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

Anna Maria Romanelli,Fabrizio Bianchi,Fabrizio Minichilli,Olivia Curzio

doi:10.3390/ijerph16162863

Abstract

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 NOχ (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 NOχ 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.

Highlights

Incineration is a waste treatment process that involves the combustion of organic substances contained in waste materials
The results achieved were sent to the administrators of the municipality of Pisa with the general recommendation that the health of all the population residing in areas adjacent to the incinerator should be protected
The present epidemiological study recommends the adoption of specific policies to contain both the production of waste and the need to dispose of it

Summary

Introduction

Incineration is a waste treatment process that involves the combustion of organic substances contained in waste materials. The thermal treatment of waste generates chemical substances that are considered as a potential health hazard to humans: metals (cadmium, thallium, zinc, mercury, chrome, arsenic, lead, cobalt, manganese, nickel, and vanadium), polycyclic aromatic hydrocarbons (PAH), fine and ultra-fine particulate, acids (fluoridric, chloridric), gases (SO2 , NO2 , CO), and polychlorinated products (polychlorinated biphenyls PCB, dioxins, furans). Inhalation (gases, particulate, PAHs), ingestion (PCB) and dermal contact (metals, PAH) are the recognized routes of exposure [1,2,3]. Waste incineration plants have been reported as a source of health damage to populations living in the vicinity of the plants, the scientific evidence is still limited due to the low number of studies carried out and as a result of various sources of uncertainty. Studies on biomarkers show that populations exposed to emissions have higher biological levels of released substances compared with less exposed populations [7,8,9,10,11]

Methods

Results

Discussion

Conclusion