Risk of congenital anomalies near hazardous-waste landfill sites in Europe: the EUROHAZCON study.
BACKGROUND
Waste-disposal sites are a potential hazard to health. This study is a multicentre case-control study of the risk of congenital anomalies associated with residence near hazardous-waste landfill sites in Europe.


METHODS
We used data from seven regional registers of congenital anomalies in five countries. We studied 1089 livebirths, stillbirths, and terminations of pregnancy with non-chromosomal congenital anomalies and 2366 control births without malformation, whose mothers resided within 7 km of a landfill site; 21 sites were included. A zone within 3 km radius of each site was defined as the "proximate zone" of most likely exposure to teratogens.


RESULTS
Residence within 3 km of a landfill site was associated with a significantly raised risk of congenital anomaly (295 cases/511 controls living 0-3 km from sites, 794/1855 living 3-7 km from sites; combined odds ratio 1.33 [95% CI 1.11-1.59], adjusted for maternal age and socioeconomic status). There was a fairly consistent decrease in risk with distance away from the sites. A significantly raised odds ratio for residence within 3 km of a landfill site was found for neural-tube defects (odds ratio 1.86 [1.24-2.79]), malformations of the cardiac septa (1.49 [1.09-2.04]), and anomalies of great arteries and veins (1.81 [1.02-3.20]). Odds ratios of borderline significance were found for tracheo-oesophageal anomalies (2.25 [0.96-5.26]), hypospadias (1.96 [0.98-3.92]), and gastroschisis (3.19 [0.95-10.77]). There was little evidence of differences in risk between landfill sites but power to detect such differences was low.


CONCLUSIONS
This study shows a raised risk of congenital anomaly in babies whose mothers live close to landfill sites that handle hazardous chemical wastes, although there is a need for further investigation of whether the association of raised risk of congenital anomaly and residence near landfill sites is a causal one. Apparent differences between malformation subgroups should be interpreted cautiously.
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK.
H
H
Dolk
M
M
Vrijheid
B
B
Armstrong
L
L
Abramsky
F
F
Bianchi
E
E
Garne
V
V
Nelen
E
E
Robert
J E
JE
Scott
D
D
Stone
R
R
Tenconi
D016022:Case-Control Studies; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology; D006256:Hazardous Waste / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D018811:Maternal Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D011159:Population Surveillance; D011247:Pregnancy; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors
D006256:Hazardous Waste