The Health Effects of Waste Incinerators

4th Report of the British Society for Ecological Medicine

Second Edition
June 200

Moderators! "r Jere#y Tho#pson and "r Honor $nthony

Preface to Second Edition Since the publication of this report, important new data has been published strengthening the evidence that fine particulate pollution plays an important role in both cardiovascular and cerebrovascular mortality (see section 3.1) and demonstrating that the danger is greater than previously realised. More data has also been released on the dangers to health of ultrafine particulates and about the risks of other pollutants released from incinerators (see section 3. ). !ith each publication the ha"ards of incineration are becoming more obvious and more difficult to ignore. #n the light of this data and the discussion provoked by our report, we have e$tended several sections. #n particular, the section on alternative waste technologies (section %) has been e$tensively revised and enlarged, as has that on the costs of

incineration (section &), the problems of ash (&. ), radioactivity (section &.'), and the sections on monitoring (section 11), and risk assessment (section 1(). !e also highlight recent research which has demonstrated the very high releases of dio$in that arise during start)up and shut) down of incinerators (section 11). *his is especially worrying as most assumptions about the safety of modern incinerators are based only on emissions which occur during standard operating conditions. +f e,ual concern is the likelihood that these dangerously high emissions will not be detected by present monitoring systems for dio$ins.

Foreword to the 1st -dition

from Professor C. V. Howard. MB. ChB. PhD. FRCPath.

*he authors are to be congratulated on producing this report. *he reader will soon understand that to come to a comprehensive understanding of the health problems associated with incineration it is essential to become ac,uainted with a large number of different disciplines ranging from aerosol physics to endocrine disruption to long range transport of pollutants. #n most medical schools, to this day, virtually nothing is routinely taught to e,uip the medical graduate to approach these problems. *his has to change. !e need the medical profession to be educated to health conse,uences associated with current environmental degredation. *here are no certainties in pinning specific health effects on incineration. the report makes that clear. /owever this is largely because of the comple$ity of e$posure of the human race to many influences. *he fact that 0proof0 of cause and effect are hard to come by is the main defence used by those who prefer the status quo. /owever the weight of evidence, collected within this report, is sufficient in the authors0 opinion to call for the phasing out of incineration as a way of dealing with our waste. # agree with that. *here is also the ,uestion of sustainability. !aste destroyed in an incinerator will be replaced. *hat involves new raw materials, manufacture, transport, packaging etc etc. #n contrast, reduction, reuse and recycling represent a win) win strategy. #t has been shown in a number of different cities that high levels of diversion of waste (1234) can be achieved relatively ,uickly. !hen that happens, there is not very much left to burn, but a number of the products left will be problematic, for e$ample 567. #ncineration, an end of pipe approach, sends the message 08o problem, we have a solution for disposal of your product, carry on business as usual9. !hat should happen is a 0front end solution0. Society should be able to say 0:our product is unsustainable and a health ha"ard ; stop making it<. #ncineration destroys accountability and this encourages industries to go on making products that lead to problematic to$ic wastes. +nce the waste has been reduced to ash who can say who made what= *he past 1'3 years has seen a progressive 0to$ification0 of the waste stream with heavy metals, radionuclides and synthetic halogenated organic molecules. #t is time to start reversing that trend. !e won0t achieve that while we continue to incinerate waste. 6yvyan /oward >ecember (33'

5rofessor of ?ioimaging, 7entre for Molecular ?iosciences, @niversity of @lster, 7romore Aoad, 7oleraine, 7o. Bondonderry ?*'( 1SC

&

Contents
Executive Summary 1. Introduction 2. Emissions from Incinerators and other Combustion Sources
2.1 Particulates 2.2 Heavy metals 2.3 Nitro en oxides 2.! "r anic #ollutants

3. Health Effects of Pollutants

3.1 Particulates 3.2 Heavy metals 3.3 Nitro en oxides and "$one 3.! "r anic toxicants 3.% Effects on enetic material 3.& Effects on the immune system 3.' Syner istic effects

!. Increased (orbidity and (ortality near Incinerators

!.1 Cancer !.2 )irth defects !.3 Ischemic heart disease !.! Comment

%. *isease Incidence and Pollution

%.1 Cancer %.2 Neurolo ical disease %.3 (ental diseases %.! +iolence and crime

&. Hi h ,is- .rou#s

&.1 &.2 &.3 &.! /he foetus /he breast0fed infant Children /he chemically sensitive

'. Past (ista-es and the Precautionary Princi#le

'.1 /he Precautionary Princi#le '.2 1earnin from #ast mista-es

2. 3lternative 4aste /echnolo ies

2.1 ,e0cyclin 5 ,e0use and Com#ostin 2.2 Producin 1ess 4aste 2.3 6ero 4aste 2.! /he Problem of Plastics 2.% 3naerobic *i estion of "r anic (atter 2.& (echanical )iolo ical /reatment 7()/8 2.' 3dvanced /hermal /echnolo ies 73//8 and Plasma .asification 2.2 .reenhouse .ases

9. /he Costs of Incineration

9.1 /he Costs of Incineration 9.2 Health Costs of Incineration 9.3 :inancial .ains from ,educin Pollution 4

9.! "ther Studies of the Health Costs of Pollution

1;. "ther Considerations of Im#ortance

1;.1 1;.2 1;.3 1;.! /he Problem of 3sh Incinerators and ,adioactivity S#read of Pollutants Cement <ilns

11. (onitorin 12. ,is- 3ssessment 13. Public ,i hts and International /reaties 1!. Conclusions 1%. ,ecommendations ,eferences

'

Executive Summary
(arge studies ha)e sho*n higher rates of adult and childhood cancer and also +irth defects around #unicipal *aste incinerators! the results are consistent *ith the associations +eing causal, $ nu#+er of s#aller epide#iological studies support this interpretation and suggest that the range of illnesses produced +y incinerators #ay +e #uch *ider, Incinerator e#issions are a #a-or source of fine particulates. of to/ic #etals and of #ore than 200 organic che#icals. including 0no*n carcinogens. #utagens. and hor#one disrupters, E#issions also contain other unidentified co#pounds *hose potential for har# is as yet un0no*n. as *as once the case *ith dio/ins, Since the nature of *aste is continually changing. so is the che#ical nature of the incinerator e#issions and therefore the potential for ad)erse health effects, 1resent safety #easures are designed to a)oid acute to/ic effects in the i##ediate neigh+ourhood. +ut ignore the fact that #any of the pollutants +ioaccu#ulate. enter the food chain and can cause chronic illnesses o)er ti#e and o)er a #uch *ider geographical area, 2o official atte#pts ha)e +een #ade to assess the effects of e#issions on long3ter# health, Incinerators produce +otto# and fly ash *hich a#ount to 30-50% by volume of the original waste 4if co#pacted5. and re6uire transportation to landfill sites, $+ate#ent e6uip#ent in #odern incinerators #erely transfers the to/ic load. nota+ly that of dio/ins and hea)y #etals. fro# air+orne e#issions to the fly ash, This fly ash is light. readily *ind+orne and #ostly of lo* particle si7e, It represents a considera+le and poorly understood health ha7ard, T*o large cohort studies in $#erica ha)e sho*n that fine 41M 2,'5 particulate air pollution causes increases in all3cause #ortality. cardio)ascular #ortality and #ortality fro# lung cancer. after ad-ust#ent for other factors, $ #ore recent. *ell3designed study of #or+idity and #ortality in post#enopausal *o#en has confir#ed this. sho*ing a 89: increase in cardio)ascular and &: increase in cere+ro)ascular #ortality in *o#en e/posed to higher le)els of fine particulates, These fine particulates are pri#arily produced +y co#+ustion processes and are e#itted in large 6uantities +y incinerators, Higher le)els of fine particulates ha)e +een associated *ith an increased pre)alence of asth#a and ;<1", =ine particulates for#ed in incinerators in the presence of to/ic #etals and organic to/ins 4including those 0no*n to +e carcinogens5. adsor+ these pollutants and carry the# into the +lood strea# and into the cells of the +ody, To/ic #etals accu#ulate in the +ody and ha)e +een i#plicated in a range of e#otional and +eha)ioural pro+le#s in children including autis#. dysle/ia. attention deficit and hyperacti)ity disorder 4$"H"5. learning difficulties. and delin6uency. and in pro+le#s in adults including )iolence. de#entia. depression and 1ar0inson>s disease, Increased rates of autis# and learning disa+ilities ha)e +een noted to occur around sites that release #ercury into the en)iron#ent, To/ic #etals are uni)ersally present in incinerator e#issions and present in high concentrations in the fly ash, Suscepti+ility to che#ical pollutants )aries. depending on genetic and ac6uired factors. *ith the #a/i#u# i#pact +eing on the foetus, $cute 9

e/posure can lead to sensitisation of so#e indi)iduals. lea)ing the# *ith life3 long lo* dose che#ical sensiti)ity, =e* che#ical co#+inations ha)e +een tested for to/icity. e)en though synergistic effects ha)e +een de#onstrated in the #a-ority of cases *hen this testing has +een done, This synergy could greatly increase the to/icity of the pollutants e#itted. +ut this danger has not +een assessed, Both cancer and asth#a ha)e increased relentlessly along *ith industrialisation. and cancer rates ha)e +een sho*n to correlate geographically *ith +oth to/ic *aste treat#ent facilities and the presence of che#ical industries. pointing to an urgent need to reduce our e/posure, In the ?@. so#e incinerators +urn radioacti)e #aterial producing radioacti)e particulates, Inhalation allo*s entry into the +ody of this radioacti)e #aterial *hich can su+se6uently e#it alpha or +eta radiation, These types of radiation ha)e lo* danger outside the +ody +ut are highly destructi)e *ithin, 2o studies ha)e +een done to assess the danger to health of these radioacti)e e#issions, So#e che#ical pollutants such as polyaro#atic hydrocar+ons 41$Hs5 and hea)y #etals are 0no*n to cause genetic changes, This represents not only a ris0 to present generations +ut to future generations, Monitoring of incinerators has +een unsatisfactory in the lac0 of rigor. the infre6uency of #onitoring. the s#all nu#+er of co#pounds #easured. the le)els dee#ed accepta+le. and the a+sence of +iological #onitoring, $ppro)al of ne* installations has depended on #odelling data. supposed to +e scientific #easures of safety. e)en though the #ethod used has no #ore than a &0: accuracy of predicting pollutants le)els correctly and ignores the i#portant pro+le#s of secondary particulates and che#ical interactions, It has +een clai#ed that #odern a+ate#ent procedures render the e#issions fro# incinerators safe. +ut this is i#possi+le to esta+lish and *ould apply only to e#issions generated under standard operating conditions, <f #uch #ore concern are non3standard operating conditions including start3up and shut3 do*n *hen large )olu#es of pollutants are released *ithin a short period of ti#e, T*o of the #ost ha7ardous e#issions A fine particulates and hea)y #etals A are relati)ely resistant to re#o)al, The safety of ne* incinerator installations cannot +e esta+lished in ad)ance and. although rigorous independent health #onitoring #ight gi)e rise to suspicions of ad)erse effects on the foetus and infant *ithin a fe* years. this type of #onitoring has not +een put in place. and in the short ter# *ould not reach statistical significance for indi)idual installations, <ther effects. such as adult cancers. could +e delayed for at least ten to t*enty years, It *ould therefore +e appropriate to apply the precautionary principle here, There are no* alternati)e #ethods of dealing *ith *aste *hich *ould a)oid the #ain health ha7ards of incineration. *ould produce #ore energy and *ould +e far cheaper in real ter#s. if the health costs *ere ta0en into account, Incinerators presently contra)ene +asic hu#an rights as stated +y the ?nited 2ations ;o##ission on Hu#an Rights. in particular the Right to (ife under the European Hu#an Rights ;on)ention. +ut also the Stoc0hol# ;on)ention and the En)iron#ental 1rotection $ct of %BB0, The foetus. infant and child are #ost at ris0 fro# incinerator e#issions! their rights are therefore +eing ignored and )iolated. *hich is not in 0eeping *ith the concept of a -ust

society, 2or is the present policy of locating incinerators in depri)ed areas *here their health effects *ill +e #a/i#al! this needs urgent re)ie*, Re)ie*ing the literature for the second edition has confir#ed our earlier conclusions, Recent research. including that relating to fine and ultrafine particulates. the costs of incineration. together *ith research in)estigating non3 standard e#issions fro# incinerators. has de#onstrated that the ha7ards of incineration are greater than pre)iously realised, The accu#ulated e)idence on the health ris0s of incinerators is si#ply too strong to ignore and their use cannot +e -ustified no* that +etter. cheaper and far less ha7ardous #ethods of *aste disposal ha)e +eco#e a)aila+le, We therefore conclude that no #ore incinerators should +e appro)ed,

1. Introduction
Both the a#ount of *aste and its potential to/icity are increasing, $)aila+le landfill sites are +eing used up and incineration is +eing seen increasingly as a solution to the *aste pro+le#, This report e/a#ines the literature concerning the health effects of incinerators, Incinerators produce pollution in t*o *ays, =irstly. they discharge hundreds of pollutants into the at#osphere, $lthough so#e attention has +een paid to the concentrations of the #a-or che#icals e#itted in an effort to a)oid acute local to/ic effects. this is only part of the pro+le#, Many of these che#icals are +oth to/ic and +io3accu#ulati)e. +uilding up o)er ti#e in the +ody in an insidious fashion *ith the ris0 of chronic effects at #uch lo*er e/posures, (ittle is 0no*n a+out the ris0s of #any of these pollutants. particularly *hen co#+ined, In addition. incinerators con)ert so#e of the *aste into ash and so#e of this ash *ill contain high concentrations of to/ic su+stances such as dio/ins and hea)y #etals. creating a #a-or pollution pro+le# for future generations, 1ollutants fro# landfill ha)e already +een sho*n to seep do*n and pollute *ater sources, It is also i#portant to note that incineration does not sol)e the landfill pro+le# +ecause of the large )olu#es of the ash that are produced, There ha)e +een relati)ely fe* studies of populations e/posed to incinerator e#issions or of occupational e/posure to incinerators 4see section 45. +ut #ost sho* higher3than3e/pected le)els of cancer and +irth defects in the local population and increased ischae#ic heart disease has +een reported in incinerator *or0ers, These findings are distur+ing +ut. ta0en alone. they #ight only ser)e to alert the scientific co##unity to possi+le dangers +ut for t*o facts, The first is the ac0no*ledged difficulty of esta+lishing +eyond 6uestion the chronic effects associated *ith any sort of en)iron#ental e/posure, The second is the )olu#e of e)idence lin0ing health effects *ith e/posure to the indi)idual co#+ustion products 0no*n to +e discharged +y incinerators and other co#+ustion processes, The purpose of this report is to loo0 at all the e)idence and co#e to a +alanced )ie* a+out the future dangers that *ould +e associated *ith the ne/t generation of *aste incinerators, There are good reasons for underta0ing this re)ie*, The history of science sho*s that it often ta0es decades to identify the health effects of to/ic e/posures +ut. *ith hindsight. early *arning signs *ere often present *hich had gone unheeded, It is rare for the effects of en)iron#ental e/posures to ha)e +een anticipated in ad)ance, =or instance it *as not anticipated that the older generation of

incinerators in the ?@ *ould pro)e to +e a #a-or source of conta#ination of the food supply *ith dio/ins, In assessing the e)idence *e shall also loo0 at data fro# a nu#+er of other areas *hich *e +elie)e to +e rele)ant. including research on the increased )ulnera+ility of the foetus to to/ic e/posures. and the ris0 of synergistic effects +et*een che#icals. the higher ris0s to people #ore sensiti)e to che#ical pollution. the difficulties of ha7ard assess#ent. the pro+le#s of #onitoring and the health costs of incineration,

2. Emissions from Incinerators and other Combustion Sources

The e/act co#position of e#issions fro# incinerators *ill )ary *ith *hat *aste is +eing +urnt at any gi)en ti#e. the efficiency of the installation and the pollution control #easures in place, $ #unicipal *aste incinerator *ill ta0e in a great )ariety of *aste conta#inated +y hea)y #etals and +y #an3#ade organic che#icals, "uring incineration #ore to/ic for#s of so#e of these su+stances can +e created, The three #ost i#portant constituents of the e#issions. in ter#s of health effects. are particulates. hea)y #etals and co#+ustion products of #an3#ade che#icalsC the latter t*o can +e adsor+ed onto the s#aller particulates #a0ing the# especially ha7ardous, The *ide range of che#icals 0no*n to +e products of co#+ustion include sulphur dio/ide. o/ides of nitrogen. o)er a hundred )olatile organic co#pounds 4D<;s5. dio/ins. polyaro#atic hydrocar+ons 41$Hs5. polychlorinated +iphenyls 41;Bs5 and furans,

2.1 Particulates
1articulates are tiny particles in the air that are classified +y si7e, 1M%0s ha)e a dia#eter of less than %0 #icrons *hereas fine particulates 41M2,'s5 are less than 2,' #icrons and ultrafine particulates 41M0,%s5 are less than 0,% #icron, Incinerators produce huge 6uantities of fine and ultrafine particulates, Incinerators are per#itted to e#it particulates at a rate of %0#g per cu+ic #etre of gaseous discharge, The co##only3used +aghouse filters act li0e a sie)e. effecti)ely allo*ing the s#allest particulates to get through and +loc0ing the less dangerous. larger particulates, <nly '3&0: of the 1M2,,'s *ill +e re#o)ed +y these filters and )irtually none of the 1M0,%s, In fact the #a-ority of particles e#itted +y incinerators are the #ost dangerous ultrafine particulates%, The +aghouse filters are least effecti)e at re#o)ing the s#allest particles. especially those of 0,2 to 0,& #icrons. and these *ill ha)e a considera+le health i#pact, Health effects are deter#ined +y the nu#+er and si7e of particles and not the *eight, Measure#ents of the particle si7e distri+ution by weight *ill gi)e a false i#pression of safety due to the higher *eight of the larger particulates, 1ollution a+ate#ent e6uip#ent. installed to reduce e#issions of nitrogen o/ides. #ay actually increase e#issions of the 1M2,' particulates2, The a##onia used in this process reacts *ith sulphurous acid for#ed *hen stea# and sulphur dio/ide co#+ine as they tra)el up the stac0. leading to the production of secondary particulates, These secondary particulates are for#ed +eyond the filters and e#itted una+ated! they can easily dou+le the total )olu#e of particulates e#itted&, 1resent #odelling #ethods do not ta0e secondary particulates into account 4see section %25, Studies ha)e sho*n that to/ic #etals accu#ulate on the s#allest particulates & and that B': of polycyclic aro#atic hydrocar+ons 41$Hs5 are associated *ith fine

particulates 41M& and +elo*5 '38, 1$Hs are to/ic and carcinogenic. and it has +een esti#ated that these increase the lung cancer ris0 +y 8, ti#es ,

2.2 Heavy (etals

Incinerators are allo*ed to e#it %0#g per cu+ic #etre of particulates and %#g per cu+ic #etre of #etals, The li#its #ean little as. e)en *ithin these li#its. the total a#ount of particulates and #etals e#itted *ill )ary *ith the )olu#e per second of e#issions generated +y the incinerator and this can )ary hugely, $ further concern is that there are no statutory a#+ient air 6uality standards for hea)y #etals apart fro# lead. *hich #eans the le)els of hea)y #etals in the surrounding air do not need to +e #onitored, The proportion of #etals to particulates allo*ed to +e e#itted +y incinerators is )ery high and #uch higher than found in e#issions fro# cars, $t the high te#peratures found in incinerators #etals are released fro# #etallic *aste. plastics and #any other su+stances, Many of the hea)y #etals e#itted. such as cad#iu#. are to/ic at )ery lo* concentrations, The selecti)e attach#ent of hea)y #etals to the s#allest particulates e#itted fro# incinerators4 increases the to/icity of these particulates, This fact is li0ely to #a0e the particulates fro# incinerators #ore dangerous than particulates fro# other sources such as fro# cars,

2.3 Nitro en "xides

Re#o)al of nitric o/ide +y incinerators is only a+out 90: effecti)e and the nitric o/ide is then con)erted to nitrogen dio/ide to for# s#og and acid rain, Sunlight acts on nitrous o/ides and )olatile organic co#pounds 4D<;s5 to produce another pollutant. o7one,

2.! "r anic Pollutants

$ *ide range of organic pollutants are e#itted fro# incinerators, These include 1$Hs 4polycyclic aro#atic hydrocar+ons5. 1;Bs 4polychlorinated +iphenyls5. dio/ins. furans. phthalates. 0etones. aldehydes. organic acids and al0enes, The *aste +eing +urnt no* differs considera+ly fro# that +urnt in the past *ith a higher load of hea)y #etals and plastics producing far greater potential for health and en)iron#ental pro+le#s, $n e/a#ple of this is 1D; *hich is #ore than B0: organic chlorine, It has +een used e/tensi)ely for doors and *indo*s and *ith an e/pected life of 40 years it is li0ely to appear in increasing 6uantities in the *aste strea#, This could easily raise the organic chlorine in the *aste strea# to o)er %:. *hich according to the European Waste "irecti)e *ould #ean the *aste *ould +e regarded as ha7ardous, Many of the co#pounds are 0no*n to +e not only to/ic +ut +io3accu#ulati)e and persistent, They include co#pounds that ha)e +een reported to affect the i##une syste#B. attach to chro#oso#es%0. disrupt hor#one regulation%%. trigger cancer%2. alter +eha)iour%&. and lo*er intelligence%4, The )ery li#ited to/icity data on #any of these su+stances is a #atter of concern%', The changing nature of *aste #eans ne* su+stances are li0ely to +e e#itted and created, =or e/a#ple poly+ro#inated diphenyl ethers 41B"Es5 are found in #any electrical goods and are increasingly finding their *ay into incinerator *aste, They ha)e +een found to affect +rain de)elop#ent and affect the thyroid gland and cause +eha)ioural and learning defects in ani#als%9.%8,

%0

3. Health Effects of Pollutants

3.1 Particulates
$ large and gro*ing +ody of literature has highlighted the dangers of particulates to health, Darious studies ha)e confir#ed that the smaller the size of the particles the more dangerous the health effects% 32%, The data fro# the World Health <rganisation sho*n in the graph +elo* clearly illustrates that 1M2,' particles ha)e a greater effect on daily #ortality than the larger 1M%0s% ,

:i ure 1. Increase in daily mortality as a function of P( concentration. 4reproduced fro# ref % . =igure &,95 The s#aller particles are not filtered out +y the nose and +ronchioles and their #iniscule si7e allo*s the# to +e +reathed deeply into the lungs and to +e a+sor+ed directly into the +lood strea# *here they can persist for hours22, They can then tra)el through the cell *alls and into the cell nucleus affecting the cell>s "2$, The WH< state that there is no safe le)el of 1M2,'% and health effects ha)e +een o+ser)ed at surprisingly lo* concentrations *ith no threshold2&.24, The s#allest particulates. particularly the ultrafine particulates 41M0,%5 are highly che#ically reacti)e. a property of their s#all si7e and large surface area2', $ further danger of the s#allest particulates is that there are thousands #ore of the# per unit *eight, In incinerators hea)y #etals. dio/ins and other che#icals can adhere to their surface29 increasing their to/icity, The +ody does not ha)e efficient #echanis#s for clearing the deeper part of the lung as only a tiny fraction of natural particles *ill +e as s#all as this, $s incinerators are effecti)ely particulate generators and produce predo#inately the s#aller particulates that ha)e the +iggest effect on #ortality it is clear that incinerators ha)e considera+le lethal potential, a8 E#idemiolo ical Studies of Particulate Pollutants =ine particulates ha)e +een associated *ith cardio)ascular disease28 and *ith lung cancer%B.2 , +oth respiratory and

%%

T*o large cohort studies in the ?S$ sho*ed increasing #ortality *ith increasing le)els of 1M2,' pollution, In the Si/ ;ity Study pu+lished in %BB&%B . .%%% indi)iduals *ere follo*ed for %43%9 years 4%B843%BB%5. in)ol)ing a total of %%%.089 person years. to e/a#ine the effect of air pollution. allo*ing for s#o0ing and other indi)idual factors, $s e/pected. the greatest ris0 factor *as s#o0ing 4ad-usted #ortality3rate ratio %,'B5 +ut. after allo*ing for indi)idual factors. #ortality rates sho*ed highly significant associations 4pE0,00'5 *ith the le)els of fine particles and sulphate particles in the cities. *ith the #ost polluted city gi)ing an ad-usted all3cause #ortality rate of %,29 co#pared to the least, This related to a 1M 2,' difference of % ,9Fg per cu+ic #etre! cardiopul#onary #ortality *as increased +y &8: and lung cancer #ortality *as also &8: higher, In the $#erican ;ancer Society study20. ''2.%& adults 4dra*n fro# the ;ancer 1re)ention II study5 *ere follo*ed fro# %B 2 to %B B and deaths analysed against #ean concentrations of sulphate air pollution in %B 0 and the #edian fine particulate concentration fro# %B8B3%B &. +oth o+tained for each participant>s area of residence fro# En)iron#ental 1rotection $gency 4E1$5 data, $gain. the strongest correlation *as +et*een lung cancer and s#o0ing 4ad-usted #ortality ris0 ratio B,8&5. +ut +oth pollution #easures sho*ed highly significant association *ith all3cause #ortality and *ith cardiopul#onary #ortality! sulphates *ere also associated *ith lung cancer, $fter ad-usting for s#o0ing and other )aria+les. higher fine particulate pollution *as associated *ith a %8: increase in all3cause #ortality and a &%: increase in cardiopul#onary #ortality for a 24,' Fg per cu+ic #etre difference in 1M2,'s, These results are highly significant and led the E1$ to place regulatory li#its on 1M2,'s. esta+lishing the 2ational $#+ient $ir Guality Standards in %BB8, These regulations *ere challenged +y industry +ut ulti#ately upheld +y the ?S Supre#e ;ourt2B after the data fro# all the studies had +een su+-ected to intense scrutiny including an e/tensi)e independent audit and a re3analysis of the original data&0, The health +enefits of +ringing in these ne* regulations ha)e +een esti#ated as H&2 +illion annually&% +ased on #ortality and chronic and acute health effects. and a White House report fro# the <ffice of Manage#ent and Budget in Septe#+er 200& calculated the +enefits in ter#s of reductions in hospitali7ations. pre#ature deaths and lost *or0ing days as +et*een H%20 and H%B& +illion o)er the last %0 years 4see section B,%5, $s this study loo0ed at only three health indicators it is li0ely to underesti#ate the true +enefits, It follo*s fro# this data that incinerators and all other #a-or sources of 1M 2,' particulates *ill generate su+stantial health costs as *ell as increasing #ortality, b8 :urther Studies $n analysis pu+lished in 2002 of the ;ancer 1re)ention II study participants lin0ed the indi)idual factors. pollution e/posures and #ortality data for appro/i#ately '00.000 adults as reported in the $;S study a+o)e. +ringing the follo*3up to %BB 2 , The report dou+led the follo*3up period and reported triple the nu#+er of deaths. a *ider range of indi)idual factors and #ore pollution data. concentrating on fine particles, S#o0ing re#ained the strongest factor associated *ith #ortality. +ut fine particulate pollution re#ained significantly associated *ith all3cause. and cardiopul#onary #ortality *ith a)erage ad-usted RRs of %,09 and %,0B, In addition. after the longer follo*3up period. fine particulates *ere significantly associated *ith lung cancer #ortality *ith an ad-usted RR of %,%4, The authors reported that e/posure to a %0Fg per cu+ic #etre higher le)el of 1M 2,'s *as associated *ith a %4: increase in lung cancer and a B: increase in cardiopul#onary disease2 ,

%2

c8 Cardiovascular *isease Researchers *ere surprised to find that the increased cardiopul#onary #ortality associated *ith particulate pollution *as pri#arily due to cardio)ascular disease, This *as found in +oth the Si/ ;ity and $;S studies *hen they *ere re3 analysed&0, When the causes of death in the ;ancer 1re)ention II Study *ere loo0ed at in #ore detail&2 to loo0 for clues to possi+le pathophysiological #echanis#s. the lin0 *as strongest *ith ischae#ic heart disease! a %0Fg per cu+ic #etre increase in 1M2,'s *as associated *ith an % : increase in deaths fro# ischae#ic heart disease 422: in ne)er s#o0ers5, $ #ore recent prospecti)e study. the Wo#en>s Health Initiati)e 4WHI5. follo*ed 9'. B& post#enopausal *o#en 4initially free of cardio)ascular disease5 o)er 9 years. to e/a#ine the effects of the fine particulate pollution in the neigh+ourhood of each participant on the first cardio)ascular or cere+ro)ascular incident and on #ortality, The results for #ortality and #or+idity *ere consistent, Each increase of %0Fg per cu+ic #etre in fine particulate pollution *as associated *ith a 89: increase in deaths fro# cardio)ascular disease and an &: increase in deaths fro# cere+ro)ascular disease&&, The effect *as independent of other )aria+les +ut o+ese *o#en and those *ho spent #ore ti#e outdoors *ere #ore )ulnera+le to the effect, The WHI in)ol)ed a #ore ho#ogeneous study population and had a nu#+er of other #ethodological ad)antages o)er the earlier studies. resulting in greater sensiti)ity. and #ore relia+le esti#ates, Ho*e)er. part of the greater effect in this study #ay +e due to gender! there has +een so#e e)idence in other studies that *o#en are #ore suscepti+le to the cardio)ascular effects of fine particulates than #en, These results i#ply that the increase in fine particulate pollution associated *ith larger incinerators can +e e/pected to increase #ortality, It is pro+a+ly safe to e/trapolate fro# the WHI assu#ing that the effect on #ortality in the WHI *as genuine for *o#en. and that the ris0 to #en *ould +e half as great, In that case. if the incinerator increased 1M2,' particulates +y as little as %Fg per cu+ic #etre. cardio)ascular #ortality *ould +e increased +y '3%0:. *ith si#ilarly increased cere+ro)ascular #ortality, $cute #yocardial infarctions ha)e +een found to rise during episodes of high particulate pollution. dou+ling *hen le)els of 1M2,'s *ere 2032'Fg per cu+ic #etre higher&4, 1articulates also increased #ortality fro# stro0e&'.&9, <ne study concluded that %%: of stro0es could +e attri+uted to outdoor air pollution &8, Episodes of increased particulate pollution also increased ad#issions *ith heart disease& , $ recent study found that each %0Fg per cu+ic #etre rise in 1M%0 particulates *as associated *ith a 80: increase in "DT ris0,&B Mortality fro# dia+etes28 and ad#issions for dia+etic heart disease are also increased40 and these *ere dou+le the non3dia+etic ;H" ad#issions. suggesting that dia+etics *ere particularly )ulnera+le to the effect of particulate pollution40, Higher le)els of particulates ha)e +een associated *ith life3threatening arrhyth#ias4% e/ercise3induced ischae#ia42. e/cess #ortality fro# heart failure&9.4& and thro#+otic disease&9, d8 Effect on Children and the :oetus 1articulates carry )arious che#icals including polycyclic aro#atic hydrocar+ons 41$Hs5 into the hu#an +ody, =rederica 1erera fro# the ;olu#+ia ;enter for ;hildren>s En)iron#ental Health has found that the foetus is %0 ti#es

%&

#ore )ulnera+le to da#age +y these su+stances44, She also found that 1M2,' particulates ha)e an ad)erse effect on the de)eloping foetus *ith significant reductions in *eight. length and head circu#ference and reiterated the i#portance of reducing a#+ient fine particulate concentrations4', In addition further studies ha)e sho*n an ad)erse effect on foetal de)elop#ent at le)els currently found in cities today. such as 2e* Ior049, $ir pollution has +een found to cause irre)ersi+le genetic #utations in #ice, Researchers found. in contrast. that if #ice +reathed air *hich had +een freed of particulates +y filtration they de)eloped only +ac0ground le)els of genetic #utations. confir#ing that particulates *ere causati)e48, $t the fourth Ministerial ;onference of En)iron#ent and Health in June 2004. the WH< announced that +et*een %, and 9,4: of deaths in the age group fro# 0 to 4 could +e attri+uted to air pollution4 , e8 3cute ,es#iratory Incidents Ele)ated particulate air pollution has +een associated *ith increased hospital ad#issions *ith asth#a24 and *ith ;<1"4B. increases in respiratory sy#pto#s'0.'%. higher incidence of asth#a'2. reduced i##unity'&.'4. higher rates of ear. nose and throat infection'2. loss of ti#e fro# school in children through respiratory disease''.'9. and declines of respiratory function'83'B, $ sad aside to the a+o)e is that children *ho did #ore outdoor sport had greater declines in respiratory function'B, We are doing a great disser)ice to our children if they cannot pursue healthy acti)ities *ithout da#aging their health, f8 (ortality from Particulate Pollution Episodes of increased particulate pollution ha)e +een associated *ith increased cardio)ascular #ortality%B.20.28.2 .&9.4&.90 and increased respiratory #ortality4&.44, $+out %'0 ti#e3series studies around the *orld ha)e sho*n transient increases in #ortality *ith increases in particulates, ;ohort studies ha)e sho*n a long3ter# effect on #ortality%B.20.2 4see section &,%a5, ;an *e 6uantify this #ortalityJ It has +een esti#ated that the increased #ortality *or0s out as a+out a 0,'3%: increase in #ortality for each %0Fg per cu+ic #etre rise in 1M%0s9% for acute e/posures and a &,': rise for chronic e/posures&%, =or 1M2,'s the increase in #ortality is #uch greater. especially for cardiopul#onary #ortality 4see Ta+le5, /able 1 Cardio#ulmonary (ortality and :ine Particulate Pollution
Study ,eference = >ear No of Partici#ants :ollo? u# 3d@usted excess cA# mortality *ifference in 1M2,,'s in B Am3 3d@usted excess cA# mortality for rise of 1;B A m3

Si/ ;ities
$;S ;ancer 1re)ention II ;ancer 1re)ention II

%B

.%%% ''2.%&

%B843%BB% %B 23%B B

&8: &%:

% ,9 24,'

%B, : %2,8:

%BB&
20

%BB'
2

'00.000

%B 23%BB

B:

%0

B:

2002

%4

Wo#en> Health Initiati)e

&&

9'. B&

%BB432002

89:

%0

89:

2008

When the data fro# the Si/ ;ities Study and the $;S study *ere su+-ect to audit and re3analysis 4see section &,%a5 the cardiopul#onary deaths *ere separated into pul#onary and cardio)ascular&0, ?ne/pectedly #ost of the e/cess deaths due to particulates had +een fro# cardio)ascular causes, This *as apparent in each of the analyses perfor#ed gi)ing figures for the increase in cardio)ascular #ortality in the Si/ ;ities study of +et*een &': and 44: for an % ,9 Fg per cu+ic #etre difference in 1M2,'s and in the $;S study +et*een &&: and 48: for a 24,'Fg per cu+ic #etre, This *as #uch higher in each case than the increase in respiratory deaths of 8:, In the $;S data it *as later found that the e/cess cardio)ascular deaths *ere pri#arily due to an % : increase in deaths fro# ischae#ic heart disease for each %0Fg per cu+ic #etre rise in 1M2,'s&2, The Wo#en>s Health Initiati)e study has de#onstrated an e)en stronger statistical relationship +et*een raised le)els of fine particulates and cardio)ascular deaths *ith a 89: increase in cardio)ascular #ortality for each %0Fg per cu+ic #etre increase in 1M2,' particulates. and this depended not -ust on *hich city a *o#an li)ed in +ut in *hich part of that city&&, This study. #ore than any other. de#onstrates the great dangers posed +y fine particulates and the highlights the urgent need to re#o)e #a-or sources of these pollutants, $s incinerators selecti)ely e#it s#aller particulates and cause a greater effect on le)els of 1M2,'s than 1M%0s. they *ould therefore +e e/pected to ha)e a significant i#pact on cardiopul#onary #ortality. especially cardio)ascular #ortality, This has not so far +een studied directly, 8 Studies Involvin Cltrafine Particles ?ltrafine particles 40,%Fg per cu+ic #etre and +elo*5 are produced in great nu#+ers +y incinerators%, They ha)e +een less studied than 1M2,' and 1M%0 particulates +ut there has +een enough data a)aila+le for the WH< to conclude that they produce health effects i##ediately. after a ti#e lag and in association *ith cu#ulati)e e/posure, They ha)e +een found to ha)e a #ore #ar0ed effect on cardio)ascular #ortality than fine particulates. *ith a ti#e lag of 43' days 92, Stro0e #ortality has +een positi)ely associated *ith current and pre)ious day le)els of ultrafine particulates and this has occurred in an area of lo* pollution suggesting there #ay +e no threshold for this effect9&, ?ltrafine particulates ha)e also +een reported to +e #ore potent than other particulates on a per #ass +asis in inducing o/idati)e stress in cells94 and they ha)e the a+ility to cross the +lood3+rain +arrier and lodge in +rain tissue9', They represent another largely un0no*n and une/plored danger of incineration, h8 3ssessment by the 4H" and "ther 3uthorities Based on the World Health <rganisation $ir Guality Kuidelines99 *e ha)e esti#ated that a %Fg per cu+ic #etre increase in 1M2,,' particulates 4a )ery conser)ati)e esti#ate of the le)el of increase that *ould +e e/pected around large incinerators5 *ould lead to a reduced life e/pectancy of 40 days per person o)er %' years 4this e6uals a reduction of life e/pectancy of %,% years for each %0Fg per cu+ic #etre increase in 1M2,' particulates5, $lthough this figure appears s#all they note that

%'

the pu+lic health i#plications are large and the effect on a typical population of 2'0.000 surrounding an incinerator *ould +e a loss of 28.'00 years of life o)er a %' year ti#e period, This figure gi)es an indication of the li0ely loss of life fro# any #a-or source of 1M2,' particulates, In addition. incinerators nor#ally operate for #uch longer periods than the %' years 6uoted here, 2ote that the esti#ated loss of life here is li0ely to +e an underesti#ate as it is fro# particulates alone and not fro# other to/ic su+stances, The European Respiratory Society98 has pu+lished its concern a+out the #is#atch +et*een European ?nion policy and the +est scientific e)idence, They state that a reduction in the yearly a)erage 1M2,' particulates to %'Fg per cu+ic #etre L *ould result in life e/pectancy gains. at age &0. of +et*een % #onth and 2 years, They point out that the +enefits of i#ple#enting stringent air pollution legislation *ould out*eigh the costs, These reco##endations are sensi+le and +ased on sound science, $ progra##e of +uilding incinerators *ould unfortunately achie)e the opposite! they *ould increase particulate pollution. reduce life e/pectancy and *ould +e at odds *ith the +est science, State#ents +y leading researchers include the follo*ing! Mthe magnitude of the association between fine particles and mortality suggests that controlling fine particles would result in saving thousands of early deaths each yearN 4Sch*art759% and Mthere is consistent evidence that fine particulates are associated with increased all cause, cardiac and respiratory mortality. These findings strengthen the case for controlling the levels of respiratory particulates in outdoor airN 90,
D /he National 3mbient 3ir Euality Standard for P( 2.% #articulates ?as introduced into the CS3 in 199' ?ith a mean annual limit of 1%B #er cubic metre. /his had measurable health benefits. 3n annual mean limit for P( 2.% #articulates is to be introduced into Scotland in 2;1; and this ?ill be 12B #er cubic metre. 3n annual mean tar et for P( 2.% #articulates is to be introduced into the C< in 2;2; and this ?ill be ?ill be 2%B #er cubic metre. (any ?ill ?onder ?hy the difference is so vast ?hen the science is the same.

i8 Summary In su##ary there is no* ro+ust scientific e)idence on the dangers to health of fine particulates and of the su+stantial health costs in)ol)ed, Recent studies ha)e sho*n the ris0 to +e considera+ly greater than pre)iously thought. =or these reasons it is i#possi+le to -ustify increasing le)els of these particulates still further +y +uilding incinerators or any other #a-or source of 1M2,' particulates, The data #a0es it 6uite clear that atte#pts should +e #ade to the reduce le)els of these particulates *hene)er possi+le, Ho*e)er particulates are not the only reasons to +e concerned a+out incinerators, There are other dangers!3

3.2 Heavy (etals

1ope reported that hospital ad#issions of children *ith respiratory disease fell dra#atically in the ?tah )alley *hen a steel #ill *as closed for a year due to a stri0e, $ir pollution analysis sho*ed that the #etal content of particulates *as lo*er that year and that the type of infla##ation found in the lungs *hile the steel #ill *as *or0ing could +e reproduced in +oth rat and hu#an lung tissue +y using air pollutants of the type e#itted +y the steel #ill9 .9B, This is a )ery clear illustration of the dangers of pollution of the air *ith hea)y #etals, E/posure to inhaled #etals. si#ilar to the type produced +y incinerators. ha)e +een sho*n to #ediate cardiopul#onary in-ury in rats80 and s#all a#ounts of #etal 4E%:5 in particulates are 0no*n to cause pul#onary to/icity8%, Salts of hea)y #etals such as iron and copper act as catalysts for dio/in %9

for#ation causing rapid rates of dio/in for#ation 82 increasing the dangers fro# +urning #etals, Incinerator e#issions to air and ash contain o)er &' #etals8&, Se)eral are 0no*n or suspected carcinogens, To/ic #etals accu#ulate in the +ody *ith increasing age84, Breathing in air containing to/ic #etals leads to +ioaccu#ulation in the hu#an +ody, They can re#ain in the +ody for years! cad#iu# has a &0 year half3life, Incineration adds to the +urden of to/ic #etals and can lead to further da#age to health, Mercury is a gas at incineration te#peratures and cannot +e re#o)ed +y the filters, Incinerators ha)e +een a #a-or source of #ercury release into the en)iron#ent, In theory #ercury can +e re#o)ed using acti)ated car+on +ut in practice it is difficult to control and. e)en *hen effecti)e. the #ercury ends up in the fly ash to +e landfilled, Mercury is one of the #ost dangerous hea)y #etals, It is neuroto/ic and has +een i#plicated in $l7hei#er>s disease8'388. learning disa+ilities and hyperacti)ity8 .8B, Recent studies ha)e found a significant increase in +oth autis# and in rates of special education students around sites *here #ercury is released into the en)iron#ent 0. %, Inhalation of hea)y #etals such as nic0el. +erylliu#. chro#iu#. cad#iu# and arsenic increases the ris0 of lung cancer%2. ;u#ulati)e e/posure to cad#iu# has +een correlated *ith lung cancer 2, Supporti)e e)idence co#es fro# Blot and =rau#eni *ho found an e/cess of lung cancer in ?S counties *here there *as s#elting and refining of non3ferrous #etals &, Inhaled cad#iu# also correlates *ith ischae#ic heart disease 4, So *hat are the dangers caused +y to/ic #etals accu#ulating in the +odyJ They ha)e +een i#plicated in a range of e#otional and +eha)ioural pro+le#s in children including autis# '. dysle/ia 9. i#pulsi)e +eha)iour 8 attention deficit and hyperacti)ity disorder 4$"H"5 . B as *ell as learning difficulties%4.8 .B03B&. lo*ered intelligence B and delin6uencyB4. B. although not e)ery study reached standard significance le)els, Many of these pro+le#s *ere noted in the study of the population round the Sint 2i0laas incineratorB', E/posed adults ha)e also +een sho*n to +e affected. sho*ing higher le)els of )iolence%&.B9. de#entiaB83%0& and depression than non3e/posed indi)iduals, Hea)y #etal to/icity has also +een i#plicated in 1ar0inson>s disease%04, Hea)y #etals e#itted fro# incinerators are usually #onitored at & to %2 #onthly inter)als in the stac0! this is clearly inade6uate for su+stances *ith this degree of to/icity,

3.3 Nitro en "xides and "$one

2itrogen dio/ide is another pollutant produced +y incinerators, It has caused a )ariety of effects. pri#arily on the lung +ut also on the spleen. li)er and +lood in ani#al studies, Both re)ersi+le and irre)ersi+le effects on the lung ha)e +een noted, ;hildren +et*een the ages of ' and %2 years ha)e +een esti#ated to ha)e a 20: increase in respiratory sy#pto#s for each 2 Fg per cu+ic #etre increase in nitrogen dio/ide, Studies in Japan sho*ed a higher incidence of asth#a *ith increasing 2< 2 le)els and that it synergistically increases lung cancer #ortality rates4%, It has also +een reported to aid the spread of tu#ours%0'.%09, Increases in 2<2 ha)e +een associated *ith rises in ad#issions *ith ;<1"%08. asth#a in children and in heart disease in those o)er 9'% , <ther studies ha)e sho*n increases in asth#a ad#issions%0 and increased #ortality *ith rising 2<2 le)els%0B,

%8

Rising o7one le)els ha)e led to increasing hospital ad#issions. asth#a and respiratory infla##ation and ha)e +een reported to lo*er i##unity%%0, Higher le)els ha)e +een significantly associated *ith increased #ortality%%% and *ith cardio)ascular disease, Both o7one and nitrogen dio/ide are associated *ith increasing ad#issions *ith ;<1"%08, When it co#es to incinerator e#issions the health effects of nitrous o/ides are li0ely to co#pound the negati)e health effects of particulates

3.! "r anic /oxicants

Hundreds of che#ical co#pounds are released fro# incinerators, They include a host of che#icals produced fro# the +urning of plastic and si#ilar su+stances and include polycyclic aro#atic hydrocar+ons 41$Hs5. +ro#inated fla#e retardants. polychlorinated +iphenols 41;Bs5. dio/ins. polychlorinated di+en7ofurans 4furans5, These su+stances are lipophilic and accu#ulate in fatty tissue and re#ain acti)e in the li)ing organis#s and the en)iron#ent for #any years, They ha)e +een lin0ed *ith early pu+erty%%2. endo#etriosis%%&. +reast cancer%%4.%%'. reduced sper# counts%%9 and other disorders of #ale reproducti)e tissues%%8. testicular cancer%% and thyroid disruption%%, It has +een clai#ed that a+out %0: of #an3#ade che#icals are carcinogenic 4see section ',%5. and #any are no* recognised as endocrine disrupters, Most of these health effects *ere not anticipated and are only no* +eing recognised, 2o safety data e/ist on #any of the co#pounds released +y incinerators, 1$Hs are an e/a#ple of organic to/icants, $lthough e#ission le)els are s#all these su+stances are to/ic at parts per +illion or e)en parts per trillion8& as opposed to parts per #illion for #any other pollutants, They can cause cancer. i##une changes. lung and li)er da#age. retarded cogniti)e and #otor de)elop#ent. lo*ered +irth *eight and lo*ered gro*th rate8&, a8 "r anochlorines The #ost detailed analysis to date on incinerator e#issions has identified se)eral hundred products of inco#plete co#+ustion 41I;s5 including & organochlorines A +ut ' : of the total #ass of 1I;s re#ained unidentified %%B, <rganochlorines. *hich include dio/ins. furans and 1;Bs. deser)e special attention. +ecause of their 0no*n to/icity. +ecause they +ioaccu#ulate. and +ecause of the li0elihood that they *ill increase in the *aste strea#, Their #a-or precursor. 1D;. presently #a0es up 0: of organically +ound chlorine and the a#ount of 1D; in *aste is li0ely to increase significantly in the future%20, ;learly organochlorines *ill +e an i#portant co#ponent of incinerator e#issions, <rganochlorines as a group are associated *ith si/ distinct types of health i#pact and these often occur at lo* concentrations, They are associated *ith %5 reproducti)e i#pair#ent in #ales and fe#ales 25 de)elop#ental da#age &5 i#paired cogniti)e a+ility and +eha)iour 45 neurological da#age '5 suppressed i##unity and 95 hor#onal disruption and hor#onal cancers, Each of these si/ effects has +een de#onstrated in three separate fields! in hu#ans. in la+oratory ani#als and in *ildlife%2%, The $#erican 1u+ic Health $ssociation 4$1H$5 concluded M)irtually all organochlorines that ha)e +een studied e/hi+it at least one of a range of serious to/ic effects. such as endocrine disruption. de)elop#ental i#pair#ent. +irth defects. reproducti)e dysfunction and infertility. i##unosuppression and cancer. often at e/tre#ely lo* dosesN%22, <ther organohalogens such as +ro#ides and fluorides ha)e #any si#ilar properties,

$ co##on #isconception is that these pollutants ha)e little effect if dispersed into the en)iron#ent, This is *rong for se)eral reasons, =irstly they are persistent as there is no #echanis# in the en)iron#ent to +rea0 the# do*n and so they accu#ulate, Secondly as they are fat solu+le they concentrate in li)ing #atter. often dra#atically. at progressi)ely higher concentrations 4+ioaccu#ulation5, =or e/a#ple dio/in has +een found in fish at le)els %'B.000 ti#es that found in the *ater%2&C 1;Bs ha)e +een found in 2orth 1acific "olphins at %& #illion ti#es the concentration in the *ater%24 and trichloroacetic acid is found in 2orth European conifers at &3%0.000 ti#es that in the a#+ient air%2', Thirdly they are concentrated +y the foetus so a typical polar +ear cu+ has a +ody +urden dou+le that of its #other %29 and at a le)el 0no*n to cause reproducti)e failure. altered +rain de)elop#ent and i##une suppression%28, =ourthly they are nearly all to/ic, In short the a+ility of ecosyste#s to assi#ilate organochlorines and other persistent +ioaccu#ulati)e co#pounds is close to 7ero and they should si#ply ne)er +e released into the en)iron#ent, b8 *ioxins "io/ins are the organochlorines co#pounds #ost associated *ith incinerators and in)entories ha)e consistently sho*n that incinerators are the #a-or source of e#issions of dio/ins into the air%2 3&0 though these are decreasingL, "io/in releases o)er the last fe* decades ha)e caused *idespread conta#ination of food. significant to/ic +ody +urdens in nearly all hu#an +eings and se)ere pollution of the $rctic, 2one of this *as foreseen, The da#age already done +y incinerators has +een incalcula+le, Eighteen separate assess#ents of dio/in>s carcinogenicity ha)e in)ol)ed fi)e different routes of e/posure. fi)e different species. lo* and high doses and long or short e/posure ti#es, In every case dio/ins ha)e caused cancer. in)ol)ing nine different types of cancer. including ly#pho#as. cancers of the lung. li)er. s0in. soft tissue and of the oral and nasal ca)ities%&%, The 2ational Institute of En)iron#ental Health ha)e loo0ed for. +ut +een una+le to find. any threshold for the to/icity of dio/in, $t the lo*est detecta+le concentrations it can induce target genes and acti)ate a cascade of intracellular #olecular effects and can pro#ote pre3#alignant li)er tu#ours and disrupt hor#ones%&2, E)en doses as lo* as 2,' parts per 6uadrillion can stop cultured cells fro# sho*ing changes characteristic of i##une responses%&&, The ?S En)iron#ental 1rotection $gency>s current esti#ate of dio/in>s carcinogenicity. deri)ed fro# ani#al studies. is that the a)erage person>s e/posure to dio/in. *hich is &39 picogra# per 0ilogra# per dayLL gi)es a lifeti#e cancer ris0 of +et*een '00 and %000 per #illion%&4, 4$n accepta+le cancer ris0 is considered to +e +et*een % in a #illion and % in %00.0005, In co#parison. a Ker#an study %&'. deri)ed fro# hu#an dio/in e/posure. found that each additional unit dose of dio/in 4one picogra# per 0ilogra# of +ody *eight per day5 is associated *ith an increase in lifeti#e cancer ris0 of +et*een %000 and %0.000 per #illion, The a)erage infant recei)es doses of dio/ins of 903 0 picogra#s 4TEG5 per 0ilogra# per day%&9.%&8 *hich is %03 20 ti#es higher than those of the a)erage adult and e/ceeds +y a factor of 9 A %0.000 e)ery go)ern#ent in the *orld>s accepta+le daily inta0e,LLL This dio/in inta0e in the first year has +een calculated to pose a cancer ris0 to the a)erage infant of % 8 per #illion 4% 8 ti#es the accepta+le le)el5%& , $ll these figures de#onstrate that dio/ins already in the en)iron#ent are at unaccepta+le le)els and are li0ely to +e causing up to 9: of all cancers and to +e ha)ing a range of ad)erse i#pacts on health including su+tle effects,

%B

Rats gi)en dio/in to produce a +ody +urden of dio/in at a+out half the a)erage in the hu#an population had #ale offspring *hose sper# count *as reduced +y 2': %&B and rhesus #on0eys gi)en dio/in e6ui)alent to t*ice the a)erage hu#an +ody +urden had increased foetal death in their offspring and cogniti)e i#pair#ent *hich *as transgenerational 4passed on to their offspring5 and a+nor#ally aggressi)e +eha)iour%40.%4%, This data indicates that releasing e)en a s#all a#ount of dio/in into an already o)erloaded en)iron#ent can si#ply not +e -ustified,
L$n assess#ent of dio/ins +y the European "io/in In)entory in 200' found that in the ?@. the +iggest single source of dio/ins in 2000 and in 200' 4pro-ected figure5 *as the incineration of #unicipal *aste. producing 20 ti#es as #uch dio/in as road transport%42, LL a picogra# is %.000.000.000.000 gra#. ie, a +illionth of a gra# in the ?@. +ut #ore typically descri+ed in ?S literature as a trillionth of a gra#, LLL Tolera+le daily inta0e 4T"I5 is set at 0,009 picogra#sO0g per day in the ?S and 2 picogra#sO0g per day in the ?@,

3.% Effects on .enetic (aterial

Both hea)y #etals and #any che#icals for# co)alent +onds *ith "2$ called "2$ adducts, This can increase the ris0 of cancer +y acti)ating oncogenes and +loc0ing anti3tu#our genes, This raises a )ery serious concern, This concern is that +y releasing che#icals into the en)iron#ent *e #ay not only +e poisoning this generation +ut the ne/t, ;arcinogenesis fro# che#icals +eing passed on through se)eral generations is not -ust a horrifying scenario +ut has +een de#onstrated to occur in ani#als%4&.%44, Incinerator e#issions *ould greatly increase this ris0, "2$ adducts to 1$Hs increase *ith e/posure to pollution and patients *ith lung cancer ha)e higher le)els of adducts 4see +elo*5, This is one de#onstration of ho* pollutants alter genes and predispose to cancer, <ther che#icals. such as )inyl chloride interfere *ith "2$ repair and yet others such as organochlorines are tu#our pro#oters,

3.& Effects on the Immune System

Starting in the late %B 0s a series of dra#atic #arine epide#ics 0illed off thousands of dolphins. seals and porpoises, Many *ere found to ha)e +een affected +y a diste#per3li0e )irus, $utopsies of the dead ani#als sho*ed *ea0ened i##une syste#s and high le)els of pollutants including 1;Bs and synthetic che#icals, $ )irologist. $l+ert <sterhaus and his co3*or0ers. de#onstrated that *hen seals *ere fed conta#inated fish containing organochlorines 4*hich *ere. ho*e)er. considered fit for hu#an consu#ption5 they de)eloped i##une suppression and *ere una+le to fight )iruses%4'38, Their natural 0iller cells *ere 203'0: +elo* nor#al and their T cell response dropped +y 2'390:, The i##une suppression *as due to dio/in3li0e che#icals. 1;Bs and synthetic che#icals, $n i##unologist Karet (ah)is found i##unity in dolphins in the ?S$ dropped as 1;Bs and ""T increased in their +lood%4 , The i##une syste# appeared #ost )ulnera+le during prenatal de)elop#ent, This de#onstrates that the i##une syste# #ay +e da#aged +y e/posure to synthetic che#icals and that *e ha)e seriously underesti#ated the dangers of these che#icals, $ni#al e/peri#ents ha)e sho*n i##unoto/icity *ith hea)y #etals. organochlorine pesticides and halogenated aro#atics%4B and accidental e/posure data on hu#ans has sho*n i##unoto/icity *ith 1BBs. dio/ins and aldicar+, In fact *hole )olu#es ha)e +een *ritten on i##unoto/icity%'0, 2ote these are the type of pollutants released +y incinerators, En)iron#ental to/ins ha)e +een sho*n to decrease T3 ly#phocyte helper3suppressor ratios in four different e/posed populations%'%, 2itrogen dio/ide e/posure leads to a+nor#ally ele)ated i##une and allergic responses, 1M2,' 20

particulates the#sel)es can cause #utagenic and cytoto/ic effects and the s#allest particulates cause the greatest effects%'2, In utero e/posure to dio/ins results in thy#us atrophy and *ea0ened i##une defences%'&, When fe#ale rhesus #on0eys *ere e/posed to 1;Bs at )ery lo* le)els producing a +ody +urden typical of general hu#an population. their offspring>s a+ility to #ount a defence against foreign proteins *as per#anently co#pro#ised%'4, In su##ary there is a+undant e)idence that a large nu#+er of the pollutants e#itted +y incinerators can cause da#age to the i##une syste#%'', $s is de#onstrated in the ne/t section the co#+ination of these is li0ely to ha)e an e)en #ore potent and da#aging effect on i##unity than any one pollutant in isolation,

3.' Syner istic Effects

Darious studies ha)e sho*n that a co#+ination of su+stances can cause to/icity e)en *hen the indi)idual che#icals are at a le)el nor#ally considered safe, The report MMan>s I#pact on the Klo+al En)iron#entN +y the Massachusetts Institute of Technology stated Msynergistic effects a#ong che#ical pollutants are #ore often present than notN%'9, Testing has +een #ini#al and #ost of the synergistic effects are li0ely to re#ain un0no*n, To/icologist 1rof Dy)yan Ho*ard has calculated that to test -ust the co##onest %.000 to/ic che#icals in uni6ue co#+inations of three *ould re6uire %99 #illion different e/peri#ents and e)en this *ould disregard )arying doses%'8, Synergy has +een de#onstrated *hen organic che#icals are co#+ined *ith hea)y #etals.%' .%'B and *ith co#+inations of pesticides%90.%9% and food additi)es%92, The last study is of particular concern, Rats fed *ith one additi)e *ere unhar#ed, Those fed t*o de)eloped a )ariety of sy#pto#s *hereas those fed all three all died *ithin t*o *ee0s, In this case the che#icals appeared to a#plify each other>s to/icity in logarith#ic fashion, In a recent e/peri#ent scientists dosed ani#als *ith a #i/ture of %9 organochlorine pesticides. lead and cad#iu# at Msafe le)elsN and found they de)eloped i#paired i##une responses. altered thyroid function and altered +rain de)elop#ent%9&, $nother study in %BB9. pu+lished in Science. reported on the dangers of co#+inations of pesticides and their a+ility to #i#ic oestrogen, They found that co#+inations could increase the to/icity +y '00 to %000 ti#es %94, Mice e/posed to 2' co##on ground*ater pollutants. all at le)els *ell +elo* those that produce any effects in isolation. de)eloped se)ere i##unosuppression%9', The le)el of concern a+out the #ultiplicity of pollutants released into the air +y incinerators is enhanced +y the fact that e)en *hen the pro+a+le effects of the single pollutants in)ol)ed are 0no*n. no one has any idea *hat da#age the co#+inations can cause, The population li)ing round an incinerator is +eing e/posed to #ultiple che#ical carcinogens. and to fine particulates. to carcinogenic hea)y #etals 4in particular cad#iu#5 and in so#e cases to radioacti)e particles. all 0no*n to increase lung cancer, 2itrogen dio/ide has also +een sho*n to synergistically increase lung cancer, When all these are co#+ined. the effects are li0ely to +e #ore potent. and. in fact. an increase in the incidence of lung cancer has +een reported around incinerators 4see section 4,%5, The potential for #ultiple pollutants to cause other serious health effects is illustrated +y the results of a 0ey study on rats e/posed to the dust. soil and air fro# a landfill site, These ani#als de)eloped a+nor#al changes in the li)er. thyroid and reproducti)e organs *ithin only t*o days of e/posure%99, $lthough effects in ani#als do not al*ays #i#ic those in hu#ans. the authors concluded that present #ethods of

2%

calculating health ris0s underesti#ate the +iological effects, This has o+)ious rele)ance to the dangers of e/posing people to #ultiple pollutants fro# incinerators,

!. Increased (orbidity and (ortality near Incinerators

!.1 Cancer
There ha)e +een a nu#+er of studies of the effect of incinerators on the health of the surrounding population. #ainly concentrating on cancer incidence, In #ost studies. the incinerators *ere situated near other sources of pollution and often in areas of depri)ation. +oth li0ely to confound the findings since +oth are associated *ith higher cancer incidence, The study of an incinerator +urning ''.000 tonnes of *aste a year and +uilt in %B88 in the #iddle of a residential area of a to*n of %40.000 *ith no hea)y industry 4Sint 2i0laas5 is scientifically unsatisfactory +ecause funds *ere not #ade a)aila+le for the study of controlsB', Ho*e)er. the in)estigators #apped a con)incing cluster of & cancer deaths i##ediately surrounding and to lee*ard of the incinerator. and this area also sho*ed high concentrations of dio/in in soil sa#ples *hen tested in %BB2, They noted that the cancer SMR for this to*n for %BB43%BB9 4national statistics5 *as high 4%%2,0 for #ales and %0',&2 for fe#ales5. supporting the genuine nature of their findings, In %BB9. Elliott et al, pu+lished a #a-or study%98 in *hich they co#pared the nu#+ers of registered cancer cases *ithin & 0# and *ithin 8,' 0# of the 82 #unicipal *aste incinerator sites in the ?@ *ith the nu#+er of cases e/pected, It in)ol)ed data on o)er %4 #illion people for up to %& years, E/pected nu#+ers *ere calculated fro# national registrations. ad-usted for une#ploy#ent. o)ercro*ding and social class, 2o account *as ta0en of pre)ailing *inds. or of differences +et*een incinerators, They first studied a sa#ple of 20 of the incinerator sites. replicating the analysis later *ith the other '2, If the results of t*o sets li0e this concur. it strengthens the data, In each set there *as an e/cess of all cancers near the incinerators. and e/cesses separately of sto#ach. colorectal. li)er and lung cancers. +ut not leu0ae#ias, The first set ga)e ad-usted #ortality ratios for all cancers of %,0 for *ithin &0# and %,0' *ithin 8,' 0#C for the second these *ere %,04 and %,02, These ris0s. representing an additional ris0 of : and ': for the first set and 4: and 2: for the second. see# s#all but re#resented a total of over 115;;; extra cancer deaths near incinerators and *ere highly significant 4p E0,00% for each5, =or each of the #ain cancer sites the e/cesses *ere higher for those li)ing *ithin & 0# than for all *ithin 8,' 0# %98.%9 . suggesting that the incinerators had caused the e/cess, The authors dou+ted this and attri+uted the findings to additional confounding in spite of the fact that they had already ad-usted 4possi+ly o)er3 ad-usted5 for une#ploy#ent. o)ercro*ding and social class. *hich gi)e a partial correction for pollution, Moreo)er. the effect on people li)ing to lee*ard of the incinerator *ould +e su+stantially higher than sho*n +y this study as the true nu#+er of people affected *as diluted +y those li)ing at the sa#e distance +ut a*ay fro# the *ind plu#e co#ing fro# the incinerator, @no/ et al, loo0ed at the data fro# 22.4' children *ho died of cancer +et*een %B'& and %B 0 in the ?@%9B, =or each child they co#pared the distance of the

22

+irth and death addresses fro# the nearest source of pollution and found a consistent asy##etry! #ore had #o)ed a*ay fro# the nearest ha7ard than to*ards it%9B, They deduced that the e/cess of #igrations a*ay fro# the ha7ard 4after allo*ing for social factors5 *as e)idence that the children had +een affected +y the cancer3causing pollution +efore or shortly after +irth, (ater they applied the #ethod to the set of incinerators studied +y Elliott et al, and again sho*ed the sa#e asy##etry in the children>s +irth and death addresses. indicating that the incinerators had posed a cancer ris0 to children %80, <f the B.224 children for *ho# they had found accurate +irth and death addresses. 4.& ' children had #o)ed at least 0,% 0#, Significantly. #ore children had #igrated a*ay fro# incinerators than to*ards, =or all those *ho had at least one address *ithin & 0# of an incinerator. the ratio *as %,28, When they li#ited the analysis to children *ith one address inside a ' 0# radius fro# the nearest incinerator and the other address outside this radius the ratio *as 2,0%C this indicated a dou+ling of cancer ris0, Both these findings *ere highly significant 4p E0,00% for each5, The e/cess had only occurred during the operational period of each incinerator and *as also noted round hospital incinerators +ut not landfill sites, This is strong e)idence that the incinerators> e#issions contri+uted to the children>s cancer deaths, Biggeri et al, in %BB9 co#pared 8'' lung cancer deaths in Trieste *ith controls in relation to s#o0ing. pro+a+le occupational e/posure to carcinogens and air pollution 4#easured nearest to their ho#es5 and the distance of their ho#e fro# each of four pollution sites, The city centre carried a ris0 of lung cancer +ut the strongest correlation *as *ith the incinerator *here they found a 9,8 e/cess of lung cancer after allo*ing for indi)idual ris0 factors%8%, ?sing a spatial scan statistic. Diel et al 2000 loo0ed at the incidence of soft tissue sarco#a and non3Hodg0in>s ly#pho#a fro# =rench ;ancer Registry data. in t*o areas close to an incinerator *ith high e#ission of dio/in %82, They found highly significant clusters of soft tissue sarco#a 4RR %,445 and of non3Hodg0ins ly#pho#a 4RR %,285 +ut no clusters of Hodg0ins disease 4used as negati)e control5, This study *as interesting in that it *as designed to loo0 +oth in a focussed *ay at the area round the incinerator. and to chec0 the association +y loo0ing for space ti#e relationships *hich should +e present if the relationship *as causal, In addition they loo0ed in an unfocussed *ay for other clusters in the *ider area *hich contained other areas of depri)ation, Both the first t*o analyses *ere positi)e close to the incinerator 3 de#onstrating that a causal relationship *as li0ely 3 and since no other clusters *ere found they concluded that depri)ation could +e )irtually e/cluded as a factor, $ccording to <hta et al. Japan +uilt 8&: of all the #unicipal *aste incinerators in the *orld and +y %BB8 had +eco#e )ery concerned a+out their health effects! in the )illage of Shintone. 42: of all deaths +et*een %B '3B' in the area up to %,2 0# to lee*ard of an incinerator 4+uilt in %B8%5 *ere due to cancer. co#pared to 20: further a*ay and 2': o)erall in the local prefecture%8&, Their data on soil conta#ination reinforced the i#portance of considering *ind directions in e)aluating the health effects of incinerators, ;o#+a found an increased incidence of soft tissue sarco#a in an Italian population li)ing *ithin 2 0# of an incinerator%84, Pa#+on et al loo0ed at cases of sarco#a fro# a different perspecti)e, They calculated dio/in e/posure fro# incinerators and other industrial sources in patients *ith sarco#a using a dispersion #odel and found the ris0 of sarco#a increased *ith the e/tent and duration of e/posure to dio/in%8',

2&

In %B B Kusta)sson reported a t*ofold increase in lung cancer in incinerator *or0ers in S*eden co#pared to the e/pected local rate%89, In %BB& he reported a %,' fold increase in oesophageal cancer in co#+ustion *or0ers. including those *or0ing in incinerators%88,

!.2 )irth *efects

There ha)e +een fi)e reports of increases in congenital a+nor#alities around incinerators, The in)estigators at Sint 2i0laas noted #ultiple +irth defects to lee*ard of the incineratorB', <rofacial defects and other #idline defects *ere found to +e #ore than dou+led near an incinerator in Pee+urg. $#sterda#%8 , Most of these defor#ed +a+ies *ere +orn in an area corresponding to *ind3flo* fro# the incinerator and other defects included hypospadius and spina +ifida, In the 2eerland area. Belgiu#. there *as a 29: increase in congenital ano#alies in an area situated +et*een t*o incinerators%8B, $ study of incinerators in =rance has sho*n chro#oso#al defects and other #a-or ano#alies 4facial clefts. #egacolon. renal dysplasias5% 0, $ recent British study loo0ed at +irths in ;u#+ria +et*een %B'9 and %BB& and reported significantly increased lethal +irth defects around incinerators after ad-usting for year of +irth. social class. +irth order. and #ultiple +irths, The odds ratio for spina +ifida *as %,%8 and that for heart defects %,%2, There *as also an increased ris0 of still+irth and anencephalus around cre#atoriu#s% %, The study pointed out that the figures for +irth defects are li0ely to +e su+stantial underesti#ates since they do not include spontaneous or therapeutic a+ortions. +oth increased +y foetal ano#alies, In addition. se)eral studies ha)e noted an increase in +irth defects near *aste sites. particularly ha7ardous *aste sites, The pattern of a+nor#alities *as si#ilar to the pattern found *ith incinerators. *ith neural tu+e defects often +eing the #ost fre6uent a+nor#ality found. *ith cardiac defects second% 23 ', Har#ful che#icals are nor#ally stored in fatty tissue! in the foetus there is little or no fatty tissue e/cept for that in the +rain and ner)ous syste#. *hich #ay e/plain the pattern of da#age, $ re)ie* of this su+-ect stated Mthe weight of evidence points to an association between residential pro imity to hazardous waste site and adverse reproductive outcomes.N% 9

!.3 Ischaemic Heart *isease

Kusta)sson found an e/cess of ischae#ic heart disease%89 in incinerator *or0ers *ho had +een e/posed for longer, We ha)e not found any epide#iological studies of cardio)ascular disease in the neigh+ourhood of incinerators. +ut in )ie* of the research on particulates 4see section &,%5 this should +e in)estigated,

!.! Comment
The authors of so#e of these reports did not consider that they had sufficient grounds for concluding that the health effects round incinerators *ere caused +y pollution fro# the incinerators, Ho*e)er. statistically their findings *ere highly significant and. ta0ing the studies together. it is difficult to +elie)e that all their results could ha)e +een due to unrecognised confounding )aria+les, This is e)en less li0ely *hen you consider the nature of the pollutants released fro# incinerators and the scientific e)idence for the health effects of those co#pounds 4see sections 2 and &5, The concordance of increased cancer incidence in local areas de#onstrated to +e #ore polluted also points to a causal association. although it does not necessarily i#ply that the pollutant #easured contri+uted to the increase, 24

The studies #ay ha)e underesti#ated the ris0s, $t %& years. the follo*3up period of the large British study *as pro+a+ly too short! at Sint 2i0laas adult cancer cases see#ed to increase fro# %& years on*ard 4although children>s cancers occurred earlier5. and in Japan. <hta noted that cancer caused 42: of all deaths in the lee of incinerators fro# %4 to 24 years after the incinerator *as co##issioned%8&, The reported ris0s *ere higher in the studies in *hich allo*ance *as #ade for the direction of pre)ailing *inds. possi+ly +ecause of dilution else*here +y relati)ely une/posed persons, The studies re)ie*ed apply to the older incinerators! ne*er incinerators #ay ha)e +etter filters +ut fine particulates and #etals are inco#pletely re#o)ed, Since so#e of these pollutants. nota+ly fine particulates. do not appear to ha)e a safe threshold. it is clearly incorrect to clai# that incinerators are safe, The higher 6uantity of to/ic fly ash produced +y #odern incinerators. *hich is easily *ind3+orne. represents an additional ha7ard, E)en if incinerators *ere e6uipped *ith perfect filters. their huge si7e and tendency to faults #eans that the ris0 of inter#ittent high le)els of pollution is a real concern, Ta0ing into account these results and the difficulty in identifying causes of cancers and other chronic diseases. it is a #atter of considera+le concern that incinerators ha)e +een introduced *ithout a co#prehensi)e syste# to study their health effects. and that further incinerators are +eing planned *ithout co#prehensi)e #onitoring either of e#issions or of the health of the local population,

%. *isease Incidence and Pollution

%.1 Cancer
Studies lin0ing cancer *ith incinerators cannot +e seen in isolation, It is i#portant to o+tain an o)erall picture and loo0 at other studies *hich lin0 pollutants *ith cancer, $nd there is another aspect to this, Many types of cancer. including lung. pancreatic and sto#ach cancer. ha)e a )ery poor prognosis and our only hope lies in pre)ention, 1re)ention #eans reducing our e/posure to carcinogenic su+stances and *e should ta0e e)ery opportunity to do this, ;ancer has sho*n an unrelenting rise o)er the last century. and is affecting younger people, The rise has +een gradual. steady and real, ;ancer incidence has +een increasing +y %: per annu# *ith an age standardi7ed increase in #ortality of 4&: +et*een %B'0 and %B % 8, 1ut another *ay. the chance of dying fro# cancer at the turn of the 20th century *as % in &&, It is no* % in 4, WH< data has de#onstrated that 0: of cancers are due to en)iron#ental influences.% and e)idence fro# #igrant studies confir#s that it is #ainly the en)iron#ent rather than the genes that deter#ine the cancer ris0% , Many people ha)e noted that the rise in cancer has paralleled the rise in the production and use of synthetic che#icals. all the #ore re#ar0a+le since there has +een a si#ultaneous large drop in s#o0ing in #ales in #any countries, In the second half of the t*entieth century synthetic che#ical production dou+led e)ery 8 to years *ith a %00 fold increase o)er the last 2 generations% B, Many con)erging pieces of e)idence lin0 che#icals to the relentless rise of cancer, a8 1in-s bet?een ex#osure to #ollutants and cancer in man

2'

;ancer is co##onest in industrialised countries *ith '0: of cases in the industrialised 20: of the *orld%B0 and the WH< has noted that cancer incidence rises *ith the K21 of a country, There is the sa#e correlation *ithin countries, The highest #ortality fro# cancer in the ?S$ is in areas of highest industrialised acti)ity, There is also a correlation in the ?S$ +et*een cancer incidence and the nu#+er of *aste sites in the county%B%.%B2, ;ounties *ith facilities for treating to/ic *aste ha)e four ti#es as #uch +reast cancer%B&, ;ancer is also co##oner in counties *ith che#ical industries%B4, 1u+lic "ata $ccess in the ?S$ sho*s a close correlation +et*een cancer #ortality and en)iron#ental conta#ination%B', 2u#erous studies ha)e sho*n higher cancer incidence in +oth industrial *or0ers and in populations li)ing in polluted areas,%B9.%B8 <ne of the three #ost rapidly rising cancers. non3Hodg0in>s ly#pho#a. has +een clearly lin0ed *ith e/posure to certain che#icals 4for instance pheno/yher+icides and chlorophenols5,%B .%BB

b8 1in-s bet?een ex#osure to #ollutants and cancer in animals Three decades of studies of cancers in *ildlife ha)e sho*n that these are inti#ately associated *ith en)iron#ental conta#ination, This is particularly i#portant as ani#als do not s#o0e. drin0 or eat -un0 food and cannot +e accused of li)ing in depri)ed areas, This strengthens the long3suspected lin0 +et*een en)iron#ental pollution and cancer, In a recent study of out+rea0s of li)er cancer in %9 different species of fish at 2' different sites. cancers *ere al*ays associated *ith en)iron#ental conta#ination200, "ogs ha)e +een found to ha)e higher rates of +ladder cancer in industrialised counties in the ?S$20%, It is inconcei)a+le that *e are not affected in the sa#e *ay, =urther#ore cancer rates in ani#als rapidly decline *hen the pollutants are re#o)ed sho*ing the critical i#portance of an unconta#inated en)iron#ent for good health,202 c8 1ar e increases in cancer in certain tissues Steep rises in cancer ha)e occurred in tissues directly e/posed to the en)iron#ent! the lung and s0in, But so#e of the steepest rises ha)e occurred in parts of the +ody *ith high fat content. including cancers of the +rain. +reast. +one #arro* and li)er, This again points to to/ic che#icals *hich are predo#inantly stored in the fatty tissues, d8 .enetic mutation Many che#icals are 0no*n to attach to "2$ causing genetic change in the for# of "2$ adducts, The research of #olecular epide#iologist. "r =rederica 1erera. of ;olu#+ia ;entre for ;hildren>s En)iron#ental Health. has sho*n consistent associations +et*een e/posures to pollution and "2$ adduct for#ation on the one hand and adduct for#ation and cancer ris0 on the other20&.204, 1erera found t*o to three ti#es the le)el of "2$ adducts to polycyclic aro#atic hydrocar+ons in people in polluted areas and also found higher le)els of adducts in people *ith lung cancer than in those *ithout, Mothers e/posed to pollution for# "2$ adducts +ut their +a+ies ha)e e)en higher adduct le)els potentially putting the# at increased ris0 of cancer fro# +irth44, e8 Cancers and Environmental #ollution

29

Se)eral studies ha)e already gi)en direct e)idence of a lin0 +et*een en)iron#ental pollution and cancer, These include the (ong Island Study sho*ing a lin0 +et*een air+orne carcinogens and +reast cancer20'.209 and the ?pper ;ape Study sho*ing that tetrachloroethylene in the *ater *as associated *ith ele)ated rates of se)eral types of cancer2083B, It is note*orthy that initial in)estigations *ere negati)e in +oth these places and it *as only de#onstrated after detailed and sophisticated studies +y scientists fro# #any fields, 2u#erous other studies ha)e sho*n lin0s +et*een cancer and che#icals! these include associations +et*een )olatile organic che#icals 4D<;s5 in the *ater and increases in leu0ae#ia in 2e* Jersey2%0. increases in ly#pho#a in counties in Io*a *here drin0ing *ater *as conta#inated *ith dieldrin2%%. ele)ated le)els of leu0ae#ia in children at Wo+urn. Massachusetts coinciding *ith a 0no*n period of *ater conta#ination *ith chlorinated sol)ents2%2. a cancer cluster lin0ed to consu#ption of ri)er *ater conta#inated +y industrial and agricultural che#icals in Bynu#. 2orth ;arolina2%& and high rates of non3Hodg0in>s ly#pho#a fro# *ater conta#ination *ith chlorophenols in =inland2%4, f8 S#read of cancer and #ollutants $ir+orne pollutants not only affect the chance of contracting cancer +ut #ay also influence the chance of the cancer spreading, $ni#al studies sho*ed that inhalation of a#+ient le)el nitrogen dio/ide. or polluted ur+an a#+ient air. facilitated +lood3+orne cancer cell #etastasis%0', 8 1evels of Carcino ens in the body The reality a+out #ost che#icals is that their ris0s are largely un0no*n, This is particularly true of che#icals ne* to the #ar0et, What *e do 0no* is that a+out ' to %0: are pro+a+le carcinogens, The International $gency for ;ancer Research tested %000 che#icals in %BB& and found that %%0 *ere pro+a+le carcinogens 2%', The 2ational To/icity 1rogra# tested 400 che#icals in %BB' and found that '3%0: *ere carcinogenic2%9, <nly 200 of the 8'.000 synthetic che#icals in e/istence are regulated as carcinogens *hereas. fro# this data. +et*een &.000 and 8.'00 #ight +e e/pected to +e, We ha)e e)en less 0no*ledge a+out the carcinogenic potential of co#+inations of to/ic che#icals +ut *hat e)idence *e do ha)e suggests co#+inations #ay +e #ore dangerous and yet these are *hat *e are routinely e/posed to, $lthough the ?@ figures are not a)aila+le *e 0no* that 2,29 +illion pounds of to/ic che#icals *ere released in the ?S$ in %BB4! a+out %88 #illion pounds of these *ill ha)e +een suspected carcinogens, But *hat happens to all these che#icalsJ The reality is that #uch of this che#ical pollution ends up inside us, The e)idence for this is as follo*s!3 In a study. a group of #iddle aged $#ericans *ere found to ha)e %88 organochlorine residues in their +odies,2%8.2% This is li0ely to +e an underesti#ate as E1$ scientists consider that the fatty tissues of the ?S general population contain o)er 800 additional conta#inants that ha)e not yet +een che#ically characteri7ed2%B, $ recent study +y the Mount Sinai School of Medicine #easured che#icals in the +lood and urine of healthy )olunteers and found an a)erage of '2 carcinogens. 92 che#icals to/ic to the +rain and ner)ous syste# and '' che#icals associated *ith +irth defects220, They point out that these *ere che#icals that could +e #easured and that there *ere #any #ore that could not. #a0ing this again a considera+le underesti#ate, $ study of pollutants in a#niotic fluid found detecta+le le)els of 1;Bs and pesticides at le)els e6ui)alent to the foetus>s o*n se/ hor#ones22%, What these studies de#onstrate is that *hat *e put out into the *orld sooner or later co#es +ac0

28

to us and *ill +e stored in our +odies. particularly the lipophilic. +ioaccu#ulati)e co#pounds *hich are particularly da#aging, This effect is slo*. insidious and real, To allo* carcinogens and other poisonous su+stances into our +odies in this *ay #ust +e to ga#+le *ith our health, Incinerators e#it carcinogens, 1articulates the#sel)es are 0no*n to +e carcinogenic. #any hea)y #etals are 0no*n or suspected carcinogens. up to %0: of the che#ical pollutants are carcinogenic and there is a+undant e)idence that carcinogens are far #ore dangerous *hen co#+ined than *hen in isolation, ;o##on sense dictates that it is rec0less to continue to pour #ore carcinogens into the air at a ti#e *hen cancer is steadily increasing, Recent studies suggest that *e already ha)e to cope *ith 9' carcinogens in food. 40 carcinogens in *ater and 90 carcinogens in the air *e +reathe222, They should not +e there at all, They should certainly not +e increased, If *e seriously *ant to pre)ent cancer it is of para#ount i#portance that *e rapidly decrease the le)els of all carcinogens that *e are e/posed to,

%.2 Neurolo ical *isease

Most to/ic co#pounds are preferentially stored in fatty tissue and this includes the +rain A #a0ing the +rain a 0ey target organ for pollutants, There is no* co#pelling e)idence that hea)y #etals and other co#pounds such as 1;Bs and dio/ins cause cogniti)e defects. learning pro+le#s and +eha)ioural distur+ances in children and these effects occur at le)els pre)iously thought to +e safe22&, It is inconcei)a+le that these sa#e pollutants ha)e no i#pact on adult +rain function, In fact. so#e organochlorines. especially those *ith to/ic #eta+olites and those that dissol)e in the cell #e#+ranes are 0no*n to 0ill +rain cells,224.22' We note also the a+ility of ultrafine particulates to carry pollutants across the +lood3+rain +arrier9', If neurones *ere lost at the undetecta+le rate of 0,%: annually this *ould lead to a #a-or decline in +rain function +y #iddle age229, <f great concern is the de)eloping crisis of $l7hei#er>s disease *hich no* affects 4,' #illion patients in the ?S$ and nearly 800.000228 in the ?@, This is a disease *hich had ne)er +een diagnosed until %B08 and in the ?@ had only reached %'0 cases +y %B4 , $t the present rate of increase. the nu#+ers *ill dou+le +y 20&0, These statistics are alar#ing +ut need to +e seen as part of an o)erall trend of increasing neurological disease, $ recent study has noted su+stantial increases in neurological diseases in the last t*o decades coupled *ith earlier onset of these illnesses, Increases *ere noted in $l7hei#er>s disease. 1ar0inson>s disease and #otor neurone disease22 , The increase in $l7hei#er>s disease *as found in al#ost all de)eloped countries. and rises )aried across countries fro# 20: 4*hich *as defined as su+stantial5 to %200:, The paper suggested en)iron#ental factors *ere li0ely to +e responsi+le, It is nota+le that these diseases of older people ha)e increased at the sa#e ti#e that diseases affecting the +rain 4including $"H". autis# and learning difficulties5 ha)e also sho*n large increases at the other end of the age spectru#. to the order of 2003%800:22B, It is )ery li0ely that these diseases ha)e aetiological factors in co##on, Hea)y #etal e/posure is 0no*n to correlate *ith +oth 1ar0inson>s %0&.2&0 disease and $l7hei#er>s disease8'.89.B 3%02, Both diseases ha)e increased dra#atically o)er the last &0 years, In addition *e ha)e already noted that the a)erage person>s +ody contains at least 92 che#icals *hich are to/ic to the +rain and ner)ous syste#220, It is crucial to loo0 at e)ery possi+le *ay to pre)ent $l7hei#er>s +ecause of 2

its huge care costs 4?S figures are H90 +illion annually5 and +ecause of its dire effect on +oth patients and carers, $lthough #ultiple factors are pro+a+ly in)ol)ed in its causation. there is e)idence of a lin0 to hea)y #etal e/posure and it is therefore i#perati)e to reduce our e/posure to these to/ic #etals and other neuroto/ic che#icals +y all #eans possi+le, To deli+erately increase our e/posure to these pollutants. at a ti#e *hen these diseases are sho*ing huge increases. sho*s a *orrying lac0 of foresight,

%.3 (ental *iseases

Many pollutants pass straight fro# the nose to the +rain *here they affect +rain function, $ir pollution correlates *ith inpatient ad#issions *ith organic +rain syndro#e. schi7ophrenia. #a-or affecti)e disorders. neurosis. +eha)ioural disorder of childhood and adolescence. personality disorder and alcoholis#2&%, Increases in the total nu#+er of psychiatric e#ergency roo# )isits and in schi7ophrenia2&2 ha)e +een noted on days *hen air pollution has +een high, "epression has also +een lin0ed to inhaled pollutants2&&.2&4, ;learly so#ething )ery profound occurs *hen *e pollute the air,

%.! +iolence and Crime

$n increasing nu#+er of studies. including studies of #urderers 2&'. case3 control and correlation studies%&.B4.2&9.2&8 and prospecti)e studiesB9.2& ha)e sho*n lin0s +et*een )iolence and hea)y #etals and these include lead. cad#iu# and #anganese, The #a-ority of the studies ha)e in)estigated lead, Diolence and cri#e ha)e +een associated *ith +oth increased +ody le)els of lead and *ith increased le)els of lead in the air, =or instance "enno2&B found early lead e/posure *as one of the #ost i#portant predictors of disciplinary pro+le#s fro# ages %& to %4. delin6uency fro# ages 8 to %8 and adult cri#inal offences. fro# ages % to 22, Stretes0y found an association +et*een air lead le)els and #urder rates in ?S counties240, It is interesting that air lead le)els *ere a #uch stronger predictor of +oth )iolent and property cri#e than une#ploy#ent. *hich has often +een considered an i#portant cause for cri#e 24%, The li0ely #echanis# is that these su+stances alter neurotrans#itters such as dopa#ine and serotonin and reduce i#pulse control, This gro*ing literature should ser)e as a *arning a+out the dangers of allo*ing hea)y #etals to +e e#itted into the en)iron#ent, ;ri#e. especially )iolent cri#e. can ha)e a dra#atic effect on people>s 6uality of life, We need to consider the effect of incinerators. not only on health. +ut on education and on 6uality of life. including the i#pact of )iolence and cri#e,

&. Hi h ,is- .rou#s

9,% /he :oetus The un+orn child is the #ost )ulnera+le #e#+er of the hu#an population, The foetus is uni6uely suscepti+le to to/ic da#age and early e/posures can ha)e life changing conse6uences, Why is the foetus so )ulnera+leJ There are t*o #ain reasons, =irstly #ost of these che#icals are fat solu+le, The foetus has )irtually no protecti)e fat stores until )ery late pregnancy so the che#icals are stored in the only fatty tissues it has. na#ely its o*n ner)ous syste# and particularly the +rain, Secondly #any pollutants are acti)ely transported across the placenta fro# the #other to the foetus, This occurs *ith hea)y #etals *hich the +ody #ista0es for essential #inerals, This is 2B

particularly critical for #ercury *here one tenth of *o#en already ha)e +ody stores of #ercury *hich can lead to neurode)elop#ental pro+le#s in the ne*+orn 242, <ther factors that increase foetal suscepti+ility are higher rates of cell proliferation. lo*er i##unological co#petence and decreased capacity to deto/ify carcinogens and repair "2$24&, Safety li#its currently do not ta0e into account this increased ris0 to the foetus, <nly 8: of high )olu#e che#icals ha)e +een tested for neurode)elop#ental to/icity244 and )ery fe* pollutants ha)e +een tested for teratogenicity, "uring a narro* *indo* of ti#e. in the first %2 *ee0s in utero. the foetus>s +ody is affected +y #iniscule a#ounts of hor#one #easured in parts per trillion, Tiny a#ounts of che#icals can upset this delicate +alance, It is no* generally accepted that che#icals that are not to/ic to an adult can ha)e de)astating effects on the ne*+orn, 1orterfield has sho*n that s#all a#ounts of che#icals such as dio/ins and 1;Bs. at doses that are not nor#ally regarded as to/ic. can affect thyroid hor#ones and neurological de)elop#ent%%, $ single e/posure is enough and ti#ing is critical24', S#all doses of oestrogenic che#icals can alter se/ual de)elop#ent of the +rain and the endocrine syste#249, It is esti#ated that ': of +a+ies +orn in the ?S$ ha)e +een e/posed to sufficient pollutants to affect neurological de)elop#ent248, It has also +een sho*n that e/posure to oestrogenic che#icals affects i##unity. reduces the i##une response to )accines. and is associated *ith a high incidence of #iddle ear and recurrent respiratory infections24 , The a#ount of che#ical that the +a+y ta0es in relates to the total persistent conta#inants that ha)e +uilt up in the #other>s fat o)er her lifeti#e24B, This *ill increase in areas around incinerators, E/posure to fine particulate pollution during pregnancy can ha)e an ad)erse effect on the de)eloping foetus and lead to i#paired foetal gro*th84, In July 200'. in a ground3+rea0ing study2'0. researchers at t*o #a-or la+oratories in the ?S$ loo0ed at the +ody +urden in the foetus, They reported an a)erage of 200 industrial che#icals and pollutants 4out of 4%& tested5 in the u#+ilical cord +lood of %0 rando#ly chosen +a+ies, These included % 0 carcinogens. 2%8 che#icals that are to/ic to the +rain and ner)ous syste# and 20 that can cause +irth defects and a+nor#al de)elop#ent in ani#als, $ state#ent +y scientists and paediatricians said that the report raised issues of su+stantial i#portance to pu+lic health. sho*ed up gaping holes in the go)ern#ent>s safety net and pointed to the need for #a-or refor# to the nation>s la*s that ai# to protect the pu+lic fro# che#ical e/posures, T*o #onths later. scientists at the ?ni)ersity of Kroningen. released the results of a European study. co##issioned +y WW= and Kreenpeace. on the foetal +ody +urden, They tested for the presence of &' che#icals in the u#+ilical cord +lood of ne*+orns2'%, $t least fi)e ha7ardous che#icals *ere found in all +a+ies and so#e had as #any as %4 different co#pounds, The report 6uestioned the *isdo# of allo*ing the foetus to +e e/posed to a co#ple/ #i/ture of persistent. +io3 accu#ulati)e and +ioacti)e che#icals at the #ost critical stage of life, Incinerators can only ha)e the effect of increasing the foetal +ody +urden and their use is therefore a retrograde step for society, It is particularly i#portant to apply the precautionary principle in issues that affect the foetus. infant and child,

&.2 /he )reast0fed Infant

It is a #a-or concern that +reast #il0. perhaps the greatest gift a #other can gi)e for the future health of her child. has no* +eco#e the #ost conta#inated food on &0

the planet. in ter#s of persistent organic pollutants2'2, In the ?S$ studies of hu#an +reast #il0 ha)e sho*n that B0: of sa#ples contained a distur+ing &'0 che#icals, This *as higher in industrialised areas sho*ing that inhalation of these to/ic su+stances is an i#portant factor2'&, The dose ta0en in +y a +reast3feeding +a+y is '0 ti#es higher than that ta0en in +y an adult2'4, The incinerator *ould add to the total load of che#icals in the #other>s fat and those to/ins accu#ulated o)er a lifeti#e +y the #other *ill then +e transferred to the tiny +ody of her +a+y through her #il0, Si/ #onths of +reast feeding *ill transfer 20: of the #other>s lifeti#e accu#ulation of organochlorines to the child 2'', =ro# %B8B one in four sa#ples of +reast #il0 ha)e +een found to +e o)er the legal li#it set for 1;Bs in co##ercial feeds24B and these are 0no*n to i#pair intellectual de)elop#ent32'93 , ;onta#ination *ith persistent organic pollutants 41<1s5 in +reast #il0 in ani#als has consistently sho*n structural. +eha)ioural and functional pro+le#s in their offspring2'B, =or instance. in #on0eys it has sho*n that it decreases their a+ility to learn29032, 1oly+ro#inated diphenyl ethers 41B"Es5 are to/ic che#icals *hich ha)e +een dou+ling in +reast #il0 e)ery fi)e years. and ha)e also +een rapidly increasing in the *aste fed to incinerators as they are no* present in #any co##on electrical and electronic goods, 1B"Es cause cancer. +irth defects. thyroid dysfunction and i##une suppression,29&.294 It is truly tragic that one of the fe* *ays of re#o)ing these conta#inants fro# the #other>s +ody is +y +reast3feeding,

&.3 Children
To/ic and carcinogenic e/posures in early life. including prenatal e/posures. are #ore li0ely to lead to cancer than si#ilar e/posures later 29'38, $t the =irst International Scientific ;onference of ;hildhood (eu0ae#ia. held in Septe#+er 2004. 1rofessor $lan 1reece suggested that pollutants crossing the placenta. *ere da#aging the i##une syste# and could +e lin0ed *ith soaring rates of leu0ae#ia. *hich *ere +eing initiated in utero, This the#e *as e/panded +y 1rofessor Keorge @no/ in his recent study *hich found that children born in F#ollution hots#otsG ?ere t?o to four times more li-ely to die from childhood cancer. The MhotspotsN included sites of industrial co#+ustion. and sites *ith higher le)els of particulates. D<;s. nitrogen dio/ides. dio/ins and +en74a5pyrenes A in other *ords -ust *hat *ould +e found around incinerators, He said that. in #ost cases. the #other had inhaled these to/ic su+stances and they *ere then passed on to the foetus through the placenta29 , This is supported +y ani#al studies *hich ha)e already confir#ed that cancer in young can +e initiated +y gi)ing carcinogens +efore conception 4to the #other5. in utero or directly to the neonate29B.280, "e)eloping syste#s are )ery delicate and in #any instances are not a+le to repair da#age done +y en)iron#ental to/icants28%, In one study there *as an age3 related difference in neuroto/icity for all +ut t*o of &% su+stances testedC these included hea)y #etals. pesticides and other che#icals282, ;hildren are not -ust a )ulnera+le group +ut the current inha+itants of a de)elop#ental stage through *hich all future generations #ust pass, This fact is recognised in the passage of the =ood Guality 1rotection $ct in the ?S$, It re6uires that pesticide standards are +ased pri#arily on health considerations and that standards are set at le)els *hich *ill protect the health of children and infants, "e)elop#ental disorders including autis# and attention deficit syndro#e are *idespread and affect &3 : of children, The ?S 2ational $cade#y of Sciences concluded in July 2000 that &: of all de)elop#ental disorders *ere a direct conse6uence of to/ic en)iron#ental e/posures and another 2': are the result of &%

interactions +et*een to/ic e/posures and indi)idual suscepti+ility, The causes included lead. #ercury. 1;Bs. certain pesticides and other en)iron#ental neuroto/icants28&. su+stances that are all discharged fro# incinerators Recently associations ha)e +een reported in case control studies +et*een the +ody +urden of #ercury and the ris0 of autis#284, In other studies in Te/as. associations ha)e +een found +et*een the a#ount of #ercury discharged into the air and *ater +y che#ical plants and the local incidence of autis# 0 and an in)erse relationship +et*een the distances of schools fro# the plants discharging #ercury and autis# in their youngest pupils 4 years laterC this is the lag e/pected fro# the fact that the greatest sensiti)ity to neuroto/icity is seen +efore +irth and in neonates %, This suggests that #ercury could +e responsi+le +ut the contri+ution of other neuroto/ins *as not e/cluded, The study of the Sint 2i0laas incinerator found a #ultitude of pro+le#s in children. including learning defects. hyperacti)ity. autis#. #ental retardation and allergiesB' and this is e/actly *hat *ould +e anticipated fro# the a+o)e and research already done on the health effects of hea)y #etals. 1;Bs and dio/ins on children, $ni#al studies sho* si#ilarities. *ith a recent study de#onstrating autistic3li0e +eha)ioural changes in rats *hose #others has +een e/posed to 1;Bs *hilst pregnantC they had de)eloped a+nor#al plasticity in the corte/ of the +rain28', We need also to consider su+clinical to/icity, The pioneering *or0 of Her+ert 2eedle#an sho*ed that lead could cause decreases in intelligence and alteration of +eha)iour in the a+sence of clinically )isi+le signs of to/icityB2, This has also +een sho*n to +e the case *ith 1;Bs289 and #ethyl #ercury8B, These effects are all the #ore li0ely *hen children are e/posed to #ultiple pollutants. nota+ly the hea)y #etals. *hich *ill +e found in the coc0tail of che#icals released +y incinerators, $lthough this has only #inor i#plications for an indi)idual it can ha)e #a-or i#plications for a population, =or instance a ' point drop of IG in the population reduces +y '0: the nu#+er of gifted children 4IG a+o)e %205 and increases +y '0: the nu#+er *ith +orderline IG 4+elo* 05288, This can ha)e profound conse6uences for a society. especially if the drop in IG is acco#panied +y +eha)ioural changes,

&.! /he Chemically Sensitive

In the +oo0. ;he#ical E/posures. (o* (e)els and High Sta0es +y 1rofessors $shford and Miller%'%. the authors noted that a proportion of the population react to che#icals and pollutants at se)eral orders of #agnitude +elo* that nor#ally thought to +e to/ic, =or e/a#ple research has disco)ered indi)iduals *ho react to le)els of to/ins pre)iously considered to +e safe, T*o e/a#ples are +en7ene28 and leadB&, It has +een de#onstrated that there is a tenfold difference +et*een different indi)iduals in the #eta+olis# of the carcinogenic 1$H +en74a5pyrene28B, $shford and Miller also noted that studies in +oth to/icology and epide#iology ha)e recognised that che#icals are har#ful at lo*er and lo*er doses and that an increasing nu#+er of people are ha)ing pro+le#s, $ significant percentage of the population ha)e +een found to react this *ay 4%' to &0: in se)eral sur)eys *ith ': ha)ing daily sy#pto#s5,%'% Research has sho*n %'0 to 4'0 fold )aria+ility in response to air+orne particles2 0, =ried#an has stated that en)iron#ental regulation re6uires the protection of these sensiti)e indi)iduals2 %, This highlights the dangers of incinerators *hich e#it a #ultitude of che#ical co#pounds, ;he#ical sensiti)ity is typically triggered +y an acute e/posure after *hich sy#pto#s start to occur at )ery lo* le)els of e/posure%'%, =aults are all too co##on *ith #odern incinerators leading to discharges of pollutants at le)els that endanger health A gi)ing &2

a )ery real ris0 of long3ter# sensitisation, ;ertain suscepti+le indi)iduals *ill +e highly affected +y these pollutants and these effects *ill +e difficult to anticipate, In addition. people affected this *ay are e/tre#ely difficult to treat,

'.

Past (ista-es and /he Precautionary Princi#le

'.1 /he Precautionary Princi#le

The 1recautionary 1rinciple has no* +een introduced into national and international la* including that of the European ?nion2 2, This principle in)ol)es acting in the face of uncertain 0no*ledge a+out ris0s fro# en)iron#ental e/posures, This #eans pu+lic health #easures should +e ta0en in response to li#ited. +ut plausi+le and credi+le. e)idence of li0ely and su+stantial har#2 &, It is su##ed up in the %BB Wingspread state#ent! MWhen an acti)ity raises threats of har# to hu#an health or the en)iron#ent. precautionary #easures should +e ta0en e)en if so#e cause and effect relationships are not fully esta+lished scientifically, In this conte/t. the proponent of the acti)ity. rather than the pu+lic. should +ear the +urden of proof,N In the case of incinerators a recent re)ie* of health effects found t*o thirds of studies sho*ed a positi)e e/posure3disease association *ith cancer 4#ortality. incidence and pre)alence52 4 and so#e studies pointed to a positi)e association *ith congenital #alfor#ations, In addition *ithout e/act 0no*ledge of *hat pollutants are produced +y incinerators. their 6uantities. their en)iron#ental fate or their health effects. it is i#possi+le to assure their safety, It is a+solutely clear fro# this and fro# the e)idence presented here that +uilding #unicipal *aste incinerators )iolates the 1recautionary 1rinciple and perhaps European (a*, 8,2 1earnin from Past (ista-es Ti#e and ti#e again it has +een found that *hat *e did not 0no* a+out che#icals pro)ed to +e far #ore i#portant than *hat *e did 0no*, $s an incinerator generates hundreds of che#icals. including ne* co#pounds. *e can e/pect #any unpleasant future surprises, Here are a fe* e/a#ples fro# the past! Chlorofluorocarbons 7C:Cs8 These che#icals *ere touted as the safest che#icals e)er in)ented *hen first synthesised in %B2 , Tho#as Midgeley recei)ed the highest a*ard fro# the che#ical industry for his disco)ery, $fter 40 years on the #ar0et suspicion fell on the#, They *ere producing holes in the o7one layer e/ceeding the *orst case scenario predicted +y scientists, Polychlorinated bi#henyls 7PC)s8 These che#icals *ere introduced in %B2B, To/icity tests at the ti#e sho*ed no ha7ardous effects, They *ere on the #ar0et for &9 years +efore 6uestions arose, By that ti#e they *ere in the +ody fat of e)ery li)ing creature in the planet and e)idence +egan to e#erge of their endocrine disrupting effects, Pesticides Early pesticides included arsenical co#pounds +ut these 0illed far#ers as *ell as pests, They *ere replaced +y ""T, 1aul Muller *as a*arded the 2o+el 1ri7e for this disco)ery as it *as considered a #ilestone in hu#an progress, But ""T +rought death in a different *ay and it *as another t*o decades +efore it *as +anned, (ess persistent pesticides then ca#e onto

&&

the #ar0et +ut they had yet another unanticipated pro+le# A endocrine disruption, /ributyl tin 7/)/8 In the early se)enties scientists noted irre)ersi+le da#age *as occurring to the reproducti)e syste# of fish and shellfish. especially cla#s. shri#ps. oysters. "o)er Sole and sal#on, It *as %% years +efore the cause *as found and it *as found to +e due to +e tri+utyl tin. a che#ical added to paint to stop +arnacles gro*ing, Incredi+ly the da#age *as occurring at a concentration of -ust fi)e parts per trillion, By the end of the eighties #ore than one hundred species of fish *ere 0no*n to ha)e +een har#ed,

This pattern of unanticipated disasters and long latent inter)als +efore their disco)ery characterises the history of #any to/ic che#icals and *arrants great caution in the use of ne* co#pounds, $ni#al studies al#ost ne)er *arn us of the uni6uely hu#an neuroto/ic effects on +eha)iour. language and thin0ing, In the case of lead. #ercury and 1;Bs the le)els of e/posure needed for these effects to occur ha)e +een o)eresti#ated +y a factor of %00 to %0.0002 ', To 6uote Krand-ean2 & M!ast e periences show the costly conse"uences of disregarding early warnings about environmental hazards. Today the need for applying the !recautionary !rinciple is even greater than beforeN

2. 3lternative 4aste /echnolo ies

$n ideal *aste strategy *ould produce no to/ic e#issions. no to/ic +y3 products. no residues that need landfilling 47ero *aste5. good reco)ery of #aterials and +e capa+le of dealing *ith all types of *aste, This #ight see# a tall order +ut *ith a co#+ination of approaches. it is no* possi+le to co#e 6uite close to this goal, <nce this ai# is #ade clear then incineration +eco#es a poor choice, The potentially dangerous e#issions to air. the high )olu#e of ash that needs landfilling and the )ery to/ic nature of the fly ash *ould rule it out, Si#ilarly pyrolysis produces to/ic +y3products and is +est a)oided, The #ost i#portant co#ponent of an integrated strategy #ust +e so#e for# of separation and recycling, We #ust also loo0 at #ethods of dealing *ith residual *aste that produce no ash. such as Mechanical3Biological Treat#ent. $naero+ic "igestion and $d)anced Ther#al Technologies, ,% ,ecyclin 5 ,e0use and Com#ostin Both go)ern#ent guidance and the European ?nion Waste Hierarchy #a0e it clear that recycling and re3use are the highest priorities in *aste #anage#ent and that this should ta0e precedence o)er incineration and landfill, This hierarchy has +een descri+ed as reduction. reuse. reco)ery and disposal, Many fine *ords ha)e +een spo0en. +ut the reality is. that *ithout incenti)es to support recycling. +oth the increase in landfill ta/ and the European "irecti)es to reduce the a#ount of +iodegrada+le *aste going to landfill are dri)ing *aste #anage#ent to*ards its lo*est priorities. principally incineration, This has no* +eco#ing the easiest option for local authorities, Waste policy is )eering a*ay fro# its stated highest priorities *ith their lo* en)iron#ental i#pact to*ards the least sustaina+le options *hich ha)e the highest en)iron#ental i#pact, The net effect of this is that incineration. *ith its large appetite for high calorific recycla+le #aterials. is no* in direct co#petition *ith recycling and has &4

+eco#e an o+stacle to sound *aste policy, This is an in)ersion of the Waste Hierarchy and re#o)es the #oti)ation to re3use and recycle, <ne *ay for*ard *ould +e to use the strategy already e#ployed +y se)eral countries such as S*eden and the 2etherlands. *here *aste cannot +e deli)ered to landfill or incinerators *ithout ha)ing undergone separation or treat#ent, In effect. this stops the sending of recycla+le ite#s to landfill and incineration, $+out 49: of #unicipal *aste consists of paper. card+oard. fa+rics. glass and #etals A all of *hich could +e recycled, Metals are +eco#ing #ore )alua+le and are already +eing #ined in du#ps in parts of the *orld, $+out &2: consists of garden and food *aste *hich could +e co#posted, Se)eral co##entators ha)e e#phasised that. for recycling progra#s to *or0 successfully. it is i#portant to ha)e syste#s in place that are easy to use, "oorstep collections of organic *aste are especially i#portant, $nother %&: of *aste is plastics *hich are discussed +elo*, The ?@ presently recycles a+out 2&: of its *aste, Many other countries recycle a far higher proportion of their *aste *ith 2or*ay. $ustria and Holland achie)ing o)er 40: and S*it7erland o)er '0:, St Ed#unds+ury in the ?@ has reached '0:, Belo* is a ta+le sho*ing that #any areas ha)e achie)ed high rates of #unicipal *aste di)ersion 4recycling. re3use and co#posting5 and this de#onstrates that di)ersion rates of '0380: are realistic targets,
Bocality Zabbaleen-served areas of 7airo, -gypt +potiki >istrict, 8ew Dealand Ea""o (5adua), #taly *renton, +ntario ?ellusco (Milan), #taly 8etherlands 8orthumberland 7ounty, +ntario, 7anada Sidney, +ntario -ast 5rince, 5rince -dward #sland, 7anada ?oothbay, Maine, @.SC /alifa$, 7anada 7hatham, 8ew Gersey, @.SC Halls 7hurch, 6irginia, @.SC Ealway, #reland ?elleville, +ntario 7anberra, Custralia ?ellevue, !ashington, @.SC Euelph, +ntario, 7anada Eisbome >istrict, 8ew Dealand 7fifton, 8ew Gersey, @.SC Boveland, 7olorado, @.SC >enmaI ?ergen 7ounty, 8ew Gersey, @.SC !orcester, Massachusetts, @.SC Beverett, Massachusetts, @.S.C. Cnn Crbor, Michigan, @.S.C. 7rockett, *e$as, @.S.C. >over, 8ew /ampshire, @.SC Jaikoura >istrict, 8ew Dealand Swit"erland 8ova Scotia, 7anada 5ortland, +regon, @.SC Madison, !isconsin, @.SC Hitchburg, !isconsin, @.SC >iversion Aate (percent) %' %' %1 F' F3 F( 2& 2& 22 22 2' 2' 2' 23 23 21 23 '% 'F '2 '2 ' ' ' '3 '( '( '( '( '3 '3 '3 '3 '3

6isalia, 7alifornia, @.SC

'3

&'

2.2 Producin 1ess 4aste

Ho*e)er efficiently *e recycle. re3use and co#post. these cannot sol)e the *aste pro+le# *ithout another )ital stepC na#ely producing less *aste in the first place, To e#phasise this point. the a#ount of #unicipal and +usiness *aste in the ?@ is still gro*ing2 9 in spite of higher rates of recycling, Darious solutions to this are gaining popularity, <ne is E/tended 1roduct Responsi+ility 4E1R5 *here fir#s ta0e physical and financial responsi+ility for products e)en after they are sold. collecting their products and pac0aging after use, This encourages fir#s not to produce non3recycla+le and non re3usa+le products, It has +een applied to pac0aging. tyres. and electronics, E1R needs to +e e/tended +ut *here this is not practical. such as *here products are ha7ardous or non3recycla+le. then a product +an #ight +e appropriate, $ further solution *ould +e to ta/ non3 recycla+le ite#s to discourage their production, There is a further aside to this issue *hich has yet to +e addressed +y go)ern#ents, The de)eloped *orld is producing. and disposing of. increasing a#ounts of goods of all 0inds. including large a#ounts of synthetic #aterials un0no*n a century ago, The rest of the *orld is not unnaturally *anting to share the prosperity. +ut *e are rapidly reaching a point *here continuing e)en at the present le)el *ill +eco#e i#possi+le +ecause *e are running out of +oth energy and of essential #aterials. particularly oil, We ha)e finite sources of oil fro# *hich so #any #aterials are #ade, We are pro+a+ly close to reaching pea0 production and this resource *ill di#inish o)er the ne/t fe* decades at a ti#e *hen de#and is increasing internationally, 2atural gas *ill pea0 a decade or t*o later and then di#inish, The only other t*o #a-or sources of energy *ould +e coal and nuclear po*er, 2uclear energy. e)en in the unli0ely e)ent that a safe *ay could +e found to deal *ith the radioacti)e *aste. *ould last +et*een 2 8 and %8 years 2 if it *as supplying 2032': of the *orld>s energy +ecause uraniu# is also a finite resource, Burning coal could cause a disastrous increase in greenhouse gases, $gain it could not #a0e up for the shortage of energy and *ould last less than a century2 B, $t present it appears that genuinely rene*a+le sources of energy could pro)ide. at the )ery #ost. 40: of our present energy re6uire#ents2 B, 4In reality it is li0ely to +e #uch less and it has +een esti#ated rene*a+le sources *ill produce 4Q : of total energy and 22: of electricity +y 2020 in the ?@5,2B0 "ifferent e/perts *ill ha)e their o*n opinions on all of these figures. +ut one thing is certain! 3 *e are running out of energy, We can anticipate a 20: reduction in energy fro# all sources in 40 years and a 40: reduction in 90 years 2 B, (ong +efore this happens the price of energy and of goods #ade fro# oil *ill soar, There is only one possi+le solution to this pro+le# in the long ter# and that is to reduce our use of energy *hich #eans reducing our production and consu#ption of goods. and preser)ing our resources. including the )alua+le co#ponents in our *aste,

2.3 6ero 4aste

Pero *aste. initially introduced in 2e* Pealand has +een ta0en up successfully +y other regions and cities such as San =rancisco. The 1hilippines. =landers. ;an+erra. Bath and 2orth East So#erset, In the ?@. 8%: of councils ha)e co##itted to 7ero *aste as part of their plan, This #eans *or0ing to*ards a goal of producing 7ero *aste and a)oiding disposal in landfill and incineration, The policy of the European ?nion is already on the path to*ards 7ero *aste, 6ero ?aste and incineration are mutually incom#atible. &9

There are so#e difficulties *ith 7ero *aste, <ne is that not all #aterials can +e recycled and there *ill +e so#e residual *aste. nota+ly plastics, <ther goods contain #i/ed ingredients 4for e/a#ple en)elopes containing plastic *indo*s5 and cannot easily +e recycled, These could +e ta/ed or +anned, So#e areas such as =landers in Belgiu# ha)e recognised this pro+le# and ha)e inno)ati)ely set a target for residual *aste. currently %'00g per capita per year 4?@! 4000g per capita per year5, This is a useful idea and the policy sends out a strong signal to #anufacturers to produce recycla+le products,

2.! /he Problem of Plastics

$ large a#ount of our *aste is plastics and related #aterials such as 1D;, 1resently only t*o types of plastics can +e recycled, The first 0ey 6uestion is *hat *ill *e do *ith these non3recycla+le plasticsJ The second 0ey 6uestion is ho* do *e #a0e chlorinated plastics safe for the future. ta0ing into account that their highly persistent and to/ic natureJ The third 0ey 6uestion is can *e use plastics as a future resourceJ These are not s#all issues, =or e/a#ple. *e use '00 +illion carrier +ags each year, They are used for an a)erage of 20 #inutes and are )irtually indestructi+le. lasting for centuries, Many end up as #icroscopic tilth in the oceans, They then find their *ay into the food chain )ia lug*or#s and +arnacles, Incineration is a poor ans*er to these issues as #any plastics are organochlorines and for# to/ic products. nota+ly dio/ins. *hen +urnt, In addition an i#portant resource is *asted, We use a+out &34: of our oil to produce these plastics and it #a0es no sense to si#ply +urn the#, The +est solution *ould +e to stop #a0ing chlorinated plastics in the first place in )ie* of their persistence and to/icity, Instead *e could #a0e +iodegrada+le plastics 4+ut note these *ill +rea0 do*n to for# the greenhouse gas #ethane5, $nother ans*er is plas#a gasification, 1las#a gasification. unli0e incineration can con)ert chlorine3+ased plastics +ac0 to their original starting #aterial. na#ely salt and *ater and synthesis gas 4car+on #ono/ide and hydrogen5, =urther procedures can +e used to con)ert synthesis gases into highly useful #aterials! fuels such as ethanol and =ischer3Tropsch diesel 4a cleaner for# of diesel5 or ethylene to produce #ore plastics, It other *ords it could +e used to +oth deto/ify and refor# plastics,

2.% 3naerobic *i estion of "r anic (atter

The pro+le#s of landfills are threefold, <ne is the production of greenhouse gases. principally #ethane, The second is the seeping of che#icals fro# landfill sites into a6uifers, The third is lac0 of space, The for#er is the #ost urgent pro+le# to sol)e, The #ethane is produced +y organic *aste. in other *ords rotting organic #atter. +ut not +y plastics 4e/cept +io3degrada+le ones5 or #etals, $t present the #ethane is +urnt in a flare to*er or gas generator plant at the landfill site, Ho*e)er this is )ery inefficient, $ far +etter option is to re#o)e the paper. plastics and #etals and allo* the *aste to +rea0 do*n in an anaero+ic digester, The #ethane can then +e +urnt in a co#+ined heat and po*er plant to produce electricity and heat, $s this occurs in a sealed unit the en)iron#ental i#pact is #uch less than a landfill gas po*er plant, If this type of facility *as used for the #a-ority of agricultural *aste and se*age then it could supply &: of the ?@>s electricity and *ould also displace car+on e#issions2 4,

2.& (echanical )iolo ical /reatment 7()/8

&8

This treat#ent is used e/tensi)ely in Ker#any. Italy and $ustria. has +een in use for o)er %0 years and is due to +e introduced into the ?@, The process in)ol)es a #echanical stage in *hich the *aste is chopped up into frag#ents and then separated +y +eing put through screens of )arious si7es and past #agnets, This process *ill separate the *aste into fractions *hich can +e used for different purposes, =or instance #etals. #inerals and hard plastics can then +e recycled, 1aper. te/tiles and ti#+er can also +e reco)ered, <rganic #atter can then +e +ro0en do*n +y co#posting A this is the +iological treat#ent, This can +e achie)ed +y e/posing the *aste to at#ospheric o/ygen or it can +e +ro0en do*n in the a+sence of o/ygen 4anaero+ic digestion5, The re#aining ru++ish can then +e landfilled, This process is )irtually pollution3free unless the remainin #ellets are burnt *ith all the ris0s this entails, With MBT #ost of the original goals are +eing #et, It fails on t*o counts only, =irstly there is so#e residue that needs landfilling A this is a #inor point +ut the second is #ore serious! MBT cannot cope *ith all types of *aste as it is not suita+le for ha7ardous *aste, This is i#portant as the a#ount of ha7ardous *aste is li0ely to increase, So MBT needs to +e part of a syste#, 2ote that residues fro# MBT ha)e had the organic #atter re#o)ed. so they *ill not produce the pro+le#atic greenhouse gases, =or this reason *e +elie)e it is *rong that it incurs the full landfill ta/ as happens at present,

2.' 3dvanced /hermal /echnolo ies 73//8 and Plasma .asification

In contrast *ith non3ther#al #ethods. any ther#al #ethod of dealing *ith *aste carries an inherent ris0 of causing fatalities, Because of this ther#al #ethods should only +e used for residual *aste after full separation of recycla+les has ta0en place, If ther#al #ethods are used. these should al*ays +e the safest ones a)aila+le, In effect this #eans plas#a gasification or gasification using the Ther#oselect process, Japan has #ore e/perience of incineration than any other country and has started to use plas#a gasification as a safer alternati)e to incineration, 1las#a gasification is also in use in ;anada, 1las#a gasification achie)es the final o+-ecti)e +y disposing of the residual *aste after separation and recycling and other separating technologies such as #echanical3+iological treat#ent, It can deal safely *ith the #ost ha7ardous types of *aste and can produce up to three ti#es as #uch energy as incineration, Kasification has +een e#ployed +y the natural gas industry for o)er 0 years +ut has not. so far. +een used e/tensi)ely for dealing *ith *aste. although such plants are no* in operation in Italy. S*it7erland. Ker#any and Japan, Kasification produces high te#peratures and can ther#ally deco#pose co#ple/ and ha7ardous organic #olecules into gases and +enign si#ple su+stances, 1las#a refers to the gas *hen it has +eco#e ioni7ed and this happens *hen an electric current is passed through the gas, 3 very im#ortant distinction from incineration is that it does not #roduce ash, The gas cleaning process can con)ert #any conta#inants into en)iron#entally +enign and useful +y3products, The a+ate#ent e6uip#ent of incinerators and gasification units is )ery different, If the a+ate#ent e6uip#ent in an incinerator fails. as is all too co##on. people do*n*ind fro# the installation *ill +e su+-ected to dangerous pollution, If the a+ate#ent e6uip#ent in a gasification unit fails it *ill cause serious da#age to the plant itself A so the plant has to +e +uilt to a #uch higher 6uality, In a plas#a gasification plant. the residual to/ic su+stances including #etals +eco#e encapsulated in silicate *hich is li0e +eing encased in stone, The plant *ill re#o)e the to/ic and persistent co#pounds fro# plastics and other che#icals and &

refor# the#, $ good 6uality plas#a gasification unit *ill not produce any ad)erse residues or +y3products. only synthesis gas. silica. sulphur and salt, Synthesis gas is a useful +y3product *hich can +e used as a fuelC R a #a-or financial ad)antage *hich allo*s the capital costs of the unit to +e paid *ithin a 8 year period, $lthough it is a relati)ely e/pensi)e process. it is far cheaper than incineration once the health costs are ta0en into account 4see section B,%5, 2ote also that it *ould not incur costs under the European ?nion E#issions Trading Sche#e. potentially sa)ing #illions of pounds annually, $ recent re)ie* of plas#a gasification considered it to +e a pro#ising alternati)e to older technologies and that the present cli#ate fa)oured the adoption of ad)anced technologies for *aste treat#ent2B%, If it is co#+ined *ith MBT and recycling. then only a s#all unit *ould +e needed, It is i#portant to realise that gasification syste#s can )ary in 6uality and therefore safety, It is crucial that there is a good gas cleaning syste# *hich goes through 8 or stages, It is also essential that te#peratures of %'00 ; are achie)ed 3 enough to +rea0 do*n organochlorines and con)ert the# +ac0 to their original safe for#. salt and *ater, <rganochlorines are pro+a+ly the #ost pro+le#atical group of che#icals on the planet so a real +enefit of this technology is that this process re)erses of the chlor3 al0ali process that produces organochlorines in the first place

2.2 .reenhouse .ases

Incineration has +een sold as a source of green energy and e)en #ore +i7arrely as a source of rene*a+le energy, This is far fro# the truth, In a recent report. incineration *as found to +e second only to coal fired po*er stations as a producer of greenhouse gases, Ho*e)er this is only part of the pro+le#, With incineration there are t*o releases of greenhouse gases A once *hen the #aterial is +urnt and another *hen it is re3#anufactured, <nce *e add to the e6uation the car+on and other greenhouse gases produced *hen these products are re#ade. as opposed to +eing recycled. then it +eco#es o+)ious ho* *rong it *ould +e to regard incineration as a source of green energy, In fact. +et*een t*o to fi)e ti#es #ore energy goes into re#a0ing products than the energy reco)ered fro# incinerating the#2B2, Recycling is far #ore energy efficient than incineration and has greater car+on +enefits, With the high rates of #ethane capture assu#ed +y "E=R$. landfill has si#ilar ;<2 e#issions to incinerators, $ll incinerators should +e routinely assessed for their effect on glo+al *ar#ing,

9. /he Costs of Incineration

9.1 *irect and Indirect Costs
Incineration has +een reported to +e #ore e/pensi)e than alternati)e *aste strategies e)en *hen health costs are not considered, $ recent docu#ent fro# the Scottish En)iron#ental 1rotection $gency esti#ated that the disposal costs to process a tonne of *aste *ould +e S'03 0 for incineration co#pared to S&0340 for aero+ic digestion, These costs include high transportation costs and the e6ui)alent figure for England *ould +e S203&0 lo*er per tonne 4#a0ing it appro/ S2'3'' per tonne for incineration and S' per tonne for aero+ic digestion5, The capital costs of aero+ic digestion *ould +e a+out half that of incineration2B&,

&B

It is li0ely that the *aste industry *ill co#e under the European ?nion E#ission Trading Sche#e 4ETS5 *ithin the ne/t %0 years. in an effort to offset car+on e#issions, This *ould greatly increase the cost of incineration, T*o tonnes of car+on are produced for e)ery tonne of *aste +urned, The present cost per tonne of car+on. under ETS. *ill +e around T20 and this cost *ill gradually increase. *hich *ould add appro/i#ately S&0 to each tonne of *aste +urned, ;ouncils *ill then +e co##itted to paying an escalating cost. starting at S%2 #illion per annu# 4for a 400.000 tonne a year incinerator5 for up to 2' yearsL, It is a tra)esty that this cost should fall on local ta/payers su+-ected to this pollution *hich they did not as0 for and *hich could +e putting their o*n health at ris0, We +elie)e that #any councils #ay +e una*are of the i#plications of E#issions Trading Sche#e, $nother consideration councils #ay +e una*are of is the financial i#pact of Rene*a+le <+ligation ;ertificates, Basically so#e *aste disposal syste#s *ill attract these certificates. *hilst others *ill not, The syste#s that attract R<; credits could produce )ery significant increases in inco#e, These *ould +e *orth #illions of pounds per annu# for the *aste co#panies operating such plants and for council ta/payers in areas *here *aste co#panies operate such e6uip#ent on their +ehalf, Incinerators generally attract no R<; pay#ents, $n e/ception to this is a ;H1 4co#+ined heat and po*er5 incinerator *hich attracts a pay#ent of % R<;. or a fraction of an R<;. per #ega*att hour of po*er generated LL, 1las#a gasification and anaero+ic digestion attract a pay#ent of 2 R<;s. or associated fraction. per #ega*att *att hour of po*er generated, These technologies are not only far safer +ut this pay#ent also #a0es the# a #uch #ore attracti)e financial proposition, The i#plication of this is that a 200.000 tonne per year incinerator *ould attract no pay#ent +ut a 200.000 tonne per year plas#a gasification unit *ould attract a pay#ent of S4,B #illion per annu# LLL, This *ould allo* the *aste co#pany to offer a su+stantial reduction in their charge to the council for each tonne of *aste recei)ed, This *ould. in turn. lead to large sa)ings for +oth council ta/payers&, Ho*e)er. calculation of the total costs of different #ethods of getting rid of *aste #ust not only include the set3up and running costs +ut also the en)iron#ental. hu#an and health costs, In the case of incineration. hu#an and health costs are su+stantial +ut tend to +e o)erloo0ed +ecause they co#e out of another +udget, Ho*e)er the health costs *ill ha)e to +e paid for and #ust +e included in the e6uation, "ealing *ith the ash produced +y incinerators represents another #a-or cost to society. *hich again *ill co#e out of so#eone else>s +udget, These are not s#all costs and to gi)e so#e idea of the #agnitude of the costs in)ol)ed. it *as esti#ated that in %BB2 the +ill for re#ediating all the conta#inated *aste sites in the ?S$ *as H8'0 +illion2B4, L $lthough these charges *ill +e directed at the *aste producer. contract clauses protecting
the# *ill ensure these high costs are passed on, LL R<; pay#ents related to rene*a+le energy generated +y *aste facilities are +ased on the percentage of feedstoc0 that can +e classed as rene*a+le, Waste is not a *holly rene*a+le su+stance and is dee#ed +y <fge# to contain '0: rene*a+le content, Therefore. only half a #ega*att of rene*a+le electricity *ill +e generated *hen one #ega*att o)erall is generated, $s a conse6uence of this. the #ega*att generated *ill only attract half an R<;, LLL a 200.000 tonne per annu# plas#a gasification unit *ould +urn 24 tonnes per hour producing %4 #ega*atts per hour or %22.940 #ega*att hours per annu#, It is assu#ed that '0: of this fuel is rene*a+le and hence there *ill +e a re+ate of '0: on the %22.940 #ega*atts of electricity produced 42 R<;s per MWh / 0,'5, Each #ega*att *ould attract a pay#ent of appro/i#ately S40, This a#ounts to a sa)ing of S4,B #illion pounds per annu#,

40

9.2 Health Costs of Incineration

The health costs of incineration are huge, $ %BB9 report +y the European ;o##ission suggested that for e)ery tonne of *aste +urnt there *ould +e +et*een S2% and S%29 of health and en)iron#ental da#age. #eaning that a 400.000 tonnes per year incinerator *ould cost the ta/3payer +et*een SB.000.000 and S'8.000.000 per year2B'! this figure *as +ased on earlier data *hen e#issions to air *ere so#e*hat higher so no* these costs *ould +e e/pected to +e less, 4Ho*e)er note the corresponding increase in costs that is no* needed to #a0e fly ash safe, The +etter the pollution control the #ore to/ic the residues *ill +e and the #ore e/pensi)e they *ill +e to deal *ith,5 Studies that ha)e tried to esti#ate the co#+ination of all these costs of incineration ha)e co#e up *ith astonishingly high figures, "E=R$>s report in 2004 found that the health costs fro# 1M%0 particulates fro# incinerators alone. using a central to high esti#ate. *ould +e S&B.24' per tonne of particulates e#itted 42B not per tonne of *aste +urnt52B9, $ 400.000 tonne per year incinerator *ould produce a+out 24.0000g 424 tonnes5 of particulates per year and the "E=R$ esti#ate of health costs *ould +e SB4%.000 per annu#, Ho*e)er "E=R$ loo0ed at %& studies of 1M2,' and 1M%0 particulates and noted that the health costs ranged fro# S2.000 3 S&00.000 per tonne for 1M2,'s and S%. 00 3 S229.800 for 1M%0s, These esti#ates *ere +ased on #odelling data *hich for reasons descri+ed in section %2 are li0ely to underesti#ate particulate e#issions, In particular they do not ta0e into account recent data de#onstrating high le)els of pollutants e#itted during start3up and shut3do*n, It is therefore reasona+le to assu#e that the actual health costs *ould +e at the higher end of the range. *ith a cost of S229.800 per tonne for 1M%0s and S&00.000 per tonne for 1M2,'s gi)ing a total health cost per annu# for particulates alone of S9,' #illion LLLL, To gi)e a realistic esti#ate of the health costs of incineration. the additional costs fro# the other pollutants #ust +e added to this, In a re)ie* of health costs of incineration Eshet 2B8 noted the co#ple/ity and difficulty of these calculations. *ith esti#ates )arying +et*een H%,& and H%8% per tonne of *aste +urnt, $ study of British incinerators esti#ated the cost to +e +et*een H2,42 and H%&,%9 per tonne of *aste +urnt2B , Most of these studies do not ta0e into account the cost of ash. the cost of clean3up of accidents or *ater conta#ination or the #ore su+tle health effects such as +eha)ioural changes. reduction in IG. reproducti)e and hor#onal effects *hich ha)e +eco#e apparent in recent years *ith #any pollutants such as lead and organochlorines, =or this reason it is li0ely the costs are considera+ly higher than esti#ated, Based on the findings of all these studies *e can esti#ate that a 400.000 tonne a year incinerator *ill cause #illions of pounds *orth of health da#age annually, These large health costs alone clearly de#onstrate that incinerators #a0e a poor choice for *aste #anage#ent, When a single incinerator can generate health costs of #any #illions of pounds e)ery year. according to the go)ern#ent>s o*n data. it is a+surd to argue that incinerators are safe, It is hard to see any -ustification for these huge health costs *hen other #ethods such as #echanical +iological treat#ent 4MBT5. aero+ic digestion and plas#a gasification *ith lo* en)iron#ental and health costs 4see section 5 are a)aila+le, These #ethods ha)e not +eing gi)en sufficient consideration in the ?@, MBT is relati)ely cheap +ut plas#a gasification is #ore e/pensi)e to install, Ho*e)er. if the health costs are ta0en into account plas#a gasification is )ery #uch cheaper than incineration, It #a0es no logical sense to use a #ethod of *aste disposal

4%

that has a total cost far in e/cess of other #ethods, $nd *e #ust as0 is it #orally accepta+le to 0no*ingly incur such high health costs, LLLL This calculation is as follo*s, The Guality of ?r+an $ir Re)ie* Kroup has esti#ated that the 1M2,' fraction of total particulates is +et*een 2 : and %00:, (ea)ing aside the li0elihood that the 1M2,' fraction is higher fro# incinerator e#issions an a)erage figure of 90: 1M2,,'s *ould +e li0ely, This calculation therefore esti#ates that a 400.000 tonne incinerator *ould produce 24 tonnes of particulates. that 90: *ould +e 1M2,' particulates at a cost of S4,&2 #illion per annu# and 40: *ould +e at the lo*er cost for other 1M %0s costing S2,% #illion per annu#, The total cost in health da#age fro# particulates *ould therefore +e S9,' #illion per annu#,

9.3 :inancial .ains from ,educin Pollution

The E; <0opol report of %BBB2BB calculated that e)ery pound spent on pollution a+ate#ent sa)ed S9 in health care costs and S4 in social security costs, $ report fro# the ?S En)iron#ental 1rotection $gency also rec0oned that e)ery dollar spent on a+ate#ent sa)ed %0 dollars in health costs, In addition. a White House study +y the <ffice of Manage#ent and Budget in 200& concluded that enforcing clean air regulations led to reductions in hospitalisations. e#ergency roo# )isits. pre#ature deaths and lost *or0days *hich led to a sa)ing of +et*een H%20 and H%B& +illion +et*een <cto+er %BB2 and Septe#+er 2002, This is an underesti#ate as it did not loo0 at other health sa)ings such as prescription costs and pri#ary care costs, =e* other #easures today *ould gi)e so dra#atic a health +enefit and such a large sa)ing in health costs&00,

9.! "ther Studies of the Health Costs of Pollution

Recent studies ha)e dra*n attention to the huge unanticipated costs to society of pollution fro# other sources, The International Joint ;o##ission>s Science $d)isory Board. the Wor0group on Ecosyste# Health 4S$B3WKEH5 loo0ed at a series of health pro+le#s *here there *as hard e)idence for en)iron#ental causation, Reasoned argu#ents suggested that the contri+ution #ade +y to/ic su+stances to these health pro+le#s *as +et*een %0 and '0:, =our health pro+le#s *hich they considered concern us here. +ecause they in)ol)e pollutants si#ilar to those released fro# incinerators, These are neurode)elop#ental defects. hypothyroidis#. loss of ' IG points and 1ar0inson>s disease, The cu#ulati)e costs in the ?S$ for these disorders alone *ere considered to +e +et*een H&80 and H'20 +illion per year, E)en using the lo*est esti#ate of en)iron#ental contri+ution 4%0:5. the costs due to pollutants *as H40 +illion dollars annually&0%, The WW= in)estigated three conditions R #ental retardation. cere+ral palsy and autis# R to assess the i#pact of che#ical pollution. and calculated the cost of to/ic che#icals on children>s +rain de)elop#ent to +e appro/i#ately S% +illion annually&02,

1;. "ther Considerations of Im#ortance

1;.1 /he Problem of 3sh
The incineration of *aste produces a large a#ount of ash. a#ounting to &0: of the *eight of the original *asteC 403'0: of the )olu#e of co#pacted *aste, This is i#portant as landfill sites are +eco#ing less and less a)aila+le so there is an urgent need for a *or0a+le alternati)e, It is clear that incineration *ill not sol)e the landfill pro+le# since it can only reduce the +ul0 +y -ust under half, (ittle thought has +een

42

gi)en to this and incinerator operators are still +eing gi)en 20 to &0 year contracts creating pro+le#s for the future, Incinerators produce t*o types of ash. +otto# ash and fly ash. so#eti#es called air pollution control 4$1;5 residues, The latter is highly to/ic and listed as an a+solute ha7ardous su+stance in the European Waste ;atalogue, It has high concentration of hea)y #etals and dio/ins, Many su+stances such as #etals ha)e little to/icity +efore incineration +ut +eco#e ha7ardous once con)erted to particulates or fine particles in the ash, In fact. the co#+ination of pollutants in the fly ash can a#plify the to/icity, ?sing a +iological test. researchers found that the to/icity in fly ash *as fi)e ti#es greater than could +e accounted for +y the content of dio/ins. furans and 1;Bs&0&, There is a +asic pro+le# *ith #odern incinerators, The less air pollution produced. the #ore to/ic the ash, Early incinerators e#itted large )olu#es of dio/ins, These e#issions ha)e +een significantly reduced. +ut at the cost of a corresponding increase in the fly ash. *ith si#ilar increases in hea)y #etals and other to/ic che#icals, $n incinerator +urning 400.000 tonnes of *aste annually for its 2' years of operation *ould produce appro/i#ately half a #illion tonnes of highly to/ic fly ash&, $part fro# )itrification. no ade6uate #ethod of disposing of fly ash has +een found, The E? ;o##ission ha)e stated that leaching fro# landfill sites #ay +e one of the #ost i#portant sources of dio/ins in the future, Hea)y #etals are 0no*n to ha)e high leacha+ility, The ?S En)iron#ental 1rotection $gency considers that all landfills e)entually leach through their liners, $s #ost of these pollutants are persistent. pro+a+ly lasting for centuries. they *ill sooner or later threaten the *ater ta+le and a6uifers *here their re#o)al *ould +e near i#possi+le, $llo*ing this to ta0e place is an a+dication of our responsi+ility to future generations, In spite of the #assi)e health ris0s associated *ith fly ash it is poorly regulated, $t By0er. near 2e*castle3upon3Tyne. 2000 tonnes of fly ash laden *ith dio/ins *as spread o)er allot#ents. +ridle paths and footpaths for si/ years +et*een %BB4 and 2000, This ca)alier approach to #anaging to/ic *aste appears to ha)e changed little, In January 200 . a recently per#itted ha7ardous *aste site at 1ades*ood 4for storing fly ash fro# a ce#ent 0iln5 *as flooded, =ortunately no ha7ardous *aste had +een stored at the ti#e other*ise it *ould ha)e carried the to/ic *aste into +roo0s and thence into the Ri)er $lyn fro# *here drin0ing *ater is e/tracted, Wor0ers are often e/posed to this ash *ithout protecti)e gear, E)en today this #aterial has +een foolishly used for construction purposes ignoring its to/ic properties and the potential for the release of pollutants during use and fro# ordinary *ear and tear, =ly ash needs to +e transported a*ay fro# the incinerator and this can in)ol)e lengthy -ourneys, These represent an i#portant ha7ard, $n accident could potentially #a0e an area uninha+ita+le. as happened at Ti#es Beach. Missouri. due to dio/in3 conta#inated oil, These potential costs ha)e yet to +e factored into the cost calculations of incinerators, Botto# ash is a less se)ere ha7ard. +ut still contains significant 6uantities of dio/ins. organohalogens and hea)y #etals, It is e/traordinary that *hereas regulations ha)e tightened in recent years to reduce dio/in e#issions to air. +otto# ash. *hich contains 20 ti#es #ore dio/in. is unregulated and +i7arrely is regarded as inert *aste, This #isclassification had allo*ed it to +e charged at the lo*est rate at landfill sites, We +elie)e this is *rong! it is not inert and should not +e classified as such, It should +e charged at a rate that is in 0eeping *ith its to/icity,

4&

The Stoc0hol# ;on)ention #a0es it clear that dio/ins and furans should +e destroyed. *hich currently #eans using )itrification, In Japan. this is done responsi+ly and #uch of the fly ash is no* treated +y plas#a gasification +ut this essential safety step has +een neglected in the ?@, Because of the to/icity of +otto# and fly ash there should +e a full assess#ent of the cost of a clean3up operation for +oth *ater and land conta#ination, En)iron#ental clean3up costs should +e sho*n as part of the cost of incineration. and. *hen rele)ant. of other *aste disposal strategies,

1;.2 ,adioactivity
a8 3ssociated ?ith Incinerators <)er thirty sites in the ?@ incinerate radioacti)e *aste, Most countries consider this too ha7ardous, The #a-ority of radioacti)e *aste incinerated in the ?@ is alpha or +eta e#itting radiation, These types of radiation are not )ery dangerous outside the hu#an +ody due to their short range 4*ithin tissues this is #illi#etres for alpha particles and centi#etres *ith +eta particles5. although +eta radiation can penetrate the s0in, <nce incinerated this relati)ely safe #aterial is con)erted into a highly dangerous and sinister pollutant, "uring incineration. +illions of radioacti)e particulates *ill +e for#ed and e#itted into the air, These #ay +e inhaled +y anyone unfortunate enough to +e do*n*ind at the *rong ti#e. and pass through the lungs and circulation and then into the cells, <nce inside the +ody it *ill continue to e#it radiation, $lpha radiation has a )ery short range +ut great destructi)e po*er, Both alpha and +eta radiation *ill +e highly destructi)e and carcinogenic to near+y tissues, Each one of the +illions of radioacti)e particulates e#itted represents a )ery real danger, There can +e no safe threshold for this #aterial, The ris0 fro# this policy is o+)ious, Safety regulations +i7arrely #a0e no distinction +et*een internal and e/ternal radiation e)en though these are #ar0edly different, =or instance Beral found that prostate cancer *as higher in *or0ers in the nuclear industry, There *as no correlation *ith e/ternal radiation +ut a highly significant correlation *ith internal radiation&04, $ni#al studies #a0e this e)en #ore clear and rats in-ected *ith 0,0%#Ky of Strontiu# B0 *ere found to ha)e pathological da#age e)en though the dose *as 200 ti#es less than +ac0ground radiation&0', <f #ore concern is the fact that transgenerational effects ha)e also +een de#onstrated, Mice t*o generations fro# a #ale in-ected *ith this Strontiu# B0 suffered lethal genetic da#age. de#onstrating that chro#oso#al da#age *as passed through the genes to the offspring of irradiated #ice&09, Many people *ould +e surprised to 0no* -ust ho* s#all a dose of radiation is needed to cause har#, $fter ;herno+yl sheep *ere #onitored for Strontiu# B0 and the li#it set *as 0,000000000%B gra#s per 0ilogra#s of #eat. so s#all it *ould +e in)isi+le&08, $nd yet regulations allo* +illions of particulates containing si#ilarly #inute 6uantities of radioacti)e #aterial to +e e#itted into the air fro# incinerators, In contrast. natural +ac0ground radiation is. at #ost. a #inor ha7ard, =or instance $+erdeen has dou+le the le)el of natural +ac0ground radiation +ut no increased ris0 of leu0ae#ias or cancers, b8 3ssociated ?ith "ther Sites Increased incidence of leu0ae#ias and cancers around sites releasing radioacti)e #aterial are *ell docu#ented, $t Seascale a pu+lic health en6uiry found children *ere #ore than ten ti#es #ore li0ely to get leu0ae#ia and three ti#es #ore 44

li0ely to get cancer&0 .&0B, The incidence of leu0ae#ias in children li)ing *ithin ' 0ilo#etres of the @ru##el and Koesthact nuclear installations in Ker#any is #uch higher than in Ker#any as a *hole, Significantly. the first cases of leu0ae#ia only appeared fi)e years after @ru##el *as co##issioned, $t "ounreay there *as a si/fold increase in children>s leu0ae#ia&%0 and at $lder#aston there *as also an increase in leu0ae#ias in the under fi)es&%%, Sharply rising leu0ae#ia rates *ere noted in fi)e neigh+ouring to*ns surrounding the 1ilgri# nuclear plant in Massachusetts in the %B 0s, It *as thought to +e lin0ed to radioacti)e releases fro# the 1ilgri# nuclear plant ten years earlier *here there had +een a fuel rod pro+le#, UMeteorological data sho*ed that indi)iduals *ith the highest potential for e/posure to 1ilgri# e#issions had al#ost four ti#es the ris0 of leu0ae#ia co#pared to those ha)ing the lo*est potential for e/posure>&%2.&%&, $ recent #eta3analysis of %8 pu+lished reports that co)ered %&9 nuclear sites across the *orld too0 a glo+al loo0 at the pro+le#, They found death rates fro# leu0ae#ia in children under the age of B *ere increased +y 2%: and in those under 2' +y %0:&%4, They noted that discharges fro# these plants ha)e +een too lo* to account for the leu0ae#ias using standard criteria 4+ased on single or inter#ittent high dose radiation5, The li0ely e/planation here is internal radiation *here a #inute dose ta0en internally *ould +e enough to trigger a cancer or leu0ae#ia, This should +e seen as a strong *arning a+out the danger of incinerating and dispersing radioacti)e #atter into the en)iron#ent, The *eight of e)idence here strongly suggests that air+orne radioacti)ity is a potent carcinogen and li0ely to +e e/tre#ely ha7ardous, To allo* it at all is foolhardy +ut to co#+ine this *ith a coc0tail of other carcinogens is rec0less,

1;.3 S#read of Pollutants

The 2ational Research ;ouncil. an ar# of the 2ational $cade#y of Sciences. that *as esta+lished to ad)ise the ?S go)ern#ent. concluded that it *as not only the health of *or0ers and local populations that *ould +e affected +y incinerators, They reported that populations li)ing #ore distantly are also li0ely to +e e/posed to incinerator pollutants, They stated M!ersistent air pollutants, such as dio ins, furans and mercury can be dispersed over large regions # well beyond local areas and even the countries from which the sources emanate. $ood contaminated by an incinerator facility might be consumed by local people close to the facility or far away from it. Thus, local deposition on food might result in some e posure of populations at great distances, due to transport of food to mar%ets. &owever, distant populations are li%ely to be more e posed through long-range transport of pollutants and low-level widespread deposition on food crops at locations remote from an incineration facility.N&%' They later co##ented that the incre#ental +urden fro# all incinerators deser)es serious consideration +eyond a local le)el, This has o+)ious rele)ance to the present policy of pro#oting incinerators in the ?@, $n i#portant point is that the #ore to/ic s#aller particulates. *hich typically ha)e #ore to/ic che#icals and carcinogens attached. *ill tra)el the furthest,&%9 Most che#ical pollutants are lipophilic and are therefore not easily *ashed a*ay +y the rain after they settle, When they land on crops they enter the food chain *here they +ioaccu#ulate, It has already +een ad#itted that #ost dio/in in food today in the ?@ ca#e fro# the older generation of incinerators, $ll che#icals capa+le of entering the food chain *ill sooner or later reach their highest concentration in the foetus or +reast fed infant,

4'

$ stri0ing e/a#ple of the unforeseen and tragic conse6uences of releasing pollutants into the air has +een seen in 2una)ut. in the far 2orth of ;anada in the 1olar Regions, The Inuit #others here ha)e t*ice the le)el of dio/ins in their +reast #il0 as ;anadians li)ing in the South. although there is no source of dio/in *ithin &00 #iles, $t the centre of Biology of 2atural Syste#s in Gueen>s ;ollege. 2e* Ior0. "r ;o##oner and his tea# used a co#puter progra##e to trac0 e#issions fro# 44.000 sources of dio/in in 2orth $#erica, This syste# co#+ined data on to/ic releases and #eteorological records, $#ong the leading contri+utors to the pollution in 2una)ut *ere three #unicipal incinerators in the ?S$&%8.&% ,

1;.! Cement <ilns

$lthough this report is pri#arily a+out incinerators it is useful to co#pare incinerators *ith ce#ent 0ilns, Both produce to/ic e#issions of a si#ilar type and #uch of the report is rele)ant to +oth, ;e#ent 0ilns con)ert ground li#estone. shale or clay into ce#ent, They re6uire large 6uantities of fuel to produce the high te#peratures needed and this lends itself to the use of non3traditional fuels such as tyres. refuse3deri)ed fuel and industrial and ha7ardous *astes )ariously called ;e#fuel. secondary li6uid fuel 4S(=5 and recycled li6uid fuel 4R(=5, Ho*e)er. pollution and planning controls are significantly *ea0er than those for ha7ardous *aste incinerators, ;e#ent 0ilns produce a nu#+er of to/ic e#issions si#ilar to incinerators, Burning tyres produces e#issions *ith dio/ins and 7inc and +urning petroleu# co0e produces )anadiu# and nic0el, Releases of #ercury and arsenic are uncontrolled as these are )apourised, The ris0 fro# dio/ins is considera+ly greater as #ost ce#ent 0ilns do not ha)e the acti)ated charcoal needed to re#o)e the#, The ris0 fro# 1M2,' particulates is e/tre#ely serious, The li#it set for the *eight of all particulates e#itted +y incinerators is %0#g per cu+ic #etre, Ho*e)er ce#ent 0ilns are allo*ed to e#it &03'0 #g per cu+ic #etre, This *ould +e e/cessi)e +y itself +ut the )olu#es of e#issions fro# ce#ent 0ilns can +e up to fi)e ti#es greater than incinerators, Therefore so#e ce#ent 0ilns can produce e#issions of particulates and other to/ic su+stances *hich are in e/cess of 20 ti#es that of incinerators under nor#al operating conditions, Worse still they ha)e poorer a+ate#ent e6uip#ent and usually lac0 the acti)ated charcoal needed to reduce e#issions of #etals and dio/ins, The electrostatic precipitators need to +e shut off *hen car+on #ono/ide le)els +uild up due to the ris0 of e/plosion, This leads to una+ated e#issions, This has happened 400 ti#es a year in one plant, The 6uantities of particulates released at these ti#es are i##ense reaching 20.000#g per cu+ic #etre *hich are the highest le)el that can +e #easured, Recent research has de#onstrated une6ui)ocally that s#all increases in 1M2,' particulates *ill increase cardio)ascular and cere+ro)ascular #ortality. so to allo* releases of this order therefore +orders on the negligent, Incredi+ly 1M2,' particulates are not routinely #easured, Independently3audited #onitoring +y a registered charity at one ce#ent 0iln in the ?@ has continuously recorded le)els of particulates. using %' #inute a)erage readings&%B, They ha)e found e/tre#ely high surges of particulates. typically *ith pea0 readings occurring at night. so#eti#es se)eral ti#es a *ee0. *ith #a/i#u# 1M%0 particulates reaching le)els of o)er 4'00 Fg per cu+ic #etre and #a/i#u# 1M2,' reaching o)er %80Fg per cu+ic #etre, ;urrent scientific 0no*ledge on particulates suggests that these le)els *ould +e e/pected to cause cardio)ascular deaths and the findings de#onstrate the urgent need for independent #onitoring 49

around all ce#ent 0ilns, This #onitoring has e/posed #a-or deficiencies in the present #onitoring and regulatory syste#, Ther#al treat#ent of ha7ardous *aste is al*ays a highly dangerous acti)ity and the )ery +est a)aila+le technology needs to +e used, ;e#ent 0ilns are effecti)ely +eing used to +urn ha7ardous *aste on the cheap, Sadly ha7ardous *aste typically finds its *ay to the least regulated and cheapest disposal #ethods. in practise those that create the #ost health ris0s and the #ost en)iron#ental da#age, ;e#ent 0iln technology has re#ained )irtually unchanged since the turn of the t*entieth century, They can only +e refitted or retrofitted to a #ini#al degree to i#pro)e efficiency and to/ic *aste destruction, The Select ;o##ittee for the en)iron#ent reco##ended studies on the safety of ce#ent 0ilns o)er %0 years ago and this has +een ignored, WhyJ ;e#ent 0ilns are therefore capa+le of e/tre#ely serious health conse6uences, Incredi+ly so#e of these ce#ent 0ilns ha)e +een sited in the #iddle of to*ns *here they *ould +e e/pected to ha)e a #a-or effect on the health of the local population, The fact that they are allo*ed at all is astonishing. for the #a/i#u# i#pact *ill ine)ita+ly +e on the #ost )ulnera+le #e#+ers of society. and in particular the un+orn child,

11. (onitorin
$t the heart of the pro+le#s *ith incineration is the poor 6uality and unsatisfactory nature of #onitoring at these installations. unsatisfactory in the *ay it is done. the co#pounds #onitored. and the le)els dee#ed accepta+le. and the lac0 of #onitoring of +ody +urdens in the local population, The pro+le#s are as follo*s! +ery :e? Pollutants are bein measured <ut of the hundreds of che#icals released fro# an incinerator only a tiny proportion are #easured, <n current data. the three #ost i#portant pollutants released +y incinerators are dio/ins. hea)y #etals and 1M2,' particulates, Incredi+ly these are )irtually un#onitored, <nly half a do7en pollutants are #easured continuously in the stac0 and a+out another half do7en are #easured occasionally 4usually 9 #onthly for the first year and then yearly5 +y spot #onitoring A these include hea)y #etals and dio/ins, This is clearly unsatisfactory and since *aste operators are *arned in ad)ance of a )isit. they are handed an opportunity to change to +urning cleaner *aste *hich is unrepresentati)e of the to/ic ris0. #a0ing the e/ercise largely pointless, /he (ost *an erous Pollutants are hardly bein (onitored $ccidental +y3passing of pollution control de)ices +y incinerators present )ery real dangers to people li)ing in the )icinity of incinerators and this danger is co#pounded +y the near a+sence of #onitoring of dio/ins, T*o episodes ser)e to illustrate this, $ #odern state of the art incinerator in Rotterda# *as found to +e +y3 passing its pollution control de)ices %0: of the ti#e e#itting dio/ins e6ui)alent to ' ti#es the national li#it o)er the city, In 2orfol0. Dirginia a si#ilar incident led to dio/in e#issions greater than the allo*a+le co#+ined li#its for traffic. incinerators and industry for S*eden. Ker#any and the 2etherlands co#+ined, This *ould cause *idespread pollution of an area *ith dio/in and other persistent pollutants that could last for decades. if not centuries. putting #any generations at ris0, Start3ups and shut do*ns of incinerators gi)e rise to a si#ilar danger, $ recent study found that a single incinerator start3up *ould. on a)erage. generate. over a '( hour period. 90: of the total annual dio/in e#issions produced during steady state 48

conditions A in other *ords 8 #onths *orth of dio/in release *ithin 2 days of a typical start3up, They also found that the le)els of dio/ins produced +y start3ups at so#e of the incinerators they studied could +e t*ice the annual dio/in e#issions under steady state conditions 4this is the e6ui)alent of 24 #onths of dio/in release *ithin 2 days5&20, The danger to people li)ing in the area is o+)ious and serious, High le)els of dio/ins can also +e produced during shut3do*ns and during co##issioning 4*hen they are not #onitored5, "io/ins are only #onitored at &3%2 #onth inter)als and then only for a fe* hours, This #eans that dio/ins are not #onitored BB: of the ti#e, It could therefore +e #any #onths +efore high le)els of dio/in e#issions *ere detected perhaps allo*ing enough dio/in to +e released to threaten the health of a *hole co##unity and render far#s in the )icinity unfit for gro*ing )egeta+les or rearing li)estoc0, In fact. the operator and the pu+lic #ight ne)er find out and then steps *ould ne)er +e ta0en to deal *ith the conse6uences, $n added pro+le# is that spot #onitoring 4as is used currently5 has +een sho*n in a recent study to +e unrepresentati)e and to underesti#ate dio/in le)els +y &03'0 ti#es&2%, The situation is no +etter *ith hea)y #etals, (i0e dio/ins. they are un#onitored for BB: of the ti#e, ;learly. continuous dio/in #onitoring is essential and *ithout such #onitoring. incinerators #ust +e regarded as unsafe and a ha7ard to anyone li)ing in the area, ;ontinuous dio/in #onitoring should +e #andatory as is the case in so#e other European countries. ;urrently. #onitoring of the three #ost i#portant and dangerous pollutants. na#ely dio/ins. hea)y #etals and 1M2,' particulates is )irtually non3e/istent in the ?@, In the case of 1M2,' particulates they are not #onitored at all A only the far less rele)ant 1M%0 particulates, Independent #onitoring of ce#ent 0ilns has already de#onstrated )ery high particulate e#issions that could seriously endanger health&%B, These releases ha)e +een fre6uent 4so#eti#es & ti#es a *ee05. dangerous 4reaching 4'00Fg per cu+ic #etre of 1M%0 particulates5 and ha)e escaped detection +y the regulatory authorities, ;learly. the present regulatory syste# is not protecting the pu+lic, /he Standard of (onitorin on the .round is also Cnacce#table In addition to #onitoring in the stac0. there is a re6uire#ent to #onitor pollutants in the surrounding air, This is nor#ally done +y the local council *ith #onitors at ground le)el, Ho*e)er this is also unsatisfactory, =or instance to #onitor for safe le)els of particulates it *ould re6uire at least 24 #onitors placed at strategic points around an incinerator 4assu#ing the *ind is distri+uted e)enly5 to achie)e a 2': sa#pling rate. *hich is the #ini#u# that can +e considered accepta+le &, Typically. there are less than three #onitors around #ost incinerators today, Measure#ent of hea)y #etals in the surrounding air. *ith the e/ception of lead. is not e)en re6uired, No (onitorin of Pollutants ?hich have accumulated in the Nei hbourhood Measuring concentration of pollutants released in the stac0 gi)es no infor#ation a+out the le)els of to/ic #aterial that ha)e accu#ulated in the )icinity, When the rate of discharge of pollutants into the en)iron#ent is greater than the a+ility of the ecosyste#s to +rea0 the# do*n then they #ust accu#ulate, We already 0no* that #any do not +rea0 do*n for centuries, The e/cretion rates of #any pollutants fro# the hu#an +ody are also )ery poor. for e/a#ple the half life of cad#iu# in the +ody is &0 years and for 1;Bs it is 8' years, Many pollutants. +eing

fat solu+le. *ill +io3accu#ulate in li)ing #atter at far high concentrations than in the a#+ient air, $ ?S E1$ #e#o ad#itted that the ris0 fro# accu#ulation of dio/in in far# ani#als Mcould result in unaccepta+le health ris0sN, ?sing a type of ris0 assess#ent called screening analysis&22 they calculated that dio/in *ould accu#ulate in cattle do*n*ind fro# an incinerator and that the ris0 fro# +eef and #il0 consu#ption *ould +e 40.000 ti#es the ris0 fro# inhalation, This is a #assi)e increase in ris0 and is in 0eeping *ith *hat *e already 0no* a+out +ioaccu#ulation in other species 4see Section &,45, Monitoring of dio/ins in cattle and other far# ani#als regularly is essential for these reasons, Regretta+ly it is not +eing done and therefore consu#ers of these products are +eing put at ris0, ;hec0s for pollutants in dust. )egetation and in the +odies of local inha+itants are also necessary, It is so#eti#es argued that these pollutants don>t #atter as they *ill +e carried a*ay in the *ind and +e so#eone else>s pro+le#, Sadly this is partly true and that is the reason there is so #uch pollution in the fragile ecosyste# in the $rctic *here #uch of the to/ic #aterial ulti#ately ends up, (onitorin relies on Safety *ata derived from 3nimal Studies $ni#al studies co##only underesti#ate hu#an )ulnera+ility +ecause of the o+)ious difficulty in testing cogniti)e. +eha)ioural and language deficiencies and conditions such as fatigue, In the case of lead. #ercury and 1;Bs. ani#al studies ha)e underesti#ated the neuroto/ic effect on hu#ans +y a factor of %00 to %0.000 ti#es2 ', (onitorin .ives 1ittle Protection to the :oetus $)erage le)els or spot #onitoring ignores e/posures at critical ti#es, The ti#ing of the e/posure is often #ore i#portant than the concentration, E/posures at critical ti#es during foetal gro*th or infancy are 0no*n to produce #ore serious effects than si#ilar e/posures in adulthood and this da#age can +e per#anent, This is *ell recognised. especially *ith lead. #ercury and 1;Bs, 2one of the safety li#its has +een de#onstrated to protect against foetal da#age, We 0no* fro# ani#al and hu#an studies that to/ins ha)e the greatest i#pact on the foetus and young child, The #ost )ulnera+le #e#+ers of the co##unity are li0ely to +ear the +runt of these to/ic releases, (any Pollutants have No Safe /hreshold or sho? 1o? *ose /oxicity So#e pollutants such as 1M2,' particulates. lead and dio/in ha)e no safe thresholds, Most organochlorines are endocrine disruptors and thresholds #ay not e/ist for these effects, Monitoring gi)es little or no protection in these situations, So#eti#es lo* dose studies ha)e sho*n to/ic effects at le)els far +elo* the Mno effectN le)el in high dose studies, $n e/a#ple of this is +isphenol $. a plastici7er, Studies sho*ed health effects at le)els 2.'00 ti#es lo*er than $#erican E1$>s lo*est o+ser)ed effect. *ith ad)erse outco#es including aggressi)e +eha)iour. early pu+erty and a+nor#al +reast gro*th220, 1erchlorate produces changes in the si7e of parts of the +rain at 0,0% #gO0gOday +ut not at &0#g220, $ldicar+ *as found to suppress the i##une syste# #ore at % pp+ than it did at %000pp+, <ther che#icals also produce different effects at lo* dose to *hat they do at high dose, This sho*s ho* )ery little *e 0no* a+out the dangers of e/posing *hole populations to che#ical pollution, Pollution "ffences are Common#lace and ,e ulation is Poor

4B

Ten incinerators in the ?@ co##itted ''& pollution offences in a t*o year period. docu#ented in Kreenpeace>s M$ Re)ie* of the 1erfor#ance of Municipal Incinerators in the ?@N, This appalling record led to only one prosecution +y the En)iron#ent $gency, There is little point in tighter regulations if they are not enforced, =ines recei)ed for pollution offences ha)e +een co#pared to a person on a S'0.000 salary recei)ing a S20 par0ing fine, This clearly gi)es *aste co#panies a green light to ignore regulations and pollute *ith little fear of the conse6uences, The a+o)e data *as +ased on self assess#ent +y the co#panies concerned, (e)els of e#issions achie)ed under test conditions or *hen inspections occur +y prior arrange#ents are li0ely to +e far lo*er than under real life conditions, This *as de#onstrated in the ?nited States in %BB0 *hen the E1$ and <ccupational Safety and Health $d#inistration conducted 92 unannounced )isits and no less than 9B: of inspections led to su##ons for )iolations of regulations&2&, 4In the ?@ inspections are +y prior arrange#ent5, This #a0es a strong case for #a0ing all )isits unannounced, When an en)iron#ental group in)estigated an incinerator in Indianapolis the situation *as e)en *orse, They found it had )iolated its per#its 9.000 ti#es in t*o years and +ypassed its o*n air control pollution de)ices % ti#es, In effect. incinerators present inherent and una)oida+le ha7ards to pu+lic safety +ut the e/tent of the ha7ards depends on ho* *ell incinerators are run, The e)idence is strong that they are often run +adly, The situation is #ade *orse +y *ea0 regulators *ith little appetite for enforcing pu+lic safety,

12. ,is- 3ssessment

<ne #ight reasona+ly e/pect that. *hen the decision to +uild an incinerator is #ade. all the a+o)e infor#ation *ould +e carefully ta0en into account, Sadly this is not necessarily the case, "irectors of 1u+lic Health. *ho usually ha)e little 0no*ledge of en)iron#ental health. are as0ed to *rite an I11; 4Integrated 1ollution 1re)ention and ;ontrol5 $pplication Report and gi)e their opinion on the health ris0s fro# the proposed incinerator, Typically this decision is +ased on an ine/act #ethod called ris0 assess#ent, They tend to rely al#ost e/clusi)ely on this type of assess#ent and often ha)e little understanding of its li#itations, Ris0 assess#ent is a #ethod de)eloped for engineering +ut is )ery poor for assessing the co#ple/ities of hu#an health, Typically it in)ol)es esti#ating the ris0 to health of -ust 20 out of the hundreds of different pollutants e#itted +y incinerators, It #as6uerades as a scientific #easure +ut has all the hall#ar0s of pseudoscience, By pseudoscience *e #ean assu#ptions +ased on false pre#ises! %5 It ma-es the assum#tion that any substance emitted but not assessed 7this means 99H of all #ollutants8 should be treated as if they have $ero ris-, This assu#ption is o+)iously untrue, 25 It assumes ?ron ly that all #ollutants have thresholds belo? ?hich they are safe. Science contradicts this, Many pollutants. including dio/ins. lead and radioacti)e particulates do not ha)e thresholds and so#e #ay e)en +e #ore dangerous at lo*er concentrations 4see section %%5, $n international #eeting of neurologists and endocrinologists concluded M;he#ical challenges in early life can lead to profound and irre)ersi+le a+nor#alities in +rain de)elop#ent at e/posure le)els that do not produce per#anent effects in an adultC there #ay not +e defina+le thresholds for response to endocrine disruptorsN&24, The

'0

&5

45

'5

95

85

B5

2ational Research ;ouncil concluded in %BB2 that Mthe assu#ption of thresholds for neuroto/icity *as +iologically indefensi+leN22', We #ight also note that the accepted thresholds for #any pollutants ha)e +een progressi)ely reduced o)er the last fe* decades 4including )inyl chloride. ethylene dichloride and si/ chlorinated sol)ents5 *ith reductions to +et*een one half and one tenth of the original li#its, We can e/pect further reductions as science progresses, It assumes ?ron ly that only air emissions need to be considered and bioaccumulation in food can be i nored. Ho*e)er air e#issions #ay +e only the tip of the ice+erg, Most food today is conta#inated *ith dio/ins. predo#inantly fro# past incinerator e#issions, $s noted in section %%. a lea0ed report in %BB& fro# the ?S En)iron#ental 1rotection $gency calculated that dio/in *ould accu#ulate in cattle in a far# do*n*ind of an incinerator in <hio posing a ris0 to the fre6uent +eef consu#er *hich *as 40.000 ti#es higher than fro# inhalation alone, If the incinerator operated for &0 years the cancer ris0 fro# eating this +eef regularly *as calculated to +e a #assi)e %.200 per #illion. far +eyond accepta+le ris0&22, We can assu#e this sort of ris0 fro# food produced near #ost incinerators occurs routinely and yet it is +eing sold to the pu+lic and regulators are turning a +lind eye to the danger, It misconstrues lac- of evidence on the dan er of #ollutants as evidence of safety, The to/ic effects of 3B0: of che#icals and pollutants are un0no*n&2', It is i#possi+le to assess the ris0 of su+stances *e +arely understand, This is particularly true in relationship to +irth and de)elop#ental defects, Many pollutants ha)e not e)en +een characterised. let alone assessed for ris0, It assumes that health effects such as infertility5 immune su##ression5 altered behaviour and reduced intellectual ca#acity ?hich are not included in the ris- assessment can be i nored, Ho*e)er there is a#ple and increasing e)idence that #any pollutants ha)e -ust these i#pacts, It assumes ?ron ly that ecosystems have the ability to absorb and de rade all environmental #ollutants, $gain science contradicts this! #any pollutants are 0no*n to +e persistent and +ioaccu#ulati)e, In fact. if the rate of input. ho*e)er s#all. is greater than the rate at *hich they +rea0 do*n they #ust accu#ulate, It is e6ui)alent to filling up a +uc0et under a slo* dripping tap! sooner or later the *ater *ill o)erflo* unless the source of *ater is stopped, It assumes ?ron ly that the ha$ard #osed by each individual com#ound tested out of context and in isolation can #redict the ha$ard of com#lex mixtures of chemicals. In the real *orld pollutants typically occur in co#+inations and a+undant e)idence no* e/ists that increased to/icity is co##on *ith #ultiple e/posures, It assumes ?ron ly that the cumulative #ollution burden of all the emissions #roduced by all these facilities can safely be i nored and each facility can be considered in isolation. It is this type of li#ited thin0ing that has led to the conta#ination of entire ecosyste#s such as the Kreat (a0es. Baltic Sea. Mediterranean and $rctic, These pollutants pose glo+al and #ultigenerational threats to health and ecosyste#s, It assumes ?ron ly that ?e have a com#rehensive understandin of the com#lexity of biolo ical #rocesses and chemical toxicity ?hen in reality

'%

there are vast information a#s. This is *hy *e ha)e +een constantly surprised +y unpleasant disco)eries li0e endocrine disruption and high +ody +urdens in ne*+orns, %05 It ?ron ly assumes all #eo#le ?ill react in the same ?ay to pollutants and in particular ignores the fact that the foetus is at far greater ris0, Hidden *ithin this type of assess#ent is a )alue -udge#ent a+out *hat is an accepta+le le)el of ris0&29 and this is not #ade e/plicit, =or instance *hat is an accepta+le nu#+er of +irth defects and *ho is it accepta+le toJ $ cancer ris0 of % per #illion is typically considered accepta+le +ut #ay not +e accepta+le to the person affected +y the cancer, Ris0 assess#ent usually in)ol)es M#odellingNC A dispersion #odels use an esti#ation of e/posure data. rather than actual e/posure data. to assess the i#pacts of pollutants and their li0ely distri+ution, These reports are typically produced +y the polluter, The #odels are not accurate 3 #odelling has a &0: confidence le)el A this #eans this techni6ue has only a &0: chance of accurately predicting the ground le)el concentrations of pollutants 3 in other *ords less accurate than tossing a coin, <nly a+out half the predictions are *ithin a factor of t*o of actual 4o+ser)ed5 concentrations and the rest are e)en less accurate, The #odels atte#pt to predict a *orst case scenario +ut the #odels cannot accurately represent real *orse case scenarios *hich typically occur *hen there is little or no *ind leading to a +uild3up of pollutants, This #eans real *orst case scenarios can +e #uch *orse than predicted&28, "ifferent #odels can gi)e )ery different results, In addition. present #odelling #ethods are not only inaccurate in esti#ating ground le)el pollutant concentration once e#itted +ut they also seriously underesti#ate the 6uantities of pollutants e#itted, In particular. #odelling al#ost ne)er ta0es into account secondary particulates for#ed as the products of co#+ustion rise up the stac0, These secondary particulates can dou+le the total )olu#e of particulates 4see section 2,%5, Modelling produces the illusion of a scientific 0no*ledge and a certainty that is entirely un-ustified +y the i#precise nature of #odelling and it is +ased on su+stantial scientific uncertainty and li#ited scientific data, It produces a #ass of co#ple/ #athe#atical data. *hich i#plies un-ustified precision. and it is difficult for people not fa#iliar *ith the #athe#atics to disentangle the inaccuracies, This *as su##ed up +y the head of the E1$ ;arcinogen $ssess#ent Kroup. Roy $l+ert. *hen he said MIndi)iduals *ith )ery different institutional loyalties can produce )ery different ris0 assess#ents fro# the sa#e #aterials. *here large uncertainties e/ist,N In other *ords it is )ery easy to +ias it to*ards the *aste operator, It is often treated +y regulators &2 and "irectors of 1u+lic Health as if it *as an accurate assess#ent, In spite of these se)ere li#itations it is e/tensi)ely used, These ris0s assess#ents ha)e al#ost al*ays concluded that incinerators are safe *hich flies in the face of epide#iological data *hich sho*s the opposite, It also flies in the face of the history of che#ical use, The latter is littered *ith e/a#ples of che#icals once said to +e safe *hich *ere later found to ha)e de)astating and unanticipated effects. often +eyond the *orst case scenario 4eg ""T. 1;Bs. ;=;s5 4see section 8,25,

13. Public ,i hts and International /reaties

'2

In 200% the ?nited 2ations ;o##ission on Hu#an Rights stated that Meveryone has the right to live in a world free from to ic pollution and environmental degradationN, It is unethical that people should die fro# the e#issions fro# incinerators *hen safe alternati)es are a)aila+le and for this reason incineration )iolates $rticle 2 of the European Hu#an Rights ;on)ention. the Right to (ife, The Stoc0hol# ;on)ention. agreed to +y o)er %00 countries including Britain. in 200%. co##its countries to eli#inating persistent organic pollutants. including 1;B. dio/ins and furans. calling for countries to pre)ent not -ust the release of these pollutants +ut also their formation, The for#ation of these su+stances is an ine)ita+le conse6uence of the use of incinerators, The ;on)ention also re6uires parties to ta0e #easures to reduce the total releases of these su+stances 4*hich includes releases to fly ash5, It identifies incinerators as pri#ary sources of these co#pounds, Incineration is. in all these *ays. a flagrant )iolation of the Stoc0hol# con)ention, Incineration is also a )iolation of the En)iron#ental 1rotection $ct of %BB0 *hich states that the ?@ #ust pre)ent e#issions fro# har#ing hu#an health,

1!. Conclusions
%5 Incineration does not remove ?aste, It si#ply con)erts it into another for# 4gas. particulates. ash5 and these ne* for#s are typically #ore ha7ardous though less )isi+le than in the original for#, 25 1ar e e#idemiolo ical studies have sho?n hi her rates of adult and childhood cancers and of birth defects around incinerators, S#aller studies and a large +ody of related research support these findings. point to a causal relationship. and suggest that a #uch *ider range of illnesses #ay +e in)ol)ed, &5 ,ecent research has confirmed that #articulate #ollution5 es#ecially the fine particulate 7P(2.%8 #ollution5 ?hich is ty#ical of incinerator emissions5 is an im#ortant contributor to heart disease, lung cancer5 and an assortment of other diseases5 and causes a linear increase in mortality. The latest research has found there is a #uch greater effect on #ortality than pre)iously thought and i#plies that incinerators *ill cause increases in cardio)ascular and cere+ro)ascular #or+idity and #ortality *ith +oth short3ter# and long3ter# e/posure, 1articulates fro# incinerators *ill +e especially ha7ardous due to the to/ic che#icals attached to the#, 45 <ther pollutants e#itted +y incinerators include hea)y #etals and a large )ariety of organic che#icals, /hese substances include -no?n carcino ens5 endocrine disru#tors5 and substances that can attach to enes5 alter behaviour5 dama e the immune system and decrease intelli ence. There appears to +e no threshold for so#e of these effects. such as endocrine disruption, The dangers of these are self3e)ident, So#e of these co#pounds ha)e +een detected hundreds to thousands of #iles a*ay fro# their source, '5 The danger of incinerating radioacti)e *aste deser)es special #ention, Incineration con)erts radioacti)e *aste into +illions of radioacti)e particulates, These particulates #a0e a near perfect deli)ery syste# for introducing the radioacti)e #atter into the hu#an +ody. *here it can then act as an internal e#itter of alpha or +eta radiation, /his ty#e of radiation is Iualitatively different5 far more dan erous and far more sinister5 than bac- round

'&

radiation. There can +e no -ustification for using this #ethod of dealing *ith radioacti)e *aste, 95 (odern incinerators #roduce fly ash ?hich is much more toxic than in the #ast5 containing large 6uantities of dio/in3rich #aterial for *hich there is no safe #ethod of disposal. e/cept )itrification. a #ethod not +eing used in the ?@, "isposal of incinerator ash to landfill sites is associated *ith long3ter# threats to a6uifers and *ater ta+les and the potential for accidents serious enough to re6uire e)acuation of an area, 85 /he ris-s to local #eo#le that occur ?hen incinerators o#erate under non0 standard ?or-in conditions have not been addressed5 particularly the e#issions at start3up and shutdo*n *hich #ay +e associated *ith the release. *ithin 2 days. of #ore dio/in than o)er 9 #onths of *or0ing under standard conditions, 5 /he reatest concern is the long-term effects of incinerator emissions on the develo#in embryo and infant5 and the real #ossibility that enetic chan es ?ill occur and be #assed on to succeedin enerations. =ar greater )ulnera+ility to to/ins has +een docu#ented for the )ery young. particularly foetuses. *ith ris0s of cancer. spontaneous a+ortion. +irth defects or per#anent cogniti)e da#age, $ *orryingly high +ody +urden of pollutants has recently +een reported in t*o studies of cord +lood fro# ne*3+orn +a+ies, B5 4aste incineration is #rohibitively expensive ?hen health costs are ta-en into account. $ )ariety of studies. including that fro# the go)ern#ent. indicate that a single large incinerator could cost the ta/ payer #any #illion of pounds per annu# in health costs, 1ut si#ply. the go)ern#ent>s o*n data is de#onstrating that incinerators are a #a-or health ha7ard, With the predicted inclusion of the *aste industry *ithin the E? European E#issions Trading Sche#e. local ta/payers. in areas *ith incinerators. *ill not only ha)e to li)e *ithin a polluted area +ut *ill +e saddled *ith costs. under ETS. of #illions of pounds per annu# to pay for it, %05 4aste incineration is un@ust because its maximum toxic im#act is on the most vulnerable members of our society5 the unborn child5 children5 the #oor and the chemically sensitive. It contra)enes the ?nited 2ations ;o##ission on Hu#an Rights. the European Hu#an Rights ;on)ention 4the Right to (ife5. and the Stoc0hol# ;on)ention. and )iolates the En)iron#ental 1rotection $ct of %BB0 *hich states that the ?@ #ust pre)ent e#issions fro# har#ing hu#an health,

1%. ,ecommendations
%5 The safest #ethods of *aste disposal should +e used, 25 Health costs should +e routinely ta0en into account *hen deciding on *aste disposal strategies, &5 The present li#ited #ethod of ris0 assess#ent +y *hich the safety of proposed installations is -udged. is inade6uate. can easily +e +iased to*ards the *aste operator. cannot +e relied on. and should +e re)ie*ed, 45 Tac0ling the pro+le#s of +oth the a#ount and the nature of *aste generated is of critical i#portance. *ith the e#phasis on reducing the production of *aste. and on recycling,

'4

'5 The serious health conse6uences of fine particulate pollution ha)e +eco#e apparent in the last ten years! incinerators are a significant source and. for this reason alone. in our considered opinion. incineration is the least preferred option for getting rid of *aste, Ta0ing into consideration all the infor#ation a)aila+le. including research indicating that there are no safe le)els for fine particulates. the increasing a#ount of plastic and related su+stances in the *aste strea# and the highly to/ic ash produced +y #odern incinerators. *e can see no reason to +elie)e that the ne/t generation of incinerators *ould +e su+stantially safer than the pre)ious ones, 95 :ar safer alternative methods are no? available including recycling. #echanical +iological treat#ent. aero+ic digestion and plas#a gasification! a co#+ination of these *ould +e safer. *ould produce #ore energy. *ould +e cheaper than incineration in the long run and *ould +e #uch cheaper *hen health costs are ta0en into account, Ther#al #ethods should only +e used for residual. non3recycla+le *aste and the safest ther#al #ethod should +e chosen! currently this is plas#a gasification, This not only produces #ore energy +ut can use plastics as a resource, These #ore ad)anced #ethods should +e e#ployed, 85 /his re#ort dra?s attention to the many deficiencies and #oor Iuality of the #resent monitorin #rocedures. We reco##end the introduction of a far stricter and #ore co#prehensi)e syste# for the #onitoring of all *aste3+urning plants +y a fully independent +ody. including rando# unannounced )isits! the #onitoring should include! a5 Continuous monitorin of dioxins J this is an absolute essential and5 not sur#risin ly5 is mandatory in some countries. This )ital step is essential +ecause of the e/tre#ely to/ic nature of the pollution e#itted *hen incinerator pollution control de)ices are +y3passed, The ?@ should not ha)e the second rate safety standards that they ha)e at present, +5 ;ontinuous #onitoring of 1M2,' particulates and #onitoring of 1B"Es, c5 $ co#prehensi)e syste# of #onitors set up +y ;ouncils around all incinerators to #easure particulates and hea)y #etals, d5 (onitorin of dioxin in all livestoc- ?ithin a % mile radius of incinerators due to the -no?n and serious ris- from bioaccumulation in food, e5 1eriodic #onitoring of the hea)y #etals and dio/ins in the fly ash f5 $ progra##e of #onitoring the +ody +urdens of so#e 0ey pollutants in local inha+itants, g5 1eriodic #onitoring of the content of dust in ho#es in the locality 5 It is particularly i#portant that incinerators should not +e sited in depri)ed areas or areas *ith high rates of #ortality *here their health i#pact is li0ely to +e greatest, This can only add to health ine6ualities, 42B, 1resently B out of %4 incinerators ha)e +een +uilt in the #ost depri)ed 20: of *ards&2B5, B5 The present su+sidies and ta/ ad)antages. *hich fa)our incineration. should +e re#o)ed, $ +an or ta/ on recycla+le #aterial going to incinerators or landfill deser)es ''

serious consideration, It is nonsense to regard +otto# ash. *ith its significant dio/in content. as an inert su+stance and it should incur landfill ta/ at a higher rate, %08 4e recommend that no further ?aste incinerators be built,

,eferencesK
Section 2. Emissions from Incinerators and other Combustion Sources 2.1 Particulates
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2.! "r anic Pollutants

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%85 <lsson 13E. Borg B. Brunstro# B. Ha0ansson H. @lasson3Wehler E, Endocrine disrupting su+stances, ISB2 B%392034 'B38. S*edish E1$. Stoc0hol# %BB ,

Section 3. Health effects of Pollutants 3.1 Particulates

% 5 WH< $ir Guality Kuidelines. %BBB. ;hapter &, %B5 "oc0ery "W. 1ope ;a &rd. Vu V et al, $n association +et*een air pollution and #ortality in si/ ?S cities, 2 Eng J Med %BB&C &2B4245! %8'&3B, 205 1ope ;$. Thun MJ. 2a#+oodiri MM et al, 1articulate air pollution as a predictor of #ortality in a prospecti)e study of ?S adults, $# J Respir ;rit ;are Med %BB'C %'% 4& pt %5! 99B384, 2%5 de Hartog JJ. Hoe0 K. 1eters $. et al, Effects of fine and ultrafine particles on cardiorespiratory sy#pto#s in elderly su+-ects *ith coronary heart disease! the ?(TR$ Study, $# J Epide#iology 200&C %'8485! 9%&32&, 225 2e##ar $. Hoet 1H. Dan6uic0en+orne B et al, 1assage of inhaled particles into the +lood circulation in hu#ans, ;irculation 2002C %0'445! 4%%34, 2&5 Maynard R(. Ho*ard ;D. $ir 1ollution and Health. (ondon! $cade#ic 1ress %BBB! 98&380', 245 1on0a $. Dirtanen M, $sth#a and air pollution in Helsin0i, J Epide#iol ;o##unity Health %BB9C '0 Suppl %! s'B392, 2'5 1articulate Matter! 1roperties and Effects upon Health. BI<S Scientific 1u+lishers (td. </ford p 9&3 4, 295 $ir+orne 1articulate Matter in the ?nited @ingdo#, Third Report of the Guality of $ir Re)ie* Kroup 4G?$RK5 May %BB9. ISB2 0 B'2088% & 2, 285 Kold+erg MS. Burnett RT. Bailar J; et al, The association +et*een daily #ortality and a#+ient air particle pollution in Montreal. Gue+ec, 2, ;ause3specific #ortality, En)iron Res 200%! 94%5! 293&9, 2 5 1ope ;$. Burnett RT. Thun MJ. et al, (ung cancer. cardiopul#onary #ortality. and long3 ter# e/posure to fine particulate air pollution, J$M$ 2002C 2 84B5! %%&234%, 2B5 Whit#an ) $#erican Truc0ing $ssoc Inc '&2 ?S 4'8 4200%5, &05 Re3analysis of the Har)ard Si/ ;ities Study and the $#erican ;ancer Society Study of 1articulate $ir 1ollution and Mortality! Special Report, ;a#+ridge. Mass! Health Effects Institute July 2000. led +y "r "aniel @re*es0i, &%5 <stro B. ;hestnut (, $ssessing the +enefits of reducing particulate #atter and pollution in the ?nited States, En)iron Res %BB C 89425! B43%09, &25 1ope ;$. Bu#ett RT. Thurston K" et al, ;ardio)ascular Mortality and (ong3Ter# E/posure to 1articulate $ir 1ollution! Epide#iological E)idence of Keneral 1athophysiological 1ath*ays of "isease, ;irculation 2004C %0B! 8%388. &&5 Miller @$. Sisco)ic0 "S. Sheppard(. et al, (ong ter# e/posure to air pollution and incidence of cardio)ascular e)ents in *o#en, 2 Eng J Med 2008. &'9!44834' &45 1eters $. "oc0ery "W. Muller JE et al, Increased particulate air pollution and the triggering of #yocardial infarction, ;irculation 200%C %0& 42&5! 2 %03', &'5 Hong I;. (ee JT. @i# H. @*on HJ, $ir pollution! a ne* ris0 factor in ische#ic stro0e #ortality, Stro0e 2002C &&4B5! 2%9'3B, &95 Hoe0 K. Brune0reef B. =ischer 1 et al, The association +et*een air pollution and heart failure. arrhyth#ia. e#+olis#. thro#+osis and other cardio)ascular causes of death in a ti#e series, Epide#iology 200%C %24&5! &''38, &85 Mahes*aran R. Haining R1. Brindley 1 et al, <utdoor air pollution and Stro0e in Sheffield. ?nited @ingdo#. S#all3$rea Keographical Study, Stro0e 200'C &9425! 2&B34&, & 5 Sch*art7 J, $ir pollution and hospital ad#issions for heart disease in eight ?S counties, Epide#iology %BBBC %04%5! %8322, &B5 Baccerelli $. Martinelli I. Pano+etti $ et al, E/posure to particulate air pollution and ris0 of deep )enous thro#+osis, $rch Int Med 200 C %9 4B5!B2038

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405 Pano+etti $. Sch*art7 J, ;ardio)ascular da#age +y air+orne particles! are dia+etics #ore suscepti+leJ Epide#iology 2002C %&4'5! ' 3B2, 4%5 1eters $. (iu E. Derrier R( et al, $ir pollution and incidence of cardiac arrhyth#ia, Epide#iology 2000C %%4%5! %%38, 425 1e00anen J. 1eters $. Hoe0 K. et al, 1articulate air pollution and ris0 of ST seg#ent depression during su+#a/i#al e/ercise tests a#ong su+-ects *ith coronary heart disease! the E/posure and Ris0 $ssess#ent for =ine and ?ltrafine 1articles in $#+ient $ir 4?(TR$5 study, ;irculation 2002C %09! B&&3& , 4&5 Kold+erg MS. Burnett RT. Bailar J; &rd et al, Identification of persons *ith cardiorespiratory conditions *ho are at ris0 of dying fro# the acute effects of a#+ient air particles, En)iron Health 1erspect 200%C %0B Supp 4! 4 83B4, 445 1erera =1. Tang ". Tu IH et al, Bio#ar0ers in #aternal and ne*+orn +lood indicate heightened fetal suscepti+ility to procarcinogenic "2$ da#age, En)iron Health 1erspect 2004C %%24%05! %%&&39, 4'5 Jedrycho*s0i W. Bend0o*s0a I. =la0 E et al, Esti#ated ris0 for altered fetal gro*th resulting fro# e/posure to fine particles during pregnancy! an epide#iologic prospecti)e cohort study in 1oland, En)iron Health 1erspect 2004C %%24%45! %&B 3%402, 495 1erera =1. Rauh D. Whyatt RM et al, Molecular e)idence of an interaction +et*een prenatal en)iron#ental e/posures and +irth outco#es in a #ultiethnic population, En)iron Health 1erspect 2004C %%24'5! 9293&0, 485 So#ers ;M. Mc;arry BE. Male0 = et al, Reduction of particulate air pollution lo*ers the ris0 of herita+le #utations in #ice, Science 2004C &044'98&5! %00 3%0, 4 5 Burden of disease attri+uta+le to selected en)iron#ental factors and in-ury a#ong children and adolescents in Europe 4no authors listed5, ;hild ;are Health "e) 2004C &0495! 8&%38&2, 4B5 Morgan K. ;or+ett S. Wlodarc7y0 J, $ir pollution and hospital ad#issions in Sydney. $ustralia. %BB03%BB4, $# J 1u+lic Health %BB C 4%25! %89%390, '05 Dichit3Dada0an 2. <stro B". ;hestnut (K et al, $ir pollution and respiratory sy#pto#s! result fro# three panel studies in Bang0o0. Thailand, En)iron Health 1erspect 200%C %0B Supp&! & %38, '%5 "oc0ery "W. Spei7er =E. Stra# "< et al, Effects of inhala+le particles on respiratory health of children, $# Re) Respir "is %B BC %&B4&5! ' 83B4, '25 Brauer M. Hoe0 K Dan Dliet 1 et al. $ir pollution fro# traffic and the de)elop#ent of respiratory infections and asth#atic and allergic sy#pto#s in children, $# J Respir ;rit ;are 2002C %994 5! %0B23 , '&5 Seaton $. Mac2ee W. "onaldson @ et al, 1articulate air pollution and acute health effects, (ancet %BB'C &4'4 B4&5! %893 , '45 Boe7en HM. )an der Pee S;. 1ost#a "S et al, Effects of a#+ient air pollution on upper and lo*er respiratory sy#pto#s and pea0 e/piratory flo* in children, (ancet %BBBC &'& 4B%'95! 843 , ''5 Killiland =". Berhane @. Rappaport EB et al, The effects of a#+ient air pollution on school a+senteeis# due to respiratory illness, Epide#iology 200%! %24%5! 4&3'4, '95 1eters $. "oc0ery "W. Heinrich J. Wich#ann HE, Short ter# effects of particulate air pollution on respiratory #or+idity in asth#atic children, Eur Respir J %BB8C %0445! 823B, '85 Kauder#an WJ. Mc;onnell R. Killiland = et al, $ssociation +et*een air pollution and lung function gro*th in Southern ;alifornian children, $# J Respir ;rit ;are Med 2000C %92 44 1t %5C %& &3B0, ' 5 Brune0reef B. Hoe0 K, The relationship +et*een lo*3le)el air pollution and short3ter# changes in lung function in "utch children, J E/po $nal En)iron Epide#iol %BB&C & Suppl %! %%832 , 'B5 Kauder#an WJ. Killiland K=. Dora H. et al, $ssociation +et*een air pollution and lung function gro*th in Southern ;alifornian children! results fro# a second cohort, $# J Respir ;rit ;are Med 2002C %994%5! 893 4, 905 Sa#et JM. "o#inici =. ;urriero =; et al, =ine particulate air pollution and #ortality in 20 ?S cities %B 83%BB4, 2 Eng J Med 2000C &4&4245! %8423B,

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9%5 Sch*art7 J. (aden =. Pano+etti $, The concentration3response relation +et*een 1M2,' and daily deaths, En)iron Health 1erspect 2002C %%04%05! %02'3B, 925 Stol7el M. Breitner S ;yrys J et al, "aily #ortality and particulate #atter in different si7e classes in Erfurt. Ker#any, J E/po Sci En)iron Epide#iol,Research. 2008C %84'5! 4'B398 9&5 @ettunen J. (an0i T. Tiittanen 1 et al, $ssociations of fine and ultrafine particulate air pollution *ith stro0e #ortality in an area of lo* pollution le)els, Stro0e. 2008C & 4&5! B% 322 945 (i 2. Sioutas ;. ;ho $ et al, ?ltrafine particulate pollutants induce o/idati)e stress and #itochondrial da#age,En)iron Health 1erspect 200&.%%%!4''3490 9'5 <+erdorster K. Sharp P $tudorei D et al, Translocation of inhaled ultrafine particles to the +rain,Inhalation To/icology. 2004. %9!4&8344' 995 $ir Guality Kuidelines for Europe. Section 8,& p%B. Second Edition. World Regional 1u+lications. Regional European Series 2o B%. World Health <rganisation. Regional <ffice for Europe. ;openhagen, 985 $nnesi3Maesano I. =orastiere =. @un7li 2 et al, 1artciculate #atter. Science and E? 1olicy, Eur Resp J 2008C 2B! 42 34&%

3.2 Heavy (etals

9 5 1roceedings of the Third ;ollo6uiu# on 1articulate $ir 1ollution and Hu#an Health 93 June %BBB. "urha#. 2orth ;arolina. Ir)ine. ;$! $ir 1ollution Effects (a+oratory. ?ni)ersity of ;alifornia.%BBB. %%O2&, 9B5 1ope ;$ &rd, Respiratory disease associated *ith co##unity air pollution and a steel #ill. ?tah Dalley, $# J 1u+lic Health. %B B. 8B4'5! 92&3 , 805 ;osta "(. "reher @(, Bioa)aila+le transition #etals in particulate #atter #ediate cardiopul#onary in-ury in healthy and co#pro#ised ani#al #odels, En)iron Health 1erspect %BB8C%0' 4suppl '5! %0'&390 8%5 "ye J$. (eh#ann JR. McKee J@ et al, $cute pul#onary to/icity of particulate #atter filter e/tracts in rats! ;oherence *ith epide#iologic studies in ?tah Dalley, En)iron Health 1erspect 200%C %0B Suppl &! &B'340&, 825 Hut7inger <. =ielder H, =or#ation of "io/ins and Related ;o#pounds in Industrial 1rocesses, 1ilot Study of International Infor#ation E/change on "io/ins and Related ;o#ponds, 2o %8&, Brussels! 2$T< ;o##ittee on ;hallenges to Modern Science. %BB 8&5 Ro*at S;, Incinerator to/ic e#issions! a +rief su##ary of hu#an health effects *ith a note on regulatory control, Med Hypotheses %BBBC '24'5! & B3B9, 845 ;asdorph R. Wal0er M, To/ic Metal Syndro#e. 2e* Ior0! $)ery 1u+lishing Kroup %BB', 8'5 Eh#ann W". Mar0es+ery WR. $lauddin M et al, Brain trace ele#ents in $l7hei#er>s disease, 2euroto/icology %B 9C 8 4%5! %B'3209, 895 Tho#pson ;M. Mar0es+ery WR. Eh#ann W" et al, Regional trace3ele#ent studies in $l7hei#er>s disease, 2euroto/icology %B C B4%5! %38, 885 Wenstrup ". Eh#ann W". Mar0es+ery WR, Trace ele#ent i#+alances in isolated su+cellular fractions of $l7hei#er>s disease +rains, Brain Res %BB0C '&&4%5! %2'3&%, 8 5 Schettler T, To/ic threats to neurological de)elop#ent of children, En)iron Health 1erspect 200%C %0B 4Suppl 95! %&39, 8B5 Krand-ean 1. Weihe 1. White R= et al, ;ogniti)e deficit in 83year old children *ith prenatal e/posure to #ethyl #ercury, 2euroto/icol Teratol %BB8C %B495! 4%832 , 05 1al#er R=. Blanchard S. Stein P et al, En)iron#ental #ercury release. special education rates. and autis# disorder! an ecological study of Te/as, Health 1lace. 2009C%2425! 20&3B %5 1al#er R=. Blanchard S. Wood R, 1ro/i#ity to point sources of en)iron#ental #ercury release as a predictor of autis# pre)alence, Health 1lace. 200 C doi!%0,%0%9O-,healthplace,200 ,02,00% 25 Thun MJ. Schnorr TM. S#ith $B. et al, Mortality a#ong a cohort of ?S cad#iu# production *or0ers A an update, J 2atl ;ancer Inst %B 'C 84425! &2'3&&, &5 Blot WJ. =rau#eni J= Jnr, $rsenical air pollution and lung cancer, (ancet %B8'C 2 48B295!%4234, 45 Se)ers R. Whitehead (. (ane R, $ir 6uality correlates of chronic disease #ortality! Harris ;ounty. Te/as %B9B38%, Te/ Rep Biol Med %B8 C &9! %9B3 4,

'B

'5 Wec0er (. Miller SB. ;ochran SR et al, Trace ele#ent concentration in hair fro# $utistic ;hildren, J Ment "efic Res %B '! 2B 4pt %5! %'322, 95 ;apel I". 1innoc0 MH. "orrell HM. et al, ;o#parison of concentrations of so#e trace. +ul0. and to/ic #etals in the hair of nor#al and dysle/ic children, ;linic ;he# %B %! 28495! 8B3 %, 85 Broc0el BJ. ;ory3Slechta "$, (ead. attention. and i#pulsi)e +eha)iour! changes in a fi/ed *aiting3for3re*ard paradig#, 1har#acol Bioche# Beha) %BB ! 90425! '4'3'2, 5 "a)id <J. Hoff#an S1. S)erd J. et al, (ead and hyperacti)ity! Beha)ioural response to chelation, $# J 1sych %B89C %&&4%05! %%''3 , B5 Masters R", Biology and politics! lin0ing nature *ith nurture, $nn Re) 1olit Sci 200%C 4! &4'39', B05 (e)iton $. Bellinger ". $llred E2 et al, 1re and postnatal lo*3le)el lead e/posure and children>s dysfunction in school, En)iron Res %BB&! 904%5! &034&, B%5 Eppright T". Sanfacon J$. Hor*it7 =$, $ttention deficit hyperacti)ity disorder. infantile autis# and ele)ated +lood lead! a possi+le relationship, Mol Med %BB9! B&4&5! %&93 , B25 2eedle#an H(. Kunnoe ;. (e)iton $ et al, "eficits in psychologic and classroo# perfor#ance in children *ith ele)ated dentine lead le)els, 2 Eng J Med %BB4C &&%4%&5! 9 B3B', B&5 Bellinger ". (e)iton $. Waternau/ ;. et al, (ongitudinal analyses of prenatal and postnatal lead e/posure and early cogniti)e de)elop#ent, 2 Eng J Med %B 8C &%9 4%85! %0&834&, B45 2eedle#an H(. Riess J$. To+in MJ. et al, Bone lead le)els and delin6uent +eha)iour, J$M$ %BB9C 28' 4'5C &9&3B, B'5 Mispelstraat! (i)ing under the s#o0e of a *aste incinerator, Report on the health i#pact of the MIW$ *aste incinerator in Sint 2i0laas. Belgiu#, ***,#ilieuge7ondheid, B95 Schauss $K, ;o#parati)e hair3#ineral analysis results of 2% ele#ents in a rando# selected +eha)iourally Mnor#alN %B3'B year old population and )iolent adult cri#inal offenders, Int J Biosoc Res %B %C %! 2%34%, B85 Bo*dler 2;. Beasley "S. =rit7e E; et al, Beha)ioural effects of alu#iniu# ingestion on ani#al and hu#an su+-ects, 1har#acol Bioche# Beha) %B8B! %0445! '023%2, B 5 Trapp K$. Miner KH. Pi##er#an R( et al, $lu#iniu# le)els in the +rain in $l7hei#er>s disease, Biol 1yschiatry %B8 C %&495! 80B3% , BB5 Multhaup K, $#yloid precursor protein. copper and $l7hei#er>s disease, Bio#ed 1har#ocother %BB8! '%4&5! %0'3%%, %005 Papatero M". Karcia de Jalon $. 1ascual =. et al, Seru# alu#iniu# le)els in $l7hei#er>s disease and other senile de#entias, Biol Trace Ele# Res %BB'C 48 4%3&5! 2&'340, %0%5 Martyn ;2. Bar0er "J. <s#ond ; et al, Keographical relationship +et*een $l7hei#er>s disease and alu#iniu# in drin0ing *ater, (ancet %B BC %4 89&5! 'B392, %025 ;rapper "R. @rishnan SS. "alton $J et al, Brain alu#iniu# distri+ution in $l7hei#er>s disease and e/peri#ental neurofi+rillary degeneration, Science %B8&! % 04 '5! '%%3&, %0&5 2eri (;. He*itt ", $l7hei#er>s disease and drin0ing *ater, (ancet %BB%C && 4 89&5! &B0, %045 Payed J. "ucic S. ;a#panella K. et al, En)iron#ental factors in the etiology of 1ar0inson>s disease, ;an J 2eurol Sci %BB0! %84&5! 2 93B%,

3.3 Nitrous "xides

%0'5 Richters $. Richters D, $ ne* relationship +et*een air pollutant inhalation and cancer, $rch En)iron Health %B &C & 425! 9B38', %095 Ruaslahti E, Ho* cancer spreads, Scientific $#erican Sept %BB9! 82388, %085 $ndersen HR. Spi/ ;. Medina S. et al, $ir pollution and daily ad#issions for chronic o+structi)e pul#onary disease in 9 European cities! results fro# the $1HE$ pro-ect, Eur Resp J %BB8C %04'5! %09438%, %0 5 Sunyer J. Spi/ ;. Guenel 1. et al, ?r+an air pollution and e#ergency ad#issions for asth#a in four European cities! the $1HE$ 1ro-ect, Thora/ %BB8C '24B5! 8903', %0B5 <stro B". Broad*in R. (ipsett MJ, ;oarse and fine particles and daily #ortality in the ;oachella Dalley. ;alifornia! a follo*3up study, J E/p $nal En)iron Epide#iol 2000C %04'5! 4%23B,

90

%%05 Breslin @, The i#pact of o7one, En) Health 1erspecti)es %BB'C %0&483 5! 99034, %%%5 Hoe0 K. Sch*art7 J". Kroot B. Eilers 1, Effects of a#+ient particulate #atter and o7one on daily #ortality in Rotterda#. The 2etherlands, $rch En)iron Health %BB8C '2495! 4''39&,

3.! "r anic /oxicants

%%25 "en Hond E. Roels H$. Hoppen+rou*ers @ et al, Se/ual #aturation in relationship to polychlorinated aro#atic hydrocar+ons! Shape and S0a00e+ae0>s hypothesis re)isited, En)iron Health 1erspect 2002C %%04 5! 88%39, %%&5 Es0ena7i B. Mocarelli 1. Warner M et al, Seru# dio/in concentrations and endo#etriosis! a cohort study in Se)enso. Italy, En)iron Health 1erspect 2002C %%0485! 92B3&4, %%45 Wolff MS. Weston $, Breast cancer ris0 and en)iron#ental e/posures, En)iron Health 1erspect %BB8C %0'4Suppl 45! B%39, %%'5 Hoyer $1. Kran-ean 1. Jorgensen T et al, <rganochlorine e/posure and the ris0 of +reast cancer, (ancet %BB C &'2 4B%4&5! % %9320, %%95 <li)a $. Spira $. Multigner ( et al, ;ontri+ution of en)iron#ental factors to the ris0 of #ale infertility, Hu# Reprod 200%C %94 5! %89 389, %%85 Sultan ;. Balaguer 1. Terouanne B et al, En)iron#ental /enoestogens. antiandrogens and disorders of #ale se/ual differentiation, Mol ;ell Endocrinol 200%C %8 4%325! BB3%0', %% 5 Hardell (. )an Ba)el B. (indstro# K et al, Increased concentrations of polychlorinated +iphenyls. he/achloro+en7ene and chlordanes in #others of #en *ith testicular cancer, En)iron Health 1erspect 200&C %%% 485! B&034,

a8 "r anochlorines
%%B5 Jay @. Stieglit7 (, Identification and 6uantification of )olatile organic co#ponents in e#issions of *aste incineration plants, ;he#osphere %BB'C &0! %24B3%290 %205 Ecocyle ;o##ission of the Ko)ern#ent of S*eden, 1D;! $ 1lan to 1re)ent En)iron#ental I#pact, Stoc0hol#! Ecocycle ;o##ission %BB4 %2%5 $#erican 1u+lic Health $ssociation, Resolution B&04! Recogni7ing and addressing the en)iron#ental and occupational health pro+le#s posed +y chlorinated organic che#icals, $# J 1u+lic Health %BB4C 4!'%43' %225 Thornton J. 1andora>s 1oison. 2000. MIT 1ress. ;a#+ridge. Massachusetts W (ondon %2&5 ?S Eniron#ental 1rotection $gency, Esti#ating e/posure to 2.&.8. T;"", 2al Re)ie* "raft, Washington ";! ?S E1$. <ffice of Research and "e)elop#ent 4E1$O900393BB3008$5. %B %245 Tatsu0a*a R. Tana+e S, =ate and +ioaccu#ulation of persistent organochlorine co#pounds in the #arine en)iron#ent, In! Bau#gartner "J. "udall IM. eds, <ceanic 1rocesses in Marine 1ollution. Dolu#e 9. Mala+ar =(! @reiger. %BB0!&B3'' %2'5 =ran0 H. 2oro0orpi I SchollH et al, Trichloroacetate le)els in the at#osphere and in conifer needles in ;entral and 2orthern Europe, <rganohalogen ;o#pounds %BB&.%4!&083 %295 2orsto# R. Muir ";K, ;hlorinated hydrocar+on conta#inants in arctic #arine #a##als, Science of the Total En)iron#ent. %BB4C %'4!%083%2 %285 $rctic Monitoring and $ssess#ent 1rogra##e, $rctic 1ollution Issues! $ state of the $rctic En)iron#ent Report, <slo!$M$1 "irectorate. %BB8

b8 *ioxins
%2 5 Br7u7y(1. Hites R$, Klo+al #ass +alance of polychlorinated di+en7o3p3dio/ins and di+en7ofurans, En)iron#ental Science and Technology. %BB9. &0!%8B83% 04 %2B5 ?S En)iron#ental 1rotection $gency, The In)entory of sources of dio/in in the ?nited States 4Re)ie* "raft5, Washington ";! ?S E1$ <ffice of Research and "e)elop#ent 4E1$O 900Op3B 3002a5. %BB %&05 Tho#as D. Shapiro ;, $n esti#ation of dio/in e#issions in the ?nited States, To/icology and En)iron#ental ;he#istrty. %BB'C '0!%3&8 %&%5 "a)is "(. "inse KE. Hoel "K, "ecreasing cardio)ascular disease and increasing cancer a#ong *hites in the ?nited States fro# %B8& through %B 8, J$M$. %BB4C 28%!4&%34&8 %&25 Tritscher $M. ;lar0 KS. (ucier KW, "ose3response effects of dio/ins!Species co#parison and i#plications for ris0 assess#ent, In! Schecter $. "io/ins and Health, 2e* Ior0!plenu#. %BB4!228324 %&05

9%

%&&5 2eu+ert R. Jaco+3Muller ?. Helge H et al, 1olyhalogenated di+en7o3p3dio/ins and di+en7ofurans and the i##une syste#! In )itro effects of 2.&.8. tetrachlorodi+en7o3p3dio/in 4T;""5 on ly#phocytes of )enous +lood fro# a #an and a non3hu#an pri#ate, $rchi)es of To/icology %BB%C9'!2%&3B %&45 ?S En)iron#ental 1rotection $gency, Health $ssess#ent "ocu#ent for 2.&.8. A tetrachlorodi+en7o3p3dio/in and Related ;o#pounds. Dolu#es %3&. Re)ie* "raft, Washington ";!?S E1$ <ffice of Research and "e)elop#ent 4E1$O900OB13B2300%5.%BB4 %&'5 Becher H. Steindorf @. =lesch3Janys ", Guantitati)e cancer ris0 assess#ent of dio/ins using an occupational cohort, En) Health 1erspect %BB C %094Suppl 25! 99&3980 %&95 1ap0e <, 1;""O=!Hu#an +ac0ground data fro# Ker#any. a %0 year e/perience, En) Health 1erspect. %BB C %09 4Suppl 25! 82&3&% %&85 Schecter $. Startin J. Wright ; et al, ;ongener3specific le)els of dio/ins and di+en7ofurans in ?S food and esti#ated daily dio/in to/ic e6ui)alent inta0e, En) Health 1erspect %BB4C %02! B923B99 %& 5 Schecter $. Kasie*ic7 T, Health ha7ard assess#ent of chlorinated dio/ins and di+en7ofurans contained in hu#an #il0, ;he#osphere %B 8C %9!2%483'4 %&B5 Kray (E. <st+y JS. @elce WR, $ dose3response analysis of the reproducti)e effects of a single gestational dose of 2.&.8. tetrachlorodi+en7o3p3dio/in in #ale (ong E)ens hooded rat offspring, To/icology and $pplied phar#acology. %BB8C %49! %%320 %405 Theo+ald HM. 1eterson RE, "e)elop#ental and reproducti)e to/icity of dio/ins and other $h receptor agonists, In! Schecter $. ed, "io/ins and Health, 2e* Ior0! 1lenu#, %BB4!&0B349 %4%5 Seegal R=. Schant7 S(, 2euroche#ical and +eha)ioural se6uelae of e/posure to do/ins and 1;Bs, In! Schecter $. ed, "io/ins and Health, 2e* Ior0! 1lenu#, %BB4!40B344 %425 Guass ?. =er#ann M. Bro0er K. European "io/in In)entary Dolu#e &. $ssess#ent of dio/in e#issions until 200'., 1repared +y 2orth Rhine Westphalia# State En)iron#ental $gency on +ehalf of the European ;o##ission. "irectorate Keneral for En)iron#ent 4"K E2D5

3.% Effects on enetic (aterial

%4&5 To#atis (, Transplacental ;arcinogenesis, (yon. International $gency for Research on ;ancer. I$R; Scientific 1u+lications 2o 4 pp%003%%%, %445 To#atis (. Koodall ;M, The occurrence of tu#ours in =%. =2 and =& descendants of pregnant #ice in-ected *ith 8.%2 di#ethyl+en74a5anthracene, Int J ;ancer %B9BC 4425! 2%B32',

3.& Effects on Immune System

%4'5 Ross 1. de S*art. Disser I. et al, Relati)e i##unoco#petence of the ne*+orn har+or seal. 1hoca )itulina, Deterinary I##unology and I##unopathology %BB4C 424&345! &&%34 , %495 Ross 1. de S*art R. Rei-nders 1. et al, ;onta#inant3related suppression of delayed3type hypersensiti)ity and anti+ody responses in har+or seals fed herring fro# the Baltic Sea, En) Health 1erspect %BB'C %0& 425! %9238, %485 "e S*art R, I#paired i##unity in seals e/posed to +ioaccu#ulated en)iron#ental conta#inants. 1h" Thesis. Eras#us ?ni)ersity. Rotterda#. 2etherlands. %BB', %4 5 (ah)is K. Wells RS. @uehl "W et al, "ecreased ly#phocyte response in free3ranging +ottle3nosed dolphins 4Tursiops truncatus5 are associated *ith increased concentration of 1;Bs and ""T in peripheral +lood, En) Health 1erspect %BB'C %0&445! 98382, %4B5 ;one JE.Harrison R. Reiter R, 1atients *ith #ultiple che#ical sensiti)ities! clinical diagnostic su+sets a#ong an occupational health clinic population, )n ;ullen M 4ed5 Wor0ers *ith Multiple ;he#ical Sensiti)ities. <ccupational Medicine! State of the $rt Re)ie* %B 8C 2445!82%38& , %'05 Shar#a R, I##unological ;onsiderations in To/icology. Dols % and 2 4%B %5. ;R; 1ress. Boca Raton. =(, %'%5 $shford 2. Miller ;, ;he#ical E/posures! (o* (e)els and High Sta0es, John Wiley W Sons %BB ,

92

%'25 Massolo (. Muller $. Tueros M. et al, $ssess#ent of #utagenicity and to/icity of different3 si7e fractions of air particles fro# (a 1lata. $rgentina. and (eip7ig. Ker#any, En)iron To/icol 2002C %84&5! 2%B3&%, %'&5 @er0)liet 2I, I##unoto/icity of dio/ins and related che#icals, In! Schecter $. ed, "io/ins and Health, 2e* Ior0! 1lenu#%BB4!%BB32%8 %'45 Tryphonas H, I##unoto/icity of 1;Bs 4$roclors5 in relation to Kreat (a0es, En)iron Health 1erspect. %BB'C %0& 4Suppl B5!&'349 %''5 Hilla# R1. Bice "E. Hahn ==. Scni7elein ;T, Effects of acute nitrogen dio/ide e/posure on cellular i##unity after lung i##uni7ation, En)iron Res %B &C &%4%5! 20%3%%,

3.' Syner istic Effects

%'95 ;arroll Wilson, Man>s Klo+al I#pact on the En)iron#ent! $ Study of ;ritical En)iron#ental 1ro+le#s. MIT 1ress. ;a#+ridge. Mass %B8%, %'85 Mo0hi+er R, The Ecologist %BB C 2 425! '83 , %' 5 Harrison 1T. Heath J;, $pparent synergy in lung carcinogenesis! interactions +et*een 23 nitroshepta#ethylenei#ine. particulate cad#iu# and crocidolite as+estos fi+res in rats, ;arcinogenesis %B 9C 84%%5! %B0&3 , %'B5 Wade MK. =oster WK. Iounglai ED. et al, Effects of su+chronic e/posure to a co#ple/ #i/ture of persistent conta#inants in #ale rats! syste#ic. i##une and reproducti)e effects, To/icol Sci 2002C 984%5! %&%34&, %905 Soto $M. ;hung @(. Sonnenschein ;, The pesticides endosulphan. to/aphene and dieldrin ha)e estrogenic effects on hu#an estrogen3sensiti)e cells, En)iron Health 1erspect %BB4C %02445! & 03&, %9%5 $+ou3"onia MB. Wil#arth @R. Jensen @= et al, 2euroto/icity resulting fro# co3e/posure to pyridostig#ine +ro#ide. "EET and per#ethrin! I#plications of Kulf War che#ical e/posures, J To/icol En) Health %BB9C 4 4%5! &'3'9, %925 Ershoff BH, Synergistic to/icity of food additi)es in rats fed a diet lo* in dietary fi+re, J =ood Sci %B89C 4%! B4B3'%, %9&5 Wade MK. 1arent S. =innson @W. et al, Thyroid To/icity due to a su+chronic e/posure to a co#ple/ #i/ture of %9 organochlorines. lead. and cad#iu#, To/icol Sci 2002C 98425! 2083% , %945 $rnold S=. @lot7 "M. ;ollins BM. et al, Synergistic acti)ation of estrogen receptors *ith co#+inations of en)iron#ental che#icals, Science %BB9C 282 4'2985! %4 B3B2, %9'5 Ker#olec "R. Iang RSH. $c0er#ann M1 et al, To/icology studies of a che#ical #i/ture of 2' ground*ater conta#inants! I##unosuppression in B9;&= #ice, =unda#ental and $pplied To/icology %BB%C%&! &883& 8 %995 (i MH. Hansen (K, En7y#e induction and acute endocrine effects in prepu+ertal fe#ale rats recei)ing en)iron#ental 1;BO1;"=O1;"" #i/tures, En)iron Health 1erspect %BB9C %04485! 8%2322,

Section !. Increased (orbidity and (ortality near Incinerators !.1 Cancer

%985 Elliot 1. Shaddic0 K. @leinsch#idt I etal. ;ancer incidence near #unicipal solid *aste incinerators in Kreat Britain, Brit J ;ancer %BB9C 8&4'5! 8023%0, %9 5 Elliot 1. Eaton 2. Shaddic0 K et al, ;ancer incidence near #unicipal *aste incinerators in Kreat Britain, 1art 2! Histopathological and case note re)ie* of pri#ary li)er cancer cases, British J ;ancer 2000C 24'5! %%0&39, %9B5 @no/ EK. Kil#an E$, Migration patterns of children *ith cancer in Britain, J Epide#iology W ;o##unity Health %BB C '24%%5! 8%9329, %805 @no/ EK, ;hildhood cancers. +irthplaces. incinerators and landfill sites, Int J Epide#iology 2000C 2B 4&5! &B%38, %8%5! Biggeri $. Bar+one =. (aga7io ;. et al, $ir pollution and lung cancer in Trieste. Italy! Spatial analysis of ris0 as a function of distance fro# sources, En)iron Health 1erspect %BB9C %04 485! 8'034,

9&

%825 Diel J=. $r)eu/ 1. Ba)erel J. et al, Soft tissue sarco#a and non Hodg0in>s ly#pho#a clusters around #unicipal solid *aste incinerators *ith high dio/in e#ission le)els, $# J Epide#iology 2000C %'24%5! %&3%B, %8&5 <hta S. @uriya#a S. 2a0ao et al, (e)els of 1;""s. 1;"=s and non3ortho coplanar 1;Bs in soil collected fro# high cancer3causing area close to +atch3type #unicipal solid *aste incinerator in Japan, <rganohalogen ;o#pounds %BB8C &2! %''390, %845 ;o#+a 1. $scoll D. Belli S et al Ris0 of soft tissue sarco#as and residence in the neigh+ourhood of an incinerator of industrial *astes, <ccup En)iron Med 200&C 904B5! 9 03& %8'5 Pa#+on 1. Ricci 1. Bo)o E et al, Sarco#a ris0 and dio/in e#issions fro# incinerators and industrial plants! a population3+ased case3control study 4Italy5, En)iron Health 2008C 9! %895 Kusta)sson 1, Mortality a#ong *or0ers at a #unicipal *aste incinerator, $# J Ind Med %B BC %'4&5! 24'3'&, %885 Kusta)sson 1. E)anoff B. Hogstedt ;, Increased ris0 of esophageal cancer a#ong *or0ers e/posed to co#+ustion products, $rchi)es En)iron Med %BB&C 4 445! 24&3',

!.2 )irth *efects

%8 5 ten Tusscher KW. Sta# K$. @oppe JK, <pen che#ical co#+usting resulting in a localised increased incidence of orofacial clefts, ;he#osphere 2000C 404B3%%5! %29&380, %8B5 Dan (ore+e0e 2, Health effects of a household *aste incinerator near Wilri-0. Belgiu#, )n Health I#pacts of Waste Manage#ent 1olicies. Hippocrates =oundation. @os. Kreece. 2000, % 05 ;ordier S. ;he)rier ;. Ro+ert3Knansia E et al, Ris0 of congenital ano#alies in the )icinity of #unicipal solid *aste incinerators, <ccup En)iron Med 2004! 9%4%5! 3%', % %5 "u##er TJ. "ic0inson H<. 1ar0er (, $d)erse pregnancy outco#es around incinerators and cre#atoriu#s in ;u#+ria. 2orth3*est England. %B'93B&, J Epide#iol ;o##unity Health 200&! '8495! 4'939%, % 25 "ol0 H. Dri-held M. $r#strong B et al, Ris0 of congenital ano#alies near ha7ardous3*aste landfill sites in Europe! the E?R<H$P;<2 study, (ancet. %BB C &'24B%295! 42&38, % &5Elliot 1. Briggs ". Morris S et al, Ris0 of ad)erse +irth outco#es in populations li)ing near landfill sites, BMJ. 200%C &2&48&0B5! &9&3 , % 45 ;roen ($. Sha* KM. San+on#atsu ( et al, Maternal residential pro/i#ity to ha7ardous *aste sites and ris0 for selected congenital #alfor#ations, Epide#iology %BB8C 445! &483'4, % '5 <rr M. Bo)e =. @aye W et al, Ele)ated +irth defects in racial or ethnic #inority children of *o#en li)ing near ha7ardous *aste sites, Int J Hyg En)iron Health. 2002C 20'4%325! %B328, % 95 Johnson B(, $ re)ie* of the effects of the effects of ha7ardous *aste on reproducti)e health, $# J of <+stetrics and Kynecology %BBBC % %! S%23S%9,

Section %. *isease Incidence and Pollution %.1 Cancer

% 85 2;I. %BB%! M;ancer Statistics Re)ie* %B8&3 N. 2IH 1u+lications 2o B%328 B, % 5 To#atis (. ;ancer. ;auses. <ccurrence and ;ontrol. I$R; Scientific pu+lications %00. 4(yon. =rance. I$R; %BB95 2%, % B5 Kraphs of che#ical production! =ro# International Trade ;o##ission. Washington ";, %B05 "a)ies "(. Hoel ". =o/-. (ope7 $, International trends in cancer #ortality in =rance. West Ker#any. Italy. Japan. England and Wales and the ?S$, (ancet %BB0C &&9 4 8%&5! 4843 %, %B%5 1ic0le (W. Mason TJ. =rau#eni J= Jr, The ne* ?nited States ;ancer $tlas, Recent Results ;ancer Res. %B BC %%4! %B93208, %B25 2a-e# KR. (ouria "B. (a)enhar M$ et al, ;lusters of cancer #ortality in 2e* Jersey #unicipalities. *ith special reference to che#ical to/ic *aste disposal sites and per capita inco#e, Int J Epide#iol %B 'C %4445! '2 3&8, %B&5 2a-e# KR. Kreer W, =e#ale reproducti)e organs and +reast cancer #ortality in 2e* Jersey ;ounties and the relationship *ith certain en)iron#ental )aria+les, 1re) Med %B '! %44'5! 9203&', %B45 Hoo)er R. =rau#eni J= Jr, ;ancer #ortality in ?S counties *ith che#ical industries, En)iron Res %B8'C B425! %B93208,

94

%B'5 Kold#an B$, The Truth $+out Where Iou (i)e! $n $tlas for $ction on To/ins and Mortality, 2e* Ior0! Rando# House %BB%, %B95 Pah# SH. Blair $, ;ancer a#ong #igrant and seasonal far#ers! an epide#iologic re)ie* and research agenda, $# J of Ind Med %BB&C 24495! 8'&399, %B85 Tornling K. Kusta)sson 1. Hogstedt ;, Mortality and cancer incidence a#ong Stoc0hol# fire fighters, $#er J Industrial Med %BB4! 2'425! 2%B32 , %B 5 Pah# SH. Weisen+urger "". Ba++itt 1$ et al, $ case control study of non3Hodg0in>s (y#pho#a and the Her+icide 2.4 "ichloropheno/yacetic acid 42.43"5 in Eastern 2e+ras0a, Epide#iology %BB0C %4'5! &4B3'9, %BB5 Hardell (. Eri0sson M. (enner 1 et al, Malignant ly#pho#a and e/posure to che#icals. especially organic sol)ents. chlorophenols and pheno/y acids! a case control study, Brit J ;ancer %B %C 4&425! %9B389, 2005 Harsh+arger J; and ;lar0 JB, Epi7ootiology of neoplas#s in +ony fish of 2orth $#erica, Sci Total En)iron %BB0C B44%325! %3&2, 20%5 Hayes HM Jr. Hoo)er R. Tarone RE, Bladder cancer in pet dogs! a sentinel for en)iron#ental cancer, $# J Epide#iol %B %C %%4425! 22B3&&, 2025 Bau#ann 1;. Harsh+argerJ;, "ecline in li)er neoplas#s in *ild +ro*n +ullhead catfish after co0ing plant closes and en)iron#ental 1$Hs plu##et, En)iron health 1erspect %BB'C %0&! %9 380, 20&5 1erera =,1. He##in0i @. Kry7+o*s0a E et al, Molecular and Kenetic "a#age in Hu#ans fro# En)iron#ental 1ollution in 1oland, 2ature %BB2C &90 4940%5! 2'93' , 2045 1erera =1. Mooney ($. Sta#fer M et al, $ssociations +et*een carcinogen3"2$ da#age. glutathione S transferase genotypes. and ris0 of lung cancer in the prospecti)e 1hysician>s Health ;ohort Study, ;arcinogenesis 2002C 2&4%05! %94%39, 20'5 (e*is3Michl E(. Melius JM. @allen+ach (R et al, Breast cancer ris0 and residence near industry or traffic in 2assau and Suffol0 ;ounties. (ong Island. 2e* Ior0, $rch En)iron Health %BB9C '%445! 2''39', 2095 The (ong island Breast ;ancer Study Reports %3& 4%B 3B05. 2e* Ior0 State "epart#ent of Health. "epart#ent of ;o##unity and 1re)entati)e Medicine. 2assau ;ounty "epart#ent of Health and Suffol0 ;ounty "epart#ent of Health Ser)ices, 2085 $schengrou $. <7onoff "M, ?pper ;ape ;ancer Incidence Study! =inal Report, Boston! Mass, "epts of 1u+lic Health and En)iron#ent 1rotection %BB%, 20 5 $schengrau $. <7onoff ". 1aulu ; et al, ;ancer ris0 and tetrachloroethylene3containing drin0ing *ater in Massachusetts, $rch En)iron Health %BB'C 4 4'5! 2 43B2, 20B5 Mc@el)ey W. Brody JK. $schengrau $ et al, $ssociation +et*een residence on ;ape ;od. Massachusetts. and +reast cancer, $nn Epide#iol 2004C %4425! B3B4, 2%05 =agliano J. Berry M. Boye = et al, "rin0ing *ater conta#ination and the incidence of leu0ae#ia!an ecologic study, $# J 1u+lic Health %BB0C 0 4%05! %20B3%2, 2%%5 ;antor @1 et al,. Water 1ollution )n Schottenfeld " and =rau#eni J= Jr 4eds,5. ;ancer Epide#iology and 1re)ention. 2nd ed, </ford! </ford ?ni) 1ress %BB9, 2%25 (aga0os S,W et al, $n analysis of conta#inated *ell *ater and health effects in Wo+urn. Massachusetts, J $#er Stat $ssoc %B 9! &B'! ' &3B9, 2%&5 <s+orne J,S. Shy ;M. @aplan BH, Epide#iologic analysis of a reported cancer case cluster in a s#all rural population, $# J Epide#iol %BB0C %&2 4Supp %5! S 83B', 2%45 (a#pi 1. Ha0ulinen T. (uostarinen et al, ;ancer incidence follo*ing chlorophenol e/posure in a co##unity in Southern =inland, $rch En)iron Health %BB2C 484&5! %9838', 2%'5 I$R; Monographs on E)aluation of ;arcinogenic Ris0s to Hu#ans Suppl 8 4(yon. =rance! I$R; %B 85, 2%95 ?S,"HHS Se)enth $nnual Report on ;arcinogens. Research Triangle 1ar0. 2;!us, "epart#ent of Health and Hu#an Ser)ices. %BB0, 2%85 Hol7#an ", Ban0ing on tissues, En)iron Health 1erspect %BB9C %04495! 9093%0, 2% 5 Moses M. Johnson ES. $nger W@ et al, En)iron#ental e6uity and pesticide e/posure, To/icol Ind Health %BB&C B4'5! B%&3'B,

9'

2%B5 <nstot J. $yling R. Stanley J, ;haracteri7ation of HRK;OMS ?nidentified 1ea0s fro# the $nalysis of Hu#an $dipose tissue, Dolu#e %! Technical approach, Washington ";! ?S En)iron#ental 1rotection $gency <ffice of To/ic Su+stances 4'90O93 83002a5. %B 8 2205 Body Burden! E/ecuti)e Su##ary. 200&. En)iron#ental Wor0ing Kroup. Mount Sinai School of Medicine and ;o##on*eal, ***,e*g,orgOreportsO+ody+urdenO 22%5 =oster W. ;han S. 1latt (. Hughes ;, "etection of endocrine disrupting che#icals in sa#ples of second tri#ester hu#an a#niotic fluid, J ;linic Endocrinol Meta+ol 2000C '4 5! 2B'438, 2225 Pieger M, Bio#ar0ers! The clues to genetic suscepti+ility, En)iron Health 1erspecti)es %BB4C %024%5! '038,

%.2 Neurolo ical *isease

22&5 Rodier 1M, "e)eloping +rain as a target of to/icity, En)iron Health 1erspect %BB'! %0& Suppl 9! 8&39, 2245 Hattis ". Klo*a J Tilson H et al, Ris0 assess#ent for neuro+eha)ioural to/icity! SK<MSE; -oint report, En) Health 1erspect %BB9C%04 4Suppl 25! 24B38% 22'5 (andrign 1J. Kraha# "K. $nger W@ et al, En)iron#ental to/icology, Washington ";! 2ational $cade#y 1ress.%BB2, 2295 WeissB,Ris0 assess#ent! The insidious nature of neuroto/icity and the aging +rain, 2euroto/icology %BB0C%%!&0'3%4 2285 @napp et al, "e#entia ?@! Report to the $l7hei#er>s Society. @ing>s ;ollege. (ondon and (ondon School of Econo#ics and 1olitical Science. 2008 22 5 1ritchard ;. Bald*in ". Mayers $, ;hanging patterns of adult neurological deaths 44'384 years5 in the #a-or *estern *orld countries 4%B8B3%BB85, 1u+lic Health 2004C %% 445! 29 3 &, 22B5 Taylor B. Miller E. =arrington ;1 et al, $utis# and #easles. #u#ps and ru+ella )accine! no epide#iological e)idence for a causal association, (ancet %BBBC &'&4B%9B5! 20293B, 2&05 Ry+ic0i R$. Johnson ;;. ?#an J. Korrell JM, 1ar0inson>s disease #ortality and the industrial use of hea)y #etals in Michigan, Mo) "isord %BB&C 4%5! 83B2,

%.3 (ental *isease

2&%5 Strahile)it7 M. Strahile)it7 $. Miller JE, $ir pollutants and the ad#ission rate of psychiatric patients, $# J 1sychiatry %B8BC %&9425! 20'38, 2&25 Briere J. "o*nes $. Spensley J, $, su##er in the city! ur+an *eather conditions and psychiatric e#ergency roo# )isits, J $+nor# 1yschol %B &C B24%5! 883 0, 2&&5 Morro* ($. @a#is H. Hodgson MJ, 1sychiatric sy#pto#atology in persons *ith organic sol)ent e/posure, J ;onsult ;linic 1yschol %BB&C 9%4%5! %8%34, 2&45 Morro* ($. Stein (. Scott $ et al, 2europsychological assess#ent. depression and past e/posure to organic sol)ents, $pplied 2europyschol 200%C 425! 9'38&,

%.! +iolence and Crime

2&'5 Hall RW, $ study of #ass #urder! e)idence of underlying cad#iu# and lead poisoning and +rain3in)ol)ed i##unoreacti)ity, Int J Bioscoc Med Res %B BC %%! %443'2, 2&95 Marlo*e M. Schneider HK. Bliss (B, Hair #ineral analysis in e#otionally distur+ed and )iolence prone children, Int J Biosoc Med Res %BB%C %&! %9B38B, 2&85 1ihl R<. Er)in =, (ead and cad#iu# le)els in )iolent cri#inals, 1yschol Rep %BB0C 994&1t %5! &B344, 2& 5 "enno "W, Kender. cri#e and the cri#inal la* defences, J ;ri# (a* ;ri#inol %BB4C '! 03% 0, 2&B5 "e+orah "enno, Biology and Diolence! =ro# Birth to $dulthood, ;a#+ridge ?ni)ersity 1ress. %BB0, 2405 Stretes0y 1B. (ynch MJ, The relationship +et*een lead e/posure and ho#icide, $rch 1ed $dolesc Med 200%C %''4'5! '8B3 2, 24%5 Stretes0y 1B. (ynch MJ, The relationship +et*een lead and cri#e, J Health W Soc Beha) 2004C 4'425! 2%432B,

&. Hi h ,is- .rou#s

99

&.1 /he :oetus

2425 ;enters for "isease ;ontrol, Blood and hair #ercury le)els in young children and *o#en of child+earing age, ?nited States %BBB Mor+idity and Mortality Report. 200%C '0! %4034&, 24&5 $nderson (M. "i*an B$. =ear 2T. Ro#an E, ;ritical *indo*s of e/posure for children>s health! cancer in hu#an epide#iological studies and neoplas#s in e/peri#ental ani#al #odels, En)iron Health 1erspect 2000C %0 suppl &! '8&3B4, 2445 ?S En)iron#ental 1rotection $gency. <ffice of 1ollution 1rotection and To/ic Su+stances. ;he#ical Ha7ard "ata $)aila+ility Study! What do *e really 0no* a+out high production )olu#e che#icalsJ ?SE1$! Washington ";.%BB , 24'5 Sonnenschein ;. Soto $M, $n ?pdated re)ie* of en)iron#ental estrogen and androgen #i#ics and antagonists, J Steroid Bioche# Mol Biol %BB C 9' 4%395! %4&3'0, 2495 Mar0ey ;M. ;oo#+s M$. Sonnenschein ;. Soto $M, Ma##alian de)elop#ent in a changing en)iron#ent! e/posure to endocrine disruptors re)eals the de)elop#ental plasticity of steroid3hor#one target organs, E)ol "e) 200&C '4%5! 9838', 2485 Tilson H$. Jaco+son J(. Rogan WJ, 1olychlorinated +iphenyls and the de)eloping ner)ous syste#! cross species co#parisons, 2euroto/icol Teratol %BB0C %2 4&5! 2&B34 , 24 5 Weisgals3@uperas 2. 1atandin S. Ber+ers K$. et al, I##unological effects of +ac0ground e/posure to polychlorinated +iphenyls and dio/ins in "utch preschool children, En)iron Health 1erspect 2000C %0 4%25! %20&38, 24B5 Rogan WJ. Kladen B;. Mc@inney J". et al, 1olychlorinated +iphenyls 41;Bs5 and dichlorodiphenyldichloroethene 4""E5 in hu#an #il0! effects of #aternal factor and pre)ious lactation, $# J 1u+lic Health %B 9C 89425! %8238, 2'05 Body Burden! The 1ollution in 2e*+orns! E/ecuti)e Su##ary. July 200'. En)iron#ental Wor0ing Kroup. Mount Sinai School of Medicine and ;o##on*eal,***,e*g,orgOreportsO+ody+urden2Oe/ecsu##,php 2'%5 $ 1resent for (ife! Ha7ardous che#icals in u#+ilical cord +lood, WW=OKreenpeace. Septe#+er 200', ***,greenpeace,orgOra*OcontentOinternationalOpressOreportsOu#+ilicalcordreport,pdf

&.2 /he )reast0fed Infant

2'25 Jensen $$. Slorach S$, $ssess#ent of infant inta0e of che#icals )ia +reast #il0 in ;he#ical ;onta#inants in Hu#an Mil0, Boca Raton! ;R; 1ress %BB%, pp2%'322, 2'&5 @oop#an3Esse+oo# ;. Huis#an M. Weisglas3@uperus 2. et al, "io/in and 1;B le)els in +lood and hu#an #il0 in relation to li)ing in the 2etherlands, ;he#osphere %BB4C 2B 4B3%%5! 2&283& , 2'45 1atandin S. "agnelie 1;. Mulder 1K. et al, "ietary e/posure to polychlorinated +iphenyls and dio/ins fro# infancy until adulthood! a co#parison +et*een +reast3feeding. toddler and long3ter# e/posure, En)iron Health 1erspect %BBBC %084%5! 4'3'%, 2''5 Rogan WJ. Bagnie*s0a $. "a#stra T, 1ollutants in +reast #il0, 2 Engl J Med %B 0C &024295! %4'03&, 2'95 Jaco+son J(. Jaco+son SW, 1renatal e/posure to polychlorinated +iphenyls and attention at school age, J 1aediatr 200&C %4&495! 8 03 , 2'85 Jaco+son J(. Jaco+son SW, $ssociation of prenatal e/posure to an en)iron#ental conta#inant *ith intellectual function in childhood, J To/icol ;lin To/icol 2002C 40445! 49838', 2' 5 Jaco+son J(. Jaco+son SW, Intellectual i#pair#ent in children e/posed to polychlorinated +iphenyls in utero, 2 Eng J Med %BB9C &&'4%%5! 8 &3B, 2'B5 @in+rough R", To/icological i#plications of hu#an #il0 residues as indicated +y to/icological and epide#iological studies in Jensen $$ W Slorach S$! ;he#ical ;onta#inants in Hu#an Mil0. %BB0 pp28%3 &, 2905 Rice ";, Beha)ioural i#pair#ent produced +y lo*3le)el postnatal 1;B e/posure in #on0eys, En) Res %BBBC 042 1t 25! S%%&3S%2%, 29%5 Rice ";, Effects of postnatal e/posure of #on0eys to a 1;B #i/ture on spatial discri#ination re)ersal and "R( perfor#ance, 2euroto/icol Teratol %BB C 20445! &B%3400,

98

2925 Rice ";. Hay*ard S, Effects of postnatal e/posure to a 1;B #i/ture in #on0eys on non3 spatial discri#ination re)ersal and delayed alternation perfor#ance, 2euroto/icology %BB8C % 425! 48B3B4, 29&5 Hallgren S. Sin-ari T. Ha0ansson H. "arnerud 1<, Effects of poly+ro#inated diphenyl ethers 41B"Es5 and polychlorinated +iphenyls 41;Bs5 on thyroid hor#one and )ita#in $ le)els in rats and #ice, $rch To/icol 200%C 8'445! 2003 , 2945 Hooper @. Mc"onald T$, The 1B"Es! an e#erging en)iron#ental challenge and another reason for +reast #il0 #onitoring progra#s, En) Health 1erspect 2000C %0 4'5! & 83B2,

&.3 Children
29'5 Moolga)0ar SH. Den7on "J, T*o3e)ent #odel for carcinogenesis! incidence of cur)es for childhood and adult tu#ours, Maths Biosci %B8BC 48! ''388, 2995 Rodier 1M, ;hronology of neuron de)elop#ent! ani#al studies and their clinical i#plications, "e) Med ;hild 2eurol %B 0C 22445! '2'34', 2985 E0+o# $. Hsieh ;;. (ip*orth (. et al, Intrauterine en)iron#ent and +reast cancer ris0 in *o#en! a population3+ased study, J 2atl ;ancer Inst %BB8C B4%5! 8%39, 29 5 @no/ EK, ;hildhood cancers and at#ospheric carcinogens, J Epide#iol ;o##unity Health 200'C 'B425! %0%3', 29B5 To#atis (. <)er)ie* of perinatal and #ultigeneration carcinogenesis, $R; Sci 1u+l %B BC B9! %3%', 2805 $nderson (M. "ono)an 1J. Rice JM. Ris0 assess#ent for transplacental carcinogenesis, )n 2e* $pproaches in To/icity Testing and their $pplication in Hu#an Ris0 $ssess#ent 4ed (i $15, %B ' pp%8B3202, 28%5 (andrigan 1J. Karg $, ;hronic effects of to/ic en)iron#ental e/posures in children>s health, J To/icol ;linical To/icol 2002C 40445! 44B3'9, 2825 ;ala+rese E,J, $ge and Suscepti+ility to To/ic Su+stances, 2e* Ior0. John Wiley W Sons %B 9, 28&5 2ational $cade#y of Sciences, Scientific =rontiers in "e)elop#ental To/icology and Ris0 $ssess#ent, 2ational $cade#y 1ress. Washington "; 2000, 2845 Windha# K;. Phang (. Kunier R et al, $utis# spectru# disorders in relation to distri+ution of ha7ardous air pollutants in the San =rancisco +ay area, En)iron Health 1erspect 2009C%%44B5! %4& 344 28'5 @enet T et al, 1erinatal e/posure to a noncoplanar polychlorinated +iphenyl alters tonotopy. recepti)e fields and plasticity in rat pri#ary auditory corte/, 1roc 2atl $cad Sci ?S$ 2008C %04 4% 5!89493'% 2895 Jaco+son J(. Jaco+son SW. Hu#phrey HE, Effects of in utero e/posure to polychlorinated +iphenyls and related conta#inants on cogniti)e functioning in young children, J 1aediatr %BB0C %%94%5! & 34', 2885 2eedle#an H(. (e)iton $. Bellinger ", (ead3associated intellectual deficit, 2 Eng J Med %B 2C &09495! &98,

&.! /he Chemically Sensitive

28 5 Rins0y R$ et al, Ben7ene and leu0e#ia! an epide#iologic ris0 assess#ent, 2 Eng J Med %B 8C &%94%85! %0443'0, 28B5 1el0onenn <, ;o#parison of acti)ities of drug3#eta+oli7ing en7y#es in hu#an fetal and adult li)ers, ;linic 1har#acol Ther %B8&C %44'5! 4039, 2 05 Hattis ". Russ $. Ko+le R. et al, Hu#an interindi)idual )aria+ility in suscepti+ility to air+orne particles, Ris0 $nal 200%C 2%445! ' '3BB, 2 %5 =ried#an R, Sensiti)e 1opulations and En)iron#ental Standards, The ;onser)ati)e =oundation. Washington "; 4%B %5,

Section '. Past (ista-es and the Precautionary Princi#le '.1 /he Precautionary Princi#le

2 25 European ;o##ission 2000, ;o##unications fro# the ;o##ission on the 1recautionary 1rinciple 4;<M 420005 %5 Brussels, ?R(! http!OOeuropa,eu,intOco##,OdgsOhealthXconsu#erOli+raryOpu+Opu+08Xen,pdf 4accessed &0 2o)e#+er 200&5, 2 &5 Krand-ean 1. Bailar J;. Kee ". et al, I#plications of the precautionary principle in research and policy3#a0ing, $# J Ind Med 2004C 4'445! & 23', 2 45 =ranchini M. Rial M. Buiatti E. Bianchi =, Health effects of e/posure to *aste incinerator e#issions! a re)ie* of the epide#iological studies, $nn Ist Super Sanita. 2004C 404%5! %0%3%',

'.2 1earnin from Past (ista-es

2 '5 Rice ";. E)angelista de "uffard $M. "uffard R et al, (essons for neuroto/icology fro# selected #odel co#pounds SK<MSE; -oint report, En) Health 1erspect %BB9C %04 4Supp 25! 20'3%',

Section 2. 3lternative 4aste /echnolo ies 2.2 Producin 1ess 4aste

2 95 "epart#ent of =ood. En)iron#ent and Rural $ffairs 420095C Re)ie* of England>s Waste Strategy! $ ;onsultation "ocu#ent. (ondon. "efra, 2 85 Energy Kreen 1aper. To*ards a European Strategy for the Security of Energy. European ;o##ission.200%, http!OOeuropa,eu,intOco##OenergyXtransportOdoc3principalOpu+finalXen,pdf 2 5 World Energy <utloo0 200%. 200% Insights. International Energy $gency4IE$5 and the <rganisation for Econo#ic ;o3operation and "e)elop#ent 45E;"5. 200%, http!OOli+rary,iea,orgOd+t*3*pdOTe/t+aseOnpoldOnpoldXpdfO*eo200%,pdf 2 B5 Mo++s 1. Energy +eyond <il. ;ron*ell 1ress (td. 200'.Tro*+ridge. ?@ 2B05 ;a#+ridge Econo#etrics. ?@ Energy and the En)iron#ent, March 200 2.' 3davanced /hermal /echnolo ies 73//8 and Plasma .asification 2B%5 Ko#e7 E. $#utha Rani ". ;hees#an ;R et al, Theral plas#a technology for the treat#ent of *astes! $ critical re)ie*. 200 . Journal of ha7ardous Materials. doi!%0,%0%9O-,ha7#at,200 ,4,0%8!%3%&

2.2 .reenhouse .ases

2B25 White 1. =ran0e M. Hindle 1, Integrated Solid Waste Manage#ent! $ (ifestyle In)entory. %BB4. Blac0ie $cade#ic $nd 1rofessional

Section 9. Costs of Incineration

9.1 *irect and Indirect Costs 2B&5 1u+lic ;onsultation on Waste #anage#ent <ptions. Scottish En)iron#ental 1rotection $gency. Western Isles Strategy $rea. 2o) 200% 2B45 Russell M. ;olgla7ier W. Tonn BE, The ?S ha7ardous *aste legacy, En)iron#ent. %BB2C &4495! %&3&B 9.2 Health costs of Incineration 2B'5 Energy Technology Support ?nit 4ETS?5. %BB9. Econo#ic E)aluation of the draft incinerator "irecti)e. European ;o##ission 2B95 =inal report for "E=R$ +y En)iros ;onsulting (td in association *ith E2TE;! Daluation of the E/ternal ;osts and Benefits to Health and En)iron#ent of Waste Manage#ent <ptions, "ec 2004 2B85 Eshet T. $yalon <. Schecter M, $ ;ritical Re)ie* of Econo#ic E)aluation Studies of E/ternalities fro# Incineration and landfilling, Waste #anage#ent Res. 200'C 2&!4 83'04 2B 5 Miranda M(. Hale B, Waste not. *ant not. the pri)ate and social cost of energy production, Energy 1olicy. %BB8C 2'!' 83900 9.3 :inancial .ains from reducin Pollution 2BB5 Wulf3Schna+el J. (ohse J, Econo#ic e)aluation of dust a+ate#ent techni6ues in the European ;e#ent Industry, $ report produced for the European ;o##ission. May %BBB,

9B

&005 1ianin E, Study finds 2et Kain fro# 1ollution rules, Washington 1ost. Sept 28th. 200&, 9.! "ther Studies of the Health Costs of Pollution &0%5 Muir T. Pegarac M, Societal ;osts of E/posure to To/ic Su+stances! Econo#ic and health ;osts of =our ;ase studies that are ;andinates for En)iron#ental ;ausation, En) Health 1erspect 200%C %0B 4Suppl 95! 'B0& &025 World Wildlife =und Report! ;o#pro#ising <ur ;hildren! ;he#ical I#pacts on ;hildren>s intelligence and Beha)iour. June 2004, ***,**f,org,u0Oche#icals

Section 1;. "ther Considerations of Im#ortance 1;.1 /he Problem of 3sh

&0&5 Mar0us T. Behnisch 1. Hagen#aier H et al, "io/inli0e co#ponents in incinerator fly ash! $ co#parison +et*een che#ical analysis data and results fro# a cell culture +ioassay, En)iron Health 1erspect %BB8C %0'4%25! 48'3 %

1;.2 ,adioactivity
&045 Beral D. Rooney ;.Maconochie 2 et al, ;ase control study of prostatic cancer in E#ployees of the ?nited @ingdo# $to#ic Energy$uthority, BMJ.%BB&C &08! %&B%38 &0'5 Sto00e T. <ftedal 1. 1appas $, Effects of a s#all doses of radioacti)e strontiu# on the rat +one #arro*, $cta Radiologica %B9 ! 8!&2%3B &095 (uning @K. =rolen H. 2elson $, Kenetic effects of Strontiu# B0 in-ected into #ale #ice, 2ature %B9&C %B8!&043' &085 Bus+y ;. Wings of "eath! 2uclear 1ollution and Hu#an Health. %BB'. Kreen $udit 4Wales5 (td. $+eryst*yth &0 5 Berd D et al 4eds,5. ;hildhood ;ancer and 2uclear Installations 4(ondon. BMJ 1u+lishing Kroup %BB&5, &0B5 Kardner MJ, ;hildhood leu0ae#ia around the Sellafield nuclear plant, )n 1 Elliot et al 4eds,5 Keographical and En)iron#ental Epide#iology! Methods for S#all $rea Studies, </ford. </ford ?ni)ersity 1ress %BB2. pp2B%3&0B, &%05 Heas#an M$. @e#p IW. ?r6uart J". Blac0 R, ;hildhood cancer in 2orthern Scotland, (ancet %B 9C % 4 48'5! 299, &%%5 Ro#an E. Watson $. Beral D. et al, ;ase control study of leu0e#ia and 2on3Hodg0in ly#pho#a a#ong children aged 034 Iears li)ing in West Ber0shire and 2orth Ha#pshire health districts, BMJ %BB&C &0949 8 5! 9%'32%, &%25 Morris MS. @norr RS, $dult leu0e#ia and pro/i#ity3+ased surrogates for e/posure to 1ilgri# plant>s nuclear e#issions, $rch En)iron Health %BB9C '%445! 299384, &%&5 ;lapp RW et al, (eu0ae#ia near Massachusetts nuclear po*er plant, (ancet %B 8C 24 '8%5! %&243', &%45 Ba0er 1J. Hoel "K, Meta3analysis of standardi7ed incidence and #ortality rates of childhood leu0ae#ia in pro/i#ity to nuclear facilities, Eur J ;ancer ;are. 2008C%9! &''39&

1;.3 /he S#read of Pollutants

&%'5 2ational Research ;ouncil 420005! Waste Incineration and 1u+lic Health ISB2! 03&0B309&8%3V.Washington ";. 2ational $cade#y 1ress, &%95 Mittal $@. Dan Krie0en R. Ra)indra,, Health ris0 assess#ent of ur+an suspended particulate #atter *ith special reference to polycyclic aro#atic hydrocar+ons! a re)ie*, Re) En)iron Health 200%C %9 41t &5! %9B3 B, &%85 =inal report to the 2orth $#erican ;o##ission for En)iron#ental ;ooperation 4=lushing. 2,I,! ;entre for the Biology of 2atural syste#s. Gueens ;ollege. ;?2I. 20005, &%B5 Raloff =J, E)en 2una)ut gets plenty of dio/in, Science 2e*s 2000C %' ! 2&0,

1;.! Cement <ilns

&%B5 1ersonal ;o##unication. ;hristine Hall. E#ission3Watch. ;hester ***,e#ission3*atch,co#

80

Section 11. (onitorin

&205 Wang (. His H ;hang J et al, Influence of start3up on 1;""O= e#ission of incinerators, ;he#osphere. 2008C 98! %&493'& &2%5 "e =re and We)ers, ?nderesti#ation of "io/in e#ission in)entories,%BB ! <rganohalogen ;o#pounds &9!%8320 &225 =arland W. (or+er M. ;le)ely ", WTI Screening le)el analysis, Washington ";! ?S En)iron#ental 1rotection $gency <ffice of Research and "e)elop#ent. =e+ruary B. %BB&, &2&5 Wates J, The 2on3Ko)ern#ental <rgani7ation and Manage#ent of Ha7ardous Waste in Ireland. %BB4. Earth*atch. European En)iron#ental Bureau

Section 12. ,is- 3ssessment

&245 $lle)a E. Broc0 J. Brou*er $ et al, State#ent fro# the *or0 session on en)iron#ental endocrine3disrupting che#icals! 2eural. endocrine and +eha)ioural effects, Erice. Italy! Ettore Ma-orana ;entre for Scientific ;ulture. %BB', &2'5 2ational Research ;ouncil 42R;5, To/icity Testing! Strategies to "eter#ine 2eeds and 1riorities 4%B 45. 2ational $cade#y 1ress. Washington. ",;, &295 Moore ;=, Silent Scourge! ;hildren. 1ollution and Why Scientists "isagree, </ford ?ni)ersity 1ress. 200&. </ford &285 Bostoc0 $, Waste Incineration and its I#pact upon Health. the En)iron#ent and Sustaina+ility. 200'. $cro (ogic &2 5 Schettler T. Solo#on K. Dalenti M and Huddle $, Kenerations at Ris0! Reproducti)e Health and the En)iron#ent. %BBB. MIT 1ress. ;a#+ridge. Massachusetts. W (ondon,

Section 1%. ,ecommendations

&2B5 =riends of the Earth Briefing, Incinerators and "epri)ation. Jan 2004,

(This article is also available as a booklet. For a copy please contact BS !"

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