Health Outcomes Near Landfill Sites: Analyzing Congenital Anomalies, Stillbirth, Cancer, Slides of Public Health

Download Health Outcomes Near Landfill Sites: Analyzing Congenital Anomalies, Stillbirth, Cancer and more Slides Public Health in PDF only on Docsity! Health outcomes in populations living close to landfill sites docsity.com Modelling exposures from landfill sites: Methods and issues docsity.com Cc Aims  Primary objectives: to test the hypotheses that living near a landfill site is associated with excess risk of congenital anomalies, stillbirth, low birthweight or very low birthweight  Secondary objective: to test the hypothesis that living near a landfill site is associated with an excess risk of certain cancers docsity.com Industrial emissions Vehicle emissions Mineral dusts Solid waste Waste handling Atmospheric dispersion Animal/bird dispersion Drainage/ Leaching Runoff Gaseous emissions Aqueous emissions Soil contamination Dermal contact IngestionWater pollution Inhalation Prior land use Excavation Waste disposal Capping/ restoratio n After- use Plant uptake Click for larger picture docsity.com Analyses  Effects of socio-economic status and other explanatory variables  urban-rural differences  maternal age (for abdominal wall defects)  Landfill sites classified as receiving ‘special’ (hazardous) or ‘non-special’ waste  Periods before and after opening of landfill sites  Poisson regression  99% confidence intervals docsity.com DATA ISSUES Landfill data • Point locations only • Locational errors in point co-ordinates (< 1000 metres+) • Landfill sites evolve/change over time • Incomplete data on opening/closing dates, waste types • Inconsistencies in reported operating dates and waste types Health/denominator data • Reporting errors and inconsistencies • Changes in coding • Socio-economic data at ED level only (1991 census) • Postcodes = points to represent areas (<1 km + approximation in rural area) • Errors in reported postcodes (<100 metres +) docsity.com Nr of landfill sites per 5 x 5 km2 1 2 3 - 4 5 - 8 9 - 68 docsity.com docsity.com Enpronand poet och Cactuded postcodes: Usenpesed pntutes © Larch pikes With complete ciate (© Lanett stes wih mecornpiete dete | Exposed area Eaeuded oree Uneapoeet arm 19,196 landfill sites x 1.6 million postcodes x 16 years x 2 lag periods = 1011 buffering operations! docsity.com 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 0 - 9 10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90 - 100 Percentage Urban R at io : e xp os ed /u ne xp os ed docsity.com 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 < 0 0 - 1 1 - 2 2 - 3 3 - 4 4 - 5 5 - 6 6 - 7 > 7 Air quality index (NOx, PM10, SO2 and Benzene) R at io o f e xp os ed /u ne xp os ed p op ul at io n docsity.com Birth outcome Sites that opened during the study period Before opening During operation or after closure All congenital anomalies 1.02 (0.99-1.05) 1.00 (0.99-1.01) Neural tube defects 0.98 (0.82-1.16) 1.05 (0.99-1.10) Cardiovascular defects 0.92 (0.81-1.04) 0.92 (0.88-0.95) Hypospadias and epispadias 1.08 (0.98-1.19) 1.05 (1.02-1.09) Abdominal wall defects 1.24 (0.97-1.60) 1.06 (0.98-1.14) Hospital admissions Abdominal wall defects 2.26 (1.23-4.15) 1.12 (1.01-1.25) Surgical corrections Gastroschisis and exomphalos 1.33 (0.46-3.81) 1.24 (1.09-1.42) Hypospadias and epispadias 1.42 (0.94-2.16) 0.93 (0.86-1.00) docsity.com Results - stillbirth and birth weights Birth outcome All operating and closed sites, by waste type All wastes Special waste Non-special waste Stillbirths 1.00 (0.99 -1.02) 0.99 (0.95-1.03) 1.00 (0.99-1.02) Low birth weight 1.05 (1.05 -1.06) 1.05 (1.04-1.06) 1.06 (1.05-1.06) Very low birth weight 1.04 (1.03 -1.05) 1.03 (1.00-1.06) 1.04 (1.03-1.06) docsity.com Results - stillbirth and birth weights Birth outcome Sites that opened during the study period Before opening During operation or after closure Stillbirths 1.01 (0.96-1.06) 1.02 (1.00-1.03) Low birth weight 1.01 (0.99-1.02) 1.07 (1.062-1.072) Very low birth weight 0.98 (0.94-1.02) 1.04 (1.03-1.05) docsity.com Discussion  The largest study to report on the possible association between residence near landfill and health outcomes  Deprivation adjustment may incompletely account for individual-level characteristics associated with risk of congenital anomalies and cancers  Need to take account of the complexity of the system, and data limitations, in using GIS for exposure assessment docsity.com  80% of population live within 2km of a landfill site  No causal mechanisms currently available to explain our findings  Alternative explanations possible  data artefacts  residual confounding  Further understanding of the potential toxicity of landfill emissions and possible exposure pathways is needed in order to help interpret the epidemiological findings Conclusion docsity.com