of a hydrogen sulfide crisis in Carson, California

BACKGROUND

In October 2021, many residents in Carson, California experienced malodors, headaches, and respiratory symptoms. Hydrogen sulfide (H2S), a toxic odorous gas, was measured in Carson at concentrations up to 7000 parts per billion (ppb) and remained above California's acute air quality standard of 30 ppb for about a month. Research on how low- and medium-level H2S exposure affects the respiratory and nervous systems has yielded conflicting results, and few studies have examined the effects of subacute H2S exposure.

METHODS

We calculated daily rates of emergency department (ED) visits with various respiratory and nervous systems diagnosis codes in Carson area ZIP codes (≤6 km from event's epicenter) and in Los Angeles County ZIP codes >15 km from event's epicenter (control area). Using controlled interrupted time series, we compared ED visit rates during the month of the H2S crisis in Carson to the predicted rates had the incident not occurred, based on 2018-2021 ED trends, and controlling for ED visit rate changes in the control area.

RESULTS

We observed a 24 % increase in ED visit rate for all respiratory system diseases (rate ratio = 1.24, 95 % CI: 1.16, 1.32), a 38 % increase for asthma (RR = 1.38, 95 % CI: 1.26, 1.50), a 26 % increase for acute upper respiratory infections (RR = 1.26, 95 % CI: 1.13, 1.38), a 21 % increase for dizziness (RR = 1.21, 95 % CI: 1.04, 1.38), and a 25 % increase for migraines and headaches (RR = 1.25, 95 % CI: 1.13, 1.36) in the Carson area during the first month of the H2S event compared to the expected rates.

CONCLUSIONS

This H2S crisis was associated with increased ED visit rates for multiple respiratory and nervous system outcomes. Reducing H2S exposure and improving to response during H2S episodes may improve public health.

Elevated levels of anthropogenic antibiotic resistance gene marker, sul1, linked with extreme fecal contamination and poor water quality in wastewater-receiving ponds

In several low- and middle-income countries, such as India, the rapid construction of toilets to combat open defecation has not been matched with adequate wastewater treatment, resulting in extreme fecal contamination of the receiving environments. The sewage-receiving surface water bodies, typically close to the residences, are a potential hotspot for disease transmission and antibiotic resistance. Water, soil, and sediment samples from seven wastewater-receiving ponds (WRPs) were analyzed for water quality, chlorophyll-a, fecal contamination (yccT for Escherichia coli), 16S rRNA gene copies, and anthropogenic antibiotic resistance gene markers-sul1 and intI1. These WRPs were contrasted with two ponds that did not directly receive sewage. The water quality in the WRPs was comparable to raw sewage (BOD: 210-380 mg/L; COD: 350-630 mg/L; total-N: 100-190 mg/L; and total-P: 6-21 mg/L), and the relative levels of the DNA marker of E. coli were very high (yccT: 0.1% to ∼100% of total bacterial count) indicating extreme fecal contamination. The relative levels of sul1 and intI1 were 1-3 orders of magnitude higher in WRPs (sul1: 0.32%-10% of total bacterial count; and intI1: 0.2%-5% of total bacterial count) compared to the ponds that did not receive sewage directly. The relative levels of sul1 correlated with the DNA marker for the fecal indicator, E. coli (p-value < 0.05; r = 0.50; Spearman's rank correlation), and poor water quality.

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

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

Health risks and perceptions of residents exposed to multiple sources of air pollutions: A cross-sectional study on landfill and stone mining in Danang city, Vietnam

Health risks and perceptions of residents living nearby landfills or stone mines/quarries have been well documented; however, the multiple impacts of these two pollution sources have yet to be investigated. This study aims at giving insights into the impacts of residents exposed to two pollution sources in Danang city, Vietnam: Khanh Son landfill and Phuoc Tuong quarry. In this cross-sectional study, 7-point-Likert scale questionnaires were used to collect information from 314 respondents which were divided into three groups: i) Landfill-Stone mine (LS) exposed group within 1 km from both sources, ii) Stone mine (ST) exposed group within 1 km from the stone mine, and iii) the far-exposed group about 2-3 km from the two emission sites. Air pollutants (including H₂S, CH₄, and total suspended particles (TSP)) and noise levels were also sampled. In addition, we estimated the potential health risk assessment due to the exposure to hydrogen sulphide in the study areas. The findings have shown that 1) There is a statistical difference (p-value < 0.001) between the two exposed groups and far-exposed group regarding health risks and residents' perceptions; 2) Compared to the ST exposed group, the LS exposed group statistically showed a higher perception to bad odours and skin diseases; lower satisfaction with regards to the personal health condition and the operation of the landfill; and higher willingness to change current living locations; and 3) There is evidence to indicate that elevated concentrations of air pollutants are associated with the high self-reported health risks and residents' perceptions. Urgent actions should be focused on the LS exposed group, landfill and quarry operations to prevent further adverse health effects.

Management of the Organic Fraction of Municipal Solid Waste in the Context of a Sustainable and Circular Model: Analysis of Trends in Latin America and the Caribbean

The main objective of this research is to analyze the most relevant aspects of the management of the organic fraction of municipal solid waste (OFMSW) and the Sustainable and Circular Production Models (SCPMs) in Latin America and the Caribbean (LAC). The bibliometric method was used for the analysis of 190 studies obtained from the Scopus and Latin America and The Caribbean on Health Sciences (LILACS) databases. The systematic review provided information on the main research approaches: identification and characterization; quantification; strategic and interdisciplinary management; and processes for treatment or valorization. Finally, an evaluation of public policies and strategies was performed. The results show that Brazil, Mexico, and Colombia have the highest number of publications on OFMSW. The findings also indicate that both research and policy strategies on SCPMs prioritize bioenergy and biofuels as the leading alternatives for the valorization of OFMSW. It also reflects the relevance of the Circular Economy (CE) and Bioeconomy (BE) as the main drivers of waste recovery and/or valorization in LAC. These aspects are of great interest to governments that are still in the process of implementing SCPMs. However, for those more advanced in this area, it provides valuable information on progress, policy effectiveness, and future actions for improvement.

Men and women waste pickers on landfills in Johannesburg, South Africa: divergence in health, and socioeconomic status

OBJECTIVE

To investigate gender differences in health in informal waste pickers affected by poverty and multiple environmental and work hazards.

METHODS

A cross-sectional descriptive study was conducted at two major landfill sites in a large city. Information on health, work hazards and health care access as well as blood pressure, blood glucose, cholesterol and BMI were measured.

RESULTS

A total of 361 waste pickers participated in the survey. The women interviewed earned on average 22% less per month than the men waste pickers. The women presented with worse chronic health outcomes (OR 2.69 95% CI 1.51-4.78) and signs of chronic disease (OR 1.73 95% CI 1.02-2.96) compared to men despite showing greater health-seeking behaviours.

CONCLUSION

Women waste pickers suffer worse health outcomes, such as lifestyle diseases and HIV. Further research is needed to identify the factors involved. Responsive programs supporting health care, improved working conditions and income for waste pickers may also improve their health.

Comparative Life Cycle Assessment of Gasification and Landfilling for Disposal of Municipal Solid Wastes

Disposal of municipal solid wastes (MSW) remains a challenge to minimize its impacts on the environment and human health. Landfilling, currently the most common method used for MSW disposal, occupies land space and leads to soil and air emissions. Gasification, an alternative MSW disposal method, can convert waste to energy, but can also lead to soil and air emissions and is a more extensive operation. In this study, life cycle assessments (LCA) of the two disposal methods (landfilling without energy recovery and gasification) were compared to understand impacts on environment and health. The LCA was conducted following the ISO 14040 standards with one ton of MSW as the functional unit. The life cycle inventory was obtained from published journals, technical reports, LandGEM, HELP and GREET database. The impact assessment was done using TRACI 2.1 and categorized into eight groups. The LCA revealed that landfilling is a higher contributor in global warming, acidification, smog formation, eutrophication, ecotoxicity and human health cancer and non-cancer categories. The negative environmental impacts of MSW landfilling can be primarily attributed to the fate of leachate loss and landfill gas, while those of the MSW gasification can be attributed to the disposal of its solid residues.

Investigating correlations between illness and defensive behaviour approach: A case of twin cities of Pakistan

Municipal solid waste (MSW) management has emerged as a major problem for modern societies in recent decades. An optimal waste management system is essential to prevent the pollution burden and associated health related issues. This study carries out an empirical evaluation of the illness caused by inadequate solid waste management in the metropolitan of Rawalpindi-Islamabad. The model is based on utility-maximizing consumer behavior and predicted probability of disease in the household is estimated by employing “seemingly uncorrelated bivariate probit model”. Primary data obtained through multistage random sampling that comprises of 849 respondents. The findings show that irregular waste disposal sites in the vicinity of residences cause illness. The key findings indicate that distance from dumpsites and use of contaminated water adversely affect the health outcomes. Furthermore, the results show that respondents were unable to engage in defensive activities due to a lack of awareness. Oft-times, the waste is dumped in illegal sites that is burnt thus causing excessive air and ground water pollution. The results shed light on the respondents' understanding of the negative consequences of excessive waste disposal and study suggests measures that motivate households to engage in defensive activities through effective campaigns and capacity building programmes that ensure sustainable solid waste management.

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An overview of the household solid waste generation and management practices.

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Construct households' illness function regarding improper waste disposal practices.

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Construct households' defensive behaviour regarding illness function.

Risk Perceptions and Experiences of Residents Living Nearby Municipal Solid Waste Open Dumpsite in Ginchi Town, Ethiopia: A Qualitative Study

BACKGROUND

Due to improper municipal solid waste management, the use of open dump sites for final disposal of solid waste is common in towns and cities of Ethiopia.

PURPOSE

This study explored risk perceptions and experiences of Ginchi town residents living near Aba-Semer municipal solid waste open dumpsite in Ethiopia.

METHODS

Data on lived experiences were generated using a phenomenological approach. Focus group discussion was used to explore risk perception. Purposive sampling was used to select five in-depth interviewees and 12 participants in two focus group discussions among residents living near Aba-Semer open dumpsite. Amharic language tape recorded data were transcribed verbatim and translated to English. Data were analyzed using OpenCode and a thematic approach was employed.

RESULTS

All the participants perceived municipal solid waste open dumpsite as a risk to the environment and health. Disappointment and anger were experienced due to lack of solutions and ongoing dumping of municipal solid waste at the open dumpsite. Residents were mainly victims of respiratory-related health problems and emotional stresses.

CONCLUSION AND RECOMMENDATION

Risk perception was much influenced by lived experiences and observations of physical features. In return, risk perception and lived experiences had affected the level of emotional reactions from living near the open dumpsite. The municipality of the town should provide sustainable solution with provision of properly sited and designed municipal solid waste disposal site for the community in order to alleviate environment and health impacts from open dumpsite.

Methane oxidation of residual landfill gas in a full-scale biofilter: human health risk assessment of volatile and malodours compound emissions

A human health risk assessment was performed to evaluate if a biofilter for the biological methane oxidation reduces the risk from exposure to landfill gas emissions and improves the air quality mitigating odour emissions from an aftercare landfill. Accordingly, three different scenarios of landfill gas management were defined, 9 volatile organic compounds (VOCs) (cyclohexane, n-hexane, 2-methylpentane, 3-methylpentane, benzene, xylenes, toluene, dichlorodifluoromethane, vinyl chloride) were identified and using the CALPUFF dispersion model; the pollutant concentration at eleven sensitive receptors was determined. Consequently, the risk (for cancer and non-cancer compounds) was assessed applying the methodology proposed by USEPA 2009. From one hand, to determine concentration and emission rates of VOCs and hydrogen sulphide, a sample of raw landfill gas and three air samples from the biofilter surface were collected with dynamic flux chamber method and analysed in accordance with US EPA, 1986 and USEPA TO-15, 1999. To the other hand, odour emissions were assessed based both on chemical and dynamic olfactometric measurements (EN 13725:2003). The field surveys results showed a reduction of the cancer risk on average by 79% and of the hazard quotient on average by 92%. In contrast, the results of olfactometry measurements showed a lower efficiency on odour reduction than the target value of 70%. Nonetheless, the odour concentration was always far below 300 uo_E m^-3 at the biofilter surface and odour concentration never exceed 1 uo_E m^-3 at the sensitive receptors.

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

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

Renal impairment assessment on adults living nearby a landfill: Early kidney dysfunction biomarkers linked to the environmental exposure to heavy metals

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Health risk of the neighboring population of the Mbeubeuss landfill (Senegal).

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Assessment of the impact of Cd/Pb exposure through dysfunction renal biomarkers.

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Specific increases of a set of early dysfunction renal biomarkers in exposed subjects.

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Glomerular and tubular dysfunction in exposed subjects.

The aim of this study was to assess the integrity and kidney overall functional capacity of subjects exposed to landfill emissions. Urine and blood levels of Pb and Cd, and several of the newly biomarkers of nephrotoxicity (Kim Injury Molecule 1 (KIM-1), alpha-1 Microglobulin (α1 M), beta-2 Microglobulin (β2 M), Cystatin-C (Cyst C), Clusterin, alpha-glutathione S-transferase (GSTα), pi-glutathione S-transferase (GSTπ), Tissue Inhibitor of Metalloproteinase-1 (TIMP1), Calbindin, Neutrophil Gelatinase-Associated Lipocalin (NGAL), Osteopontin (OPN), (Retinol Binding Protein(RBP), Liver-type Fatty Acid-Binding Protein (FABP-1), Trefoil Factor 3 (TFF3), Collagen VI) were measured in order to assess glomerular and tubule damage in adults living near a landfill.

Our results indicate glomerular dysfunction in exposed subjects, and supported evidence of necrosis of proximal and distal tubule epithelial cells as specific biomarkers began to appear in the urine.

Positive correlation by Pearson test were obtained between : blood Pb and B-OPN, B-Cyst C, Calbindin, U-KIM-1, TIMP1, U-OPN, and U-Clusterin; and also, between urinary Cd and TIMP1, B-Clusterin, U-OPN, FABP-1, Albumin, and U-Clusterin. The relation between biomarkers of Cd/Pb exposure and early effect biomarkers in this study clearly predicts the future risk of severe kidney injury in subjects living close to the landfill.

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

BACKGROUND

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

METHODS

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

FINDINGS

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

INTERPRETATION

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

FUNDING

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

Mortality and hospitalization associated to emissions of a coal power plant: A population-based cohort study

BACKGROUND

Coal-fired thermal power plants represent a significant source of air pollutants, especially sulfur dioxide (SO₂) that has been associated with an increased risk of mortality and morbidity for respiratory and cardiovascular disease. A coal power plant in Vado Ligure (Italy) (CPP_VL) started in 1970 was stopped in 2014 by the Prosecutor's Office on the grounds of environmental and health culpable disaster.

OBJECTIVE

To investigate the association between the exposure of residents to atmospheric pollutants emitted by CPP_VL and the risk of mortality and hospitalization, considering both cancer and non-cancer causes in a population-based cohort study.

METHODS

SO₂ and nitrogen oxides (NO_x), estimated using the ABLE-MOLOCH-ADMS-Urban dispersion model, were selected as representative surrogates of exposure to CPP_VL emissions (SO₂-CPP_VL) and cumulative emissions from other sources of pollution (NO_x-MS), respectively. The relationship between each health outcome and categories of exposure to SO₂-CPP_VL was estimated by the Hazard Ratio (HR) using multiple sex-specific Cox regression models, adjusted for age, exposure to NO_x-MS, and socio-economic deprivation index using SO₂-CPP_VL first quartile as a reference.

RESULTS

144,019 individuals were recruited (follow-up 2001-2013). An excess of mortality was found for all natural causes (men: 1.49; 95% CI 1.38-1.60; women: 1.49; 95% CI 1.39-1.59), diseases of the circulatory system (men: 1.41; 95% CI 1.24-1.56; women: 1.59; 95% CI 1.44-1.77), of the respiratory system (men: 1.90; 95% CI 1.47-2.45; women: 1.62; 95% CI 1.25-2.09), and of the nervous system and sense organs (men: 1.34; 95% CI 0.97-1.86; women: 1.38; 95% CI 1.03-1.83), and in men for trachea, bronchus, and lung cancers (1.59; 95% CI 1.26-2.00). Results of hospitalization analysis were consistent with those of mortality.

CONCLUSION

Results obtained, also when considering multiple sources of exposure, indicate that exposure to CPP emissions represents a risk factor for selected health outcomes as well as the urgently adoption of primary prevention measures and of a specific surveillance programme.

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

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

Health effects associated with chronic exposure to low-level hydrogen sulfide from geothermoelectric power plants. A residential cohort study in the geothermal area of Mt. Amiata in Tuscany

BACKGROUND

Geothermal power plants for the production of electricity are currently active in Mt. Amiata, Italy. The present study aimed to investigate the association between chronic low-level exposure to H₂S and health outcomes, using a residential cohort study design.

METHODS

Spatial variability of exposure to chronic levels of H₂S was evaluated using dispersion modelling. Cohorts included people residing in six municipalities of the geothermal district from 01/01/1998 to 31/12/2016. Residence addresses were georeferenced and each subject was matched with H₂S exposure metrics and socio-economic status available at census tract level. Mortality and hospital discharge data for neoplasms and diseases of the respiratory, central nervous and cardiovascular systems were taken from administrative health databases. Cox proportional hazard models were used to test the association between H₂S exposure and outcomes, with age as the temporal axis and adjusting for gender, socio-economic status and calendar period.

RESULTS

The residential cohort was composed of 33,804 subjects for a total of 391,002 person-years. Analyses reported risk increases associated with high exposure to H₂S for respiratory diseases (HR = 1.12 95%CI: 1.00-1.25 for mortality data; HR = 1.02 95%CI: 0.98-1.06 for morbidity data), COPD and disorders of the peripheral nervous system. Neoplasms were negatively associated with increased H₂S exposure.

CONCLUSIONS

The most consistent findings were reported for respiratory diseases. Associations with increased H₂S exposure were coherent in both mortality and hospitalization analyses, for both genders, with evidence of exposure-related trends. No positive associations were found for cancer or cardiovascular diseases.

Mortality and morbidity associated with ambient temperatures in Taiwan

BACKGROUND

This study evaluated integrated risks of all-cause mortality, emergency room visits (ERVs), and outpatient visits associated with ambient temperature in all cities and counties of Taiwan. In addition, the modifying effects of socio-economic and environmental factors on temperature-health associations were also evaluated.

METHODS

A distributed lag non-linear model was applied to estimate the cumulative relative risks (RRs) with confidence intervals of all-cause mortality, ERVs, and outpatient visits associated with extreme temperature events. Random-effect meta-analysis was used to estimate the pooled RR of all-cause mortality, ERVs, and outpatient visits influenced by socio-economic and environmental factors.

RESULTS

Temperature-related risks varied with study area and health outcome. Meta-analysis showed greater all-cause mortality risk occurred in low temperatures than in high temperatures. Integrated RR of all-cause mortality was 1.71 (95% confidence interval [CI]:1.43-2.04) in the 5th percentile temperature and 1.10 (95% CI: 1.05-1.15) in the 95th percentile temperature, while the lowest mortality risk was in the 60th percentile temperature (22.2 °C). Risk for ERVs increased when temperature increased (RR was 1.21 [95% CI: 1.17-1.26] in 95th percentile temperature), but risk of outpatient visits increased at low temperatures (RR was 1.06 [95% CI: 1.01-1.12] in the 5th percentile temperature). Certain socio-economic factors significantly modified low-temperature-related mortality risks, including number of employed populations, elders living alone from lower-income families, and public and medical services.

CONCLUSIONS

This study found that mortality and outpatient visits were higher at low temperature, while ERVs risk was higher at high temperature. Future plans for public health and emerging medical services responding to extreme temperatures should consider regional and integrated evaluations of temperature-related health risks and modifying factors.

Characterization of leachates from waste landfill sites in a religious camp along Lagos-Ibadan expressway, Nigeria and its hepatotoxicity in rats

Landfill sites near human settlements are known to have adverse health effects. Here, we investigated the effect of different concentrations of leachates from the Redemption Camp landfill (RCLL, 10%, 30%, 50%) on the liver of adult female rats after 21 days of exposure in their drinking water. The physicochemical and metal analyses showed that biochemical oxygen and chemical oxygen demand, zinc and magnesium levels were significantly high, whereas copper level was low in RCLL when compared to water samples from residential areas close to the landfill site, and were higher than the acceptable limits (p < 0.05). The predominant bacteria isolates recovered from the leachate and drinking water samples were Escherichia coli, Salmonella spp and Shigella spp. At the end of the 21-day exposure, RCLL increased the weight of the liver. Malondialdehyde concentrations were increased and glutathione levels were decreased significantly in the liver of treated animals at all concentrations of leachates tested. Furthermore, the activities of serum alanine amino transferase, aspartate amino transferase, gamma glutamyl transferase and cholesterol concentrations were increased whereas bilirubin and albumin levels were decreased dose-dependently. Histological examination of the liver was characterized by accumulation of inflammatory cells around hepatocytes, and extended sinusoids. The histo-pathological alterations and oxidative damage observed in the liver of treated rats and occurrence of pathogenic species and metals in the RCLL may suggest possible impaired hepatic health in subjects with occupational or environmental exposure.

A respiratory health survey of a subsurface smoldering landfill

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

Effects of ambient air pollution from municipal solid waste landfill on children's non-specific immunity and respiratory health

This cross-sectional study investigated the association between air pollutant (AP) and respiratory health of 951 children residing near a municipal solid waste (MSW) landfill in Northern China. Results showed that students in non-exposure areas had significantly higher levels of lysozyme, secretory immunoglobulin A (SIgA), and better lung capacity than students in exposure areas (p < .05). Multiple regression model analysis indicated that lysozyme levels exhibited a consistent negative association with methane (CH₄: β = -76.3, 95% CI -105 to -47.7) and sulfuretted hydrogen (H₂S: β = -11.7, 95% CI -20.2 to -3.19). In addition, SIgA levels were negatively associated with H₂S (β = -68.9, 95% CI -97.9 to -39.9) and ammonia (NH₃: β = -30.3, 95% CI -51.7 to -8.96). Among all AP, H₂S and sulfur dioxide (SO₂) were the most robustly related with reduced lung function. H₂S exposure was negatively associated with six lung function indices, 1-s forced expiratory volume (FEV1%), mean forced expiratory flow between 25% and 75% (MMF), maximum voluntary ventilation (MVV), and forced expiratory flow at 25%, 50%, and 75% of the pulmonary volume (FEF25, FEF50, FEF75); and SO₂ was negatively associated with FEV1%, MVV, FEF25, FEF50 and FEF75. Our results suggested that AP exposure was negatively associated with more lung function parameters in boys than in girls. In conclusion, our findings suggested that children living adjacent to landfill sites were more likely to have deficient non-specific immunity and impaired lung function.

Fully integrated modelling for sustainability assessment of resource recovery from waste

This paper presents an integrated modelling approach for value assessments, focusing on resource recovery from waste. The method tracks and forecasts a range of values across environmental, social, economic and technical domains by attaching these to material-flows, thus building upon and integrating unidimensional models such as material flow analysis (MFA) and lifecycle assessment (LCA). We argue that the usual classification of metrics into these separate domains is useful for interpreting the outputs of multidimensional assessments, but unnecessary for modelling. We thus suggest that multidimensional assessments can be better performed by integrating the calculation methods of unidimensional models rather than their outputs. To achieve this, we propose a new metric typology that forms the foundation of a multidimensional model. This enables dynamic simulations to be performed with material-flows (or values in any domain) driven by changes in value in other domains. We then apply the model in an illustrative case highlighting links between the UK coal-based electricity-production and concrete/cement industries, investigating potential impacts that may follow the increased use of low-carbon fuels (biomass and solid recovered fuels; SRF) in the former. We explore synergies and trade-offs in value across domains and regions, e.g. how changes in carbon emissions in one part of the system may affect mortality elsewhere. This highlights the advantages of recognising complex system dynamics and making high-level inferences of their effects, even when rigorous analysis is not possible. We also indicate how changes in social, environmental and economic 'values' can be understood as being driven by changes in the technical value of resources. Our work thus emphasises the advantages of building fully integrated models to inform conventional sustainability assessments, rather than applying hybrid approaches that integrate outputs from parallel models. The approach we present demonstrates that this is feasible and lays the foundations for such an integrated model.

Studies in using a universal exchange and inference language for evidence based medicine. Semi-automated learning and reasoning for PICO methodology, systematic review, and environmental epidemiology

The Q-UEL language of XML-like tags and the associated software applications are providing a valuable toolkit for Evidence Based Medicine (EBM). In this paper the already existing applications, data bases, and tags are brought together with new ones. The particular Q-UEL embodiment used here is the BioIngine. The main challenge is one of bringing together the methods of symbolic reasoning and calculative probabilistic inference that underlie EBM and medical decision making. Some space is taken to review this background. The unification is greatly facilitated by Q-UEL's roots in the notation and algebra of Dirac, and by extending Q-UEL into the Wolfram programming environment. Further, the overall problem of integration is also a relatively simple one because of the nature of Q-UEL as a language for interoperability in healthcare and biomedicine, while the notion of workflow is facilitated because of the EBM best practice known as PICO. What remains difficult is achieving a high degree of overall automation because of a well-known difficulty in capturing human expertise in computers: the Feigenbaum bottleneck.