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

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.

[1]  David W. Hosmer,et al.  Applied Logistic Regression , 1991 .

[2]  L. Kaminsky,et al.  Teratology of 2,3,7,8-tetrachlorodibenzo-p-dioxin in a complex environmental mixture from the love canal. , 1989, Fundamental and applied toxicology : official journal of the Society of Toxicology.

[3]  L S Birnbaum,et al.  A critical review of the developmental toxicity and teratogenicity of 2,3,7,8-tetrachlorodibenzo-p-dioxin: recent advances toward understanding the mechanism. , 1990, Teratology.

[4]  L. Birnbaum,et al.  Effects of TCDD on embryonic ureteric epithelial EGF receptor expression and cell proliferation. , 1990, Teratology.

[5]  A B Lawson,et al.  Low sex ratios of births in areas at risk from air pollution from incinerators, as shown by geographical analysis and 3-dimensional mapping. , 1992, International journal of epidemiology.

[6]  M. Stenbeck,et al.  Urinary tract. , 1995, Acta oncologica.

[7]  H. Rydhstroem.  No obvious spatial clustering of twin births in Sweden between 1973 and 1990. , 1998, Environmental research.

[8]  S. Yufit.  Role of electronic factors in the formation of a standard, quasi-stable mixture of toxic polychlorinated dibenzo-para-dioxins and polychlorinated dibenzofurans , 1999 .

[9]  J. Koppe,et al.  Open chemical combustions resulting in a local increased incidence of orofacial clefts. , 2000, Chemosphere.

[10]  Patrick Arveux,et al.  Dioxin Emissions from a Solid Waste Incinerator and Risk of Non-Hodgkin Lymphoma , 2003, Epidemiology.

[11]  L. Parker,et al.  Adverse pregnancy outcomes around incinerators and crematoriums in Cumbria, north west England, 1956–93 , 2003, Journal of epidemiology and community health.

[12]  T. Tango,et al.  Risk of Adverse Reproductive Outcomes Associated with Proximity to Municipal Solid Waste Incinerators with High Dioxin Emission Levels in Japan , 2004, Journal of epidemiology.

[13]  M. J. Nicholls,et al.  Adverse pregnancy outcomes around incinerators and crematoriums , 2003, Journal of epidemiology and community health.

[14]  C. Chevrier,et al.  Risk of congenital anomalies in the vicinity of municipal solid waste incinerators. , 2004, Occupational and environmental medicine.

[15]  I. Mao,et al.  Birth outcomes of infants born in areas with elevated ambient exposure to incinerator generated PCDD/Fs. , 2006, Environment international.

[16]  H. Su,et al.  Patterns of serum PCDD/Fs affected by vegetarian regime and consumption of local food for residents living near municipal waste incinerators from Taiwan. , 2006, Environment international.

[17]  Yoon-Seok Chang,et al.  Influence of a municipal solid waste incinerator on ambient air and soil PCDD/Fs levels. , 2006, Chemosphere.

[18]  Roger E. Stevenson,et al.  Human Malformations and Related Anomalies , 2006 .

[19]  Peter Adriaens,et al.  Geostatistical modeling of the spatial distribution of soil dioxin in the vicinity of an incinerator. 2. Verification and calibration study. , 2008, Environmental science & technology.

[20]  J. Viel,et al.  Risk for non Hodgkin’s lymphoma in the vicinity of French municipal solid waste incinerators , 2008, Environmental health : a global access science source.

[21]  S. Deguen,et al.  A small-area index of socioeconomic deprivation to capture health inequalities in France. , 2008, Social science & medicine.

[22]  Joint Fao,et al.  Joint FAO/WHO Expert Committee on Food Additives Seventy-second meeting: Summary and conclusions , 2010 .

[23]  A. Zuckerman,et al.  IARC Monographs on the Evaluation of Carcinogenic Risks to Humans , 1995, IARC monographs on the evaluation of carcinogenic risks to humans.