Table 7.

Landfill sites and incinerators and congenital heart disease: Main findings from the literature.

Author Ref.	Article Type	All CHDs or Any CHD Subtypes	Study Limitations
Langlois et al. [65]	Case control study	All CTDs: No association with hazardous waste sites. Truncus arteriosus: Any waste site: OR 2.80 (95% CI: 1.19, 6.54); hazardous waste sites: OR 4.99 (95% CI: 1.26, 14.51)	Used proximity to waste sites at birth date as surrogate for earlier exposure; did not consider CHDs in non-live births or potential for change of residence during pregnancy.
Dummer et al. [66]	Retrospective cohort study	Fatal CHDs: Incinerators: OR: 1.12 (95% CI: 1.03, 1.22)	Used proximity to waste sites at birth date as surrogate for earlier exposure; did not consider CHDs in live births.
Shaw et al. [67]	Population study	All CHDs: Various sources of known contamination: OR 1.1 (95% CI: 1.1, 2.0)	As per Langlois et al.
Croen et al. [68]	Population based case control study	All CHDs: No association with proximity to hazardous waste sites.	As per Langlois et al.
Kuehl et al. [69]	Case control study	TGA: OR 13.4 (95% CI: 4.7, 37.8): Proximity to hazardous waste sites and release of chemicals into the air.	As per Langlois et al.
Dolk et al. [70]	Population-based register study	Residence within 3 km of hazardous industrial waste site: SDs: OR 1.49 (95% CI: 1.09, 2.04); Arterial or venous anomalies: OR 1.81 (95% CI: 1.02, 3.20) No association for malformations of cardiac chambers, valves or other heart defects.	As per Langlois et al. Ignored other exposures.

Abbreviations: CTDs: Conotruncal defects; TGA: Transposition of the great arteries; SDs: Septal defects.