Adverse pregnancy outcomes near landfill sites in Cumbria, northwest England, 1950--1993.

Although several researchers have addressed the risk of congenital anomaly in relation to proximity to landfill sites, few have considered the risks of stillbirth or neonatal death for mothers who reside near landfills. The authors studied all 4,325 stillbirths, 3,430 neonatal deaths, and 1,569 lethal congenital anomalies that occurred among 287,993 births to mothers residing in Cumbria, northwest England, during the years 1950 to 1993. Logistic regression models, with data stratified by time period and adjusted for subject-specific demographic factors, were used to investigate the risk for each outcome in regard to proximity at birth to landfill sites within Cumbria. For the years 1970--1993, a small but significantly increased risk of death from "Other congenital anomalies of nervous system" (International Classification of Diseases, 9th rev. [ICD-9], code 742) was found in children of mothers living near domestic waste landfill sites. There was no increased risk of any other lethal adverse pregnancy outcome associated with residence near the landfills studied. The authors' finding of increased risk of death from "Other congenital anomalies of nervous system" closer to landfill sites (e.g., continuous odds ratio = 1.14 [95% confidence interval = 1.03, 1.25] for increasing proximity to landfill sites during 1976--1993) was consistent with findings of other researchers; however, a casual effect could not be inferred from this statistical association, and the possibility that this was a chance finding (in view of multiple significance testing) could not be excluded. Further research incorporating actual pollution data collected around landfill sites and the examination of both lethal and nonlethal congenital anomalies is recommended