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Health effects of industrial incinerators in England

Author: Nicola Reeve
Institution: Lancaster University
Type of case study: Research

About the research

Research specific to waste incinerators has provided mixed evidence for the effects of proximity to incinerators on health. Older incinerators have been associated with increased incidence and mortality from selected cancers, while more recent reports show little association. Despite this, the effect of incinerator emissions remains a public health issue.

This study assesses whether living close to industrial incinerators in England is associated with increased risk of cancer incidence and mortality. It analyses five circular regions in England with industrial incinerators (each with a radius of 10 kilometres) along with five matched control regions, for the period 1998 to 2008. All cases of diseases of interest within the circular areas were considered. The health outcome measures included incidence of childhood cancer; childhood and adult leukaemia; liver cancer; lung cancer; non-Hodgkin’s lymphoma; all-cause mortality; infant mortality and liver cancer mortality.

The results show no evidence of elevated risk for those living in areas containing an incinerator compared to those living in matched areas without an incinerator. Moreover, within areas, there is little evidence of an increase in risk for those living in close proximity to an incinerator compared to those living further away.

Methodology

The researchers considered five regions with industrial incinerators in England (case regions), compared with five matched control regions, from 1998 to 2008. Spatial and temporal trends in annual health outcome data within each circular region are analysed.

Initially, the researchers used a Poisson log-linear model including age-standardised expected count as an offset and covariates for case-control status, matched pair and deprivation, fitted to circle level data to investigate temporal trends. They later modelled data at a finer resolution – at the Lower Super Output Area (LSOA) level. A Poisson log-linear model was then used, as previously, with additional covariates for the effect of distance from the incinerator in case areas included as a multiplicative factor.

Population data was used in the calculation of the age-standardised expected count.

Publications

Reeve, N.F., Fanshawe, T. R., Keegan, T.J., Stewart, A.G. and Diggle, P.J. (2013) ‘Spatial analysis of health effects of large industrial incinerators in England, 1998–2008: A study using matched case–control areas’, BMJ Open. doi: 10.1136/ bmjopen-2012-001