Towards an assessment of the health impact of industrially contaminated sites: waste landfills in Europe.

OBJECTIVES: this paper is based upon work from COST Action ICSHNet. To develop and apply recently proposed methods for assessing the health impact of pollution from contaminated sites and apply them to the case of landfills using available large European datasets. METHODS: standard methods for health impact assessment and burden of disease were applied using the available evidence on the health effects of living near a landfill. Geo-referenced data on landfills from the European Pollutant and Transfer Register (E-PRTR) were combined with population density data (European Environment Agency dataset) and disease frequency data from European health for all database (HfA); uncertainty was assessed via simulation methods. Countries covered by the European Environment Agency's E-PRTR registry on contaminated sites were considered (European Union Member States plus four additional European Countries) for the period 2007-2014. Four outcomes, for which suggestive evidence is available, were included: - low birth weight; - congenital anomalies; - respiratory disease; - annoyance from odour. Firstly, they were analysed separately, in terms of excess number of cases, and then combined into disability-adjusted life years (DALYs). RESULTS: 1,544 landfill sites were considered. 29.3 million people (6% of the total population) live within 4 km from one or more of these sites. The number of yearly attributable cases associated with low birth weight, congenital anomalies, respiratory diseases, and annoyance from odour were estimated, respectively, at 1,239, 70, 33,039, and 1,582,624. Associated DALYs were 10,192, 958, 2,688, and 47,505, respectively; 61,325 in total. CONCLUSIONS: estimates indicate a sizable health impact, largest for annoyance from odour, given the high frequency of the outcome and in spite of its lesser severity compared to the other ones. Application of the methodology is relatively straightforward, once the main assumption of causality is made. The present work offers a first approximation of the impact on health of waste landfills in Europe and can be further applied to other contaminated sites.

[Health impact assessment of policies for municipal solid waste management: findings of the SESPIR Project]. / Impatto sulla salute delle politiche di gestione dei rifiuti solidi urbani: i risultati del Progetto SESPIR.

The SESPIR Project (Epidemiological Surveillance of Health Status of Resident Population Around the Waste Treatment Plants) assessed the impact on health of residents nearby incinerators, landfills and mechanical biological treatment plants in five Italian regions (Emilia-Romagna, Piedmont, Lazio, Campania, and Sicily). The assessment procedure took into account the available knowledge on health effects of waste disposal facilities. Analyses were related to three different scenarios: a Baseline scenario, referred to plants active in 2008-2009; the regional future scenario, with plants expected in the waste regional plans; a virtuous scenario (Green 2020), based on a policy management of municipal solid waste (MSW) through the reduction of production and an intense recovery policy. Facing with a total population of around 24 million for the 5 regions, the residents nearby the plants were more than 380,000 people at Baseline. Such a population is reduced to approximately 330.000 inhabitants and 170.000 inhabitants in the regional and Green 2020 scenarios, respectively. The health impact was assessed for the period 2008-2040. At Baseline, 1-2 cases per year of cancer attributable to MSW plants were estimated, as well as 26 cases per year of adverse pregnancy outcomes (including low birth weight and birth defects), 102 persons with respiratory symptoms, and about a thousand affected from annoyance caused by odours. These annual estimates are translated into 2,725 years of life with disability (DALYs) estimated for the entire period. The DALYs are reduced by approximately 20% and 80% in the two future scenarios. Even in these cases, health impact is given by the greater effects on pregnancy and the annoyance associated with the odours of plants. In spite of the limitations due to the inevitable assumptions required by the present exercise, the proposed methodology is suitable for a first approach to assess different policies that can be adopted in regional planning in the field of waste management. The greatest reduction in health impact is achieved with a virtuous policy of reducing waste production and a significant increase in the collection and recycling of waste.

[Methods for health impact assessment of policies for municipal solid waste management: the SESPIR Project]. / Metodologia di valutazione degli impatti sulla salute delle politiche di gestione dei rifiuti solidi urbani: il Progetto SESPIR.

The Project Epidemiological Surveillance of Health Status of Resident Population Around the Waste Treatment Plants (SESPIR) included five Italian regions (Emilia-Romagna, Piedmont, Lazio, Campania, and Sicily) and the National Institute of Health in the period 2010-2013. SESPIR was funded by the Ministry of Health as part of the National centre for diseases prevention and control (CCM) programme of 2010 with the general objective to provide methods and operational tools for the implementation of surveillance systems for waste and health, aimed at assessing the impact of the municipal solid waste (MSW) treatment cycle on the health of the population. The specific objective was to assess health impacts resulting from the presence of disposal facilities related to different regional scenarios of waste management. Suitable tools for analysis of integrated assessment of environmental and health impact were developed and applied, using current demographic, environmental and health data. In this article, the methodology used for the quantitative estimation of the impact on the health of populations living nearby incinerators, landfills and mechanical biological treatment plants is showed, as well as the analysis of three different temporal scenarios: the first related to the existing plants in the period 2008-2009 (baseline), the second based on regional plans, the latter referring to MSW virtuous policy management based on reduction of produced waste and an intense recovery policy.