Table 3.
Health outcomes associated with landfills.
| Study Location | Study Design | Study Participants | Study Period | Exposure Source | Outcomes Investigated | Ref. |
|---|---|---|---|---|---|---|
| Italy | Cohort study (retrospective) | 21,517 births in women (aged 15–49 years) residing within 4 km from an incinerator | Residents between 2003 and 2010 | 8 MSW incinerators operating in the Emilia Romagna region | Assessment of the effects of air emissions from MSW incinerators (simulated with a dispersion model) on reproductive outcomes a | [45] |
| Italy | Cohort study (retrospective) | 11,875 pregnancies with 1375 miscarriages from women (aged 15–24 years) residing within 4 km from a MSW incinerator | Residents between 2002 and 2006 | 7 MSW incinerators operating in the Emilia Romagna region | Assessment of the effects of air emissions from MSW incinerators (simulated with a dispersion model) on spontaneous abortions | [52] |
| France | Case-control study | Comparison of 304 infants with urinary tract birth defects with a control group of 226 infants randomly selected in the same region | Between 2001 and 2004 | 21 MSW incinerators active in the Rhone-Alps region | Association between the risk of urinary tract birth defects and living near MSW incinerators, using a model to predict the exposure to dioxins | [46] |
| Great Britain (UK) | Cohort study (retrospective) | 1,025,064 births and 18,694 infant deaths in Great Britain. Incinerators emissions within 10 km were considered | Births and deaths between 2003 and 2010 | 22 MSW incinerators (operating between 2003 and 2010) | Associations between modelled ground-level particulate matter from incinerators emission within 10 km and selected reproductive/birth outcomes | [24] |
| Taiwan | Cohort study (retrospective) | 6697 neonates assessed one year before the MSW incinerator started, and 6282 neonates assessed five years later incinerator opening | Neonates in 1991 and in 1997 | The MSW incinerator of Taipei | The relationships between exposure to elevated PCDD/Fs concentration generated by a MSW incinerator (using a model), and various birth outcomes | [51] |
| Spain | Cohort study (perspective) | 104 exposed subjects (living < 1 km from the MSW incinerator) and 97 non-exposed subjects (living > 3 km from the incinerator) were randomly selected. From 1999 one additional group (100 unexposed subjects, in Arenys de Mar, about 11 km from the incinerator) was selected |
7 different campaigns were performed between 1995 and 2012 | The MSW incinerator of Matarò (activated in 1995) | To monitor PCDD/Fs and PCBs levels in blood samples in the different exposed groups | [53] |
| England and Scotland (UK) | Cohort study (retrospective) | 219,486 births, stillbirths, and terminations of pregnancy for foetal anomaly, in which 5154 were cases of congenital anomalies. Incinerators emissions within 10 km were considered |
Birth and adverse birth outcomes between 2003 and 2010 | 10 MWIs in England and Scotland (operating between 2003 and 2010) | Associations between modelled ground-level particulate matter from incinerators emission within 10 km and selected reproductive/birth outcomes | [25] |
| Italy | Cohort study (retrospective) | 31,347 residents within a 3.5 km radius of two incinerators | Residents between 1990 and 2003 | An MSW incinerator and a hospital waste incinerator in Forlì | Health outcomes among people living close to incinerators (using a dispersion model for exposure assessment) | [44] |
| France | Case-control study | 434 incident cases of invasive breast cancer diagnosed (case group) compared with 2170 controls randomly selected | Between 1996 and 2002 (cancer diagnosis in the case group).1999 (control group) b | The MSW incinerator in Besançon | The association between dioxins emitted from a MSW incinerator (air exposure using a model) and invasive breast cancer risk among women residing in the area | [48] |
| Italy | Cohort study (retrospective) | Women residing or working near a MSW incinerator of Modena | Residents or workers between 2003 and 2006 | The MSW incinerator of Modena | Rates of spontaneous abortion and prevalence of birth defects among women living or working near a MSW incinerator, modelling incinerator emissions exposure | [49] |
| Italy | Case-control study | Women (aged 16–44 years) residing near a MSW incinerators, assessing 228 cases of congenital anomalies | Birth defects between 1998 and 2006 | The MSW incinerator of Reggio Emilia | The relationship between exposure to the emissions from an MSW incinerator and risk of birth defects, modelling incinerator emissions exposure | [50] |
| China | Cross-sectional study | 82 children living near a MSW incinerator in China and 49 from a control area, both in Zhejiang Province | Samples collected in October 2013 | A MSW incinerator in the Zhejiang Province | To monitor PCDD/F levels in blood in different exposed groups | [9] |
| China | Cross-sectional study | 14 mothers living near a MSW incinerator (exposure area) and 18 mothers from a control area, both in Zhejiang Province | Samples collected in September and October 2013 | A MSW incinerator in the Zhejiang Province | To monitor PCDD/Fs and PCBs in the breast milk of mothers in different exposed groups | [47] |
a The estimated annual average exposure to PM10 from incinerators in the study areas was 0.96 ng/m3 in 2003, decreasing to 0.26 ng/m3 in 2010 because of the improvements of the plant during the study period; b Some weaknesses in the study: controls were residents in 1999, whereas cases were diagnosed between 1996 and 2002, introducing a time lag in the sampling for some matched sets.