Health impacts of emissions from incinerators: UKHSA opinion of the evidence
Source: gov.uk (2025-06-09)

UKHSA reviewed recent evidence on the potential health effects from municipal waste incinerator emissions. This work builds on previously carried out evidence reviews.

UKHSA opinion

UKHSA’s opinion on incinerators is that modern, well run and regulated Municipal Waste Incinerators are not a significant risk to public health, as these incinerators only make a small contribution to local concentrations of air pollutants.

The role of UK Health Security Agency and Municipal Waste Incineration

UK Health Security Agency (UKHSA) is consulted by the Environment Agency (EA) on environmental permit applications to operate Municipal Waste Incinerators (MWI) in their role as regulator in England. To support our response to these consultations, UKHSA undertakes reviews of the available evidence on the health effects of MWI sites.

The following information relating to MWI provides background information and a description of the evidence review carried out by UKHSA. A link to the evidence review can be found below.

Municipal Waste Incineration and the Waste Hierarchy

Waste sent to MWIs in England is known as Residual Municipal Solid Waste. This material is waste that is household or household like, for example, non-recyclable household waste. It comprises household waste collected by local authorities, and some commercial and industrial wastes (Defra 2013): Incineration of Municipal Solid Waste (https://assets.publishing.service.gov.uk/media/5a7c909ced915d48c24109e5/pb13889-incineration-municipal-waste.pdf).

The UK uses a waste hierarchy as a guiding principle in the management of waste and one of the options available is to generate energy from waste, which includes Municipal Waste Incineration. The incineration process comprises the combustion of waste and the recovery of energy in electricity or heat.

Modern Municipal Waste Incinerators: Legislation

The implementation of the European Union (EU) Waste Incineration Directive (WID) (2000/76/EC) in the late 1990s, now currently under the Industrial Emissions Directive (2010/75/EU), came into operation in late 2003 for new build MWI and 2005 for existing MWI, with the objective to limit and minimise the release of pollutants from new and existing incineration of waste as far as practicable (European Union, 2000; Department for Environment Food & Rural Affairs, 2015). The legislative emission limit values set in the WID are to control the levels of harmful pollutants, including acidic gases, such as nitrogen oxides (NOx), ammonia (NH3); sulphur dioxide (SO2), chlorinated gases (HF, HCl, HBr); carbon monoxide (CO); particulate matter (PM2.5 and PM10); heavy metals, such as lead, zinc and chromium; hydrocarbons, including polycyclic aromatic compounds; and persistent organic pollutants, namely dioxins and furans (UK Legislation, 2010).

The Department for Environment, Food and Rural Affairs (Defra) lead on waste management policy and the legislation relating to MWI, and the EA regulate MWI under the Environmental Permitting Regulations:

The Environmental Permitting (England and Wales) Regulations 2016 (https://www.legislation.gov.uk/uksi/2016/1154/contents). UKHSA responds to consultations on Environmental Permits received from the EA.

Scope and content of the evidence review

To assess the available evidence, UKHSA carried out a review of academic peer-reviewed papers on the potential health impacts of emissions from modern MWI. The review looks at studies investigating populations exposed to incinerator emissions and health outcomes following implementation of the Waste Incineration Directive (WID) (2000/76/EC).

The purpose of this review (https://www.gov.uk/government/publications/municipal-waste-incinerators-emissions-impact-on-health/epidemiological-evidence-review-in-the-uk-and-eu-following-implementation-of-the-waste-incineration-directive) is to inform the UKHSA opinion. It also aims to increase awareness and provide scientific knowledge on the effects of emissions on health for populations that live near MWI, present in the UK and EU.

Adverse health impacts including cancers, and adverse birth outcomes have been evaluated for associations with exposures to emissions from MWI. The evidence review shows that currently there is no clear evidence of any associations.

Municipal Waste Incineration and exposure

A study by Douglas and others in 2017 on exposure to incinerator emissions in Great Britain, between 2002 and 2010, showed a very small contribution (1000 times lower) of particulate matter (PM10) from MWI to ambient background pollution levels.

The paper demonstrated that PM10 emissions from MWI correlate well with the levels of other pollutant emissions, therefore we consider PM10 to be a reasonable proxy for other pollutants. For example, emissions of heavy metals, polycyclic aromatic hydrocarbons, and dioxins.