A programme for exposure and epidemiological surveillance of populations living in the vicinity of industrial waste dumps in France

Following the environmental contamination at the industrial waste site of Montchain, the government of France has resolved to sponsor a programme for monitoring the impact of industrial waste dumps on the environment and on the health of neighbouring populations. The epidemiological approach is generally limited in its power to quantify risks and even to identify hazards because of: 1. the usual lack of information on the identify and level of toxic substances in the dump itself, on the exposures of individuals in the vicinity and therefore on the diseases and symptoms to be studied; 2. the relatively small size of the populations 'at risk' of exposure. The proposed solution is to carry out a systematic - prospective - surveillance of specific exposures in, and around, every industrial waste site in activity in France. The surveillance will be tailored to each dump. This will yield much needed information on the distribution and temporal pattern of exposures in the population. Risk projection models can then be applied and ranges of risk estimates derived in order that public authorities can make decisions on the operation of the dump. A health risk information campaign will be set up. A prospective epidemiologic study of dump workers, involving exposure monitoring, and biological and clinical follow-up, will also be set up. Subsequently, and depending on the agents and levels of exposure identified at individual dumps, epidemiologic surveillance of high risk groups (pregnant women, children) and biological monitoring of a subsample of the population may be set up