Risk of adverse reproductive outcomes associated with proximity to municipal solid waste incinerators with high dioxin emission levels in Japan

BACKGROUND: Great public concern about health effects of dioxins emitted from municipal solid waste incinerators has increased in Japan. This paper investigates the association of adverse reproductive outcomes with maternal residential proximity to municipal solid waste incinerators. METHODS: The association of adverse reproductive outcomes with mothers living within 10 km from 63 municipal solid waste incinerators with high dioxin emission levels (above 80 ng international toxic equivalents TEQ/m3) in Japan was examined. The numbers of observed cases were compared with the expected numbers calculated from national rates adjusted regionally. Observed/expected ratios were tested for decline in risk or peak-decline in risk with distance up to 10 km. RESULTS: In the study area within 10 km from the 63 municipal solid waste incinerators in 1997-1998, 225,215 live births, 3,387 fetal deaths, and 835 infant deaths were confirmed. None of the reproductive outcomes studied here showed statistically significant excess within 2 km from the incinerators. However, a statistically significant peak-decline in risk with distance from the incinerators up to 10 km was found for infant deaths (p=0.023) and infant deaths with all congenital malformations combined (p=0.047), where a "peak" is detected around 1-2 km. CONCLUSION: Our study shows a peak-decline in risk with distance from the municipal solid waste incinerators for infant deaths and infant deaths with all congenital malformations combined. However, due to the lack of detailed exposure information to dioxins around the incinerators, the observed trend in risk should be interpreted cautiously and there is a need for further investigation to accumulate good evidence regarding the reproductive health effects of waste incinerator exposure.     

Risk of congenital anomalies around a municipal solid waste incinerator: a GIS-based case-control study

Background  

Waste incineration releases into the environment toxic substances having a teratogenic potential, but little epidemiologic evidence is available on this topic. We aimed at examining the relation between exposure to the emissions from a municipal solid waste incinerator and risk of birth defects in a northern Italy community, using Geographical Information System (GIS) data to estimate exposure and a population-based case-control study design. By modelling the incinerator emissions, we defined in the GIS three areas of increasing exposure according to predicted dioxins concentrations. We mapped the 228 births and induced abortions with diagnosis of congenital anomalies observed during the 1998–2006 period, together with a corresponding series of control births matched for year and hospital of birth/abortion as well as maternal age, using maternal address in the first three months of pregnancy to geocode cases and controls.     

Dioxin emissions from a solid waste incinerator and risk of non-Hodgkin lymphoma

BACKGROUND: It is not clear whether low environmental doses of dioxin affect the general population. We previously detected a cluster of patients with non-Hodgkin lymphoma around a French municipal solid waste incinerator with high dioxin emissions. To explore the environmental route suggested by these findings, we carried out a population-based case-control study in the same area. METHODS: We compared 222 incident cases of non-Hodgkin lymphoma diagnosed between 1980 and 1995 and controls randomly selected from the 1990 population census, using a 10-to-1 match. Dioxin ground-level concentrations were modeled with a second-generation Gaussian-type dispersion model, yielding four dioxin exposure categories. The latter were linked to individual places of residence, using Geographic Information System technology. RESULTS: The risk of developing non-Hodgkin lymphoma was 2.3 times higher (95% confidence interval = 1.4-3.8) among individuals living in the area with the highest dioxin concentration than among those living in the area with the lowest dioxin concentration. No increased risk was found for the intermediate dioxin exposure categories. Adjustment for a wide range of socioeconomic characteristics at the block group level did not alter the results. CONCLUSION: Although emissions from incinerators are usually not regarded as an important source of exposure to dioxins compared with other background sources, our findings support the hypothesis that environmental dioxins increase the risk of non-Hodgkin lymphoma among the population living in the vicinity of a municipal solid waste incinerator.     

Negative association between serum dioxin level and oxidative DNA damage markers in municipal waste incinerator workers

Objectives: To investigate the effect of dioxin on the formation of oxidative DNA damage and urinary mutagenicity, we measured the concentrations of serum dioxins and lymphocytic 8-hydroxydeoxyguanosine (8-OH-dG) in 57 male waste incinerator workers, urinary 8-OH-dG and urinary mutagenicity in 29 male waste incinerator workers. Methods: Information about the subjects was obtained from a questionnaire. Concentrations of polychlorinated dibenzo-p-dioxin (PCDD), polychlorinated dibenzofuran (PCDF), and coplanar-polychlorinated-biphenyl (Co-PCB) in serum samples from the workers were measured with a high-resolution gas chromatograph /high-resolution mass spectrometer. Lymphocytic and urinary 8-OH-dG levels were measured with a high-performance liquid chromatography-electrochemical detector system. The urinary mutagenicity was measured with umu assay. Results: The lymphocytic 8-OH-dG level showed a negative association with the serum dioxin level (total value of TEQ-PCDD, PCDF, and Co-PCB). Urinary 8-OH-dG did not show correlation with serum dioxin level, but showed positive correlation with the smoking index. Conclusions: With respect to the subjects‘ serum dioxin level, dioxin did not increase the urinary 8-OH-dG level by oxidative DNA damage, but upregulation of the primary defenses with oxidative damage and/or DNA repair system activity might have occurred.     

Mental health status of municipal solid waste incinerator workers compared with local government office workers

Recently in Japan dioxin problem of municipal solid waste incinerator (MSWI) became social issue. The news spread all around Japan and induced fear that workers at incinerators would suffer from cancer or other serious illness induced by the exposure to dioxins. Authors were interested in the effect of this stressful event occurred to the workers and intended to evaluate mental health status of MSWI workers compared with office workers. Subjects were male workers from two MSWI plants and a local government office; 20 government office workers who were engaging in health administration and 55 MSWI workers. Subjects were interviewed about their age, educational carrier, and working schedule. POMS and GHQ30 were used to evaluate mood status of subjects. There were differences in mood state between the two occupational groups. POMS showed that Tension-Anxiety, Depression-Dejection, and Fatigue levels were high in the health administration worker group. GHQ30 showed that General Illness, Social Dysfunction, and Anxiety and Dysphoria state were deviated to abnormal in the health administration worker group. General mental health status evaluated by GHQ30 score was also deviated to abnormal in the office worker group. Our results showed that mental health status of health administration workers was less healthy compared with MSWI workers. This meant that the stress of MSWI workers enhanced by the fear that they might have been exposed to dioxin did not exceed the stress the health administration workers usually had suffered from.     

Environmental health risks perception,attitude, and avoidance behaviour toward municipal solid waste incinerator

This study aims to assess the relationship between risk perception, attitude, and avoidance among residents toward an urban incinerator in Taichung, Taiwan. A cross-sectional study was conducted and three schools were enrolled. The case group was composed of 514 residents who live near an incinerator. The control group was composed of 264 people nearly the same age and who have lived in that area basically the same period of time. All participants were interviewed using a structured questionnaire. Results of this study showed that there was no significant difference between the exposure group and the control group in risk perception and attitude regarding the incinerator. However, the exposure group showed a significantly higher desire to move within one year or move sometime in the future than the control group. Therefore, these people should encourage the Environmental Protection Administration (EPA) to do everything it can to make sure that the incinerator operates safely.     

Evaluation of the relative contribution of exposure routes in a health risk assessment of dioxin emissions from a municipal waste incinerator.

Polychlorinated dioxins (PCDDs) and furans (PCDFs) are perceived by the public as the most hazardous materials emitted from municipal waste incinerators. These compounds disperse in the atmosphere and deposit on environmental media, where they may bioconcentrate in the food chain, resulting in a number of potential sources for human exposure. We performed a cancer risk assessment of PCDD/PCDF emissions from a municipal waste incinerator to evaluate the relative contribution of various exposure routes. Three scenarios were examined, all of which predicted ingestion of fish to be a significant source of exposure. In the common case, representative of the general population consuming mainly foods from commercial sources, inhalation was predicted to be the source of greatest exposure, followed by ingestion of fish, beef, milk, vegetation, and soil. In addition to fish, milk and beef ingestion contributed significantly to total exposure under the highly-exposed and worst case scenarios. Life-time cancer risk from the emitted PCDD/PCDFs was assessed for each scenario and was estimated as 1.8 x 10(-7) (common case), 2.5 x 10(-6) (highly-exposed case), and 6.7 x 10(-6) (worst case). In view of the conservative assumptions used in the assessment, the relatively low magnitude of these risks suggests that the PCDD/PCDF emissions from this incinerator should not be considered a significant public health concern.     

Dioxin emissions from a municipal solid waste incinerator and risk of invasive breast cancer: a population-based case-control study with GIS-derived exposure

Background  

To date, few epidemiologic studies have examined the relationship between environmental PCDD/F exposure and breast cancer in human populations. Dioxin emissions from municipal solid waste incinerators (MSWIs) are one of the major sources of environmental dioxins and are therefore an exposure source of public concern. The purpose of this study was to examine the association between dioxins emitted from a polluting MSWI and invasive breast cancer risk among women residing in the area under direct influence of the facility.     

Exposure of maintenance workers to dioxin-like contaminants during the temporary shutdown of a municipal domestic solid waste incinerator: a case series

To evaluate workers' exposure to dioxin-like substances (such as polychlorinated dibenzo-p-dioxins, dibenzofurans, and polychlorinated biphenyls), the authors used a chemical-activated luciferase gene expression (CALUX) assay to determine serum dioxin-like activity in five workers before and after two different cleaning-up activities inside a municipal domestic solid-waste incinerator. The workers' mean serum concentration of dioxin-like substances before the first cleaning operation, shown as a weighted value of toxic equivalents (or TEQs) according to the CALUX test, was 17.2 pg CALUX TEQ/g fat (range = 12-22), which is comparable with concentrations found in similarly aged men in a Flemish environmental health pilot study. After cleaning work, the workers' mean serum concentration was 28.5 pg CALUX TEQ/g fat (range = 18-31). At the second plant stoppage, the workers' mean dioxin-like activity was 15.4 pg CALUX TEQ/g fat (range = 12-21) before and 16.4 pg CALUX TEQ/g fat (range = < 10-32, where 10 pg is the limit of determination) after the cleaning operation. These results indicate that workers may be exposed to dioxin-like substances during their performance of cleaning operations in a municipal domestic solid-waste incinerator.     

Microbiological characterization of solid wastes and aerosol in a municipal solid waste landfill site

Authors report data about microbiological characterization of solid wastes and aerosol in the municipal solid waste landfill site in Poiatica (RE). In solid waste samples high values of total coliform and fecal coliform were observed (10(5)-10(6) CFU/g): total bacterial counts at 22 degrees, at 36 degrees and at 44 degrees ranged from 10(7) to 10(9) CFU/g. Aerosol samples collected during waste movement in the landfill site showed values of total and fecal bacterial ranging from 10(3)-10(4) CFU/m3. Staphylococci and fungi reported the same values while streptococci, total and fecal coliform and spore evidenced lower values. Municipal solid wastes and aerosol have to be considered as an infective substrate: it is necessary to adopt protective barriers in occupationally exposed subjects.     

Potential exposure levels and health effects of neighborhood exposure to a municipal incinerator bottom ash landfill

An investigation was conducted to assess the potential exposure levels and pursuant public health implications of neighborhood exposure to a municipal incinerator bottom ash landfill. This site received ash from a single incinerator without pollution control devices from 1954-1973. Soil was sampled for 10 heavy metals, polychlorinated dibenzodioxins, polychlorinated dibenzofurans, 2,3,7,8-tetrachlorodioxin and furan congeners, polychlorinated biphenyls, and polycyclic aromatic hydrocarbons. Soil concentrations for these substances were converted to estimates of exposure, health effects, and/or cancer risk by the application of a general exposure model and exposure/effect and exposure/risk models for specific substances. The results of soil analysis and modeling indicate that the level of lead detected on the site was considerably above the recommended levels of the Centers for Disease Control (CDC) and may lead to an elevated blood lead level in exposed children above that currently defining a case of lead poisoning. The potential for health effects resulting from exposure to other substances measured in the soil on this site is considered to be small, and no significant increased cancer risk is expected. Comparison of levels of various substances obtained at this site with levels obtained in fresh bottom ash in other studies suggests that these results may be applicable to exposures from other municipal incinerator bottom ash landfills.     

Relationships between physicochemical parameters and the toxicity of leachates from a municipal solid waste landfill

Landfills are used to dispose municipal solid wastes, and although on-site recycling in these places is an extensive practice in Latin America, diverse pollutants are incorporated into the leachates. The objective of this work was to establish relationships between composition and toxicity of leachates from the landfill of the city of Cartagena, Colombia. Leachates were characterized measuring Cd, Ni, Hg, Mn, Cu, and Pb concentrations, and physicochemical parameters including pH, conductivity, chemical oxygen demand (COD), and hardness. Bioassays were conducted diluting with synthetic sea water, recording toxicity against Artemia franciscana as median lethal concentrations (LC50 values) after 24 and 48 h exposure. Average LC₅₀ values oscillated between 3.20% and 39.33% (v/v). Multivariate analysis showed that toxicity was dependent on Cd and COD. The slope of the concentration–response curve correlated with Ni concentration independently from toxicity. Results suggest toxicity of these leachates depends on Cd concentrations associated with organic matter, this effect being modulated by Ni.     

Cobalt and nickel uptake by rice and accumulation in soil amended with municipal solid waste compost

Effect of addition of municipal solid waste compost (MSWC) on cobalt (Co) and nickel (Ni) contents of submerged rice paddies were studied. A sequential extraction method was used to determine the metal (Co and Ni) fractions in MSWC and cow dung manure (CDM). Both metals were significantly bound to the organic matter and Fe and Mn oxides in MSWC and CDM. Metal content in rice straw was higher than in rice grain. Metal bound with Fe and Mn oxides in MSWC and CDM best correlated with straw and grain metal followed by water soluble and exchangeable fractions. Carbonate, organic matter bound and residual fractions in MSWC and CDM did not significantly correlate with rice straw and grain metal. MSWC would be a valuable resource for agriculture, but long-term field experiments with MSWC are needed to assess by regular monitoring of the metal loads and accumulation in soil and plants.     

Leaching of polychlorinated dibenzo-p-dioxins and dibenzofurans in fly ash from municipal solid waste incinerators to a water system

In order to predict how much polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/Fs) are leached from fly ash by rain water when fly ash is disposed, leaching of PCDDs/Fs from a fly ash obtained from a municipal solid waste incinerator (MSWI) was investigated by packing the ash in a column and eluting with water. In the beginning of the elution, PCDDs/Fs associated with water-soluble particulates in the ash were eluted, whereas in the latter half, those associated with water slightly soluble particles were eluted, judging from the comparison of PCDDs/Fs in eluate fractions with those transferred to solutions from the original ash by stepwise batch methods with water and 2N hydrochloric acid.The amounts of PCDDs/Fs eluted from the ash column were 2.9% and 1.7% of those extracted from the original ash, respectively, while large amounts of PCDDs/Fs were contained in the fly ash in the column after the elution, suggesting that PCDDs/Fs in water-insoluble particulates of the ash would not be eluted by water.     

Survey on the health effects of chronic exposure to dioxins and its accumulation on workers of a municipal solid waste incinerator,rural part of Osaka Prefecture,and the results of extended survey afterwards

In September 1998 the Ministry of Health and Welfare announced that high concentrations of dioxins were detected in the samples of soil near the incinerator and ash, drainage, sludge and others remained in the furnace and air pollution control devices of municipal solid waste incinerator (MSWI) in rural part of Osaka Prefecture. According to the results the Ministry of Labor immediately organized the "Research and investigation committee on the dioxin problem of Toyono-gun Clean Center" under Japan Industrial Safety and Health Association to investigate the health effects of chronic exposure to dioxins and its accumulation on workers of the incinerator plant. The investigation was carried out in Sept 1998 and from the results, the committee concluded that the concentrations of dioxin among the blood of the workers who had engaged in maintenance of the furnace, the electric dust collector, and the wet scrubber of the incinerator were higher compared with those of residents in surrounding areas. However, there were no signs or findings correlating to blood level of dioxns, and the level was not high enough to induce sufficient health effects from the review of published papers. According to the results of this survey the committee understood that the follow-up study of blood dioxins level of group III and IV workers was inevitable and concerned about the other MSWI workers in Japan who might also be exposed to similar level of dioxins. The Ministry of Labor decided to expand the survey to other MSWI workers in Japan as 3-year project from 1999. The summarized report on the project is appended in this paper.     

Temporal trends in the incidence of non-Hodgkin's lymphoma and selected malignancies in a population with a high incidence of acquired immunodeficiency syndrome (AIDS)

Annual incidence rates for 1975-1985 were derived for Kaposi's sarcoma, non-Hodgkin's lymphomas, and seven other malignancies. Never-married men in the San Francisco Bay area constituted the study population. The pattern of increase in incidence of non-Hodgkin's lymphoma among men aged 25-44 years was similar to that seen for Kaposi's sarcoma; both increased significantly in San Francisco between 1980 and 1985 (p less than 0.001), with an increase among census tracts with high incidence of acquired immunodeficiency syndrome (AIDS) that was greater than the increase seen in other San Francisco census tracts. Among men in tracts with a high incidence of AIDS, non-Hodgkin's lymphoma reached an incidence in 1985 that was five times greater than preepidemic rates. These increased rates support the conclusion of clinical studies that non-Hodgkin's lymphoma is an additional manifestation of AIDS. Similar increases in incidence rates were not observed for other malignancies, suggesting that reports of these malignancies in homosexuals may be isolated incidents. Whether rates of non-Hodgkin's lymphoma will continue to increase and whether rates of other potentially AIDS-associated malignancies will increase in the future may depend on the latency of these malignancies and the survival period of AIDS patients.     

Respiratory and general health impairments of workers employed in a municipal solid waste disposal at an open landfill site in Delhi

The objective of this study was to examine the respiratory and general health of workers employed in a municipal solid waste (MSW) disposal at an open landfill site in India. Ninety-six landfill workers of Okhla landfill site, Delhi, and 90 controls matched for age, sex, and socioeconomic conditions were enrolled. Health data was obtained from questionnaire surveys, clinical examination and laboratory investigations. Lung function was evaluated by spirometry. Compared with matched controls, landfill workers had significantly higher prevalences of both upper and lower respiratory symptoms, and they suffered more often from diarrhea, fungal infection and ulceration of the skin, burning sensation in the extremities, tingling or numbness, transient loss of memory, and depression. Spirometry revealed impairment of lung function in 62% of the landfill workers compared to 27% of the controls. Sputum cytology showed squamous metaplasia, abundance of inflammatory cells, alveolar macrophages (AM) and siderophages (macrophages with iron deposits), and high elastase enzyme activity in neutrophils and AM of a majority of landfill workers, indicating adverse cellular lung reaction. Hematological profiles of these workers depicted low hemoglobin and erythrocyte levels with high total leukocyte, eosinophil and monocyte counts. Erythrocytes with target cell morphology were abundant in 42% of the landfill workers compared to 10% of the controls. Toxic granulation in neutrophils, an indication of infection and inflammation, was recorded in 94% of the landfill workers and in 49% of the controls. The results demonstrated higher prevalence of respiratory symptoms, inflammation of the airways, lung function decrement and a wide range of general health problems in MSW disposal workers.     

Reactivation of Chagas' disease in a patient with non-Hodgkin's lymphoma: gastric, oesophageal and laryngeal involvement

Changes in the natural course of Trypanosoma cruzi infection have been associated with immunosuppression. We report here a case of the reactivation of Chagas' disease in a patient with non-Hodgkin's lymphoma with gastric, oesophageal and laryngeal involvement. This is the first report describing the involvement of the larynx by T. cruzi.     

Case-control assessment of the association between non-Hodgkin's lymphoma and occupational radiation with doses assessed using a job exposure matrix

BACKGROUND: Epidemiologic data for an association between radiation exposure and non-Hodgkin's lymphoma (NHL) have been inconclusive though the strongest evidence has been provided by studies of patients treated with radiotherapy. METHODS: We evaluated the association between occupational radiation exposure and non-Hodgkin's lymphoma in men using a population-based case-control study with 1,056 case and 1,860 control subjects sampled from eight geographic areas in the United States. Because dosimetry data were not available, doses were estimated for individuals who reported occupational radiation exposure using a radiation job exposure matrix developed for this purpose. Conditional logistic regression was used to model the association between reported occupational radiation exposure and NHL incidence. RESULTS: We found that most men (> 90%) did not report exposure to occupational sources of radiation. Among those who reported exposure, estimated cumulative doses were low, with an estimated mean of less than 0.02 Gray and a maximum of 0.12 Gray. The risk for NHL was not associated with ever having reported an occupational radiation exposure (OR = 0.90, 95% CI = 0.74-1.10) nor was there evidence of a dose-response relationship between risk and either the estimated cumulative doses or duration of exposure. CONCLUSIONS: The findings in this study are consistent with results from most current research on occupational radiation and NHL risk that have found no increased risk of NHL at low levels of occupational radiation exposure. While it should be noted that exposure misclassification likely biased our results toward the null, this large population-based case-control study adds to existing evidence which suggests that there is little to no increased risk for NHL associated with exposure to low levels of radiation such as that commonly found in many occupational settings. Copyright Published 2000 Wiley-Liss, Inc.