Health effects of residence near hazardous waste landfill sites: A review of epidemiologic literature

This review evaluates current epidemiologic literature on health effects in relation to residence near landfill sites. Increases in risk of adverse he alth effects (low birth weight, birth defects, certain types of cancers) ha ve been reported near individual landfill sites and in some multisite studi es, and although biases and confounding factors cannot be excluded as expla nations for these findings, they may indicate real risks associated with re sidence near certain landfill sites. A general weakness in the reviewed stu dies is the lack of direct exposure measurement. An increased prevalence of self-reported health symptoms such as fatigue, sleepiness, and headaches a mong residents near waste sites has consistently been reported in more than 10 of the reviewed papers. It is difficult to conclude whether these sympt oms are an effect of direct toxicologic action of chemicals present in wast e sites, an effect of stress and fears related to the waste site, or an eff ect of reporting bias. Although a substantial number of studies have been c onducted, risks to health from landfill sites are hard to quantify. There i s insufficient exposure information and effects of low-level environmental exposure in the general population are by their nature difficult to establi sh. More interdisciplinary research can improve levels of knowledge on risk s to human health of waste disposal in landfill sites. Research needs inclu de epidemiologic and toxicologic studies on individual chemicals and chemic al mixtures, well-designed single- and multisite landfill studies, developm ent of biomarkers, and research on risk perception and sociologic determina nts of ill health.