The human health impact of waste management practices: A review of the literature and an evaluation of the evidence

A literature review was carried out of the health impacts of incineration, landfill, composting, landspreading sewage sludge and sewage discharges. A protocol for making judgements about the strength and reliability of the evidence was applied using an algorithm with defined criteria. Possible judgements were “convincing”, “probable”, “possible” or “insufficient”. The review found that the evidence linking any adverse health outcomes with incineration, landfill or landspreading sewage sludge was “insufficient” to claim a causal association. The evidence is “insufficient” to link residence near a centralised composting facility with adverse health outcomes but it is “possible” that working at a centralised composting facility causes health problems. Working in sewage treatment plants “probably” causes gastrointestinal tract problems, headache, fatigue and airways symptoms. The only “convincing” evidence is that gastrointestinal symptoms result from bathing in sewage contaminated recreational waters.