title: A systematic critical review of epidemiological studies on public health concerns of municipal solid waste handling.
abstract: OBJECTIVE
  The ultimate aim of this review was to summarise the epidemiological evidence on the association between municipal solid waste management operations and health risks to populations residing near landfills and incinerators, waste workers and recyclers. To accomplish this, the sub-aims of this review article were to (1) examine the health risks posed by municipal solid waste management activities, (2) determine the strengths and gaps of available literature on health risks from municipal waste management operations and (3) suggest possible research needs for future studies.
  
  
  METHODS
  The article reviewed epidemiological literature on public health concerns of municipal solid waste handling published in the period 1995-2014. The PubMed and MEDLINE computerised literature searches were employed to identify the relevant papers using the keywords solid waste, waste management, health risks, recycling, landfills and incinerators. Additionally, all references of potential papers were examined to determine more articles that met the inclusion criteria.
  
  
  RESULTS
  A total of 379 papers were identified, but after intensive screening only 72 met the inclusion criteria and were reviewed. Of these studies, 33 were on adverse health effects in communities living near waste dumpsites or incinerators, 24 on municipal solid waste workers and 15 on informal waste recyclers. Reviewed studies were unable to demonstrate a causal or non-causal relationship due to various limitations.
  
  
  CONCLUSIONS
  In light of the above findings, our review concludes that overall epidemiological evidence in reviewed articles is inadequate mainly due to methodological limitations and future research needs to develop tools capable of demonstrating causal or non-causal relationships between specific waste management operations and adverse health endpoints.
authors.affiliation: University of Pretoria, Private Bag 323, Pretoria 0007, South Africa.
authors.forename: France
authors.initials: F
authors.lastname: Ncube
authors.affiliation: University of Pretoria, Pretoria, South Africa.
authors.forename: Esper Jacobeth
authors.initials: EJ
authors.lastname: Ncube
authors.affiliation: University of Pretoria, Pretoria, South Africa.
authors.forename: Kuku
authors.initials: K
authors.lastname: Voyi
mesh_terms: D001724:Birth Weight; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology*; D011634:Public Health; D059027:Recycling; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D062611:Solid Waste / Q000009:adverse effects*; D018505:Waste Management
chemical_list: D062611:Solid Waste
keywords: epidemiological studies; municipal solid waste; risk