Health effects of living near an incinerator: A systematic review of epidemiological studies, with focus on last generation plants

Huge reductions in incinerators' emissions occurred over time, and results of older studies cannot be directly generalized to modern plants. We conducted a systematic review of the epidemiologic evidence of the health effects of incinerators, classifying plants in three generations, according to emission limits. A systematic search identified 63 epidemiologic studies, published in English, investigating health effects of incinerators on humans. We focused on cancer, cardio-cerebrovascular diseases (CVD) and respiratory diseases, pregnancy outcomes and congenital anomalies. Only six studies in the general population were on third generation incinerators providing data on pregnancy outcomes and congenital anomalies. Given the heterogeneity of methods, the abundance of ecological/semi-ecological studies and the lack of reliable quantitative measures of exposure in several studies we did not perform any meta-analysis. No excesses emerged concerning all cancers and lung cancer. An excess of non-Hodgkin lymphoma was reported in some earlier studies, but not for second generation plants. Possible excesses of soft tissue sarcomas were confined to earlier incinerators and the areas closer to the plants. No clear association emerged for CVD and diseases of the respiratory system. Several different pregnancy outcomes were considered, and no consistent association emerged, in spite of a few positive results. Studies were negative for congenital anomalies as a whole. Sporadic excesses were reported in a few studies for specific types of anomalies, but no consistent pattern emerged. Evaluation of the evidence was hindered by heterogeneity in reporting and classification of outcomes across studies. Direct evidence from third generation plants is scarce. Methodological issues in study design (mainly related to exposure assessment, confounding and ecological design) and analysis make interpretation of results complex. In spite of this, the overall evidence suggests that, if there were any excesses at all for older incinerators, they were modest at most. Additional monitoring of third generation plants needs to overcome methodological weakness

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

Improving exposure assessment and defining health outcomes in the reproductive epidemiology of municipal solid waste incinerators

The last decade has seen a shift away from disposal of waste in landfills to more environmentally desirable methods of waste management, such as recycling, composting and incineration. There is ongoing public concern about health risks associated with incineration. Epidemiological studies investigating exposure to incinerator emissions and risk of adverse birth outcomes are limited by poor exposure assessment lack of information on uptake of these emissions and the small numbers of birth outcomes explored. The aim of this thesis was to estimate population exposure to emissions from four municipal solid waste incinerators (MSWI) in England. Also, at an individual level, to design and undertake a study to ascertain the exposure profile to dioxins for women resident near two MSWIs. Finally, to compare the availability and quality of national birth data in England and make recommendations on their use in epidemiological studies of birth outcomes. The findings of this thesis have contributed to the ongoing national study being conducted by the Small Area Health Statistics Unit (SAHSU), investigating the association between MSWI emissions and the risk of adverse birth and neonatal outcomes in Great Britain (GB). Atmospheric dispersion modelling was undertaken to estimate population exposure to particulate matter as a proxy for all MSWI emissions. Model outputs presented will be used in the SAHSU study and the model developed rolled out for all MSWIs in GB. The Incinerators Biomonitoring Study achieved a study database of 97 participants, each providing breast milk samples and questionnaire information. The study showed variability in participation by demographic and lifestyle factors, alongside dietary dioxin intake estimates. The findings of this study will help to interpret the results of SAHSU’s study, providing an insight into the relationship between MSWI exposure and total body burden of dioxins. Finally, a comparison of routine national birth data revealed variation in completeness and fields of information collected by dataset. Hospital birth data compared favourability with registry data at a national scale after 2002, with considerable improvements in quality between 2001 and 2010. However, large differences between datasets were observed at small area level, reflecting the influence of hospital provider effects on this dataset.Open Acces

A multi-criteria fuzzy method for selecting the location of a solid waste disposal facility

Facility location is a multicriteria decision process that has important operational and economic impacts and that typically involves uncertainty and vagueness of evaluations. A fuzzy-based method supporting preliminary decision-making about siting solid waste incinerators is proposed building on a structured classification of criteria for location selection developed from the existing literature. The application to a case study revealed the advantages of the methodology. The work intends to provide a general and comprehensive taxonomy of decision criteria that may be adapted to various facility location problems together with a fuzzy inference process that is useful for companies and public administration institutions looking for rigorous but relatively simple decision-making tools in uncertain environments. Future research will compare the developed method with the most common tools for making location decisions. The approach will be then extended to different kinds of facilitie

Biomonitoring of metals in children living in an urban area and close to waste incinerators

The impact of waste incinerators is usually examined by measuring environmental pollutants. Biomonitoring has been limited, until now, to few metals and to adults. We explored accumulation of a comprehensive panel of metals in children free-living in an urban area hosting two waste incinerators. Children were divided by georeferentiation in exposed and control groups, and toenail concentrations of 23 metals were thereafter assessed. The percentage of children having toenail metal concentrations above the limit of detection was higher in exposed children than in controls for Al, Ba, Mn, Cu, and V. Exposed children had higher absolute concentrations of Ba, Mn, Cu, and V, as compared with those living in the reference area. The Tobit regression identified living in the exposed area as a significant predictor of Ba, Ni, Cu, Mn, and V concentrations, after adjusting for covariates. The concentrations of Ba, Mn, Ni, and Cu correlated with each other, suggesting a possible common source of emission. Exposure to emissions derived from waste incinerators in an urban setting can lead to body accumulation of specific metals in children. Toenail metal concentration should be considered a noninvasive and adequate biomonitoring tool and an early warning indicator which should integrate the environmental monitoring of pollutants

Dioxins and Furans: Emerging Contaminants of Air

Dioxins and furans are classified highly contaminating toxic chemicals having serious effect on human health. This chapter begins with a brief summary on the formation, occurrence and toxicity of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) with their potential health effects, mitigation measures of these harmful compounds. Depending on position of chlorine atoms on aromatic rings, about 210 chemically different PCDD/PCDFs known as “congener” are present in the environment. The expected biological activity of PCDD/PCDFs is expressed relatively to the activity of 2,3,7,8-tetrachloro-dibenzo-p-dioxin (TCDD) using a common metric. TCDD is the most biologically potent among all the congeners. Toxic level of a mixture of PCDD/PCDFs is therefore expressed in TCDD toxicity equivalents or TEQs. There are two mechanisms for the formation of dioxins and furans, one from precursors and other by de novo synthesis. PCDD/PCDFs followed a mechanism which uses macromolecule carbon and chlorine in fly ash to form dioxins at low temperature. There are various sources of the formation of PCDD/PCDFs like hospital waste incinerators, industrial combustion and burning of domestic waste. Dioxins and furans have very harmful effects on the human health causing cancer, diabetes, neurotoxicity, immunotoxicity and chloracne. It has been experienced that hybrid method secure a sustainable future for the incinerators and PCDD/PCDFs removal technologies. This chapter will help the researchers and practitioners for better understanding and decision making for future research to establish a sustainable PCDD/PCDFs free life

Pyrolysis processing for solid waste resource recovery

Solid waste resource recovery in space is effected by pyrolysis processing, to produce light gases as the main products (CH.sub.4, H.sub.2, CO.sub.2, CO, H.sub.2O, NH.sub.3) and a reactive carbon-rich char as the main byproduct. Significant amounts of liquid products are formed under less severe pyrolysis conditions, and are cracked almost completely to gases as the temperature is raised. A primary pyrolysis model for the composite mixture is based on an existing model for whole biomass materials, and an artificial neural network models the changes in gas composition with the severity of pyrolysis conditions

Pyrolysis process for producing fuel gas

Solid waste resource recovery in space is effected by pyrolysis processing, to produce light gases as the main products (CH.sub.4, H.sub.2, CO.sub.2, CO, H.sub.2O, NH.sub.3) and a reactive carbon-rich char as the main byproduct. Significant amounts of liquid products are formed under less severe pyrolysis conditions, and are cracked almost completely to gases as the temperature is raised. A primary pyrolysis model for the composite mixture is based on an existing model for whole biomass materials, and an artificial neural network models the changes in gas composition with the severity of pyrolysis conditions

Health impact assessment of waste management facilities in three European countries

<p>Abstract</p> <p>Background</p> <p>Policies on waste disposal in Europe are heterogeneous and rapidly changing, with potential health implications that are largely unknown. We conducted a health impact assessment of landfilling and incineration in three European countries: Italy, Slovakia and England.</p> <p>Methods</p> <p>A total of 49 (Italy), 2 (Slovakia), and 11 (England) incinerators were operating in 2001 while for landfills the figures were 619, 121 and 232, respectively. The study population consisted of residents living within 3 km of an incinerator and 2 km of a landfill. Excess risk estimates from epidemiological studies were used, combined with air pollution dispersion modelling for particulate matter (PM₁₀) and nitrogen dioxide (NO₂). For incinerators, we estimated attributable cancer incidence and years of life lost (YoLL), while for landfills we estimated attributable cases of congenital anomalies and low birth weight infants.</p> <p>Results</p> <p>About 1,000,000, 16,000, and 1,200,000 subjects lived close to incinerators in Italy, Slovakia and England, respectively. The additional contribution to NO₂levels within a 3 km radius was 0.23, 0.15, and 0.14 μg/m³, respectively. Lower values were found for PM₁₀. Assuming that the incinerators continue to operate until 2020, we are moderately confident that the annual number of cancer cases due to exposure in 2001-2020 will reach 11, 0, and 7 in 2020 and then decline to 0 in the three countries in 2050. We are moderately confident that by 2050, the attributable impact on the 2001 cohort of residents will be 3,621 (Italy), 37 (Slovakia) and 3,966 (England) YoLL. The total exposed population to landfills was 1,350,000, 329,000, and 1,425,000 subjects, respectively. We are moderately confident that the annual additional cases of congenital anomalies up to 2030 will be approximately 2, 2, and 3 whereas there will be 42, 13, and 59 additional low-birth weight newborns, respectively.</p> <p>Conclusions</p> <p>The current health impacts of landfilling and incineration can be characterized as moderate when compared to other sources of environmental pollution, e.g. traffic or industrial emissions, that have an impact on public health. There are several uncertainties and critical assumptions in the assessment model, but it provides insight into the relative health impact attributable to waste management.</p