title: Down syndrome in births near landfill sites.
abstract: OBJECTIVE
  The aim of the study was to examine the risk of giving birth to a child with Down syndrome associated with residence near landfill sites in England and Wales.
  
  
  METHODS
  A 2-km zone around 6289 landfill sites processing special (hazardous), non-special and unknown waste type was used to indicate exposure. Postcodes within the 2-km zone were classified as 'exposed' and people living beyond 2 km comprised the reference population. Health outcome data were Down syndrome registrations from a national registry including 21 cytogenetic laboratories in England and Wales, for the years 1989 to 1998. With a Bayesian regression model, we calculated relative risks for the population living within 2 km of landfill sites relative to the reference population, assuming a common relative risk for all landfill sites. Adjustments were made for major confounders.
  
  
  RESULTS
  There were 4640 cases of Down syndrome within 2 km of a landfill site. We found no excess risks of Down syndrome related to landfill sites. Adjustment for socio-economic status (SES) did not influence our estimates. There were no differences in risk between hazardous waste sites and other landfill sites.
  
  
  CONCLUSIONS
  We found no excess risk of Down syndrome in populations living near landfill sites.
authors.affiliation: The Small Area Health Statistics Unit, Department of Epidemiology and Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK. l.jarup@imperial.ac.uk
authors.forename: Lars
authors.initials: L
authors.lastname: Jarup
authors.forename: Sara
authors.initials: S
authors.lastname: Morris
authors.forename: Sylvia
authors.initials: S
authors.lastname: Richardson
authors.forename: David
authors.initials: D
authors.lastname: Briggs
authors.forename: Norman
authors.initials: N
authors.lastname: Cobley
authors.forename: Cornelis
authors.initials: C
authors.lastname: de Hoogh
authors.forename: Krisztian
authors.initials: K
authors.lastname: Gorog
authors.forename: Paul
authors.initials: P
authors.lastname: Elliott
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004314:Down Syndrome / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D004781:Environmental Exposure; D005260:Female; D006256:Hazardous Waste; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012037:Refuse Disposal; D012042:Registries; D012111:Residence Characteristics; D012189:Retrospective Studies; D018570:Risk Assessment; D019371:Topography, Medical; D014852:Wales / Q000453:epidemiology
chemical_list: D006256:Hazardous Waste