A Comparison of Burden of Disease from Toxic Waste Sites with other Recognized Public Health Threats in India, Indonesia and the Philippines

Abstract

Background. Although toxic waste sites have been well investigated in many developed countries, their prevalence and health impact have not been well documented in low and middle income countries where risks attributable to environmental pollution are generally higher than in developed nations. Methods. We compared the burden of disease from toxic waste sites expressed in disability-adjusted life-years (DALYs) with the same measurement for other threats in India, Indonesia and the Philippines. We used Blacksmith Institute for a Pure Earth's DALY estimates for chemical exposure at 373 toxic waste sites in the 3 countries and World Health Organization (WHO) DALY estimates for different health conditions in the same countries. Results. Chromium VI causes the majority of DALYs among chemicals in India, while lead does so in the Philippines and Indonesia. In India, exposure to chromium VI showed higher DALY estimates than health conditions such as multiple sclerosis, Parkinson's disease and various cancers. In Indonesia, exposure to chromium VI and lead presented higher DALYs than conditions such as upper respiratory infections. In the Philippines, lead had higher DALYs than most of the examined conditions, including malaria and human immunodeficiency virus (HIV)/AIDS. Conclusions. This study highlights that the burden of disease expressed in DALYs from toxic waste sites may be greater than previously recognized and greater than other well addressed public health threats. We call attention to the need for surveillance of toxic waste sites, epidemiological analysis of the associations between exposure to toxic chemicals and outcomes, and remediation of chemical contamination in India, Indonesia and the Philippines.