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January 10th, 2012:

The EK Yeoh annual Oration, Hong Kong College of Community Medicine, 27 November 2011, Anthony J Hedley

Powerpoint slide show:

Dioxin concentrations in the blood of workers at municipal waste incinerators.

1. A Schecter,

2. O Päpke,

3. M Ball,

4. A Lis,

5. P Brandt-Rauf

+ Author Affiliations

1.      Department of Preventive Medicine, State University of New York, Binghamton 13903, USA.


OBJECTIVES–Increased concentrations of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzo-furans (PCDFs) in pooled blood samples from workers at municipal waste incinerators have been reported. This study was undertaken to confirm these results in individual blood samples from potentially exposed and unexposed workers at municipal waste incinerators compared with matched unexposed controls and compared with concentrations in the slag and fly ash from the municipal waste incinerators. METHODS–Concentrations of PCDDs and PCDFs were determined in the blood of 10 workers from an old municipal waste incinerator without adequate pollution controls, 11 workers from a newer incinerator with modern pollution controls, and 25 controls from the general population group matched for age (+/- 10 years), sex, and race, and in the slag and fly ash from the older incinerator. RESULTS–Significant increases of certain PCDDs and PCDFs were found in the blood of the workers from the older incinerator compared with the controls as follows: octaCDD (1051 (438) v 637 (344), P < 0.001), hexaCDF (52.3 (28.7) v 30.2 (18.2), P < 0.01), heptaCDF (43.9 (30.4) v 22.7 (12.4), P < 0.001), total PCDDs (1262 (484) v 825 (454), P < 0.001), total PCDFs (133.0 (68.1) v 93.7 (36.7), P < 0.05), and total PCDD/Fs (1395 (537) v 918 (437), P < 0.001). The workers from the older incinerator with the greatest exposure were found to have the most significant increases of the blood PCDDs and PCDFs, and the pattern of increased PCDD and PCDF congeners in the blood corresponded to the pattern in the incinerator slag and ash. No significant differences were found between the blood concentrations of the workers at the newer incinerator and the controls. CONCLUSION–Occupational exposure to slag and fly ash from municipal waste incinerators may increase the blood concentrations of PCDDs and PCDFs. Modern pollution control technology in new incinerators may be able to minimise potential exposure to slag and fly ash and thus the absorption of PCDDs and PCDFs from this source.

Articles citing this article

Does long term residency near industry have an impact on the body burden of polychlorinated dibenzo-p-dioxins, furans, and polychlorinated biphenyls in older women? Occup. Environ. Med. 2005;62:895-901

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Associations between oxidative stress levels and total duration of engagement in jobs with exposure to fly ash among workers at municipal solid waste incinerators Mutagenesis 2003;18:533-537

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Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in serum samples of workers at intermittently burning municipal waste incinerators in Japan Occup. Environ. Med. 2002;59:362-368

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In Utero and Lactational Exposure to 2,3,7,8-Tetrachlorodibenzo-p-Dioxin and 2,3,4,7,8-Pentachlorodibenzofuran Reduces Growth and Disrupts Reproductive Parameters in Female Rats Biol. Reprod.2002;66:1621-1626

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Polychlorinated dibenzo-p-dioxin and dibenzofuran concentrations in the serum samples of workers at continuously burning municipal waste incinerators in Japan Occup. Environ. Med. 2000;57:204-210

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This Article

Maternal residence near municipal waste incinerators and the risk of urinary tract birth defects

1. Sylvaine Cordier1,

2. Anne Lehébel1,

3. Emmanuelle Amar2,

4. Lucie Anzivino-Viricel3,

5. Martine Hours3,

6. Christine Monfort1,

7. Cécile Chevrier1,

8. Mireille Chiron3,

9. Elisabeth Robert-Gnansia2

+ Author Affiliations

1.      1INSERM U625; IFR-140; Université Rennes I, Campus de Beaulieu, Rennes, France
2.      2Registre des Malformations en Rhône-Alpes, Lyon, France
3.      3UMRESTTE UMR T 9405; Inrets; Université Lyon I; InVS; Bron, France

1.      Correspondence to Sylvaine Cordier, INSERM, U625, Université Rennes I, Campus de Beaulieu, 35 042 Rennes Cedex, France;

Received 8 October 2009

Revised 5 February 2010

Accepted 18 February 2010


Objectives Waste incineration releases a mixture of chemicals with high embryotoxic potential, including heavy metals and dioxins/furans, into the atmosphere. In a previous ecological study we found an association between the risk of urinary tract birth defects and residence in the vicinity of municipal solid waste incinerators (MSWIs). The objective of the present study was to specifically test this association.

Methods A population-based case–control study compared 304 infants with urinary tract birth defects diagnosed in the Rhône-Alpes region (2001–2003) with a random sample of 226 population controls frequency-matched for infant sex and year and district of birth. Exposure to dioxins in early pregnancy at the place of residence, used as a tracer of the mixture released by 21 active waste incinerators, was predicted with second-generation Gaussian modelling (ADMS3 software). Other industrial emissions of dioxins, population density and neighbourhood deprivation were also assessed. Individual risk factors including consumption of local food were obtained by interviews with 62% of the case and all control families.

Results Risk was increased for mothers exposed to dioxins above the median at the beginning of pregnancy (OR 2.95, 95% CI 1.47 to 5.92 for dioxin deposits). When only interviewed cases were considered, risk estimates decreased mainly because the non-interviewed cases were more likely to live in exposed residential environments (OR 2.05, 95% CI 0.92 to 4.57). The results suggest that consumption of local food modifies this risk.

Conclusions This study confirms our previous observation of a link between the risk of urinary tract birth defects and exposure to MSWI emissions in early pregnancy and illustrates the effect of participation bias on risk estimates of environmental health impacts.


Linked articles 054635.

Funding This study was funded by grants from ADEME (Agence de l’Environnement et de la Maitrise de l’Energie) and from AFSSET (Agence Française de Sécurité Sanitaire de l’Environnement et du Travail) in France.

Competing interests None.

Ethics approval This study was conducted with the approval of the Commission Nationale sur l’Informatique et les Libertés (CNIL) and the Comité Consultatif sur le Traitement de l’Information en Matière de Recherche (CCTIRS).

Provenance and peer review Not commissioned; externally peer reviewed.

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Commentary: Incinerators, birth defects and the legacy of Thomas Bayes

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Occup Environ Med 2010;67:433-434 doi:10.1136/oem.2009.054635

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Green group hits at consultation on third runway

South China Morning Post – 10 Jan 2012

Environmentalists say public has been misled but survey designers reject the allegations

A green group has accused the University of Hong Kong and the Airport Authority of misleading the public into supporting the building of a third runway at Chek Lap Kok with a consultation full of loaded – and leading – questions.

Green Sense chief Roy Tam Hoi-pong said yesterday the survey – released on December 29 – which found that more than 70 per cent of respondents supported the expansion of Chek Lap Kok airport, was “full of problems” and should be regarded with scepticism.

For instance, he said, the heading “Contribution of the airport” appeared over the survey’s first question, which asked respondents if they agreed the airport had provided high-quality services, and created employment. But the heading was improper because the word “contribution” implied a positive result, he said. Benson Wong Wai-kwok, assistant professor of politics at Baptist University, told yesterday’s press conference: “The word `use’ would have been a lot more suitable in the survey.” Another criticism was that the survey put too much emphasis on the extra runway’s economic benefits and too little on its environmental impact.

Tam accused the University of Hong Kong’s Social Sciences Research Centre, which was commissioned by the authority to carry out the survey, of pandering to the government and sacrificing academic integrity for money.

Professor John Bacon-Shone, the centre’s director, rejected the accusations and said the green group was not competent to criticise the design of the survey “because we’re the experts and they’re not”.

“What they said is untrue. It’s easy to criticise but it’s unfair to do it without having read the full report,” he said. “Only those who haven’t read the report could have reached the conclusion [the study was biased].”

Secretary for Transport and Housing Eva Cheng said last month there was overwhelming public support for building the HK$136.2 billion third runway. In a government commissioned study, 73 per cent of nearly 24,000 respondents backed the project. The authority says the third runway will bring HK$912 billion in economic benefits in the 50 years to 2061. It says the expansion is essential for coping with growth in the volume of air passengers and cargo, which are expected to double from current levels by 2030.

A spokesman for the Transport and Housing Bureau said the government was carefully considering the recommendation – the finding of support for a new runway – with a view to deciding on the next stage of work. A spokesman for the authority said it thought the report reflected views of the public and stakeholders.