A boom in waste sites is affecting SA’s health
There are more than 1 000 licensed waste disposal sites across South Africa. A new study suggests that those who live nearby are at much higher risk of asthma, diabetes, TB and depression.
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13 August 2020
“This whole place stinks. We can’t get away from the stigma because we are encircled by foul smells,” says Collin Memela, wrinkling up his nose as he describes the place where he was born and has lived for 29 years.
Memela is talking about Sobantu Village, the first formal black township to be established next to the city of Pietermaritzburg, in the late 1920s.
His home on the corner of Vuma Street and Jabula Drive overlooks the city’s main municipal dump. To his left lies the city’s main sewerage works. Adding to this ripe aroma are the chemical fumes from factories and warehouses in the nearby Willowton industrial area.
So it’s not surprising that Memela has had enough, especially in light of a new scientific study published by The Lancet medical journal that suggests South Africans who live close to waste dumps are more likely to get sick.
When he was a boy, Memela remembers being able to see the neighbouring suburbs of Hayfields and Lincoln Meade on the other side of the Msunduzi River. But with so much rubbish dumped in the river valley in recent decades, the view from his front stoep is dominated by an oval mountain of garbage covered by a sprinkling of plastic bags, rotting refuse and smoke from the tipper trucks and bulldozers that scrape and pile up fresh heaps of refuse each day.
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What irks him most is that the dump has been engulfed by fire and choking clouds of black smoke countless times in the past decade.
In July, a dump fire that burned for several days caused the closure of the N3 highway because of the dense pall of smoke hanging over it. And the South African Human Rights Commission has launched a formal investigation into human rights and dignity in Sobantu because of the increase in complaints about the dump.
“On Friday morning [24 July], I could not even see my front gate three metres in front of me because there was so much smoke … Between the sewerage works, the dump and all the other chemical odours, this whole place just stinks,” says Memela.
“This dump is totally out of control now and no one will help us when we get sick. The time has come to close it down forever.”
Hidden costs
Memela is one of the hundreds of thousands of South Africans who have the misfortune of living next to one of more than 1 000 formally registered waste dumps, places that scientists are now linking to a growing likelihood of disease and other harmful health impacts.
Writing in The Lancet Planetary Health journal, a team of researchers led by University of KwaZulu-Natal (UKZN) vice-chancellor Rob Slotow reports that living within 5km of a waste disposal site is “significantly associated” with a higher risk of developing asthma, tuberculosis (TB), diabetes and depression.
Slotow and his colleagues say the observed associations between waste dumps and disease risks persisted, even after controlling for multiple socioeconomic factors.
They calculated that people had a 41% higher risk of developing asthma, an 18% higher risk of contracting TB, a 25% higher chance of having diabetes and an 8% greater chance of suffering from depression compared with those who live further than 5km from a waste site.
Overall, they concluded that the study results highlight the need to reduce the number and size of waste sites and to pay greater attention to the hidden costs of pollution and poor waste management on human health.
“You don’t have to be knocked over and end up in a trauma ward to be impacted. Unfortunately, these are often intangible issues that don’t necessarily manifest as dead bodies lying on the ground … so they remain less visible.”
Rapid growth in waste sites
Slotow, who heads the university’s flagship African Cities of the Future research project, says the study was based on data gathered from more than 32 000 people nationally who were part of the South African National Income Dynamics Study (SA-Nids) between 2008 and 2015.
The research was co-authored by Andrew Mitsuaki Tomita of the UKZN school of nursing and public health, Frank Tanser of the African Health Research Institute at UKZN, Diego Cuadros from the University of Cincinnati in the United States and Jonathan Burns, an honorary professor of psychiatry at the University of Exeter in the United Kingdom and the former head of psychiatry at UKZN.
Slotow and his colleagues used self-reported health data from the study’s 33 255 participants to map the proximity of their homes to registered waste dumps using geographic information systems or GIS satellite data.
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The study showed a rapid and unsustainable increase in the number of registered waste sites nationwide. The data suggests that the number of sites grew from at least 42 sites in 2008 to 280 sites in 2010, 519 in 2012 and 1 086 in 2015. Slotow says that while there were probably many more than 42 waste dumps in 2008, there has nevertheless been a rapid increase in the number of dumps established in recent years.
The study also highlighted the shrinking distances separating people from dumps. For example, the median distance between households and dumps was just over 65km in 2008, whereas by 2015 this gap had shrunk to around 7km.
By 2015, more than half the people registered in the SA-Nids study were living within 10km of a waste site, while more than 35% lived within 5km of a dump.
Adding to these concerns, Slotow says government reports have shown that the country is in the midst of a waste crisis.
Landfill sites almost full
A 2018 report by the Department of Environment, Forestry and Fisheries says that only 10% of waste is recycled, with around 98 million tonnes dumped in landfill sites each year. A second report suggests that waste volumes are growing so fast that the majority of the landfill sites in the largest municipalities will be full before 2025.
Slotow and his colleagues made note of hantavirus, which are viruses spread to humans by rodents, hantavirus pulmonary syndrome and asthma as health problems associated with waste dumps.
Airborne pollutants such as hydrogen sulphide not only harm the respiratory system but also contribute to lung ailments such as asthma and less obvious non-respiratory illnesses, such as diabetes, through exposure to polychlorinated biphenyls in hazardous waste sites.
Burns comments that polluting facilities are often located in areas where there are vulnerable residents because of lower property values and business costs. Prior to 1994, black people were dispossessed of their land and forcibly removed to racially designated areas, often on the urban outskirts. This was also where industrial activity took place in the form of factories, airports and landfill sites.
“The spatial planning policies extended to environmental racism, where non-white communities were situated adjacent to waste sites. Despite the diversity of waste products, the danger posed by certain landfill gases lasts for decades, specifically for those living in close proximity to such sites and who had little choice as to where they could live in pre-democratic South Africa. The enduring effects of racist environmental policies, inherited from the apartheid regime, cannot be dismissed,” say the authors of the research.
Psychological impact
Researchers at Indiana’s Purdue University in the US have found that issues such as foul smells, traffic, pollution and property devaluation can have a psychological impact on residents who live near waste dumps.
Slotow and his colleagues say diseases such as asthma, diabetes and depression can have deadly consequences when left untreated, yet they are often neglected when compared with other, more endemic public health problems in South Africa like HIV and TB.
“Although reliable nationwide data are scarce, estimates suggest that one in 20 adults have asthma, and age-adjusted asthma death rates are among the highest in the world, according to the 2018 Global Asthma Report,” they say.
Despite being treatable, TB remains the top cause of death at 6.5% of all deaths in 2016 in South Africa, followed by diabetes at 5.5% in 2016. Depression is a serious health condition that affected an estimated 8% of South Africans in their lifetime.
To the best of their knowledge, the researchers’ latest report is the first national-level, evidence-based study in South Africa to explore the health effects of living near waste sites.
They acknowledge that it can be difficult to draw a causal relationship between exposure to waste sites and adverse health outcomes. But a recent cohort study from Italy found that exposure to hydrogen sulphide emitted from landfill sites was associated with higher death rates and hospital admissions caused by respiratory diseases in people living within 5km of these waste sites.
“Although South Africa is at the forefront of strict environmental regulations in sub-Saharan Africa, legal compliance among documented waste site operators is believed to be remarkably low in South Africa, which might explain our findings of close proximity to waste sites showing an association with adverse health outcomes.”
Further studies required
The researchers acknowledge that they did not measure land, water or airborne contamination exposure at the waste sites. Nor did they control for general air pollution in the area. So, they were unable to establish any causation between the observed health outcomes and living in close proximity to waste sites.
However, they suggest that high concentrations of hydrogen sulfide and polychlorinated biphenyls near waste sites might be one explanation for the significant association they found between living within 10km of a waste site and the development of asthma and diabetes among residents.
They also say that the study did not take illegal waste sites into consideration and focused solely on publicly available licensed sites.
Slotow says the red flags raised by the study highlight the need for more detailed studies on airborne chemical pollution from dump sites, as well as other environmental pathways such as water or soil.
“We need to establish whether some of these things, hazardous or toxic compounds, may be bio-accumulating in communities via garden-grown vegetables, chickens or other livestock.”
He says the study was not designed to investigate the incidence of cancer in people living next to dump sites. However, cancer remained extremely under-researched in South Africa and further studies would have to be designed to examine potential pathways and the types of cancers that are most common in these areas.
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New waste sites are being established and their design and management should be informed by this study and others that reveal the negative impacts on residents exposed to poor waste management or regulation.
Slotow says that while South Africa needs to improve its ability to recycle and reuse “waste” material, he cautions against importing waste for treatment or disposal from richer nations. “There is a reason why countries export their waste … We need to look at the hidden costs, especially for the marginalised and socioeconomically vulnerable.
“Contrary to popular belief, environmental protection and economic growth are not mutually exclusive, as effectively functioning ecosystems are essential for economic development. Our study reaffirms the need for a sustainable development approach to address and reduce the enormous rise in the number of waste sites in South Africa, in order to effectively improve health and wellbeing.”
