Systematic review of epidemiological studies on health effects associated with management of solid waste

Table 1 Summary of the overall epidemiologic evidence on municipal solid waste disposal: landfills and incinerators.

HEALTH EFFECT	LEVEL OF EVIDENCE
	LANDFILLS	INCINERATORS
All cancer	Inadequate	Limited
Stomach cancer	Inadequate	Limited
Colorectal cancer	Inadequate	Limited
Liver cancer	Inadequate	Limited
Larynx cancer	Inadequate	Inadequate
Lung cancer	Inadequate	Limited
Soft tissue sarcoma	Inadequate	Limited
Kidney cancer	Inadequate	Inadequate
Bladder cancer	Inadequate	Inadequate
Non Hodgkin's lymphoma	Inadequate	Limited
Childhood cancer	Inadequate	Inadequate
Total birth defects	Limited	Inadequate
Neural tube defects	Limited	Inadequate
Orofacial birth defects	Inadequate	Limited
Genitourinary birth defects	Limited*	Limited**
Abdominal wall defects	Inadequate	Inadequate
Gastrointestinal birth defects§	Inadequate	Inadequate
Low birth weight	Limited	Inadequate
Respiratory diseases or symptoms	Inadequate	Inadequate

"Inadequate": available studies are of insufficient quality, consistency, or statistical power to decide the presence or absence of a causal association. "Limited": a positive association has been observed between exposure and disease for which a causal interpretation is considered to be credible, but chance, bias, or confounding could not be ruled out with reasonable confidence.
* Hypospadias and epispadias
** Renal dysplasia
§ The original estimates were given for "surgical corrections of gastroschisis and exomphalos"

ISSN: 1476-069X