Academic journal article Perspectives in Public Health

A Systematic Critical Review of Epidemiological Studies on Public Health Concerns of Municipal Solid Waste Handling

Academic journal article Perspectives in Public Health

A Systematic Critical Review of Epidemiological Studies on Public Health Concerns of Municipal Solid Waste Handling

Article excerpt

Introduction

Several epidemiological studies conducted in both developed and developing countries have suggested that municipal solid waste management is a risky and life-threatening activity for populations residing near landfills and waste incinerators, for municipal waste workers and for informal waste recyclers.

A central theme in literature reviewed in this article is that the major health problems of populations residing near landfills and incinerators are cancer, low birth weight, congenital anomalies and Down's syndrome and for municipal waste workers and recyclers the health problems are musculoskeletal disorders, injuries, respiratory, gastro-intestinal and skin conditions. Unfortunately, these epidemiological studies have essentially neglected several critical aspects on the human health risks of municipal solid waste handling.

Noteworthy, all the studies reviewed in this article on cancer risks on populations residing near landfill sites or former sites merely suggest either elevated or no risk, but none has conclusively identified a causal or non-causal relationship between cancers and landfills for such populations.

Equally important, a major limitation of some studies on cancer, low birth weight and congenital anomalies in populations near municipal landfills is their failure to account for potential sources of error like misclassification of waste sites, operating dates of landfills and non-examination of possible effects of multiple or differential exposures from different sites.[1]-[3] However, on the positive, it is noteworthy that, despite these shortcomings, some of these studies were very large and had high power.[1],[2],[4]

Some studies of residents potentially exposed to landfills reported an elevated risk of cancers of the pancreas and liver[2] , kidneys[2],[5] and bladder.[5] Additionally, Gensburg et al .[5] reported higher bladder cancers in exposed children. With regard to the popular Love Canal landfill, Gensburg et al.[5] concur that the role of exposure to the landfill is unclear, given limitations such as a relatively small and incomplete study cohort, imprecise measurements and the exclusion of cancers diagnosed before 1979.

Noteworthy, most studies on municipal waste workers have regrettably negated performing exposure assessments for waste handlers. Epidemiological studies with exposure classification based on field measurement are needed, both to further identify high-risk work conditions and to provide a detailed basis for establishment of occupational exposure limits for mechanical and energetic load particularly in relation to pulling and tilting of containers.[6] Evidently, non-conduction of exposure assessments in this body of research does not allow for strong evidence-based conclusions to be drawn regarding exposure levels and associated health effects of municipal solid waste handling. There is need for an appropriate risk assessment that informs local government structures and relevant sectors on the health risks associated with different waste management technologies.

Finally, while most studies on waste handling have revealed abundant evidence on respiratory complaints among waste handlers, a lot of research needs to be done on other associated health problems of waste handling. While moderate evidence is available to support that waste collection increases the risk of respiratory complaints, there is limited evidence on gastro-intestinal complaints and hearing loss.[7] This suggests that research on occupational health risks of waste handlers has not been exhaustive but is rather limited in its coverage of occupational health risks of municipal solid waste handling. There is therefore a paucity of information on other occupational health problems of waste handling.

Review

Method

The PubMed and MEDLINE computerised literature searches were employed to identify the relevant papers using the keywords solid waste, waste management, health risks, recycling, landfills and incinerators. …

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