Landfills and preterm birth in the Guadeloupe archipelago (French West Indies): a spatial cluster analysis

BACKGROUND: A high rate of preterm birth is observed in the Guadeloupe archipelago (French West Indies), raising the hypothesis of harmful environmental exposures, including landfilling. Our aim was to evaluate whether preterm births cluster around the three main open landfills located in this area. METHODS: The study population consisted of 911 women enrolled in the Timoun mother-child cohort (2004–2007). Home addresses during pregnancy and locations of landfills were geocoded. To test for the presence of preterm birth clusters around each dumpsite, we used a focused cluster test specifically designed to detect spatial clustering around point sources. RESULTS: A total of 144 (15.8%) preterm births were observed among 911 births. Using the term births (n = 767) as controls, a significant cluster was identified within 2 km around the Saint-François landfill with a relative risk (RR) of 4.82 (p = 0.04). No clusters were found around the other two landfills (RR = 2.01, p = 0.26 and RR = 1.06, p = 0.64, for La Gabarre and Baillif, respectively). CONCLUSION: The paucity of data available on open landfill sites regarding waste quantities, composition, and changes over time precludes any site-specific interpretation because of the variable degree of possible emissions. This result has to be confirmed in other tropical island environments where waste management has become a major concern with the potential to negatively impact the environment and public health.