Editorials

Does exposure to landfill waste harm the fetus?

BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7309.351 (Published 18 August 2001) Cite this as: BMJ 2001;323:351

Perhaps, but more evidence is needed

  1. R McNamee, senior lecturer in medical statistics,
  2. H Dolk, professor of epidemiology and health services research
  1. School of Epidemiology and Health Sciences, University of Manchester, Manchester M13 9PT
  2. Faculty of Life and Health Sciences, University of Ulster, Belfast BT37 0QB

    Papers p 363

    In this issue Elliott and colleagues report on the risks to fetuses associated with residence near landfill sites: they compared pregnancy outcomes among British women living within 2 km of any of 9565 landfill sites operational between 1982 and 1997 with outcomes among those who lived at least 2 km away from all known sites (the reference area).1 They found excess risks for some adverse pregnancy outcomes, a finding consistent with previous literature, but a clear pattern of excess did not emerge and the excesses were small enough (generally less than 10%) that they could be due to study bias, a problem that is difficult to rule out in this type of study. Therefore, the question whether these results represent a causal connection between residential exposures to landfill and adverse outcomes is unresolved.

    The authors found that 80% of the British population lives within 2 km of a current or closed landfill site. This remarkable finding has several implications. Firstly, it suggests that even small excess risks near landfill sites would be important in public health terms. Secondly, it raises the question of whether the reference population is unusual, and thus …

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