Issue date: 10 July 2003

ISSUE DATE: 10/07/03

If you live near an incinerator, are you more likely to get cancer? Is there an increase in birth defects around landfill sites? Researchers at the University of the West of England set out to answer these questions in an article published in ‘Management of Environmental Quality: An International Journal’.

They conclude that, despite the hundreds of studies on the health impacts of different waste management practices, scientists cannot answer these questions with any certainty. But lack of conclusive evidence is not the same as saying that there are no health risks. Decisions about how we as a society manage our waste have to be based on our many competing values and our different ways of managing uncertainty.

The article is based on a report produced by the Unit of Applied Epidemiology, Faculty of Applied Sciences at the University of the West of England on behalf of the South West Public Health Observatory.

The report is a review of the literature and evaluation of the evidence of the health impacts of incineration, composting, land spreading sewage sludge and sewage discharges. A protocol for making judgements about the strength and reliability of the evidence was applied using an algorithm with defined criteria. Possible judgements were "convincing", "probable", "possible" or "insufficient".

Based on the evidence currently available, the review concluded that there was ‘insufficient’ evidence to say that, incineration, landfill, or landspreading sewage sludge were the cause of any adverse health effects. Living near a centralised composing facility was not shown to cause adverse health effects although working within such a facility could ‘possibly’ cause health problems. It is also ‘probable’ that working in sewage treatment plants causes stomach problems and other symptoms. The only clear cut case of cause and effect was that bathing in water which was contaminated by sewage would cause gastrointestinal problems.

Speaking about this report Lisa Saffron, the author of the report, says, “This review is timely. As a society we produce vast quantities of waste and need to find methods of disposing of it which don’t cause health problems. Our study shows that we need more hypothesis-testing studies to confirm the links shown in the many hypothesis-generating studies that have been published. But to carry out hypothesis-testing studies, we need better scientific methods which accurately assess exposure levels to different substances and we need a better understanding of the effects those substances have. This will help us to make accurate judgements about the best methods to use and where to place them.”


Editor’s notes

The human health impact of waste management practices –A review of the literature and an evaluation of the evidence – by Lisa Saffron, Lorenzo Giusti and Derek Pheby is published in Management of Environmental Quality: An International Journal Vol.14 no 2, 2003 pp 191 – 213.

The article is based on a report prepared for the south West Public Health Obervatory. The full report can be found at:

The Unit of Applied Epidemiology is headed by Dr Dr Derek Pheby BSc MBBS Mphil LLM MFPHM. He is an Epidemiologist specialising in Cancer and Medicine Informatics.

Epidemiology – is the study of patterns of disease in humans using scientific and statistical data.

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