Abstract
BackgroundA high rate of preterm birth is observed in the Guadeloupe archipelago (French West Indies), raising the hypothesis of harmful environmental exposures, including landfilling. Our aim was to evaluate whether preterm births cluster around the three main open landfills located in this area.MethodsThe study population consisted of 911 women enrolled in the Timoun mother-child cohort (2004–2007). Home addresses during pregnancy and locations of landfills were geocoded. To test for the presence of preterm birth clusters around each dumpsite, we used a focused cluster test specifically designed to detect spatial clustering around point sources.ResultsA total of 144 (15.8%) preterm births were observed among 911 births. Using the term births (n = 767) as controls, a significant cluster was identified within 2 km around the Saint-François landfill with a relative risk (RR) of 4.82 (p = 0.04). No clusters were found around the other two landfills (RR = 2.01, p = 0.26 and RR = 1.06, p = 0.64, for La Gabarre and Baillif, respectively).ConclusionThe paucity of data available on open landfill sites regarding waste quantities, composition, and changes over time precludes any site-specific interpretation because of the variable degree of possible emissions. This result has to be confirmed in other tropical island environments where waste management has become a major concern with the potential to negatively impact the environment and public health.
Highlights
A high rate of preterm birth is observed in the Guadeloupe archipelago (French West Indies), raising the hypothesis of harmful environmental exposures, including landfilling
Because three main open landfills were used for solid waste disposal in the Guadeloupe archipelago, our aim was to evaluate whether preterm births cluster around these predefined locations
Using the term births (n = 767) as controls, a significant cluster was identified within 2 km around the Saint-François landfill with a relative risk (RR) of 4.82 (p = 0.04) (Table 3)
Summary
A high rate of preterm birth is observed in the Guadeloupe archipelago (French West Indies), raising the hypothesis of harmful environmental exposures, including landfilling. Waste management has always been a crucial issue in island environments due to limited land space and increased volumes and diversity of solid waste (due to rapid population growth, heavy reliance on imported goods, lack of recycling initiatives, or poor waste collection systems). Landfills can represent a health risk for residents because of exposure to pollutants through different pathways: inhalation of substances emitted by the site, contact with water or polluted soil, and consumption of contaminated foodstuffs or drinking water In this respect, residential proximity to landfills has been previously linked to preterm births or congenital malformations, several alternative explanations (including ascertainment bias and residual confounding) cannot be excluded [3, 4]
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