Waste incineration and pulmonary function: an epidemiologic study of six communities

This study investigated the chronic effects of emissions from three different waste incinerators on pulmonary function of both healthy and sensitive subjects with chronic respiratory symptoms. Participants were 8-80 years old, not currently smoking, and living in one of three communities each with an incinerator or one of three matched comparison communities. In total, 1018 subjects underwent a spirometric test once a year during 1992-1994. Exposure was assessed by three methods: living in an incinerator community; distance from the incinerator; and an incinerator exposure index, a function of the distance and direction of each subject's residence to the incinerator, days downwind, and average time spent outdoors. The results generally showed no statistically significant association between pulmonary function and these three incinerators, adjustment for gas oven/range use at home, length of residency, and smoking history in the mixed linear models. Two significant associations were that exposure to the hazardous waste incinerator in 1994 and to the municipal waste incinerator in 1993 were related to poor forced vital capacity. Sensitive subjects were not more adversely affected by incineration emissions than were hay fever or normal subjects. Possible explanations for the negative findings are low exposure levels and bias due to nondifferential misclassification of exposures.