Risk of congenital anomalies near municipal waste incinerators in England and Scotland: Retrospective population-based cohort study

Brandon Parkes, Anna L. Hansell*, Rebecca E. Ghosh, Philippa Douglas, Daniela Fecht, Diana Wellesley, Jennifer J. Kurinczuk, Judith Rankin, Kees de Hoogh, Gary W. Fuller, Paul Elliott, Mireille B. Toledano

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: Few studies have investigated congenital anomalies in relation to municipal waste incinerators (MWIs) and results are inconclusive. Objectives: To conduct a national investigation into the risk of congenital anomalies in babies born to mothers living within 10 km of an MWI associated with: i) modelled concentrations of PM10 as a proxy for MWI emissions more generally and; ii) proximity of residential postcode to nearest MWI, in areas in England and Scotland that are covered by a congenital anomaly register. Methods: Retrospective population-based cohort study within 10 km of 10 MWIs in England and Scotland operating between 2003 and 2010. Exposure was proximity to MWI and log of daily mean modelled ground-level particulate matter ≤10 μm diameter (PM10) concentrations. Results: Analysis included 219,486 births, stillbirths and terminations of pregnancy for fetal anomaly of which 5154 were cases of congenital anomalies. Fully adjusted odds ratio (OR) per doubling in PM10 was: 1·00 (95% CI 0·98–1·02) for all congenital anomalies; 0·99 (0·97–1·01) for all congenital anomalies excluding chromosomal anomalies. For every 1 km closer to an MWI adjusted OR was: 1·02 (1·00–1·04) for all congenital anomalies combined; 1·02 (1·00–1·04) for all congenital anomalies excluding chromosomal anomalies; and, for specific anomaly groups, 1·04 (1·01–1·08) for congenital heart defect sand 1·07 (1·02–1·12) for genital anomalies. Discussion: We found no increased risk of congenital anomalies in relation to modelled PM10 emissions, but there were small excess risks associated with congenital heart defects and genital anomalies in proximity to MWIs. These latter findings may well reflect incomplete control for confounding, but a possible causal effect cannot be excluded.

Original languageEnglish
Article number104845
JournalEnvironment International
Volume134
DOIs
Publication statusPublished - Jan 2020
Externally publishedYes

Bibliographical note

Funding Information:
The study was funded by a grant from Public Health England (PHE), by a grant from the Scottish Government , funding from the MRC-PHE Centre for Environment and Health and funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London and Imperial College London in partnership with PHE (HPRU-2012-10141). The UK Small Area Health Statistics Unit (SAHSU) is funded by PHE as part of the MRC-PHE Centre for Environment and Health, funded also by the UK Medical Research Council (MR/L01341X/1). PE is Director of the MRC-PHE Centre for Environment and Health and acknowledges support from the NIHR Imperial Biomedical Research Centre. Until March 2013 NorCAS (Northern England) was funded by the Healthcare Quality Improvement Partnership (HQIP), EMSYCAR (East Midlands & South Yorkshire) was funded by the individual Primary Care Trusts (PCTs), SWCAR (South West England) was funded by Specialist Commissioners and WANDA (Wessex) was funded by the Wessex Clinical Genetics Service. From April 2013, EMSYCAR, NorCAS, SWCAR and WANDA are funded by PHE. CAROBB was funded from 2003 to 2012 with grants from the Department of Health (now called Department of Health and Social Care) (England) and from 2013 to 2014 with a grant from PHE.

Funding Information:
The study was funded by a grant from Public Health England (PHE), by a grant from the Scottish Government, funding from the MRC-PHE Centre for Environment and Health and funding from the National Institute for Health Research (NIHR) Health Protection Research Unit in Health Impact of Environmental Hazards at King's College London and Imperial College London in partnership with PHE (HPRU-2012-10141). The UK Small Area Health Statistics Unit (SAHSU) is funded by PHE as part of the MRC-PHE Centre for Environment and Health, funded also by the UK Medical Research Council (MR/L01341X/1). PE is Director of the MRC-PHE Centre for Environment and Health and acknowledges support from the NIHR Imperial Biomedical Research Centre. Until March 2013 NorCAS (Northern England) was funded by the Healthcare Quality Improvement Partnership (HQIP), EMSYCAR (East Midlands & South Yorkshire) was funded by the individual Primary Care Trusts (PCTs), SWCAR (South West England) was funded by Specialist Commissioners and WANDA (Wessex) was funded by the Wessex Clinical Genetics Service. From April 2013, EMSYCAR, NorCAS, SWCAR and WANDA are funded by PHE. CAROBB was funded from 2003 to 2012 with grants from the Department of Health (now called Department of Health and Social Care) (England) and from 2013 to 2014 with a grant from PHE.

Funding Information:
The study uses SAHSU data, supplied from the Office for National Statistics; data use and link between UK National Births and Stillbirth register data and NHS Numbers for Babies (NN4B), BINOCAR/LCAR data covered by approval from the National Research Ethics Service REC Reference 17/L0/0846 and by the Health Research Authority Confidentiality Advisory Group (HRA-CAG) for Section 251 support (HRA – 14/CAG/1039). Approval for Scottish data was covered by SAHSU's existing ethics and from the NHS National Services Scotland Privacy Advisory Committee (PAC) reference - PAC 17/14.

Publisher Copyright:
© 2019

Keywords

  • Congenital anomalies
  • Environment
  • Epidemiology
  • Municipal waste incinerator

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