APH 2005, 63, 259-278:

Adequacy of routinely collected data for the assessment of the reproductive health of a community
living in the neighbourhood of two household refuse incinerators: a critical case study.

W. Aelvoet, J. Vanoverloop, G. Molenberghs, G. Schoeters, M. van Sprundel

Keywords: household refuse incinerator, routinely collected data, reproductive health, environmental surveillance,
                risk perception and communication

Background: Given repeated complaints of the occurrence of congenital anomalies in the neighbourhood of two waste incinerators, closed for their violation of the emission norms, the authorities decided to condition the resumption of the activities on the results of a study of the possible harmful effects of the emissions on the reproductive health in the neighbourhood. As the local population felt reluctant to participate in that study, we had to rely exclusively on routinely collected data.

Methods: Observational study regarding Neerland, an area in the conurbation of Antwerp (Belgium), with an ecological and a retrospective cohort component, combining data of several medical and public
databases. In a database of all children, born in Flanders (Northern Belgium) in the years 1989-1996 (N= 506,632), a group of 636 children, whose mothers were residents of the neighbourhood at any point in time, was identified and compared with the overall population.

Results: The comparison with the overall population did not reveal, multiplets excepted (odds ratio (OR) 2.04, 95% confidence interval (CI) 1.33 - 4.76), a significant excess of congenital anomalies (OR 1.20, 95% CI 0.69- 2.08), perinatal mortality, low birth weight, short gestational duration, diminished parity, or a reversal of the sex ratio. However, within the group of Neerland children a significant negative relationship between duration of exposure of the mother and congenital anomalies
(OR 0.78, 95% CI 0.60-0.95) was found.

Conclusion: Notwithstanding the obvious limitations of the study and although an excess of congenital anomalies could not be confirmed nor excluded, the findings regarding reproductive health seemed not to
suggest the occurrence of major health threats.