THE INCINERATORS BIOMONITORING STUDY. Study design and methods

Abstract

Background. To address public concerns about health risks associated with incineratation, the Small Area Health Statistics Unit (SAHSU) have initiated a national epidemiological study investigating the association between modelled exposure to emissions from municipal solid waste incinerators (MSWI) and adverse birth and neonatal outcomes. MSWIs release a number of pollutants; those of particular concern are a group of chemicals known as dioxins. Aim. The Incinerators Biomonitoring Study will investigate the relationship between modelled ambient dioxin exposure and individual level breast milk dioxin exposure in residents living near two MSWIs in England, Marchwood and Stockton-on-Tees. Methods. Dispersion models will be used to identify areas of modelled high and low dioxin exposure from the two selected MSWIs. This study will recruite 100 pregnant women through their maternity units located near the selected MSWIs. Eligible participants are women in their third trimester of their first pregnancy, living in modelled high and low dioxin exposure zones, over 18 years of age. Eligible participants will be invited via a letter to take part in this study. Following consent, women will be asked to complete a study questionnaire (during the third trimester of pregnancy) and to provide a small, 20mL, breast milk sample (between 1-6 weeks after birth). Once the breast milk samples have been collected, they will be sent to the Centers for Disease Control and Prevention, Atlanta, USA for dioxin analysis. Conclusion. This study will enable us to acquire a detailed personal exposure profile to dioxins for approximately 100 pregnant women residing near two MSWI and to determine the relationship between the modelled ambient dioxin exposure and individual level dioxin uptake. Additionally the Incinerators Biomonitoring Study will aid the interpretation of the SAHSU epidemiological study results and enhance this important, high profile, national study.