1. NEW APPROACHES TO IDENTIFY HAZARDS ASSOCIATED WITH INDUSTRIAL SITES:
A PRIORI ESTIMATION AND PROSPECTIVE POPULATION MONITORING
Contiero P1, Tagliabue G2, Davoli E3, Fattore E3, Borgini A1, Tittarelli A2, Bertoldi M1, Fabiano S2, Maghini A2, Codazzi T2 1 IRCCS Istituto Nazionale Tumori, Environmental Epidemiology Unit, Milan 2 IRCCS Istituto Nazionale Tumori, Cancer Registry Unit, Milan 3 IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan
OBJECTIVES.
Environmental epidemiologists mainly perform retrospective studies to identify health hazards due to chemical substances whose effects become evident some years after beginning exposure. Although this approach has led to many useful discoveries, we believe two new approaches are necessary, including: (a) estimation of population hazards before the building of new industrial sites, using existing data on known dangerous substances; and (b) setting up prospective cohort studies on exposed populations to rapidly detect hazards as they arise. Our working group has designed a study to evaluate the health hazards of a landfill site as construction starts.
METHODS.
A systematic literature review was conducted to identify known landfill hazards, searching for disease conditions associated with landfills for which evidence of a causal effect is strong and also for disease conditions more weakly associated with exposure to landfill. Various methods to estimate attributable risks were assessed to identify a priori risks before starting the landfill. The prospective study has been designed and methodology limitations have been assessed.
RESULTS.
The cohort of exposed people was defined as those resident up to 3 km from the landfill. Three reference cohorts were also defined. The WHO AirQ program was chosen to estimate a priori population attributable risks. Adverse reproductive outcomes (birth defects, low birth weight, premature births, miscarriages) and other chronic and acute disease (cancer, cardiovascular diseases, respiratory diseases, and mortality) will be monitored in the prospective study. Effects will be monitored by using disease registries, hospital discharge data, mortality records, pathology reports, outpatient data and pharmacological databases. We are assessing people residence comparing data from health sources to municipality data. The limited size of the population living near the landfill is a potential limitation.
Tab. 1 – A systematic review of the evidence of an increased risk of adverse birth outcomes in populations living in the vicinity of landfill waste disposal sites.
DISCUSSION.
Because landfill hazards are associated with many different kinds of organic or inorganic waste and also with waste transportation, identification of risks may be difficult. For this reason it is mandatory to consider a wide spectrum of diseases.
CONCLUSIONS.
A considerable work is required to monitor all possible landfill hazards but is feasible making use of current information sources.
source: Patrick Saunders, Health Protection Agency, Chemical Hazards and Poisons Division, University of Birmingham Science Parks