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1. Our study shows a peak-decline in risk with distance from the municipal solid waste incinerators for infant deaths and infant deaths with all congenital malformations combined.”

J Epidemiol. 2004 May;14(3):83-93.

Risk of adverse reproductive outcomes associated with proximity to municipal solid waste incinerators with high dioxin emission levels in Japan.
Tango T, Fujita T, Tanihata T, Minowa M, Doi Y, Kato N, Kunikane S, Uchiyama I, Tanaka M, Uehata T.
Department of Technology Assessment and Biostatistics, National Institute of Public Health, Wako, Saitama, Japan.
BACKGROUND: Great public concern about health effects of dioxins emitted from municipal solid waste incinerators has increased in Japan. This paper investigates the association of adverse reproductive outcomes with maternal residential proximity to municipal solid waste incinerators. METHODS: The association of adverse reproductive outcomes with mothers living within 10 km from 63 municipal solid waste incinerators with high dioxin emission levels (above 80 ng international toxic equivalents TEQ/m3) in Japan was examined. The numbers of observed cases were compared with the expected numbers calculated from national rates adjusted regionally. Observed/expected ratios were tested for decline in risk or peak-decline in risk with distance up to 10 km. RESULTS: In the study area within 10 km from the 63 municipal solid waste incinerators in 1997-1998, 225,215 live births, 3,387 fetal deaths, and 835 infant deaths were confirmed. None of the reproductive outcomes studied here showed statistically significant excess within 2 km from the incinerators. However, a statistically significant peak-decline in risk with distance from the incinerators up to 10 km was found for infant deaths (p=0.023) and infant deaths with all congenital malformations combined (p=0.047), where a “peak” is detected around 1-2 km. CONCLUSION: Our study shows a peak-decline in risk with distance from the municipal solid waste incinerators for infant deaths and infant deaths with all congenital malformations combined. However, due to the lack of detailed exposure information to dioxins around the incinerators, the observed trend in risk should be interpreted cautiously and there is a need for further investigation to accumulate good evidence regarding the reproductive health effects of waste incinerator exposure.

Epidemiology:Volume 18(5) SupplSeptember 2007p S125
Infant Mortality in 27 Italian Municipalities With Solid Waste Incinerators (1981-2001)
[ISEE 2007 CONFERENCE ABSTRACTS SUPPLEMENT: Abstracts]
Bianchi, F; Minichilli, F; Pierini, A; Linzalone, N; Rial, M
CNR National Research Council, Institute of Clinical Physiology, Epidemiology Unit, Pisa, Italy.
ISEE-546
Objective:
Recently, an epidemiological study was carried out to verify the hypothesis of an association between infant mortality and residence near incinerators (Tango, 2004). Limits to the study were represented by rarity of death events and heterogeneity of infant mortality. However, availability of mortality data and of an incinerator database has allowed performing an exploratory investigation.
Materials and Methods:
Infant mortality was investigated over 2 periods (1981-1991, 1992-2001) in 27 municipalities with active incinerators in the 1981-2001 time frame. For each municipality the observed/expected ratio (O/E) was obtained. To calculate expected mortality, municipalities were included inside a 50-km radius circle. A pooled estimation of the O/E ratio obtained by meta-analysis was performed for the 27 municipalities. A multiple metaregression model was used to analyze the study, activity and latency periods, the incinerator burning capacity, the number of resident newborns, the residence density, the deprivation index.
Results:
Mortality analysis was performed on resident population for the whole period on approximately 250,000 infants under 1 year of age. In the overall period 1673 cases of infant mortality were observed. The pooled estimation of the O/E ratio resulted 1.04 (CI 95%: 0.97-1.11) for total cases. The multiple metaregression model showed the incinerator burning capacity as a statistically significant factor (P=0.011). Municipalities having incinerators with a burning capacity >50,000 ton/year showed a higher mortality excess (O/E=1.11, CI 95% 1.03-1.20) compared to municipalities with incinerators of <50,000 ton/year (O/E=0.95; CI 95%: 0.86-1.04).
Conclusions:
Findings call for further insight by analytic epidemiologic studies to confirm possible association between infant mortality and living near incinerators.
© 2007 Lippincott Williams & Wilkins, Inc.

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