title: Land application of treated sewage sludge: community health and environmental justice.
abstract: BACKGROUND
  In the United States, most of the treated sewage sludge (biosolids) is applied to farmland as a soil amendment. Critics suggest that rules regulating sewage sludge treatment and land application may be insufficient to protect public health and the environment. Neighbors of land application sites report illness following land application events.
  
  
  OBJECTIVE
  We used qualitative research methods to evaluate health and quality of life near land application sites.
  
  
  METHODS
  We conducted in-depth interviews with neighbors of land application sites and used qualitative analytic software and team-based methods to analyze interview transcripts and identify themes.
  
  
  RESULTS
  Thirty-four people in North Carolina, South Carolina, and Virginia responded to interviews. Key themes were health impacts, environmental impacts, and environmental justice. Over half of the respondents attributed physical symptoms to application events. Most noted offensive sludge odors that interfere with daily activities and opportunities to socialize with family and friends. Several questioned the fairness of disposing of urban waste in rural neighborhoods. Although a few respondents were satisfied with the responsiveness of public officials regarding sludge, many reported a lack of public notification about land application in their neighborhoods, as well as difficulty reporting concerns to public officials and influencing decisions about how the practice is conducted where they live.
  
  
  CONCLUSIONS
  Community members are key witnesses of land application events and their potential impacts on health, quality of life, and the environment. Meaningful involvement of community members in decision making about land application of sewage sludge will strengthen environmental health protections.
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina 27599, USA. amy_lowman@unc.edu
authors.forename: Amy
authors.initials: A
authors.lastname: Lowman
authors.forename: Mary Anne
authors.initials: MA
authors.lastname: McDonald
authors.forename: Steve
authors.initials: S
authors.lastname: Wing
authors.forename: Naeema
authors.initials: N
authors.lastname: Muhammad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004782:Environmental Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D036301:Qualitative Research; D012722:Sewage; D012935:Social Justice; D013022:South Carolina; D014768:Virginia; D014865:Waste Disposal, Fluid / Q000379:methods*
chemical_list: D012722:Sewage
references.citation: J Environ Health. 2011 Jan-Feb;73(6):14-20
references.pmid: 21306090
references.citation: Environ Health Perspect. 2007 Sep;115(9):1344-50
references.pmid: 17805426
references.citation: Environ Sci Technol. 2002 Jul 1;36(13):286A-293A
references.pmid: 12144261
references.citation: Am J Public Health. 2009 Nov;99 Suppl 3:S610-5
references.pmid: 19890165
references.citation: New Solut. 2002;12(4):363-70
references.pmid: 17208783
references.citation: N C Med J. 2011 Mar-Apr;72(2):98-104
references.pmid: 21721493
references.citation: New Solut. 2002;12(4):409-23
references.pmid: 17208786
references.citation: Environ Health Perspect. 2003 Nov;111(14):1789-98
references.pmid: 14594634
references.citation: New Solut. 2008;18(2):193-205
references.pmid: 18511396
references.citation: New Solut. 2011;21(1):43-56
references.pmid: 21411425
references.citation: Soc Sci Med. 2003 Aug;57(3):437-51
references.pmid: 12791487
references.citation: New Solut. 2002;12(4):387-408
references.pmid: 17208785
references.citation: Environ Health Perspect. 2000 Mar;108(3):233-8
references.pmid: 10706529
references.citation: Environ Sci Technol. 2007 May 15;41(10):3537-44
references.pmid: 17547175
references.citation: J Agromedicine. 2004;9(2):397-403
references.pmid: 19785232
references.citation: Sci Total Environ. 2006 Aug 31;367(2-3):481-97
references.pmid: 16750559
references.citation: Environ Health Perspect. 2004 Feb;112(2):126-31
references.pmid: 14754565
references.citation: J Agric Saf Health. 2002 May;8(2):175-84
references.pmid: 12046804
references.citation: Environ Health Perspect. 2010 Aug;118(8):1146-54
references.pmid: 20421191
references.citation: Epidemiology. 2007 May;18(3):300-8
references.pmid: 17435437
references.citation: J Anim Sci. 1998 May;76(5):1343-55
references.pmid: 9621940
references.citation: Epidemiology. 2011 Mar;22(2):208-15
references.pmid: 21228696
references.citation: Environ Health Perspect. 2008 Oct;116(10):1362-8
references.pmid: 18941579
references.citation: Appl Environ Microbiol. 2007 Jul;73(14):4522-31
references.pmid: 17513591