title: Risk of adverse reproductive outcomes associated with proximity to municipal solid waste incinerators with high dioxin emission levels in Japan.
abstract: BACKGROUND
  Great public concern about health effects of dioxins emitted from municipal solid waste incinerators has increased in Japan. This paper investigates the association of adverse reproductive outcomes with maternal residential proximity to municipal solid waste incinerators.
  
  
  METHODS
  The association of adverse reproductive outcomes with mothers living within 10 km from 63 municipal solid waste incinerators with high dioxin emission levels (above 80 ng international toxic equivalents TEQ/m3) in Japan was examined. The numbers of observed cases were compared with the expected numbers calculated from national rates adjusted regionally. Observed/expected ratios were tested for decline in risk or peak-decline in risk with distance up to 10 km.
  
  
  RESULTS
  In the study area within 10 km from the 63 municipal solid waste incinerators in 1997-1998, 225,215 live births, 3,387 fetal deaths, and 835 infant deaths were confirmed. None of the reproductive outcomes studied here showed statistically significant excess within 2 km from the incinerators. However, a statistically significant peak-decline in risk with distance from the incinerators up to 10 km was found for infant deaths (p=0.023) and infant deaths with all congenital malformations combined (p=0.047), where a "peak" is detected around 1-2 km.
  
  
  CONCLUSIONS
  Our study shows a peak-decline in risk with distance from the municipal solid waste incinerators for infant deaths and infant deaths with all congenital malformations combined. However, due to the lack of detailed exposure information to dioxins around the incinerators, the observed trend in risk should be interpreted cautiously and there is a need for further investigation to accumulate good evidence regarding the reproductive health effects of waste incinerator exposure.
authors.affiliation: Department of Technology Assessment and Biostatistics, National Institute of Public Health, Wako, Saitama, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Tango
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Fujita
authors.forename: Takeo
authors.initials: T
authors.lastname: Tanihata
authors.forename: Masumi
authors.initials: M
authors.lastname: Minowa
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Doi
authors.forename: Noriko
authors.initials: N
authors.lastname: Kato
authors.forename: Shoichi
authors.initials: S
authors.lastname: Kunikane
authors.forename: Iwao
authors.initials: I
authors.lastname: Uchiyama
authors.forename: Masaru
authors.initials: M
authors.lastname: Tanaka
authors.forename: Tetsunojo
authors.initials: T
authors.lastname: Uehata
mesh_terms: D000393:Air Pollutants / Q000633:toxicity*; D002273:Carcinogens; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D004147:Dioxins / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D017745:Incineration; D007220:Industrial Waste; D007226:Infant Mortality; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012111:Residence Characteristics; D018570:Risk Assessment; D012906:Smoke / Q000009:adverse effects*; D013723:Teratogens
chemical_list: D000393:Air Pollutants; D002273:Carcinogens; D004147:Dioxins; D007220:Industrial Waste; D012906:Smoke; D013723:Teratogens