It is not true that all peer reviewed health studies conclude ‘modern’ incinerators are safe. If the Health Protection Agency had conducted their own research instead of relying on studies selected for them by waste industry consultants (see DEFRA 2004 review) they might have offered a different view. Below are details of some peer reviewed scientific studies not selected by the waste industry.

Ann 1st Super Sanita 2004;40(1):101-115

Health effects of exposure to waste incinerator emissions:

a review of epidemiological studies

Michela FRANCHINI (a), Michela RIAL (a), Eva BUIATTI (b) e Fabrizio BIANCHI (a, b)

(a) Unita di Epidemiologia, Istituto di Fisiologia Clinica,

Consiglio Nazionale delle Ricerche, Pisa, Italy
(b) Osservatorio di Epidemiologia, Agenzia Regionale di Sanita, Florence, Italy

Summary - This review evaluates the epidemiological literature on health effects in relation to incineration facilities. Several adverse health effects have been reported. Significant exposure-disease associations are reported by two thirds of the papers focusing on cancer (lung and larynx cancer, non- Hodgkin's lymphoma). Positive associations were found for congenital malformations and residence near incinerators. Exposure to PCB and heavy metals were associated with several health outcomes and in particular with reduction of thyroid hormones. Findings on non-carcinogen pathologies are inconclusive. Effect of biases and confounding factors must be considered in the explanation of findings. Methodological problems and insufficient exposure information generate difficulties on study results. Research needs include a better definition of exposure in qualitative and quantitative terms in particular by developing the use of biomarkers and by implementing environmental measurements.
Key words: incinerators, health effects, environmental exposure, epidemiology, review.

Riassunto (Effetti sulla salute di esposizioni a inceneritori di rifiuti: rassegna di studi epidemiologici). - Viene presentata una rassegna della letteratura epidemiologica in tema di salute e inceneritori. Alcuni studi riferiscono effetti avversi sulla salute umana, in particolare per tumori (polmone, laringe, linfoma non- Hodgkin), altri hanno evidenziato eccessi di malformazioni congenite in aree con impianti. Esposizioni a PCB e metalli pesanti sono state associate ad alcune patologie, soprattutto riduzione degli ormoni tiroidei. I risultati riguardanti patologie non tumorali sono maggiormente inconsistenti. Fattori di distorsione e confondirnento possono avere una rilevante influenza sulle associazioni identificate. Natura e complessita delle esposizioni, dimensioni delle popolazioni indagate, difficile definizione del profilo socio-economico, elevata variabilita di patologie e sintomi studiati, sono trattati in rassegna. Una nuova generazione di studi epidemiologici necessita di una migliore definizione dell’esposizione in termini qualitativi e quantitativi, in particolare mediante una evoluzione delle misurazioni ambientali e lo sviluppo dell'uso di bio-marcatori individuali di esposizione.
Parole chiare: inceneritori, effetti sulla salute, esposizione ambientale, epidemiologia, rassegna di studi.

Introduction

Although landfills are still widely used in Europe for the disposal of wastes, there is a rapid increase in the use of incineration instead of landfilling for the disposal of solid waste. Incinerators are known to release numerous toxic chemicals into the atmosphere and to produce ashes and other solid waste residues.
Adverse health effects associated with mass burn incineration are of great concern as large population groups and workers may be exposed to derived toxic substances. Many of these chemicals are known to be persistent, bioaccumulative, carcinogenic or endocrine disruptors [1].
Several studies have demonstrated that old but also new incinerators can contribute to the contamination of local soil and vegetation by organic and inorganic compounds present in variable quantities in fly ash and flue gases released from the plants. Similarly, in several European countries, cow's milk from farms located close to incinerators has been found to contain elevated levels of dioxins, in some cases above regulatory limits [2, 3].
Populations living near incinerators - alike those living near landfill sites - are potentially exposed to chemicals by way of inhalation of contaminated air, consumption of contaminated foods, water or dermal contact with contaminated soil [1, 4, 5]. People can...

Indirizzo per la corrispondenza (Address for correspondence): Fabrizio Bianchi, Unita di Epidemiologia, Istituto di Fisiologia Clinica, Consiglio Nazionale delle Ricerche, Via Moruzzi 1, 56124 Pisa, Italy. E-mail: fabrepi@ifc.cnr.it

Peer Reviewed Health Studies

Tango T, Fujita T, Tanihata T, Minowa M, Doi Y, Kato N, Kunikane S, Uchiyama I, Tanaka M, Uehata T: Risk of adverse reproductive outcomes associated with proximity to municipal solid waste incinerators with high dioxin emission levels in Japan.  Epidemiol 2004, 14:83-93. PubMed Abstract | Publisher Full Text OpenURL

 

Vinceti M, Malagoli C, Teggi S, Fabbi S, Goldoni C, De Girolamo G, Ferrari P, Astolfi G, Rivieri F, Bergomi M: Adverse pregnancy outcomes in a population exposed to the emissions of a municipal waste incinerator. Sci Total Environ 2008, 407:116-21. PubMed Abstract | Publisher Full Text OpenURL

 

Lin CH, Li CY, Mao I-F: Birth outcomes of infants born in areas with elevated ambient exposure to incinerators generated PCDD/F. Environ Int 2006, 32:624-629. PubMed Abstract | Publisher Full Text OpenURL

 

EDXRF characterisation of elemental contents in PM2.5 in a medium-sized Swedish city dominated by a modern waste incineration plant† Innocent Joy Kwame Aboh1,‡, Dag Henriksson1,*, Jens Laursen2, Magnus Lundin1, Niels Pind3, Eva Selin Lindgren1, Tomas Wahnström1 Article first published online: 27 FEB 2007

 

Viel JF, Arveux P, Baverel J, Cahn JY: Soft-tissue sarcoma and non-Hodgkin's lymphoma clusters around a municipal solid waste incinerator with high dioxin emission levels. Am J Epidemiol 2000, 152:13-9. PubMed Abstract | Publisher Full Text OpenURL

 

Floret N, Mauny F, Challier B, Arveux P, Cahn JY, Viel JF: Dioxin emissions from a solid waste incinerator and risk of non-Hodgkin lymphoma. Epidemiology 2003, 14:392-8. PubMed Abstract | Publisher Full Text OpenURL

 

Viel JF, Daniau C, Goria S, Fabre P, de Crouy-Chanel P, Sauleau EA, Empereur-Bissonnet P: Risk for non Hodgkin's lymphoma in the vicinity of French municipal solid waste incinerators.

Environ Health 2008, 7:51. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text OpenURL

 

Comba P, Ascoli V, Belli S, Benedetti M, Gatti L, Ricci P, Tieghi A: Risk of soft tissue sarcomas and residence in the neighbourhood of an incinerator of industrial wastes.

Occup Environ Med 2003, 60:680-3. PubMed Abstract | Publisher Full Text | PubMed Central Full Text OpenURL

 

Zambon P, Ricci P, Bovo E, Casula A, Gattolin M, Fiore AR, Chiosi F, Guzzinati S: Sarcoma risk and dioxin emissions from incinerators and industrial plants: a population-based case-control study (Italy).

Environ Health 2007, 16:6-19. OpenURL

 

Cordier S, Lehébel A, Amar E, Anzivino-Viricel L, Hours M, Monfort C, Chevrier C, Chiron M, Robert-Gnansia E: Maternal residence near municipal waste incinerators and the risk of urinary tract birth defects.

Occup Environ Med 2010, 67:493-499. PubMed Abstract | Publisher Full Text OpenURL

 

Morselli L, Passarini F, Bartoli M: The environmental fate of heavy metals arising from a MSW incineration plant. Waste Manag 2002, 22:875-81. PubMed Abstract | Publisher Full Text OpenURL

 

Hu CW, Chao MR, Wu KY, Chang-Chien GP, Lee WY, Chang LW, Lee WS: Characterization of multiple airborne particulate metals in the surroundings of a municipal waste incinerator in Taiwan.

Atmos Environ 2003, 37:2845-2852. Publisher Full Text OpenURL