Industrial toxic waste and health: a practical case study

The objective of this thesis is to develop a standard, simple methodology for the assessment of health in areas near sources of pollution. This methodology should make use of readily available data and computing facilities. A literature review on previous studies on the subject was carried out in order to draw from existing experience. A total of twenty-five studies on health near sources of pollution were reviewed. These studies were carried out between 1982 and 1991, most of them in Britain, two in France. The types of pollution sources studied ranged from waste dumps to incinerators, to nuclear power stations. Each study was described, stressing on their respective backgrounds, building on geographical (study) areas, data, analysis and results. Brief synopses of the studies were next grouped, according to those using conventional epidemiological methods and more innovative ones. Finally, it was concluded from the review that the methodology intended should be descriptive, making use of routinely collected data, with a study area based on small geographical divisions (small areas) and taking into account socio-economic differences over its study area. In the absence of accurate data on pollution levels, and from the previous experience of one of the studies reviewed, circular study areas centred on the source of pollution and subdivided into rings were used, with distance of each ring to the centre as a proxy indicator of levels of pollution. The new methodology was found valid and the objective of the study was met. It compared favourably with previously reviewed methodologies. The methodology is intended to be used as a descriptive, exploratory tool, whose findings may warrant further analytic studies, which the method is not designed to, and can not, replace. The use of routinely collected data greatly facilitated the study, although caveats for future studies exist on them. Distance as a surrogate for exposure is seen as a simplistic approach, but in the absence of reliable exposure data it is a useful one. Standardization by Deprivation category has also been found useful to account for factors for which little data exist