A Review of Exposure Assessment Methods in Epidemiological Studies on Incinerators

Author:

Cordioli Michele12,Ranzi Andrea2,De Leo Giulio A.3,Lauriola Paolo2

Affiliation:

1. Department of Bio-Sciences, University of Parma, Parco Area delle Scienze 11/a, 43124 Parma, Italy

2. Regional Reference Centre Environment & Health, Regional Agency for Environmental Protection in Emilia-Romagna, Via Begarelli 13, 41121 Modena, Italy

3. Hopkins Marine Station and Woods Institute for the Environment, Stanford University, 120 Oceanview Boulevard, Pacific Grove, CA 93950, USA

Abstract

Incineration is a common technology for waste disposal, and there is public concern for the health impact deriving from incinerators. Poor exposure assessment has been claimed as one of the main causes of inconsistency in the epidemiological literature. We reviewed 41 studies on incinerators published between 1984 and January 2013 and classified them on the basis of exposure assessment approach. Moreover, we performed a simulation study to explore how the different exposure metrics may influence the exposure levels used in epidemiological studies. 19 studies used linear distance as a measure of exposure to incinerators, 11 studies atmospheric dispersion models, and the remaining 11 studies a qualitative variable such as presence/absence of the source. All reviewed studies utilized residence as a proxy for population exposure, although residence location was evaluated with different precision (e.g., municipality, census block, or exact address). Only one study reconstructed temporal variability in exposure. Our simulation study showed a notable degree of exposure misclassification caused by the use of distance compared to dispersion modelling. We suggest that future studies (i) make full use of pollution dispersion models; (ii) localize population on a fine-scale; and (iii) explicitly account for the presence of potential environmental and socioeconomic confounding.

Funder

Health and Environmental Assessorships of the Emilia-Romagna Region

Publisher

Hindawi Limited

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

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