Major congenital malformations and residential proximity to a regional industrial park including a national toxic waste site: An ecological study

Abstract

BackgroundPublic concern about exposure to emissions from the regional industrial park (IP), including 17 chemical plants and the national industrial toxic waste site, initiated this study of the possible association between major congenital malformations (MCM) and residence near the IP in Israel's Southern District.MethodsThe study was conducted during the period 1995–2000 and included 63,850 deliveries. Data on deliveries and MCM detected at births were obtained from the regional medical center, and stratified by ethnicity and type of locality. As exposure indicator we used distance categories (proximal and distant) and predominant wind direction from the IP. Distance stratification was based on the geographical distribution of the localities and complaints about the odor related to IP emissions. Based on these complaints, localities up to 20 km from the IP were considered proximal to the IP.ResultsAverage rates of MCM were 5.0% and 4.1% for Bedouin and Jewish newborns, respectively. The rate of MCM for Bedouin from proximal localities was significantly greater compared with distant localities (5.6% vs. 4.8%; RR = 1.17 with 95% CI: 1.04–1.29). In the proximal Bedouin permanent localities, the MCM rate reached 8.2 %, which was significantly higher than in distant areas (RR = 1.63, 95% CI: 1.39–1.80). Significant risk increase of central nervous system MCM was found in these localities, compared to distant ones (RR = 2.27, 95% CI: 1.44–3.60). Among newborns from the traditional tribal settlements, proximity to the IP was associated with increased rates of the following MCM: 1) all combined, 2) those associated with chromosomal abnormalities, and 3) those defined as "others unclassified MCM." Comparison of autosomal recessive disease rates by proximity to the IP in Bedouin newborns indicates that the observed increased risk of MCM is not explained by consanguineous marriages. The rates of MCM in the Jewish population were similar among "exposed" and "unexposed" inhabitants.ConclusionResidential proximity to the IP is associated with increased rates of MCM among Arab-Beduin but not in Jewish populations. These observations indicate the need for public health protection of a vulnerable society in transition, although the relative importance of chemical exposure and health care utilization requires further study.

Systematic literature review of reproductive outcome associated with residential proximity to polluted sites

“…LBW; LBW, Stillbirths Landfill site Mother exposure defined as residential postcodes within 2 km buffer zone around each siteYear of birth, sex deprivationModel prediction from poisson regressionNo statistically significant excess risks of adverse pregnancy outcomes (LBW, stillbirth, Congenital anomalies) detected in population living within 2 km of a hazardous waste siteCresswell et al 2003 [24]Ecologic study in city of New Castle upon Tyne, 85–99United Kingdom Specific defects Chromosomal and non-chromosomal defects Waste combustion plant Mother’s exposure defined as residence within 3 km of Byker waste combustion plantED-level deprivationNot able to adjust for other characteristicsPoisson regressions used to estimate Rate ratios for congenital anomalyLittle evidence of relation between prevalence of congenital malformations and residence near waste combustion plantKloppenbor et al 2005 [26]Ecological study in Denmark, 1997–2001DenmarkAll congenital anomalies combined Specific defects The nervous or cardiovascular systems in live births Landfill Three buffer zones: 0–2 (proximal zone), 2–4 (middle zone), and 4–6 km (distal zone) was constructed surrounding waste landfill sites–The risk rate (RR) was calculated by dividing the sum of congenital anomaly (or specific defects) by total proximal sum of birthsNo association found between maternal residential proximity to landfills and all congenital malformations combined or of the nervous system. However, the result noted small excess risk for anomalies of the cardiovascular systemBentov et al 2006 [57]Ecologic study of live births and stillbirthsBeer-Sheva subdistrict1995–2000 IsraelMajor congenital malformations combined Specific defects Central nervous system, chromosomal anomalies and other major congenital malformations Industrial park Distance of localities from regional industrial park and predominant wind directionCalculation of rateby dividing the number of newborns born with birth defect by the number of deliveriesResidential proximity to industrial park associated with increased rates of major congenital malformations among Bedouin populationsJarup et al 2007 a [49]Ecologic study of England and Wales 1989–1998Great Britain Specific defects Down syndrome Landfill site Mother exposure defined as an residential address within 2-km zone of a landfill siteMaternal ageUrban–rural status, Carstairs’ index of deprivationRegressionmodelling within a Bayesian framework…”

“…The first category, in number, is congenital malformations, encompassing studies of all congenital abnormalities combined [1, 11–13, 21–26, 30–39, 41, 45–48, 50, 52, 55, 57], specific abnormalities such as heart defects [1, 11–13, 22, 23, 26, 31, 34–36, 45–47, 52, 55], neural tube defects (NTD) [1, 11, 12, 35, 39, 45, 47, 52, 55], central nervous system abnormalities [12, 23, 26, 36–38, 52, 57], oral defects [11, 12, 23, 35, 37, 41, 45, 47, 52], chromosomal abnormalities [12, 13, 24, 33, 34, 37, 46, 49–51, 55, 57] and lethal congenital abnormalities [42–44, 56]. The second most investigated category of outcome encompassed low birth weight (LBW) [21, 23, 27–30, 45, 47, 48, 50, 53–56], preterm birth (PTB) [27, 29, 53–55], small for gestational age (SGA) [53, 54] and intrauterine growth retardation (IUGR) [29, 55].…”

“…Fewer papers have examined residential proximity to industries [13, 22, 32, 33, 38, 39, 43, 48, 53, 57], municipal waste incinerators [44, 56], dumpsites [29, 36] or crematoriums [44]. One study encompassed environmental risks from across landfills, dumpsites, hazard waste sites and industrial sites [23] (see Table 4).…”

Exposure to metals and congenital anomalies: A biomonitoring study of pregnant Bedouin-Arab women

“…The Bedouin-Arab population in Israel is characterized by a high rate of congenital malformations in comparison to the country's Jewish and Science of the Total Environment 517 (2015) [106][107][108][109][110][111][112] other Arab populations (Bentov et al, 2006). In southern Israel, the Bedouin-Arab population numbers around 200,000 inhabitants, most of who are of low socio-economic level owing to their high rate of unemployment and generally low education level (The Central Bureau of Statistics in Israel).…”

Environmental Justice and Infectious Disease: Gaps, Issues, and Research Needs

“…[6][7][8][9][10][11][12] Since the publication of the Toxic Wastes and Race in the United States report, 13 the environmental justice (EJ) movement has drawn attention to the interplay of differential exposure to environmental hazards and social determinants on health outcomes with a wealth of literature demonstrating these relationships especially among EJ communities. [14][15][16][17][18][19][20] For example, several studies have provided evidence for the role that environmental hazards and social determinants play in driving disparities in cardiovascular disease, 22,23 asthma, [24][25][26][27] congenital anomalies, [28][29][30][31][32] diabetes, 33,34 and infant mortality 35,36 in EJ communities. In spite of the established associations between environmental hazards and social determinants on these health outcomes, little work has been performed to examine similar relationships between these processes and infectious diseases in EJ communities.…”