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Risk of congenital anomalies around a municipal solid waste incinerator: a GIS-based case-control study

Marco Vinceti1*, Carlotta Malagoli1, Sara Fabbi2, Sergio Teggi2, Rossella Rodolfi3, Livia Garavelli4, Gianni Astolfi5 and Francesca Rivieri5

Author Affiliations

1 CREAGEN – Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Public Health Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy

2 LARMA – Laboratory of Environmental Analysis, Surveying and Environmental Monitoring, Department of Mechanical and Civil Engineering, University of Modena and Reggio Emilia, Modena, Italy

3 Local Health Unit of Reggio Emilia, Reggio Emilia, Italy

4 Department of Paediatrics, Santa Maria Nuova Hospital, Reggio Emilia, Italy

5 IMER Registry, Department of Reproduction and Growth, St. Anna Hospital, Ferrara, Italy

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International Journal of Health Geographics 2009, 8:8  doi:10.1186/1476-072X-8-8

Published: 10 February 2009



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 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 modelling 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 three months of pregnancy to geocode cases and controls.


Among women residing in the areas with medium and high exposure, prevalence of anomalies in the offspring was substantially comparable to that observed in the control population, nor dose-response relations for any of the major categories of birth defects emerged. Furthermore, odds ratio for congenital anomalies did not decrease during a prolonged shut-down period of the plant.


Overall, these findings do not lend support to the hypothesis that the environmental contamination occurring around an incineration plant such as that examined in this study may induce major teratogenic effects.