Impact of waste treatment on human health in Campania region (Italy)

Waste management in the region of Campania, in southern Italy, has been problematic for more than a decade. The problem is referred to as a national emergency and repeated episodes of social unrest take place on an almost regular basis. Existing facilities are insufficient and there have been documented practices of illegal waste dumping and burning. The health impact of such operations is largely unknown, although it was often claimed that people living in the area experience large excesses in mortality and morbidity attributable to waste exposure.

A study, focusing on the 196 municipalities in the two provinces where most of the waste-related problems occur, was requested by the Italian national authority charged with the management of waste crisis in Campania, and started with a pilot (descriptive) phase. Based on the results of the pilot study, a second phase analysed the correlation of mortality and congenital malformations with waste and socioeconomic risk factors

Summary of the pilot study

In some municipalities there are consistent and significant statistical increases regarding some of the causes of deaths examined, including cancer of the stomach, kidney, liver and lung and for urogenital and cardiovascular congenital malformations. The majority of the increases were observed in an area between the two provinces, where most of the illegal waste treatment activities are known to take place. However, the link with the exposures due to waste disposal is unclear, as many other risk factors (environmental and related to lifestyle) are at play.

The pilot study focused on cancer mortality (20 causes of death) in 1994-2001, and on congenital malformations (11 types of congenital malformations) in 1996-2002. The geographical distribution of risks was mapped using traditional and Bayesian methods.

Correlation study

Based on the excesses observed in the pilot study, a second phase studied in detail the correlation of mortality and congenital malformations with waste and socioeconomic risk factors. The degree of environmental pressure due to waste dumping activities was estimated through the creation of a synthetic index, used at municipality level.

Overall mortality, cancer mortality for several causes and congenital anomalies, previously known to be higher than regional averages, were found positively correlated to waste exposure within the area, at small area level (municipality). Although the causal nature of the association is uncertain, findings support the hypothesis that waste-related environmental exposures in Campania produce increased risks of mortality and, to a lesser extent, congenital anomalies.

Study results strengthen the case for urgent clean-up of contaminated areas, adoption of proper waste management practices, and eradication of illegal waste trafficking in the Campania region and in other European countries where illegal hazardous waste disposal occurs.