Adverse birth outcomes associated with open dumpsites in Alaska Native Villages

Adverse birth outcomes associated with open dumpsites in Alaska Native Villages.
Gilbreath S, Kass PH
Am J Epidemiol. 2006 Sep 15; 164(6): 518-28

This retrospective cohort study evaluated adverse birth outcomes in infants whose birth records indicated maternal residence in villages containing dumpsites potentially hazardous to health and environment. Birth records from 1997 to 2001 identified 10,073 eligible infants born to mothers in 197 Alaska Native villages. Outcomes included low or very low birth weight, preterm birth, and intrauterine growth retardation. Infants from mothers in villages with intermediate (odds ratio (OR) = 1.73, 95% confidence interval (CI): 1.06, 2.84) and high (OR = 2.06, 95% CI: 1.28, 3.32) hazard dumpsites had a higher proportion of low birth weight infants than did infants from mothers in the referent category. More infants born to mothers from intermediate (OR = 4.38, 95% CI: 2.20, 8.77) and high (OR = 3.98, 95% CI: 1.93, 8.21) hazard villages suffered from intrauterine growth retardation. On average, infants weighed 36 g less (95% CI: -71.2, -0.8) and 55.4 g less (95% CI: -95.3, -15.6) when born to highly exposed mothers than did infants in the intermediate and low exposure groups, respectively, an effect even larger in births to Alaska Native mothers only. No differences in incidence were detected across exposure levels for other outcomes. This is the first study to evaluate adverse pregnancy outcomes associated with open dumpsites in Alaska Native villages.

Read the full paper on-line

• http://tinyurl.com/yaawbo

or available as

• Full Text PDF)
  http://aje.oxfordjournals.org/cgi/ reprint/164/6/518?ijkey=820a0d0259407f55cd6b6130f08ca58f8a2919ab

I’m reading this now in more detail. Some of the important details to analyze are

Over 95 percent of Alaska Native villages use open dumpsites for solid waste disposal rather than landfills. An open dumpsite is a solid waste site that is not maintained, contains uncovered wastes, and has no boundaries. Open dumping can enable water and soil contamination, disease transmission, fire danger, and injury to site salvagers. In an attempt to reduce waste volume, dump fires are set, or nonseparated wastes are burned in metal containers in approximately 75 percent of villages, releasing potentially toxic fumes. Many Alaska Natives have subsistence diets, and there are concerns about contaminants getting into food and water supplies. Many villages lack waste management services and are responsible for disposing their own wastes, resulting in potential exposures to hazardous wastes and disposal methods. Approximately 45 percent of villages do not have running water to homes, and villagers must haul their own wastewater, often discarded at or near open dumps, increasing risks of exposure to pathogens when disposing of trash.

Negative birth outcomes were selected to evaluate potential environmental hazards posed by these dumpsites. The purpose of the study was to determine if women living in villages with open dumpsites ranked high hazard have a higher incidence of negative birth outcomes than do women living in villages with sites that have lower hazard rankings.

Some things to examine

• open dumps are ubiquitous in most rural US and Alaska communities
• not every rural/remote Alaska community is an Alaska Native ethnic population
• the data come from
  

  Birth records were obtained from the Alaska Bureau of Vital Statistics for all births to women living in federally recognized Alaska Native villages during 1997–2001.

• open dumps had to be rated to be included in the study
  

  the women had to reside in villages for which there existed an evaluation of the hazard potential of the community dumpsite(s)… The Alaska Native Tribal Health Consortium ranks dumpsites on the basis of waste contents, average rainfall, distance to drinking waster and domestic water source, site drainage, potential to create leachate at site, accessibility and exposure to the public and vectors, frequency of burning, and degree of public concern over the site

At the time of the study, the state and the federal (ANTHC) databases were not integrated. The inspections used different but somewhat similar criteria. Often the sites listed are not the same. I found the state data to be more comprehensive, but even then, as with New Mexico, there are dumps which are in one dataset but not in the other and many more dumpsites exist than are logged into the databases.

With the ADEC database, many older or “closed” dumps/landfills won’t show up in the database (they are in the old folders in the file cabinets) because they are listed as “closed” or as federal sites or otherwise inactive. One of the ironies of developing community-run solid waste programs (Eight Northern Indian Pueblos Council) was that the information was too poor or non-existent from BIA, IHS, or other sources that we could use. I once asked for a list of dumps recorded by BIA (so we could compare to what we were discovering). A few days later I got a request, from IHS I believe, for a list of dump sites in our villages. The feds went to us in order to answer our question.

As the study authors note, the data and results are not very precise,

Future studies examining the potential health effects associated with open dumpsites in Alaska Native villages should include measurements that are more precise in nature. Misclassification errors are inherent in studies with crude exposure measurements.

One cannot say that open dump sites cause problems in pregnancy and birth. However there is a tendency for Alaska Native communities with the worse solid waste dumping to also have problems with pregnancy and births.

The most important aspect of this study is that it is the first to attempt to characterize the relation of these adverse pregnancy outcomes among residents of Alaska Native villages to open dumpsites.

This is true. But to understand whether there is any cause and effect we need to do more (could be only a relationship to tribal status or those places with less private cash or those dependent on federal health services???)

Mothers in villages with low hazard-ranked dumpsites tended to have had fewer short interpregnancy intervals and previous pregnancies, were more frequently Caucasian and between 20 and 39 years of age, completed more years of education, more often had access to acute care medical facilities, and were more likely to have households in their villages completely plumbed compared with mothers from villages with intermediate and higher hazard-ranked dumpsites.

What is needed is better study of actual community dump sites (location, number, age, contents, etc.), better integration of good quality data, more precise identification of behaviors in solid waste exposure (mothers), etc. This means each community must be the central arbiter or quality control for studies of its own local environment. Then, make sure that same quality of information can be shared with others to understand what is actually occurring and how to improve our living.

What do you all think, the ones who have to come up with integrated solid waste management plans for your own village?

---

Site Search Tags: dumps, health, inspections, SWMP, ADEC, ANTHC, class+III