Risk of congenital anomalies around a municipal solid waste incinerator

Waste incineration releases into the environment toxic substances having a teratogenic potential, but little epidemiologic evidence is available on this topic. We aimed at examining the relation between exposure to the emissions from a municipal solid waste incinerator (MSWI) and risk of birth defects in a northern Italy community, using geographical information system (GIS) data to estimate exposure and a population-based case-control study design. By modeling the incinerator emissions, we defined in the GIS three areas of increasing exposure according to predicted dioxins concentrations. We mapped the 228 births and induced abortions with diagnosis of congenital anomalies observed during the 1998-2006 period, together with a corresponding series of control births matched for year and hospital of birth/abortion as well as maternal age, using maternal address in the first 3 months of pregnancy to geocode cases and controls.