Exposures and Health Outcomes in Relation to Bioaerosol Emissions From Composting Facilities: A Systematic Review of Occupational and Community Studies

Abstract

The number of composting sites in Europe is rapidly increasing, due to efforts to reduce the fraction of waste destined for landfill, but evidence on possible health impacts is limited. This article systematically reviews studies related to bioaerosol exposures within and near composting facilities and associated health effects in both community and occupational health settings. Six electronic databases and bibliographies from January 1960 to July 2014 were searched for studies reporting on health outcomes and/or bioaerosol emissions related to composting sites. Risk of bias was assessed using a customized score. Five hundred and thirty-six papers were identified and reviewed, and 66 articles met the inclusion criteria (48 exposure studies, 9 health studies, 9 health and exposure studies). Exposure information was limited, with most measurements taken in occupational settings and for limited time periods. Bioaerosol concentrations were highest on-site during agitation activities (turning, shredding, and screening). Six studies detected concentrations of either Aspergillus fumigatus or total bacteria above the English Environment Agency's recommended threshold levels beyond 250 m from the site. Occupational studies of compost workers suggested elevated risks of respiratory illnesses with higher bioaerosol exposures. Elevated airway irritation was reported in residents near composting sites, but this may have been affected by reporting bias. The evidence base on health effects of bioaerosol emissions from composting facilities is still limited, although there is sufficient evidence to support a precautionary approach for regulatory purposes. While data to date are suggestive of possible respiratory effects, further study is needed to confirm this and to explore other health outcomes.Waste management policy is rapidly evolving, largely because European countries are running out of space for landfill sites. Further, poor waste management contributes to climate change and threatens environmental sustainability. It is estimated that each tonne of food waste diverted from landfill to composting

Respiratory hospital admission risk near large composting facilities

“…There are few other studies of health effects in communities living near a composting site (Aatamila et al 2005;Browne et al 2001;Herr et al 2003a;2003b;Kramer et al1989;, and these provide limited evidence of increased exposure levels to bioaerosols at distances greater than 200m to 300m downwind of a composting site (Pearson et al 2015). Three questionnaire-based community health studies reported increases in respiratory symptoms in those living nearer to composting sites (Aatamila et al 2011;Herr et al 2003a;2003b).…”

“…There were not enough people living within 250m, where measurements show that concentrations of bioaerosol are most likely to exceed the EA's acceptable levels (Deacon et al, 2009, Pearson et al, 2015, Williams et al, 2013) nor respiratory admissions to reliably investigate respiratory admission risk within the EA 250m precautionary area exclusion zone. Population characteristics were also different from those in other distance bands, with no COAs classified as deprived (Table 2) raising the likelihood of bias.…”

“…There were 2,326,310 (5.4%) of HES inpatient records in 2008-10 in England that did not have a valid postcode and therefore could not be assigned to a spatial location. Use of objectively collected data is advantageous as it avoids response bias associated with health questionnaires, a significant limitation of previous health studies (Pearson, 2015).…”

“…Bioaerosols with an aerodynamic diameter of less than 10 micrometres are of particular concern in relation to respiratory health because they can be inhaled; some are small enough to penetrate deep into the lung and to the alveolar sac which might trigger negative health effects (Douwes et al, 2003;Ivens et al, 1999). However, quantitative evidence on both exposure and response to bioaerosols from waste composting is limited (Pearson et al 2015) and there are few studies looking at health effects of waste composting (Giusti 2009;Pearson et al 2015;Searl, 2008;Wéry 2014). Occupational health studies of compost site workers have mainly focussed on respiratory impacts (Pearson et al 2015), with some studies showing reduction in lung function (Bunger et al 2007;Sigsgaard et al 1994); respiratory symptoms (Bünger et al 2000;Hambach et al 2012) and symptoms consistent with allergic rhinoconjunctivitis (Bünger et al 2007;Hambach et al 2012;van Kampen et al 2014); and increased chronic bronchitis (Bünger et al 2007).…”

“…Occupational health studies of compost site workers have mainly focussed on respiratory impacts (Pearson et al 2015), with some studies showing reduction in lung function (Bunger et al 2007;Sigsgaard et al 1994); respiratory symptoms (Bünger et al 2000;Hambach et al 2012) and symptoms consistent with allergic rhinoconjunctivitis (Bünger et al 2007;Hambach et al 2012;van Kampen et al 2014); and increased chronic bronchitis (Bünger et al 2007). Community studies have reported increases in respiratory symptoms and throat and eye irritation near sites (Pearson et al 2015). No community studies have looked at healthcare usage.…”