摘要：Authors Lucie Anzivino-Viricel , Nicole Falette , Julien Carretier , Lucile Montestrucq , Olivier Guye , Thierry Philip , Béatrice Fervers Observatoire régional de la santé Rhône-Alpes 9, quai Jean-Moulin 69001 Lyon France, Centre Léon-Bérard Unité cancer et environnement 28, rue Laënnec 69373 Lyon cedex 08 France, Université de Lyon 1 EA 4129 « Santé, Individu, Société » Faculté de Médecine Laënnec 7-11 rue Guillaume Paradin 69372 Lyon cedex 08 France Key words: environmental exposure, occupational exposure, review, risk assessment, waste management DOI : 10.1684/ers.2012.0559 Page(s) : 360-77 Published in: 2012 The growing production of waste and the diverse methods by which it is managed contribute to the environmental release of hazardous substances and raise numerous questions about their risk to human health. We conducted a systematic review of the scientific literature (26 summary reports and systematic reviews and 48 epidemiological studies) on the impact of the management of household and similar waste (collection and sorting, composting, incineration and storage) on the health of waste management workers and the nearby population. We also formalized levels of evidence to grade the strength of the available evidence. In addition to musculoskeletal disorders, potential health problems identified in the occupational population were respiratory, gastrointestinal, and skin disorders, associated with the inhalation of bioaerosols and direct contact with waste containing certain chemicals. Pollutant levels and diseases identified in the population living around landfills depended on the nature of the waste and the facility's operating practices. The diseases identified in the population living near incineration plants were cancer and reproductive disorders, neither of which has been studied or identified among employees. These risk levels appear closely linked to the performance levels of the municipal solid waste incinerators, and thus the transferability of these results to facilities brought up to standard since 2002 is limited. Our review indicates the utility of a more detailed examination of the issues for which data are contradictory or inconclusive. Our results also encourage further research in areas where scientific data are currently lacking and the improvement of exposure characterization, particularly of local residents, for whom we took into account individual risk factors, which were often associated with a greater risk than environmental factors.
