A meta-analysis of mortality data in Italian contaminated sites with industrial waste landfills or illegal dumps.

OBJECTIVES Adverse effects of waste management represent a public health issue. Mortality meta-analysis in Italian National Priority Contaminated Sites (NPCSs) with industrial waste landfills or illegal dumps is presented. METHODS 24 NPCSs include industrial waste landfills or illegal dumps. Class 1 (10 NPCSs with industrial waste landfills) and Class 2 (14 NPCSs with illegal dumps) were categorized. Random-effects model meta-analyses of Standardized Mortality Ratios non-adjusted (SMRs) and adjusted for Deprivation (DI-SMRs) computed for each CS (1995-2002) were performed for overall 24 NPCSs and the two classes. The North- Southern gradient was considered. RESULTS 24 CSs pooled-SMRs are significantly increased in both genders for cancer of liver (men: SMR=1.13; women: SMR=1.18), bladder (men: SMR=1.06; women: SMR=1.11), and for cirrhosis (men: SMR=1.09; women: SMR=1.13). In Class 2 the increase is confirmed in both genders for liver and bladder cancers and for cirrhosis and in men only for lung cancer. Congenital anomalies and adverse perinatal conditions are not increased. CONCLUSION The results are consistent with the hypothesis of adverse health effects of non-adequately managed hazardous waste. Causal interpretation is not allowed, but the meta-analytic approach provides more confidence in the findings.