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Inequalities, inequities, environmental justice in waste management and health


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The scientific evidence on the health effects of waste-related exposure is not conclusive. Differential exposure to waste by socio-economic status (SES) is often documented, but the interplay between environmental and social factors, crucial for policy making, is not well known. This review aims at investigating the role of health inequalities and inequities in waste management. Grey and peer-reviewed literature, published after 1983, was reviewed from Europe and the USA. Available data provide consistent indications that waste facilities are often disproportionally more located in areas with more deprived residents, or from ethnical minorities. This applies to waste incinerators, landfills, hazardous waste sites, legal and illegal. In studies considering health effects (mainly from Europe), risks are estimated with standardization for SES. Such standardization almost always decreases risk estimates for several cancers and reproductive outcomes. However, effect modification is not investigated in these studies. The patterns of association between waste-related environmental pressures and SES suggest that some of the observed inequalities in exposure and health represent a case of environmental injustice as they are the result of social processes and may be prevented, at least partly. Disentangling the possible health effects remains difficult, due to limitations in the methodology. It seems important to investigate if disadvantaged people are more vulnerable, i.e. risks differ in different social groups living in the same area. Notwithstanding these open questions, public health officers and decision makers should identify waste management policies to minimize their potential health impacts and their unequal distribution.
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Inequalities, inequities, environmental justice
in waste management and health
Marco Martuzzi
, Francesco Mitis
, Francesco Forastiere
Background: The scientific evidence on the health effects of waste-related exposure is not conclusive.
Differential exposure to waste by socio-economic status (SES) is often documented, but the interplay
between environmental and social factors, crucial for policy making, is not well known. This review aims
at investigating the role of health inequalities and inequities in waste management. Methods: Grey and
peer-reviewed literature, published after 1983, was reviewed from Europe and the USA. Results:
Available data provide consistent indications that waste facilities are often disproportionally more
located in areas with more deprived residents, or from ethnical minorities. This applies to waste
incinerators, landfills, hazardous waste sites, legal and illegal. In studies considering health effects
(mainly from Europe), risks are estimated with standardization for SES. Such standardization almost
always decreases risk estimates for several cancers and reproductive outcomes. However, effect
modification is not investigated in these studies. Conclusions: The patterns of association between
waste-related environmental pressures and SES suggest that some of the observed inequalities in
exposure and health represent a case of environmental injustice as they are the result of social
processes and may be prevented, at least partly. Disentangling the possible health effects remains
difficult, due to limitations in the methodology. It seems important to investigate if disadvant-
aged people are more vulnerable, i.e. risks differ in different social groups living in the same
area. Notwithstanding these open questions, public health officers and decision makers should
identify waste management policies to minimize their potential health impacts and their unequal
Keywords: adverse effects, environmental exposure, hazardous waste, health effects, social class, socio-
economic factors
Waste and health: scientific evidence and
knowledge gaps
Given the growing production of waste, policy-makers are
increasingly confronted with the necessity of developing
more capacity to safely dispose of waste. Despite the lack of
univocal evidence on the health implications of waste-related
environmental exposures, there are concerns over the health
effects of different waste management options, including land
filling, incineration, disposal of healthcare and other hazardous
Further insights on health effects of landfills and incinera-
tors are needed; it is important to investigate these possible
effects in conjunction with other environmental hazards, as
concurrent exposures can result in synergistic health effects.
In particular, it is of interest to consider how possible health
effects of waste may take place in combination with other
powerful health determinants depending on lifestyle and the
social environment. It is urgent to clarify how population
distribution of waste-related exposures (i.e. how uneven are
such exposures among different subgroups) can inform the
policy response, affect its effectiveness and acceptance, and
how these aspects can be taken into account more system-
atically in policy-making. In particular, it is of great interest
to clarify what proportion of health inequalities (i.e. general
differences in health status and in exposure levels due for
example to age or individual predisposition) can be regarded
as inequities (i.e. avoidable differences, for example in access
to healthcare service, preventing individuals from attaining
their full health potential, and carrying an ethical negative
judgement) and as such result in environmental injustice.
The present contribution is dedicated to the role of socio-
economic differences and environmental justice on the
potential health burden due to exposure to hazardous waste
Role of social health determinants
Social determinants of health have a strong influence on
virtually all health endpoints considered in studies designed
to assess the role of waste–related exposure. As in many
other fields in environmental health, this realization has
resulted in the adoption of methodology to formally take
into account these effects in epidemiological studies.
Typically, socio-economic factors have a strong potential for
acting as confounders of the parameter of interest, i.e. the
association between health and waste exposure. This is
because exposed subjects often have socio-economic char-
acteristics that can differ from those of unexposed subjects,
and thus create differences in risk that could be erroneously
attributed to waste. This is why effects of socio-economic
factors are often regarded, in epidemiological studies, as
nuisance factors, and standardization techniques are applied
to remove their contribution and assess the waste–health
association, net of the influence of socio-economic factors.
This routine standardization reflects the strong expectation
that socio-economic factors are associated with environmental
exposures—a prerequisite for a confounding effect. The
systematic adoption of this practice relies on an important
assumption, and suggests a certain attitude: the assumption
is hazard proportionality, i.e. health risks from socio-
economic conditions act as multipliers of an independent
World Health Organization (WHO) Regional Office for Europe,
Rome Office, Rome, Italy
Local Health Authority Roma E, Rome, Italy
Correspondence: Marco Martuzzi, World Health Organization
(WHO) Regional Office for Europe, Rome Office, Via Francesco
Crispi, 10-I-00187, Rome 00198, Italy, tel: +39-06-4877520,
fax: +39-06-4877599, e-mail:
European Journal of Public Health, Vol. 20, No. 1, 21–26
ßThe Author 2010. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
doi:10.1093/eurpub/ckp216 Advance Access published on 8 January 2010
by guest on November 5, 2015 from
risk due to environmental factors. In other words, through
standardization for socio-economic factors the environmental
risk is assumed constant across different social strata, and the
possibility of modification of effect (for example, different risks
for different socio-economic groups) is seldom investigated.
The attitude is the one of considering the multiple effects as
independent of each other and attaching less importance to
the contextual ones. Admittedly, full, holistic consideration of
the mutual action of different risks is very challenging and is
often not feasible; however, a fuller understanding of how
environmental risk factors operate in the reality of the social
environment would be very informative especially for
designing effective policy responses.
In this paper we examine the evidence and the implications
of the confounding effect of socio-economic factors. First of all
then, we address the question of how strong is the evidence
that more deprived communities are more exposed to waste-
related contaminants; later, we examine how these gradients,
where observed, can influence the risks for several health
endpoints, considering how risks differ before and after
adjustment for socio-economic factors. Finally, we discuss
the implications of these inequalities.
Grey and peer-reviewed literature, published after 1983, when
an influential paper appeared,
was reviewed from Europe and
the USA.
Keywords or references in the titles to ‘waste’, ‘health
effects’, ‘socio-economic factors’, ‘inequities’, ‘environmental
justice’, ‘congenital anomalies’ and ‘mortality’ were used to
search the Medline database. All European studies were
selected. With regard to US studies, given the large amount
of literature dealing with social differences on the residence
near waste facilities, only the most s studies were chosen
and commented. The grey literature was searched with the
same criteria using Google Scholar and looking at the key
references listed in the peer-reviewed articles to identify
nongovernmental organization (NGO) reports and studies
published by other agencies. A total of 47 studies were
included in the review.
Residence near waste facilities: unequal
and inequitable
The characteristics and main findings of the identified studies
are summarized in Supplementary Table 1.
The first studies on environmental justice, contaminated
sites and waste were carried out in the USA and were
prompted by the concerns of civil activists on the dispro-
portionate location of landfills in predominantly black
The correlation between race, income and
residence influenced several outcomes such as a higher
likelihood of being exposed to environmental hazards, the
disproportionate impacts of environmental processes and
policies, the targeting and siting of noxious facilities in more
deprived communities and inequalities in the delivery of
environmental services such as rubbish removal.
Other studies found skewed distributions around waste
sites, with less affluent population subgroups, and with more
black people, living in the surroundings of the facilities.
In a US national assessment
(later updated
), a correlation
was found between proportion of black residents and
the presence of hazardous waste sites in the surroundings.
Although these results were criticized,
ethnicity was
considered to be a stronger predictor of the presence of toxic
dumps than other variables, such as household income,
the value of homes and the estimated amount of hazardous
waste generated by local industry.
reviewed (i) exposure to toxic hazards, includ-
ing the presence of hazardous waste sites and facilities
(ii) regulations, ameliorations and cleanups, including record
of decisions and cleanups at National Priority List (NPL) sites
and (iii) regulatory actions, as measured by assessed fines for
environmental pollution; he concluded that ‘the overwhelming
bulk of evidence supports the ‘‘environmental justice’’ belief
that environmental hazards are inequitably distributed by
class, and especially race’. These results were confirmed by
the most recent study,
and the underlying social processes
were analysed in different settings.
Compared to US studies, European data are based on a
different approach to measuring socio-economic status
(SES), based on composite indices built combining infor-
mation on several domains, such as social class, education,
unemployment, housing, family structure, rather than
variables such as income or ethnicity.
The association between social characteristics and resid-
ence in the vicinity of waste sites has been repeatedly
documented in England and Wales. Several studies analysed
the correlation between income and deprivation with local-
ization of solid waste and other polluting facilities, finding
that facilities were disproportionally located in the more
deprived areas.
The correlation was not always observed
for landfills at the subregional level.
At the national level, a study by Elliott et al.
showed that
‘the area within two km of the 9565 landfill sites tended to be
more deprived than the reference area: 34% (versus 23%) of
the population were in the most deprived tertile of Carstairs
score (36% for special waste sites)’.
A national study on environmental inequalities in France on
the distribution of environmental burden tested the hypothesis
that poor and immigrant communities are disproportionately
exposed to environmental risks. Eight types of hazardous sites
(industrial and nuclear sites, incinerators, waste management
facilities) and the socio-economic characteristics of popula-
tions were associated at the commune, or town, level for all
36 600 French towns. The results of the spatial regression
analyses showed that towns with high proportions of
immigrants hosted more hazardous sites, even controlling for
population size, income, degree of industrialization of the
town and region.
In the European Union project Integrated Assessment of
Health Risks of Environmental Stressors in Europe
(INTARESE), an integrated approach for the health impact
assessment of landfills and incinerators on the population
living in the surroundings has been applied in Italy, UK
and Slovakia, for a total 905 municipal urban solid waste
landfills and 53 waste incinerators.
A direct relationship
was found between social class and residence near waste
facilities in Italy and UK, and an inverse relationship was
found in Slovakia (Table 1). For incinerators, this may be
due to the location of the two facilities in urban areas, where
most affluent Slovakian people live.
The results of European Collaborative Study of Residence
near Hazardous Waste Landfill Sites and Risk of Congenital
Malformations (EUROHAZCON),
a multisite study that
considered 21 landfills in several countries, suggested
‘no overall evidence that socio-economically more deprived
communities live near to landfill sites’.
An inverse relationship was also found in a study of a Welsh
landfill, where most affluent people were found to be living
closer the site.
Cancer mortality and congenital anomalies of populations
living in 196 municipalities of two provinces of Campania
22 European Journal of Public Health
by guest on November 5, 2015 from
Region, southern Italy, were recently investigated.
The study
area was characterized by more than 20 years of waste
mismanagement (with the involvement of organized crime),
including uncontrolled waste disposal, release of toxic
substances and illegal waste burning. A positive correlation
(r= 0.30) was found at municipality level between a waste
exposure indicator (built using 227 waste facilities sites–138
of which illegal) and a deprivation index.
Interest in environmental justice and in unequal distribution
of environmental hazards and benefits has recently grown in
countries of central and eastern Europe. It has been
documented that hazardous sites and illegal waste disposal
activities are disproportionally located in the working-class
areas, as in Hungary with illegal asbestos disposal,
and in
communities of ethnic or national minorities, predominantly
the Roma populations,
whose camps are often settled on
(or near) contaminated sites. The Hungarian National Public
Health and Medical Officers’ Service reported, for example,
that 15% of the 767 Roma colonies identified in Hungary,
for a total of three million persons, are within 1 km of illegal
waste disposal sites, and 11% within one km of animal carcass
disposal sites.
In addition, minority groups in European countries are
more at risk of environmentally based discrimination
because they are more likely to be object of discrimination,
and be segregated in enclaves or in deprived zones along the
borders, or in refugee camps.
Finally, besides differential levels of exposure to waste-
related contaminants by socio-economic levels at local or
national level, inequalities in exposure might take place at
the international level, through the transfer of related
hazards from one country to another.
In fact, illegal
shipment and disposal of hazardous waste is of growing
relevance in some countries of central and eastern Europe.
Exposure to waste and socio-economic factors:
compounded effects
Many of the studies above, especially from Europe, document
a pattern where deprived people are overrepresented in the
vicinity of waste treatment facilities. In some of these studies,
in addition, it is observed that health effects—notably
mortality, congenital anomalies, low birth weight—are
associated with socio-economic factors.
Several studies were performed in UK on congenital
Down syndrome
and cancer
in population
living near landfills. In a recent study on congenital anomalies
and landfill density, risks were standardized by SES, presence
of a congenital anomalies registry and maternal age. On
adjusting for these factors, risks decreased for all the
anomalies under study, more markedly in areas with the
highest special waste sites density.
In a subsequent study
a decreasing risk of Down’s
syndrome with increasing levels of socio-economic deprivation
was observed; however, adjustment for SES resulted in a
marginal correction of the estimates of the risks from
landfills, perhaps not surprising because of the strong effect
of maternal age.
In another UK study on cancer and residence near landfill
adjustment for SES decreased the risk estimate for
bladder cancer, which however remained significantly in
excess. The same was observed for hazardous sites, but the
adjusted risk for bladder cancer lost statistical significance.
In the EUROHAZCON multi-site study a positive
association was reported in the UK between SES and non-
chromosomal congenital anomalies close to landfills.
risk in the most deprived group was 40% higher than in the
most affluent quintile; an impact measure was also estimated:
if the rates observed in the most affluent group prevailed in the
whole exposed population, the 18% fewer anomalies would
have occurred.
This pattern was not observed in other
European sites.
In a study carried out in Campania a positive association
was observed between mortality for various cancer causes and
both illegal waste exposure and socio-economic factors. For
both sexes, mortality risk estimates unadjusted by socio-
economic deprivation were much higher than adjusted ones,
as shown in Table 2. Risk estimates were markedly corrected
across the five levels of waste exposure, and so were estimates
of linear trends. The only exception was stomach cancer in
In a study in the New York state near PCB-contaminated
(i) superfund sites, (ii) NPL sites and (iii) the six areas of
the risk of giving birth to a low-birth-weight and
to a very low-birth-weight baby was investigated. Positive
associations were observed between having a low-birth-
weight baby and (i) low levels of income and (ii) mother’s
educational level less than (or equal to) high school while
only a low-income level was associated to having a very
low-birth-weight baby.
Another US study
considered only ethnic minorities
(Black/African American, Hispanic/Latino, American Indian/
Alaska Native and Asian/Pacific Islander) and found a positive
association between a range of anomalies and residence in the
census tracts near the NPL hazardous waste sites. The largest
association was found between potential exposure and
neural tube defects [odds ratio (OR) = 1.54, 95% confidence
Table 1 Characteristics of residents living close to waste facilities
in Italy
, Slovakia and England, by quintiles of deprivation
index, 2001
Landfills Incinerators
Italy Slovakia England and Wales Italy Slovakia England and Wales
Number of sites 619 165 232 40 2 11
Population within 2 km 1350 852 328 869 1425 350 1060 569 16 409 1203 208
Most affluent population (I group, %) 13.3 24.2 2.5 12.6 55.6 30.
II group 15.0 24.7 17.9 15.1 2.4 6.3
III group 22.4 22.6 18.7 21.0 9.8 12.5
IV group 23.0 16.4 19.1 24.2 29.6 22.8
Most deprived population (V group, %) 26.1 12.1 20.1 24.9 2.5 55.4
Missing information (%) 0.0 0.0 21.7 2.2 0.2 0.0
Source: adapted from Forastiere et al.
a: 2 km from municipal urban solid waste landfills; 3 km from waste incinerators
b: 118 landfills were geocoded, for population of 257 513. Socio-economic data were then extrapolated to 619 landfills
Environmental justice, waste and health 23
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interval (CI) = 0.93–2.55]. The strongest association between
birth defects and potential exposure was among American
Indians/Alaska Natives (OR = 1.19, 95% CI = 0.62–2.27). This
study design, however, does not allow a comparison with the
effects in the majority population.
Waste and health: same risk for everyone?
The evidence summarized above indicates that there is a
tendency in poorer, less educated, disadvantaged people or
ethnical minorities to live closer to waste treatment facilities
of any kind and, in addition, that when adverse health
effects due to such proximity are detected, these are often
compounded (usually multiplicatively) with the adverse
effects of social disadvantage. This pattern may occur for
other localized source of environmental pollutants, but is not
systematically documented. On the whole, the evidence
suggests marked inequalities in the health pressures and
impacts due to the combination of environmental and social
factors. Some of these inequalities are due to socially driven
processes, for example residential segregation or differential
access to health-promoting resources, amenable to mitigation.
Some questions arise from these observations.
Are disadvantaged people, besides being disproportionally
exposed to waste-related environmental risk, also more
vulnerable to its impacts?
Do risks differ in different social groups living in the same
exposed place and, if so, to what extent?
In other words, is there an interactive, synergistic relation-
ship between the adverse health effects of waste exposure
and of the disadvantaged social environment, or conversely
does the proportionality assumption hold?
How preventable are the observed inequalities?
The available information on the health effects of waste
facilities by social groups, needed to address these questions,
is limited. First, not all the studies carried out to evaluate the
potential associations between exposure to waste facilities and
health have considered SES; in some studies, socio-economic-
adjusted risks are estimated but unadjusted risks are not
published, or are indistinguishable from those due to other
factors (for example, maternal age or the presence of a
dedicated registry in studies of congenital anomalies).
Secondly, and crucially, in no cases are interaction effects
between socio-economic factors and waste exposure tested
and reported. Some studies are designed with selected popu-
lations either highly exposed
or from socially disadvant-
making the assessment of the interaction impossible.
For waste and health as well as for many other cases in
environment and health, these issues are central; together
with better quality data on waste-related exposures,
recognized as a prerequisite for more informative studies,
more detailed information on exposure and health by the
socio-economic group would not only shed light on the
nature of the interrelationship between the social and the
physical environment but would also allow the identification
of more effective strategies to prevent or reduce the impacts.
There are, however, substantial difficulties in estimating
the joint effects of different risk factors, for example,
low power to estimate interactive effects, given the high
collinearity between environmental exposures and depriva-
tion. This is one facet of environmental justice: different
risk factors, such as environmental contamination, social
disadvantage, unhealthy lifestyles, are often observed to
insist on the same subgroups. This makes the assessment
of the interplay between these different factors difficult
and represents an important reason to consider inequalities
Table 2 Waste exposure, SES and mortality outcomes in Campania region
Mortality excess (%) risks by waste exposure group
Unadj Adj
Unadj Adj Unadj Adj Unadj Adj Unadj Adj
Cause of death—men
All causes 9.2 5.4 6.9 7.9 7.1 3.9 13.6 9.2 2.2 1.7
All cancers 9.3 4.2 3.2 5.6 9.3 4.9 11.0 4.1 2.2 1.5
Lung cancer 11.4 5.5 4.2 6.4 11.1 6.1 14.0 6.7 2.7 1.9
Liver cancer 0.1 9.2 12.7 20.6 7.0 0.7 35.5 19.3 5.6 4.3
Stomach cancer 1.5 3.0 0.1 2.8 17.0 19.4 16.2 15.7 5.0 5.2
Bladder cancer 17.3 11.7 11.0 6.4 10.8 7.1 4.6 4.1 0.8 0.7
Kidney cancer 4.4 2.8 4.3 0.6 8.5 14.9 7.6 16.7 3.0 4.0
Soft tissues sarcoma 10.6 9.8 7.2 20.4 23.6 31.0 18.7 25.0 3.1 3.9
Non Hodgkin lymphoma 24.2 9.4 29.8 25.4 18.7 6.8 2.8 3.7 2.3 1.3
Other cancers 9.1 4.7 2.4 4.3 7.6 3.3 6.2 0.3 1.4 0.7
Cause of death—women
All causes 3.1 1.7 7.2 8.1 5.6 4.8 14.4 12.4 2.6 2.4
All cancers 9.8 5.1 2.3 2.4 6.7 3.6 10.0 6.6 1.6 1.0
Lung cancer 63.8 45.4 10.2 14.4 14.1 5.6 22.7 9.4 0.2 2.3
Liver cancer 3.5 9.3 5.0 9.1 13.6 9.6 39.5 29.1 7.3 6.6
Stomach cancer 8.1 8.3 2.3 6.4 1.0 2.2 10.7 16.7 2.1 2.6
Bladder cancer 17.9 7.7 6.5 12.7 3.2 2.8 17.3 16.7 2.8 3.3
Kidney cancer 19.2 6.9 2.4 11.2 8.7 3.4 36.2 19.1 3.8 1.7
Soft tissues sarcoma — 4.3 7.7 76.0 84.1 35.2 33.6 4.2 0.3 7.8 8.3
Non Hodgkin lymphoma 9.8 10.1 3.3 3.5 15.9 19.7 2.1 0.2 1.8 1.6
Other cancers 7.4 3.5 1.3 1 5.2 2.3 6.3 3.7 1.1 0.7
Source: Adapted from Martuzzi et al.
a: In bold, statistically significant risks are reported (95% CI)
b: I group is used as reference, i.e. no waste-related exposure; V group has highest exposure
c: Mortality excess risks (%) = (relative risk 1) 100. Risks adjusted by SES
24 European Journal of Public Health
by guest on November 5, 2015 from
(in exposure and in health outcomes) as inequities. Other
relevant considerations in terms of equity include the
While a certain degree of inequalities are inevitable, at least
a part (arguably a substantial one) of the observed
inequalities is preventable. Exposure inequalities can and
must be reduced by appropriate measures of mitigation
and abatement of emissions from potential sources. This
includes not only established noxious agents (for example,
particulate matters, persistent organic pollutants, heavy
metals) but also emissions interfering with residents’
quality of life (for example, odours, noise). Inequalities
can be further countered by primary prevention and
health promotion initiatives undertaken in conjunction.
It is possible that people who bear the most part of the
adverse impacts from waste disposal activities (in terms of
health and well-being) produce less waste. This might
occur, for example, when residential exposures are
disproportionately distributed towards population strata
with lower income, lower purchasing power and lower
rates of consumption of material goods. There are
examples, in other domains, where this unfair, negative
correlation between benefits and negative impacts is
obvious (for instance, greenhouse gas emission at global
level) and similar mechanisms may take place at more
local level too.
Currently, both of these dimensions of environmental
justice are, by and large, speculative. Data and evidence to
assess the extent of these inequities would be highly
Numerous studies in Europe and in the USA have documented
that disadvantaged communities often suffer disproportion-
ately from the impact of waste facilities. Several questions
are unresolved that should be addressed with the collection
of targeted data and research. Uncertainties include the
presence and magnitude of environmental different waste-
related risks, the possible synergistic effects with the social
environment, the extent to which inequalities are preventable
and the degree to which benefits and adverse impacts are
differentially distributed in the population. However, while
these knowledge gaps are being filled, public health profes-
sionals should contribute to the identification and develop-
ment of waste management policies that minimize health
impacts and inequalities. In the words of Mohan:
Health inequalities should be one of the key considerations
when developing waste management strategies or when
conducting HIAs of waste sites. If waste management
installations are to be located in an area, every effort
should be made to mitigate any potential adverse health
effects. [...] Every effort should also be made to ensure
that the local community enjoys any potential benefits
from waste management.
For waste management as well as for other domains, a direct
participation of the health sector in the decision-making
process is desirable. Participatory processes are necessary to
achieve fairer policies, where the interests of all stakeholders
are taken into consideration. In view of the various limitations
hampering our ability to characterize all risks, policy decisions
on new facilities and remediation schemes should be inspired
by a precautionary approach,
where health and equity are put
at the centre of the debate.
Supplementary data
Supplementary data are available at EURPUB online.
The authors would like to acknowledge Lubica Palkovicova
and Kees De Hoogh for providing data on Slovakia and UK.
They are grateful to Pietro Comba for his useful suggestions.
Partly funded by INTARESE, an Integrated Project of the EU
6th Framework Programme.
Conflicts of interest: None declared.
Key points
The expectation that waste-related environmental
exposure is stronger in disadvantaged population
subgroups is confirmed by most studies available in
Europe and the USA.
The effects of socio-economic health determinants are
often removed, through standardization, in epidemio-
logical studies; the possible occurrence of modification
of effect would be of great interest, but is not
Despite the limited understanding of the interplay
between waste-related exposures and social health
determinants, observed patterns raises a question of
environmental justice, which require adequate policy
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Received 19 August 2009, accepted 1 December 2009
26 European Journal of Public Health
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... Within the current socioeconomic landscape in which the fashion industry has globalized, high-consumption countries, often located in the Global North, have more agency in urban politics than countries that largely produce these goods, often located in the Global South. This results in an uneven distribution of environmental and social consequences [1,[5][6][7][8][9][10], as the waste is often displaced for treatment in marginalized spaces [11]. In 1989, the signatories of the Basel Convention warned about the growing threat to human health and the environment posed by the increased transboundary movement of hazardous and other wastes [12]. ...
... However, decades later, waste colonialism practices still exist, and groups of people dominate the land of others for the disposal of their own waste. As this practice most frequently affects the poorest populations (e.g., Black, Indigenous, and People of Color), it is a significant source of inequality [9,13,14]. This is particularly true within the clothing and textile industries, as many countries in the Global North export a large share of their unwanted clothing Alternative perspectives on waste management are emerging, including those that recognize waste management as the recovery of resources and prevention of environmental impact [4], as is the case in a circular economy (CE). ...
... The term Global South refers to countries located in the Southern Hemisphere with generally but not always (e.g., Australia) low levels of income and often a history of colonialism. Multiple references [9,[58][59][60] have been consulted to form the above definitions, the aim of which was to erase any notion that could be condescending and further enhance postcolonial dynamics using Western standards as the global norm (e.g., highly developed infrastructure in the Global North versus unstable structures in the Global South). ...
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Large quantities of second-hand clothing have been exported from the Global North to the Global South in recent decades, placing a heavy social and environmental burden on local communities. Consequently, countries in the Global South are leveraging indigenous craftsmanship through various practices, such as care, repair, and upcycling, to enable durability and extend product life, saving millions of garments from landfills. However, this knowledge is not included in global narratives on durability and the circular economy. Moreover, the Global North dominates the conversation, often leaving out the social dimension and risking a circular transition from achieving important goals such as decent jobs to reducing the unequal distribution of negative environmental and social impacts. This study examines the trinary interrelationship between circularity, garment durability, and just transition through an integrative literature review. The review revealed several key findings. Firstly, the authors posit that garment durability is an ongoing interaction between the garment and its changing environment(s) and user(s), enabling it to move through different life cycles via the practices of care, mending, and repair. Secondly, all three concepts must place people at the heart of the fashion industry to ensure a just and circular transition.
... MSW open burning emissions deteriorate air quality in neighborhood-, urban-, and regional-scales (Oleniacz et al., 2023). Communities with lower 35 socioeconomic status are often more impacted by MSW burning emissions, leading to environmental justice concerns (Nagpure et al., 2015;Martuzzi et al., 2010). It is estimated that exposure to PM2.5 from open burning of solid waste causes at least 270,000 premature deaths per year globally (Williams et al., 2019). ...
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Open burning of household solid waste is a large source of air pollutants worldwide, especially in developing countries. 10 However, waste burning emissions are either missing or have large uncertainties in local, regional, or global emission inventories due to limited emission factor (EF) and activity data. Detailed particulate matter (PM) chemical speciation data is even scarcer. This paper reports source profiles and EFs for PM2.5 species as well as acidic and alkali gases measured from laboratory combustion of ten waste categories that represent open burning in South Africa. Carbonaceous materials contributed more than 70% of PM2.5 mass. Elemental carbon (EC) was most abundant from flaming materials (e.g., plastic bags, textile, 15 and combined materials) and its climate forcing exceeded the corresponding CO2 emissions by a factor of 2-5. Chlorine had the highest EFs among elements measured by X-ray fluorescence (XRF) for all materials; vegetation emissions showed high abundances of potassium, consistent with its use as a marker for biomass burning. Fresh PM2.5 emitted from waste burning appeared to be acidic. Moist vegetation and food discards had the highest hydrogen fluoride (HF) and PM fluoride EFs due to fluorine accumulation in plants, while burning rubber had the highest hydrogen chloride (HCl) and PM chloride EFs due to 20 high chlorine content in the rubber. Plastic bottles and bags, rubber, and food discards had the highest EFs for polycyclic aromatic hydrocarbons (PAHs) and nitro-PAHs as well as their associated toxicities. Distinct differences between odd and even carbon preferences were found for alkanes from biological and petroleum-based materials: dry vegetation, paper, textile, and food discards show preference for the odd-numbered alkanes, while the opposite is true for plastic bottles, bags, and rubber. As phthalates are used as plasticizers, their highest EFs were found for plastic bottles and bags, rubber, and combined materials. 25 Data from this study will be useful for health and climate impact assessments, speciated emission inventories, source-oriented dispersion models, and receptor-based source apportionment.
... More research is needed to clarify the relative impact of different nature types (Jarvis et al., 2020Knobel et al., 2021), different types of interaction with nature (Kahn et al., 2010;White et al., 2021), and forms of sensory input (e.g., visual, olfactory, auditory, or tactile) on the reported associations between green exposure and mental health (Bratman et al., 2019). In addition, although the harmful aspects of urbanization are particularly pronounced in vulnerable populations (Martuzzi et al., 2010), much of the previous work is situated in the Global North; diversification to other geographic and sociocultural perspectives would greatly extend our understanding of beneficial effects of green spaces in relation to inequities in access (Masterson et al., 2022;Rigolon et al., 2018;Torres Toda et al., 2022;Uchiyama and Kohsaka, 2020). Finally, more research is needed to better evaluate the association between early (including pre-natal) exposure to natural environments and health-related outcomes throughout life (Anabitarte et al., 2022;Fernández-Barrés et al., 2022;Jarvis et al., 2021;Kabisch et al., 2019;Mygind et al., 2021;Pagalan et al., 2022;Yuchi et al., 2022). ...
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Our study examined the use of green spaces before and during the pandemic in a large cohort of Italian twins and evaluated its impact on measures of mental health (depressive, anxiety, stress symptoms). Twins were analysed as individuals and as pairs. A twin design approach was applied to minimize confounding by genetic and shared environmental factors. Questionnaires from 2,473 twins enrolled in the Italian Twin Registry were screened. Reduced green space use was associated with significantly higher levels of depression, anxiety and distress. Being a woman, residing in urban areas, and having a high perceived risk of the outbreak resulted in a higher likelihood to modify green space use, with a negative impact on mental health.
Célunk egy koncepciójában új környezettoxikológiát – mint koherens, az ökológia fogalomrendszerét használó – szupraindividuális tudományt elméletileg megalapozni, és gyakorlati példákon keresztül igazolni ennek létjogosultságát és használhatóságát. Emberek populációi, és nem az egyének befolyásolják azt a fizikai környezetet és kulturális rendszert, amelyben élnek (és vice versa). Ebből következik, hogy az emberre veszélyes, valamilyen betegség, malformáció, vagy egyéb biológiai válasz kiváltására képes expozíciók vizsgálata is szupraindividuális megközelítést igényel, jelentősen hangsúlyozva a természeti és kulturális környezet kölcsönhatásait. A környezeti eredetű expozíciókra az egyes (szub)populációk által adott válaszok különbözősége azok eltérő sérülékenységéből/érzékenységéből (vulnerabilitás) ered. Az ember többes természetéből fakadóan az eltérések csak részben vezethetők vissza pusztán biológiai (genetikai, fiziológiai, stb.) okokra. Léteznek egyéb okok is, melyek azonban – elsősorban határterületi jellegük miatt – nem vagy még nem eléggé vizsgált determinánsai, modulánsai a környezeti expozícióra adott válasznak. Illetve az adott (szub)populáció számára fokozott expozíciós helyzetek éppen ezek miatt jöhetnek létre. E tényezőket emberi populációk esetében egyáltalán nem lehet figyelmen kívül hagyni, sőt operatívan figyelembe kell venni a környezeti expozíciók kontrolljánál és a kockázatbecslésben. A populációkat rétegezhetjük biológiai (életkor, nem, fenotípus, stb.) vagy társadalmi-történelmi (osztály-, nemzetiségi, kulturális, képzettségi, foglalkozási, stb.) alapon, az expozíció kialakulása és következménye nagyban függ a vizsgált részpopuláció elhelyezkedésétől ebben a rendszerben. A dolgozatban idézett példák sorra veszik azokat a lehetséges okokat, melyek alapján az érintett közösség az átlagostól eltérően reagálhat bizonyos típusú expozíciókra, vagy az expozíció eleve csak az adott közösségben jöhet létre. Magyarországi roma (beás, ill. oláh) populációk egyedi környezeti expozícióit, nemzeti kisebbségeket és szomszédos nemzeteket érő expozíciók társadalmi és történelmi gyökereit vizsgáljuk. Partikulumexpozíciók (azbesztrostok, szénnanocsövek) példáján bizonyítjuk, hogy csak populációs szintű vizsgálatokban deríthető fel a valós expozíciós út, a valóban exponált részpopuláció mérete és valós kockázata. A szénnanocsövekkel kapcsolatos vizsgálatok a nanotoxikológia első eredményeinek populációs szintű konzekvenciáit nyújtják. A Kárpát-medence ásvány- és gyógyvizeinek különböző célú felhasználása (balneoterápia, ásványvízfogyasztás) nem pontosan azonosítható, de méretében becsülhető népességet érint. A vizek mikroszennyező anyagainak, szerves összetevőinek genotoxicitása – mindamellett, hogy antimutagén, protektív tulajdonságokat is találtunk – alkalmazásuk kockázatait is jelzi. A hazai gyógyiszapok (peloidok) ökotoxikológiai vizsgálata is fontos eleme ezeknek a balneotoxikológiai kutatásoknak. Speciális foglalkozási csoportokat (komplex expozíciókat) is tudunk új fejlesztésű biomarker-vizsgálatainkkal egzakt módon követni, így az expozícióból fakadó kockázatukat is tudjuk csökkenteni. Egy olyan szupraindividuális szemléletű alaptudományról van tehát szó a környezettoxikológia esetében, amelyre bátran felépülhet egy környezet-egészségügyi cselekvési stratégia, a prevenció érdekében meghozott intézkedések összessége. Célunk eléréséhez – mint azt a dolgozat igyekszik reprezentálni – a modern tudomány minden lehetséges eszköze bevethető.
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Heavy metal exposure has been linked to several detrimental health outcomes, including cancer, neurotoxicity and cardiovascular diseases. Recent research suggests that the sensitivity to heavy metal toxicity may vary by gender. This review summarizes scientific research on sex-specific vulnerability to heavy metal toxicity. Several studies have shown that women may be less likely than men to have cardiovascular illness brought by exposure to heavy metals. This could be partly attributed to estrogen's preventive properties, which have been shown to mitigate the harmful cardiovascular consequences of heavy metal intake. Contrarily, testosterone has been found to negatively affect the cardiovascular system and may make men more susceptible to cardiovascular illness brought by heavy metals. Disparities in heavy metal absorption, distribution, metabolism, and excretion as well as variances in lifestyle and exposure patterns, may also play a role in sex disparities and vulnerability to heavy metals. The results as a whole point to the possibility that gender variations may significantly affect the susceptibility to heavy metal toxicity, particularly in connection to cardiovascular diseases. To appreciate the underlying mechanisms, develop specific preventive and treatment measures for both men and women, further research is still required.
Food waste is an important concern of modern societies, and the European Union has committed to significantly reducing it, especially at the consumption level. This comparative case study analysis examines the barriers that actual interventions in the EU have experienced and explores the mechanisms and dynamics behind them using meta‐ethnographic approaches. Barriers relating to culture, politics and policies, administration, the economy, and the spatial and temporal organization of life were identified. It is concluded that food waste reduction is a bundle of interrelated practices, and it is best understood with a sociological approach that focuses on social practices rather than individuals. Concepts that emerged as important include risk and the spatial and temporal organization of everyday life. This study proposes that a focus on the nexus of food waste generation–risk–household dynamics–spatial/temporal organization of urban life, as well as the use of interventions (rather than individuals) as units of analysis are fruitful directions for future research and action.
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A national clean energy standard, modeled upon existing state-level Renewable Portfolio Standards, has been proposed to decarbonize the U.S. electric grid. Most such state policies include municipal solid waste incineration as a form of “renewable” energy, despite incinerators’ prominent contributions to air pollution, primarily in environmental justice communities. This study finds that incinerators emit more greenhouse gas emissions per unit of electricity produced (1707 g CO 2 e/kWh) than any other power source (range: 2.4 to 991.1 g CO 2 e/kWh). They also emit more criteria air pollutants than replacement sources of energy, such as natural gas. Incineration’s inclusion in “renewable” or “clean” energy standards is thus counterproductive, as they also divert more than $40 million in subsidies annually from cleaner energy sources. As the electric grid decarbonizes, these disparities will only grow. With most U.S. incinerators nearing their end of life, policy choices about their eligibility for subsidies may well decide whether they shut down or undertake expensive capital improvements to continue operating. Extending incinerators’ operational lives by 20 years would result in excess emissions of up to 637.7 million tonnes CO 2 e, 61.9 million tonnes NO x , and 161,200 tonnes SO 2 . Conversely, a rapid shutdown of existing incinerators would help decarbonize the electric grid and reduce criteria air pollution, particularly in environmental justice communities, which are disproportionately burdened by environmental health hazards.
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The need for better environmental protection, human rights, and health has been widely asserted. Poorer and minority communities, namely those with the least economic and political participation capacity and targets of discrimination, benefit the least and take on more than their fair share of the burdens accruing from industrialized society. In the last five years, environmental justice has gained specific attention in Central and Eastern Europe (CEE). Research and advocacy are growing, and affirming the need for environmental justice in Europe, especially amongst the Roma. In this article, we introduce briefly some of the emerging findings on the status of environmental justice in CEE and summarize a general framework for asserting environmental justice in Europe.
Professor Been argues that the major studies that purport to show that locally undesirable land uses (LULUs) have been disproportionately sited in poor and minority neighborhoods are methodologically flawed. These studies compare the current socioeconomic characteristics of host communities to those of non-host communities. Been, however, argues that such comparisons do not prove that the original siting decisions were made unfairly. Been explores the role market dynamics may play in the distribution of LULUs. A LULU's presence in a neighborhood often causes property values to fall, and that decline in turn changes the demographics of the neighborhood. Accordingly, the disproportionate burdens LULUs now impose upon poor and minority communities may have been caused by the dynamics of the housing market, rather than by flaws in the original siting process. If so, the proposed remedies for the problem are inadequate. To test the market dynamics theory, Been revises two leading studies of disproportionate siting by examining the characteristics of host neighborhoods at the time that the LULUs were sited and tracing demographic changes in the neighborhoods. One of the revisions shows that market dynamics play a major role in determining the demographics of host neighborhoods and therefore should be taken into account in the structure of any remedy for disproportionate siting.
This article uses social movement theory to analyze environmentaljustice rhetoric. It argues that the environmental justice frame is a masterframe that uses discourses about injustice as an effective mobilizing tool. The article identifies an environmental justice paradigm and compares it with the new environmental paradigm. In addition, the article discusses why the environmental justice movement grew so fast and why its adherents find the environmental justice frame so appealing.
Early “environmental equity” studies claimed hazardous waste facilities (TSDFs) were disproportionately located in minority and disadvantaged communities. Recently, research has challenged such claims. Regardless of conclusions, no national study has evaluated inequity in the siting process or the impact of TSDFs on the demographic composition of communities after TSDFs began operations, or distinguished between TSDF-caused change and general population trends. This article presents findings from the first national tract-level longitudinal study of communities with TSDFs. We find no stark evidence of environmental inequity or disparate impact. Results suggest compositional change in host communities may best be explained by general population trends.