Adverse health effects for populations living near waste incinerators with special attention to hazardous waste incinerators. A review of the scientific literature.

Incinerators of municipal, hazardous and medical wastes are sources of emissions of toxic pollutants, being polychlorinated dibenzo-p-dioxins and dibenzofurans, as well as a number of heavy metals of special concern. Moreover, waste incineration also generates ashes that must be properly disposed. In all countries, waste management is currently being an issue of tremendous importance. While the treatment and disposal of municipal solid waste (MSW) is a problem in the entire world, in industrialized countries, the management of hazardous waste (HW) is an additional issue of important concern. While the available scientific information on the environmental impact and the health risks of MSWIs is quite considerable, that related with the potential adverse health effects for the populations living near HWIs is much more reduced. In this paper, we have reviewed the information on health effects-including the incidence of cancer and cancer mortality-for the people residing in the vicinity of HWIs. For a better understanding of the problem, some studies on cancer and other adverse health effects near MSWIs have been also reviewed. Special attention has been paid to the HWI of Constantí (Catalonia, Spain) on which the most complete information among all HWIs in the entire world is available. In our conclusions, a series of important issues/questions are raised: is really safe the limit value of 0.1 ng TEQ/Nm3 for PCDD/Fs to protect human health? Where are the evidences on this? On the other hand, to date, risk assessment studies have been only focused on certain substances; heavy metals and PCDD/Fs. Studies have not included those chemicals that are not routinely analyzed, being even some of them probably unknown right now. Moreover, what about potential interactions among chemicals in order to estimate the carcinogenic and non-carcinogenic risks for the population living near incinerators? Complete epidemiological studies are clearly necessary.

New Method of Destroying Waste Anesthetic Gases Using Gas-Phase Photochemistry.

BACKGROUND: The inhalation anesthetics are potent greenhouse gases. To reduce the global environmental impact of the health care sector, technologies are sought to limit the release of waste anesthetic gas into the atmosphere. METHODS: Using a photochemical exhaust gas destruction system, removal efficiencies for nitrous oxide, desflurane, and sevoflurane were measured at various inlet concentrations (25% and 50%; 1.5%, 3.0%, and 6.0%; and 0.5%, 1.0%, and 2.0%, respectively) with flow rates ranging from 0.25 to 2.0 L/min. To evaluate the economic competitiveness of the anesthetic waste gas destruction system, its price per ton of carbon dioxide equivalent was calculated and compared to other greenhouse gas abatement technologies and current market prices. RESULTS: All inhaled anesthetics evaluated demonstrate enhanced removal efficiencies with decreasing flow rates (P < .0001). Depending on the anesthetic and its concentration, the photochemical exhaust gas destruction system exhibits a constant first-order removal rate, k. However, there was not a simple relation between the removal rate k and the species concentration. The costs for removing a ton of carbon dioxide equivalents are <$0.005 for desflurane, <$0.114 for sevoflurane, and <$49 for nitrous oxide. CONCLUSIONS: Based on this prototype study, destroying sevoflurane and desflurane with this photochemical anesthetic waste gas destruction system design is efficient and cost-effective. This is likely also true for other halogenated inhalational anesthetics such as isoflurane. Due to differing chemistry of nitrous oxide, modifications of this prototype photochemical reactor system are necessary to improve its removal efficiency for this gas.

Assessing the impact of hazardous waste on children's health: The exposome paradigm.

Assessment of the health impacts related to hazardous waste is a major scientific challenge with multiple societal implications. Most studies related to associations between hazardous waste and public health do not provide established of mechanistic links between environmental exposure and disease burden, resulting in ineffective waste management options. The exposome concept comes to overhaul the nature vs. nurture paradigm and embraces a world of dynamic interactions between environmental exposures, endogenous exposures and genetic expression in humans. In this context, the exposome paradigm provides a novel tool for holistic hazardous waste management. Waste streams and the related contamination of environmental media are not viewed in isolation, but rather as components of the expotype, the vector of exposures an individual is exposed to over time. Thus, a multi-route and multi-pathway exposure estimation can be performed setting a realistic basis for integrated health risk assessment. Waste management practices are thus assessed not only regarding their technological edge and efficacy but also their effects on human health at the individual and community level, considering intra-subject variability in the affected population. The effectiveness of the exposome approach is demonstrated in the case of Athens, the capital of Greece, where the health effects associated to long term and short term exposure to two major waste management facilities (landfill and plastic recycling) are presented. Using the exposome analysis tools, we confirmed that proximity to a landfill is critical for children neurodevelopment. However, this effect is significantly modified by parameters such as parental education level, socioeconomic status and nutrition. Proximity to a plastics recycling plant does not pose significant threats under normal operating conditions; yet, in the case of an accidental fire, release of persistent carcinogenic compounds (dioxins and furans) even for a short period results in increased lifelong risk, especially for breast feeding neonates.

Hazardous waste and health impact: a systematic review of the scientific literature.

Waste is part of the agenda of the European Environment and Health Process and included among the topics of the Sixth Ministerial Conference on Environment and Health. Disposal and management of hazardous waste are worldwide challenges. We performed a systematic review to evaluate the evidence of the health impact of hazardous waste exposure, applying transparent and a priori defined methods. The following five steps, based on pre-defined systematic criteria, were applied. 1. Specify the research question, in terms of "Population-Exposure-Comparators-Outcomes" (PECO). POPULATION: people living near hazardous waste sites; Exposure: exposure to hazardous waste; Comparators: all comparators; Outcomes: all diseases/health disorders. 2. Carry out the literature search, in Medline and EMBASE. 3. Select studies for inclusion: original epidemiological studies, published between 1999 and 2015, on populations residentially exposed to hazardous waste. 4. Assess the quality of selected studies, taking into account study design, exposure and outcome assessment, confounding control. 5. Rate the confidence in the body of evidence for each outcome taking into account the reliability of each study, the strength of the association and concordance of results.Fifty-seven papers of epidemiological investigations on the health status of populations living near hazardous waste sites were selected for the evidence evaluation. The association between 95 health outcomes (diseases and disorders) and residential exposure to hazardous waste sites was evaluated. Health effects of residential hazardous waste exposure, previously partially unrecognized, were highlighted. Sufficient evidence was found of association between exposure to oil industry waste that releases high concentrations of hydrogen sulphide and acute symptoms. The evidence of causal relationship with hazardous waste was defined as limited for: liver, bladder, breast and testis cancers, non-Hodgkin lymphoma, asthma, congenital anomalies overall and anomalies of the neural tube, urogenital, connective and musculoskeletal systems, low birth weight and pre-term birth; evidence was defined as inadequate for the other health outcomes. The results, although not conclusive, provide indications that more effective public health policies on hazardous waste management are urgently needed. International, national and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, including illegal transboundary trade, and increase support regulation and its enforcement.

The changing face of nanomaterials: Risk assessment challenges along the value chain.

Risk assessment (RA) of manufactured nanomaterials (MNM) is essential for regulatory purposes and risk management activities. Similar to RA of "classical" chemicals, MNM RA requires knowledge about exposure as well as of hazard potential and dose response relationships. What makes MNM RA especially challenging is the multitude of materials (which is expected to increase substantially in the future), the complexity of MNM value chains and life cycles, the accompanying possible changes in material properties over time and in contact with various environmental and organismal milieus, and the difficulties to obtain proper exposure data and to consider the proper dose metric. This article discusses these challenges and also critically overviews the current state of the art regarding MNM RA approaches.

PCDD/F contamination on surface soil in the vicinity of a hazardous waste incinerator: is it possible a different trend?

This study is the first to investigate the contamination of polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) on surface soils in the vicinity of the first hazardous waste incinerator of Turkey. In the study, 24 soil samples were taken from a 1625-m-radius circle whose center is the stack of the incinerator. This process was repeated 1 year later. Since the acquired average PCDD/F concentrations of the two sampling campaigns (0.05 and 0.02 ng WHO-toxic equivalent (TEQ)/kg) were meaningfully low compared to the related literatures, a new sampling campaign was carried out to control this inconsistency, but this time in a foreign laboratory (0.56 ng WHO-TEQ/kg). In the same period, eight gas samples were taken from the stack under different operational conditions of the facility. According to the evaluations of the findings, the geographical-meteorological data of the study area and the specific operational conditions of the facility corroborate the concentrations of the first and the second soil samplings rather than the third one. The major underlying reason for the inconsistency of the soil concentrations may be the fact that the data analysis procedures used by the laboratories are different. The author suggests a hypothesis which argues that the soils in the vicinity of a hazardous waste incinerator may have significantly lower concentration levels than in related literatures.

Managing risks of noncancer health effects at hazardous waste sites: A case study using the Reference Concentration (RfC) of trichloroethylene (TCE).

A method for determining a safety range for non-cancer risks is proposed, similar in concept to the range used for cancer in the management of waste sites. This safety range brings transparency to the chemical specific Reference Dose or Concentration by replacing their "order of magnitude" definitions with a scientifically-based range. EPA's multiple RfCs for trichloroethylene (TCE) were evaluated as a case study. For TCE, a multi-endpoint safety range was judged to be 3 µg/m(3) to 30 µg/m,(3) based on a review of kidney effects found in NTP (1988), thymus effects found in Keil et al. (2009) and cardiac effects found in the Johnson et al. (2003) study. This multi-endpoint safety range is derived from studies for which the appropriate averaging time corresponds to different exposure durations, and, therefore, can be applied to both long- and short-term exposures with appropriate consideration of exposure averaging times. For shorter-term exposures, averaging time should be based on the time of cardiac development in humans during fetal growth, an average of approximately 20-25 days.

Awareness assessment of harmful effects of mercury in a health care set-up in India: A survey-based study.

Mercury, one of the most toxic heavy metals, is ubiquitous in environment. The adverse health impact of mercury on living organisms is well known. The health care facilities are one of the important sources of mercury release into the atmosphere as mercury items are extensively used in hospitals. To assess the awareness about mercury toxicity and the knowledge of proper handling and disposal of mercury-containing items in health care set-up, a questionnaire-based survey was carried out amongst doctors (n = 835), nurses (n = 610) and technicians (n = 393) in government hospitals, corporate hospitals and primary health care centres in the Indian states of Delhi, Uttar Pradesh and Haryana. The study was conducted using a tool-containing pretested structured multiple-choice questionnaire. Analysis of the results using STATA 11.1 software highlighted that overall awareness was more in corporate sector. However, percentage range of knowledge of respondents irrespective of health care sector was only between 20 and 40%. Despite the commitment of various hospitals to be mercury free, mercury containing-thermometer/sphygmomanometer are still preferred by health professionals. The likely reasons are availability, affordability, accuracy and convenience in use. There is an urgent need for source reduction, recycling and waste minimization. Emphasis must be laid on mercury alternative products, education and training of health personnel and public at large, about correct handling and proper clean up of spills.

[SENTIERI Project: rationale and objectives]. / Razionale e obiettivi del Progetto SENTIERI.

The Istituto Superiore di Sanità (National Institute of Health-ISS), in partnership with a network of Italian national and regional scientific institutions, initiated the SENTIERI Project (Epidemiological Study of Residents in Italian Contaminated Sites-NPCSs), the objectives, methods and initial results of which were published by Epidemiologia & Prevenzione in 2010 and 2011. In the course of 2013, some of the SENTIERI Project findings were published in international scientific journals, and the "SENTIERI approach" was among those sanctioned by the World Health Organization to conduct an initial description of the health status of residents of contaminated sites. The present Report, set up jointly by ISS and the Italian Network of Cancer Registries (AIRTUM), as anticipated in the 2011 Report, aims to provide, for each of the 18 National Priority Contaminated Sites included in the SENTIERI Project where the Italian Association of Cancer Registries is active, a mortality update to 2010, analyses of cancer incidence (1996-2005 in 17 NPCSs) and of hospital discharges (2005-2010), as is explained in detail in Chapter 2, pertaining to the project's materials and methods. The results of the analyses for each NPCS are presented in Chapter 3, while Chapter 4 includes a critical appraisal, a discussion of the methodological approach and a series of concluding remarks. The second section of the Report takes an in-depth look at important issues of public health and scientific research in contaminated sites. This Report represents an important step towards implementing a permanent epidemiological surveillance system in Italy's contaminated sites, the ultimate goal of the SENTIERI Project.

[SENTIERI Project: materials and methods]. / Materiali e metodi del Progetto SENTIERI.

The Report considers three health outcomes - mortality, cancer incidence and hospital discharges - studied using homogenous methods and using data from official sources, namely the National Institute of Statistics (Istat), Italian Network of Cancer Registries (AIRTUM) and the Health Ministry. The timeframes of observation are: 2003-2010 for mortality, 1996-2005 for cancer incidence and 2005-2010 for hospital discharges. The causes of death are those examined by the SENTIERI Project. Hospital discharges are analysed with reference to the main diagnosis. The study of cancer incidence applies to the sites selected by AIRTUM. Statistical parameters (SMR, Standardized Mortality Ratio; SIR, Standardized Incidence Ratio; SHR, Standardized Hospitalization Ratio) were computed with a 90% confidence interval; the estimators were adjusted for age and socioeconomic status.

Environmental and occupational exposure to chemicals and telomere length in human studies.

Telomeres are complexes of tandem repeats of DNA (5'-TTAGGG-3') and protein that cap eukaryotic chromosomes and play a critical role in chromosome stability. Telomeres shorten with aging and this process can be accelerated by increased oxidative stress and episodes of inflammation. Evidence is rapidly growing that telomere length (TL) may be affected by environmental chemicals that have frequently been associated with chronic diseases. In this article, we review the published data on TL in relation to environmental and occupational exposure to several chemicals based on our own and others' studies. The environmental and occupational exposures associated with shorter TL include traffic-related air pollution (ie, particulate matter (PM), black carbon (BC), and benzene and toluene), polycyclic aromatic hydrocarbons (PAHs), N-nitrosamines, pesticides, lead, exposure in car mechanical workshops, and hazardous waste exposure. Arsenic, persistent organic pollutants (POPs) and short-term exposure to PM are associated with longer TL. We discuss the possible reasons for the differences in results, including time- and dose-related issues, study design, and possible mechanisms involved in telomere regulation. We also discuss the future directions and challenges for TL-related environmental and occupational health research, such as investigation of TL in subpopulations of blood leukocytes, and the study of genetic and epigenetic factors that may regulate telomere integrity using longitudinal designs.

The burden of disease from pediatric lead exposure at hazardous waste sites in 7 Asian countries.

Identification and systematic assessment of hazardous wastes sites in low and middle-income countries has lagged. Hazardous waste problems are especially severe in lower income Asian countries where environmental regulations are non-existent, nonspecific or poorly enforced. In these countries extensive unregulated industrial development has created waste sites in densely populated urban areas. These sites appear to pose significant risks to public health, and especially to the health of children. To assess potential health risks from chemical contamination at hazardous waste sites in Asia, we assessed 679 sites. A total of 169 sites in 7 countries were classified as contaminated by lead. Eighty-two of these sites contained lead at levels high enough to produce elevated blood lead levels in surrounding populations. To estimate the burden of pediatric lead poisoning associated with exposure to lead in soil and water at these 82 lead-contaminated sites, we used standard toxicokinetic models that relate levels of lead in soil and water to blood lead levels in children. We calculated blood lead levels, and we quantified losses of intelligence (reductions in IQ scores) that were attributable to lead exposure at these sites. We found that 189,725 children in the 7 countries are at risk of diminished intelligence as a consequence of exposure to elevated levels of lead in water and soil at hazardous waste sites. Depending on choice of model, these decrements ranged from 4.94 to 14.96 IQ points. Given the restricted scope of this survey and the conservative estimation procedures employed, this number is almost certainly an underestimate of the full burden of disease. Exposure to toxic chemicals from hazardous waste sites is an important and heretofore insufficiently examined contributor to the Global Burden of Disease.

Characterization and environmental risk assessment of heavy metals found in fly ashes from waste filter bags obtained from a Chinese steel plant.

The environmental risk of exposure to six heavy metals (Cu, Pb, Zn, Cr, Ni, and Cd) found in fly ashes from waste filter bags obtained from a steel plant was estimated based on the mineralogical compositions, total concentrations and speciation of the metals in the fly ashes. The results indicated that the fly ashes mainly consisted of hematite, magnetite, cyanite, spinel, coesite and amorphous materials. The concentrations of Zn and Pb were much higher than that of other materials. After Zn and Pb, Ni was present in the highest concentration, followed by Cu, Cr and Cd. Each heavy metal was distributed differently in fly ashes. The levels of Zn, Cd and Pb in the active fraction were very high, and ranged from 64.83 to 81.96%, 34.48 to 82.4% and 6.92 to 79.65% respectively, while Cu, Cr and Ni were mainly present in the residual fraction. The risk assessment code (RAC) values of fly ashes showed that the Zn and Cd present in the H3 sample presented a very high risk, with RAC values greater than 50%. The Cu present in the H3 sample, Cd in the H2 sample and Zn in the H4 and H5 samples presented a high risk. The Pb present in the H2 sample, Cd in the H4 sample, Ni in the H1 and H5 samples, and Zn in the H1 sample presented a medium risk. A low risk was presented by the Cu present in the H1, H2, H4 and H5 samples, the Pb in the H1, H3 and H5 samples, the Cd in the H1 and H5 samples, and the Ni in the H2 sample. No risk was presented by Cr in any sample.

Forensic case of lead poisoning from a battery manufacturing company in Nakuru, Kenya.

Acute sickness involving dairy cattle (n = 5) with a morbidity of 100% occurred in a farm in Nakuru, Kenya. A case study was undertaken with the objective of establishing the cause of the sickness. Samples of blood, soil and industrial waste contained high levels of lead. The symptoms, results of postmortem and history of the case were used to establish the diagnosis of acute lead poisoning. This is a forensic case in court between the owner of the animals and a lead recycling company that dumped the industrial waste that was associated with the poisoning. There could be many unreported cases of lead poisoning in Kenya areas with heavy industrial activities since data on of lead poisoning in Kenya is scanty.

[Actual problems of the impact of production and management of industrial waste on the environment and public health (review of literature)].

In the modern society the importance and applicability of the problem concerning the negative effect of production and consumption waste on the objects of the environment and the state sa people's health is related to their daily emergency, large tonnage, storage, and utilization. Wastes and places of their storage and waste burial constitute an toxicological and epidemiological risk. Chemical and biological contamination of solid waste is a threat to its penetration into the soil, air, groundwater and surface water bodies, vegetation, directly or indirectly, cause variations in health status of the population.