Mortality and Morbidity Risk and residential exposure to municipal waste landfills in Italy: the ERAS-2 Lazio project

Background and Aim: Evidence of health effects associated with living nearby municipal waste (MW) landfills is still controversial. Nine MW landfills have been operating in the Lazio region (Central Italy) for several decades. We evaluated the potential health effects associated with contamination from MW landfills using hydrogen sulphide (H2S) concentration as proxy of airborne contamination. Methods: A cohort of residents within 5 km of MW landfills was enrolled (residents on 1 January 1996 and those who subsequently moved into the areas until 2008) and followed up for mortality and hospitalizations until 31 December 2018. Assessment of exposure to the landfill (H2S as a tracer) was performed for each participant residential address at enrolment by using a Lagrangian dispersion model. The potential confounding effect of gender, age, socioeconomic position, outdoor PM10 concentration, and distance from busy roads and industries was considered. Cox regression analysis was performed [HRs, 95% CIs]. Results: The cohort included 242,409 individuals. H2S exposure was associated with mortality from non-accidental causes (HR=1.02, 95% CI 0.97-1.08), total cancer (HR 1.07, 95% CI 0.98-1.07), and lung cancer (HR 1.24, 95% CI 1.04-1.49) when comparing 75° percentile vs <25° percentile of H2S concentrations. We also found associations with all cause hospitalization (HR 1.04, 95% CI 1.02-1.07), kidney cancer (HR 1.68, 95% CI 1.18-2.39), and respiratory diseases (HR=1.06, 95% CI 1.00–1.11) when comparing 75° percentile vs <25° percentile of H2S concentrations. Conclusions: H2S Exposure was associated with non-accidental mortality and morbidity for respiratory diseases. The link with respiratory disease is plausible and coherent with previous studies, whereas the associations with cancers deserves confirmation through the study of cancer incidence.