Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, UK.
National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, UK; National Heart and Lung Institute, MRC PHE Centre for Environment and Health, Imperial College London, London, UK.
Int J Hyg Environ Health. 2019 Apr;222(3):364-386. doi: 10.1016/j.ijheh.2019.02.006. Epub 2019 Mar 12.
Rapid population growth and urbanisation around the world has led to increasing waste generation rates. Composting of organic waste in large-scale facilities is part of a growing trend in the UK, and elsewhere, to better manage and re-use the organic waste. However, composting inevitably generates bioaerosols, which have been associated with human health effects. In 2015, we reported that there was some, albeit limited, qualitative evidence linking bioaerosol emissions from composting facilities to poor respiratory health in nearby residents. However, the limited evidence precluded any quantitative assessment. Since then, the number of operational industrial-scale composting facilities in England has increased by 9% - nearly twice the growth from 2012 to 2014. At the same time, rapid urbanisation has led to expansion of city borders with more people living near large composting facilities and exposed to bioaerosol pollution. It is essential that regulatory authorities have access to the most up to date and accurate information.
In this update of a systematic review published in 2015, we review and summarise the evidence from more recent studies that have assessed bioaerosol exposures within and near composting facilities and their associated health effects in both community and occupational health settings. Specifically, we wanted to find out if new evidence has emerged since the previous review to strengthen and confirm its conclusions.
Two electronic databases (Medline and Embase) and bibliographies were searched for studies reporting on health outcomes and/or exposure to bioaerosols from composting facilities published between 1 January 2014 and 15 June 2018. Identification of relevant articles and data extraction was undertaken and studies were assessed for risk of bias.
23 studies met the inclusion criteria (15 exposure studies, 4 health studies, 4 health and exposure studies (one of which used an exposure proxy)). The majority of studies were conducted in occupational settings, and over short time periods. Some progress has been made in the characterisation of bioaerosol emissions from these composting facilities, with the application of molecular-based methods. Whilst the latest health studies do not rely solely on subjective self-reported measures of health status but include more objective health measures, these studies were almost exclusively carried out in compost workers and were characterised by profound methodological limitations. Only one community health study was identified and used a proxy measure of bioaerosol exposure.
Although this review identified an additional 23 studies since the earlier review, the conclusions remain largely unchanged. Given the absence of any consistent evidence on the toxicity of bioaerosols from composting facilities, there is insufficient evidence to provide a quantitative comment on the risk to nearby residents from exposure to compost bioaerosols. To improve risk assessment and to best advise on risk management, it is important to ensure that the research recommendations outlined in this review are addressed.
全球人口的快速增长和城市化导致垃圾产生率不断上升。在英国和其他地方，有机废物的堆肥是大型设施中越来越流行的管理和再利用有机废物的趋势的一部分。然而，堆肥不可避免地会产生生物气溶胶，这些气溶胶与人类健康影响有关。2015 年，我们报告说，有一些，尽管是有限的，将堆肥设施产生的生物气溶胶排放与附近居民的呼吸道健康不良联系起来的定性证据。然而，有限的证据排除了任何定量评估。自那时以来，英国运营中的工业规模堆肥设施数量增加了 9%，几乎是 2012 年至 2014 年增长的两倍。与此同时，快速城市化导致城市边界扩张，更多的人居住在大型堆肥设施附近，暴露在生物气溶胶污染中。监管机构必须掌握最新和最准确的信息。
在 2015 年发表的系统评价的更新中，我们回顾和总结了最近的研究证据，这些研究评估了堆肥设施内及其附近的生物气溶胶暴露情况，以及在社区和职业健康环境中与之相关的健康影响。具体来说，我们想知道自上次审查以来是否有新的证据出现，以加强和证实其结论。
在 2014 年 1 月 1 日至 2018 年 6 月 15 日期间，我们检索了两个电子数据库（Medline 和 Embase）和参考书目，以查找报告堆肥设施中健康结果和/或生物气溶胶暴露情况的研究。确定相关文章并提取数据，并评估研究的偏倚风险。
有 23 项研究符合纳入标准（15 项暴露研究、4 项健康研究、4 项健康和暴露研究（其中一项使用暴露代理））。大多数研究是在职业环境中进行的，并且时间较短。这些堆肥设施的生物气溶胶排放特征已经取得了一些进展，应用了基于分子的方法。虽然最新的健康研究不仅依赖于健康状况的主观自我报告测量，但包括更客观的健康测量，但这些研究几乎完全是在堆肥工人中进行的，具有明显的方法学局限性。只确定了一项社区健康研究，并使用生物气溶胶暴露的代理测量。
尽管本综述自上次综述以来确定了 23 项额外的研究，但结论基本保持不变。鉴于目前没有关于堆肥设施产生的生物气溶胶毒性的一致证据，因此没有足够的证据对附近居民接触堆肥生物气溶胶的风险进行定量评价。为了改善风险评估并为风险管理提供最佳建议，重要的是确保解决本综述中概述的研究建议。
