|Abstract||Background: Several studies have been conducted on the possible health effects for people living close to incinerators and well-conducted reviews are available. Nevertheless, several uncertainties limit the overall interpretation of the findings. We evaluated the health effects of emissions from two incinerators in a pilot cohort study. Methods: The study area was defined as the 3.5 km radius around two incinerators located near Forli (Italy). People who were residents in 1/1/1990, or subsequently became residents up to 31/12/2003, were enrolled in a longitudinal study (31,347 individuals). All the addresses were geocoded. Follow-up continued until 31/12/2003 by linking the mortality register, cancer registry and hospital admissions databases. Atmospheric Dispersion Model System (ADMS) software was used for exposure assessment; modelled concentration maps of heavy metals (annual average) were considered the indicators of exposure to atmospheric pollution from the incinerators, while concentration maps of nitrogen dioxide (NO2) were considered for exposure to other pollution sources. Age and area-based socioeconomic status adjusted rate ratios and 95% Confidence Intervals were estimated with Poisson regression, using the lowest exposure category to heavy metals as reference. Results: The mortality and morbidity experience of the whole cohort did not differ from the regional population. In the internal analysis, no association between pollution exposure from the incinerators and all-cause and cause-specific mortality outcomes was observed in men, with the exception of colon cancer. Exposure to the incinerators was associated with cancer mortality among women, in particular for all cancer sites (RR for the highest exposure level = 1.47, 95% CI: 1.09, 1.99), stomach, colon, liver and breast cancer. No clear trend was detected for cancer incidence. No association was found for hospitalizations related to major diseases. NO2 levels, as a proxy from other pollution sources (traffic in particular), did not exert an important confounding role. Conclusions: No increased risk of mortality and morbidity was found in the entire area. The internal analysis of the cohort based on dispersion modeling found excesses of mortality for some cancer types in the highest exposure categories, especially in women. The interpretation of the findings is limited given the pilot nature of the study.|
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|Name||Affiliation||Home page||Total pubs|
|Erspamer L||Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy||1|
|Fano V||Department of Epidemiology, Rome E Health Authority, Via di Santa Costanza 53 00198 Rome, Italyemail@example.com||2|
|Forastiere F||Department of Epidemiology, Rome E Health Authority, Via di Santa Costanza 53 00198 Rome, Italyfirstname.lastname@example.org||6|
|Lauriola P||Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy||1|
|Perucci CA||Department of Epidemiology, Local Health Authority Rome E, Rome, Italy||perucci@asplazio||6|
|Ranzi A||Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy||2|
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References included in article:
|Order of appearence||Full citation||SRCosmos Link|
|1||Franchini M, Rial M, Buiatti E, Bianchi F, |
2004, Health effects of exposure to waste incinerator emissions: a review of epidemiological studies. Ann Ist Super Sanita 40:101-15.
|2||WHO: 2007. Population health and waste management: scientific data and policy options. [http://www.euro.who.int/__data/assets/pdf_file/0012/91101/E91021.pdf] Report of a WHO workshop, Rome, Italy.|
|3||Porta D, Milani S, |
Lazzarino AI, Perucci CA, Forastiere F: Systematic review of epidemiological studies on health effects associated with management of solid waste. Environmental Health 2009, 8:60.
|4||Tango T, Fujita T, Tanihata T, Minowa M, Doi Y, Kato N, Kunikane S, Uchiyama I, Tanaka M, Uehata T, |
2004, Risk of adverse reproductive outcomes associated with proximity to municipal solid waste incinerators with high dioxin emission levels in Japan. J Epidemiol 14:83-93.
|5||Vinceti M, Malagoli C, Teggi S, Fabbi S, Goldoni C, De-Girolamo G, Ferrari P, Astolfi G, Rivieri F, Bergomi M, |
2008, Adverse pregnancy outcomes in a population exposed to the emissions of a municipal waste incinerator. Sci Total Environ 407:116-21.
|6||Dummer TJ, Dickinson HO, Parker L, |
2003, Adverse pregnancy outcomes around incinerators and crematoriums in Cumbria, north west England, 1956-93. J Epidemiol Community Health 57:456-61.
|7||Lin CH, Li CY, |
Mao I-F., 2006, Birth outcomes of infants born in areas with elevated ambient exposure to incinerators generated PCDD/F. Environ Int 32:624-629
|8||Elliott P, Hills M, Beresford J, Kleinschmidt I, Jolley D, Pattenden S, Rodrigues L, Westlake A, Rose G, |
1992, Incidence of cancers of the larynx and lung near incinerators of waste solvents and oils in Great Britain. Lancet 339:854-8.
|9||Elliott P, Shaddick G, Kleinschmidt I, Jolley D, Walls P, Beresford J, Grundy C, |
1996, Cancer incidence near municipal solid waste incinerators in Great Britain. Br J Cancer 73:702-10.
|10||Viel JF, Arveux P, Baverel J, Cahn JY, |
2000, Soft-tissue sarcoma and non-Hodgkin's lymphoma clusters around a municipal solid waste incinerator with high dioxin emission levels. Am J Epidemiol 152:13-9.
|11||Floret N, Mauny F, Challier B, Arveux P, Cahn JY, Viel JF, |
2003, Dioxin emissions from a solid waste incinerator and risk of non-Hodgkin lymphoma. Epidemiology 14:392-8.
|12||Viel JF, Daniau C, Goria S, Fabre P, De-Crouy-chanel P, Sauleau EA, Empereur-Bissonnet P, |
2008, Risk for non Hodgkin's lymphoma in the vicinity of French municipal solid waste incinerators. Environ Health 7:51.
|13||Comba P, Ascoli V, Belli S, Benedetti M, Gatti L, Ricci P, Tieghi A, |
2003, Risk of soft tissue sarcomas and residence in the neighbourhood of an incinerator of industrial wastes. Occup Environ Med 60:680-3.
|14||Zambon P, Ricci P, Bovo E, Casula A, Gattolin M, Fiore AR, Chiosi F, Guzzinati S, |
2007, Sarcoma risk and dioxin emissions from incinerators and industrial plants: a population-based case-control study (Italy). Environ Health 16:6-19.
|15||Cordier S, Lehebel A, Amar E, Anzivino-Viricel L, Hours M, Monfort C, Chevrier C, Chiron M, Robert-Gnansia E, |
2010, Maternal residence near municipal waste incinerators and the risk of urinary tract birth defects. Occup Environ Med 67:493-499.
|16||Morselli L, Passarini F, Bartoli M, |
2002, The environmental fate of heavy metals arising from a MSW incineration plant. Waste Manag 22:875-81.
|17||ARPA Emilia Romagna: 2001. "Environmental study in the industrial urban area of Coriano". (Italian report) Ott|
|18||Cambridge Environmental Research Consultants, Cambridge, UK.;|
|19||ESRI: 2002. ArcView GIS: Relase 8.2. Redlands, California, USA. StataCorp: 2007. Stata Statistical Software: Release 10. College Station, TX: StataCorp LP.|
|20||International Agency for Research on Cancer: 1997, Polychlorinated dibenzo-para-dioxins and polychlorinated dibenzofurans. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 69:33-343.|
|21||T-Mannetje A, Mc-Lean D, Cheng S, Boffetta P, Colin D, Pearce N, |
2005, Mortality in New Zealand workers exposed to phenoxy herbicides and dioxins. Occup Environ Med 62:34-40.
|22||Steenland K, Bertazzi P, Baccarelli A, Kogevinas M, |
2004, Dioxin revisited: developments since the 1997 IARC classification of dioxin as a human carcinogen. Environ Health Perspect 112:1265-8.
|23||Bertazzi A, Pesatori AC, Consonni D, Tironi A, Landi MT, Zocchetti C, |
1993, Cancer incidence in a population accidentally exposed to 2,3,7,8-tetrachlorodibenzo-para-dioxin. Epidemiology 4:398-406.
|24||Consonni D, Pesatori AC, Zocchetti C, Sindaco R, D-Oro LC, Rubagotti M, Bertazzi PA, |
2008, Mortality in a population exposed to dioxin after the Seveso, Italy, accident in 1976: 25 years of follow. Am J Epidemiol 167:847-858.
|25||Warner M, Eskenazi B, Mocarelli P, Gerthoux PM, Samuels S, Needham L, Patterson D, Brambilla P, |
2002, Serum dioxin concentrations and breast cancer risk in the Seveso Women's Health Study. Environ Health Perspect 110:625-8.
|26||Flesch-Janys D, Becher H, Manz A, Morgenstern I, Nagel S, Steindorf K, |
1999, Epidemiologic investigation of breast cancer incidence in a cohort of female workers with high exposure to PCDD/F and HCH. Organohalogen Compounds 44:379-382.
|27||Manz A, Berger J, Dwyer J, Flesch-Janys D, Nagel S, Waltsgott H, |
1991, Cancer mortality among workers in chemical plant contaminated with dioxin. Lancet 338:959-964.
|28||Kogevinas M, Becher H, Benn T, Bertazzi PA, Boffetta P, Bueno-De-mesquita HB, Coggon D, Colin D, Flesch-Janys D, Fingerhut M, Green L, Kauppinen T, Littorin M, Lynge E, Mathews JD, Neuberger M, Pearce N, Saracci R, |
1997, Cancer mortality in workers exposed to phenoxy herbicides, chlorophenols, and dioxins: An expanded and updated international cohort study. Am J Epidemiol 145:1061-1075.
|29||Comba P, Fazzo L, Berrino F, |
2004, Soft tissue sarcomas in Mantua: epidemiological evidence and perspectives for environmental remediation. Epidemiol Prev 28:266-71.
|30||Tessari R, Canova C, Canal F, Lafisca S, Inio A, Murer B, Stracca V, Tollot M, Simonato L, |
2006, Environmental pollution from dioxins and soft tissue sarcomas in the population of Venice and Mestre: an example of the use of current electronic information sources. Epidemiol Prev 30:191-8.
|31||Tuomisto JT, Pekkanen J, Kiviranta H, Tukiainen E, Vartiainen T, Tuomisto J, |
2004, Soft-tissue sarcoma and dioxin: A case-control study. Int J Cancer 108:893-900.
|32||Floret N, Viel JF, Lucot E, Dudermel PM, Cahn JY, Badot PM, Mauny F, |
2006, Dispersion modeling as a dioxin exposure indicator in the vicinity of a municipal solid waste incinerator: a validation study. Environ Sci Technol 40:2149-55.
|33||Hodgson S, Nieuwenhuijsen MJ, Colvile R, Jarup L, |
2007, Assessment of exposure to mercury from industrial emissions: comparing "distance as a proxy" and dispersion modelling approaches. Occup Environ Med 64:380-8.
|34||Yuan CS, Lin HY, Wu CH, Liu MH, |
2005, Partition and size distribution of heavy metals in the flue gas from municipal solid waste incinerators in Taiwan. Chemosphere 59:135-145.
|35||Hu CW, Chao MR, Wu KY, Chang-Chien GP, Lee WY, Chang LW, |
Lee WS., 2003, Characterization of multiple airborne particulate metals in the surroundings of a municipal waste incinerator in Taiwan. Atmos Environ 37:2845-2852.