Health effects of waste incineration: a review of epidemiologic studies.

There is an increasing trend toward using incineration to solve the problem of waste management; thus, there are concerns about the potential health impact of waste incineration. A critical review of epidemiologic studies will enhance understanding of the potential health effects of waste incineration and will provide important information regarding what needs to be investigated further. This study reviews the epidemiologic research on the potential health impact of waste incineration. Previous studies are discussed and presented according to their study population, incinerator workers or community residents, and health end points. Several studies showed significant associations between waste incineration and lower male-to-female ratio, twinning, lung cancer, laryngeal cancer, ischemic heart disease, urinary mutagens and promutagens, or blood levels of certain organic compounds and heavy metals. Other studies found no significant effects on respiratory symptoms, pulmonary function, twinning, cleft lip and palate, lung cancer, laryngeal cancer, or esophageal cancer. In conclusion, these epidemiologic studies consistently observed higher body levels of some organic chemicals and heavy metals, and no effects on respiratory symptoms or pulmonary function. The findings for cancer and reproductive outcomes were inconsistent. More hypothesis-testing epidemiologic studies are needed to investigate the potential health effects of waste incineration on incinerator workers and community residents.