American Univesity of Beirut

The Effect of Open-Air Waste Burning on Infant Health Evidence of serious health consequences in Lebanon

​In a paper published recently by the National Bureau of Economic Research (NBER), entitled “The Effect of Open-Air Waste Burning on Infant Health: Evidence from Government Failure in Lebanon”, researchers at the American University of Beirut (AUB) and Texas A&M University reveal new evidence and figures on the damaging effect of waste burning in Lebanon.

The 2015 Lebanese garbage crisis provided an ideal testing ground for the impact of this method of waste disposal on human health. In particular, years of mismanagement in dealing with waste disposal in Lebanon resulted in the abrupt and unanticipated accumulation of uncollected waste in the streets of Beirut and Mount Lebanon. This was quickly followed by the burning of hazardous organic and inorganic waste throughout various neighborhoods in attempts to clear the garbage from the streets.

Researchers looked at how waste burning affected newborns in Lebanon, using anonymized administrative data on every birth at the American University of Beirut Medical Center (AUBMC) from 2010 to early 2017.
Due to the sporadic nature of waste burning across neighborhoods, they were able to get at causal effects by comparing the birth outcomes of individuals living in neighborhoods exposed to waste burning to those living in neighborhoods that were never exposed.

Dr. Mark Hoekstra, Professor of Economics at the Texas A&M University said: “Pregnant women exposed to waste burning were 50% more likely to give birth prematurely, and twice as likely to have a low birthweight baby. These effects are similar to what we would expect to see if these women smoked heavily during pregnancy.”

“It’s hard to overstate just how large these effects are. This may well be the worst form of ambient air pollution in terms of its impact on human health.” Dr. Hoekstra added.

The data showed that trends in the likelihood of women having a low-birthweight delivery, defined as a newborn weighing less than 2.5kg, are similar across neighborhoods before the crisis began.

This is highlighted by the flat trend line in the six years preceding the garbage crisis as shown in Figure 1. However, after the July 2015 garbage crisis—highlighted by the blue vertical dotted line—babies born to mothers living in neighborhoods exposed to burning were significantly more likely to be low birthweight compared to those born in neighborhoods never exposed.


Figure 1: Effect of Garbage Burning on Low Birthweight Likelihood


Note: Blue vertical dotted line represents the beginning of garbage burning. The estimates represent differences in average low birthweight for newborns whose mothers were born in neighborhoods exposed to garbage burning to those whose mothers resided in neighborhoods that were never exposed.


In particular, researchers estimate that exposure to at least one incident of waste burning increased the likelihood of low birth-weight by roughly 5 to 8 percentage points, an 80 to 120 percent increase over pre-crisis levels.

According to Dr. Hoekstra, “The reason this matters is because the prenatal period is critical for development.  What happens in utero has been shown to impact health and cognitive ability years later.  Infant health also serves as a canary in the coal mine.  When we see effects on infant health, it’s almost certain adult health is also being impacted, just in ways that are more difficult to measure.”

Additionally, the studies revealed large negative effects on the likelihood of premature births as shown in Figure 2. Garbage burning led to a 4 percentage point increase in the likelihood of women giving birth prematurely, a 50 percent increase over pre-crisis levels. Combined, the findings indicate that in-utero exposure to waste burning imposed huge costs on those affected.

Given previous research documenting the negative economic and biological long-run effects of exposure to air pollutants, the study suggests that previous waste burning in Lebanon likely had large, irreversible, negative effects on infants born during this period.


Figure 2: Effect of Garbage Burning on Premature Birth Likelihood


Note: Blue vertical dotted line represents the beginning of garbage burning. The estimates represent differences in average premature births for newborns whose mothers were born in neighborhoods exposed to garbage burning to those whose mothers resided in neighborhoods that were never exposed.


Dr. Pierre Mouganie , Assistant Professor of  Economics at AUB,  said “ultimately, our biggest worry is not if, but when the garbage crisis returns. The Lebanese government, as a whole, needs to take the issue of garbage disposal more seriously and act now to resolve this issue once and for all”

“Knowing what we know about the implications of garbage burning on infants’ health outcomes, a repeat of this disaster may prove too costly, especially for a nation trying to rebuild.” He added.

Researchers believe that garbage problem ought to be doable however another failure in this regard will have serious health consequences for years to come.

Full paper on: https://www.nber.org/papers/w26835


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