A workshop held in Rome, Italy, 29-30 March 2007, addressed open questions regarding waste and its health effects.

Presentations provided an updated review of the current scientific evidence in the field, on health effects and technological developments of landfills and incinerators. The evidence of adverse health effects related to landfills and incinerators, although not conclusive, adds to other environmental concerns in directing waste management strategic choices towards reduction of waste production, re-use and recycling schemes, as prescribed by EU Directives. National and local authorities should oppose and eliminate poor, outdated and illegal practices of waste disposal, which still affect some local communities, support regulation and enforcement, and invest in state-of-the-art technology for lowering emissions.

Case studies from European countries where waste management and health is a matter of concern or where successful policies are adopted (comparing and contrasting success stories and unsolved problems) were presented. Policy options to compare and contrast real cases were discussed to provide public health and environmental health practitioners and people involved in decision making in waste management, and other interested parties, with a critical evaluation of the implications of the available evidence for developing policies in waste management.

The decision-making process concerning location and operation of waste facilities should be transparent and fair, and aim at replacing poor or even illegal waste management practices to legal and safe operations, avoiding long delays. Priority needs for research were identified.

Actions aimed at addressing population concerns should be considered and adopted where necessary, namely:

• provide information on technological standards and process characteristics and
  environmental mitigation strategies. Resources should also be concentrated on establishing
  the real level of risk associated with sites, including improved understanding of exposure
  pathways, before considering site specific epidemiological research;
• provide information on environmental monitoring;
• develop monitoring programs where applicable; and
• enhance communication and participatory activities in order to promote community autonomy and build consensus.

Background

Waste management is becoming an increasingly complex matter in many European countries. Improvements in technology and recycling schemes are often not sufficient to counter growing waste production, obsolescence of existing waste management facilities and shortage of space for the construction of new facilities. Further difficulties are posed, in many instances, by mounting public concerns on effects on health and well being.

Controversy and consequent difficulties in developing and adopting health-friendly, cost-effective and equitable policies in waste management are due to several reasons, including: abundance of suggestive, but not conclusive, evidence on possible adverse health effects of living near waste treatment plants, landfills, incinerators etc; confusion between different issues such as the disposal of solid urban waste as opposed to other types of waste (e.g., toxic industrial waste, hospital waste); mistrust in authorities and scientific community; occurrence of "NIMBY" (Not In My Back Yard) syndrome type of reaction, possibly as a result of overlooking aspects of risk perception and communication.