Exploring risk factors for respiratory illnesses: Are children who live near waste incinerators at increased risk

This study was designed to determine whether residential proximity to waste incinerators might affect the respiratory health of young children, and to identify other risk factors for childhood respiratory illnesses. Participants were selected from two residential areas located near a hazardous waste industrial furnace (HWI) or a municipal waste incinerator (MWI), and two areas selected for comparison purposes. Data were collected through telephone interviews with a parent or guardian of each child-participant, beginning with a baseline interview, followed by ten biweekly interviews from September 1993 through March 1994.;Retrospective data reported at baseline were analyzed with proportional hazards regression to compare rates of lower respiratory illness (LRI) in the incinerator areas with rates in the comparison areas. No difference was detected in the rate of LRI between the HWI area and its comparison area. However, the rate of LRI was significantly higher in the MWI area relative to its comparison area (adjusted rate ratio 2.88, 90% confidence interval (CI) 1.60-5.19), and additional analyses indicated that LRI rates were comparable between these areas before the incinerator began operating.;Rates of upper respiratory illnesses (URI) were compared through analyses of longitudinal data collected during weekly interviews. No significant difference in the incidence of URI was detected between the HWI and comparison areas. Rates of URI were elevated in the MWI area related to its comparison area, with an adjusted incidence density ratio (IDR) ranging from 1.3 (95% CI 1.0-1.6) among children who spent most daytime hours within two miles from home, to 1.9 (95% CI 1.3-2.9) among children who spent most daytime hours farther than two miles from home.;Data collected from the four areas were combined to examine independent risk factors for upper and lower respiratory illnesses while adjusting for confounding effects of the incinerators. Several risk factors identified (age of the child, history of LRI during the first year of life, larger day care or school class sizes) corroborate the results of other studies; other (use of a wood-burning fireplace in the home and age of housing) substantiate the importance of the indoor environment to childhood respiratory health.