risk assessment, both of which have been the subject of National Research Council reports (e.g., NRC 1991a, 1994, respectively). In addition, environmental monitoring studies provide immediately useful estimates of ambient concentrations, while biomarker studies hold some promise for future application. The first section of the chapter discusses these tools, and their strengths and limitations relative to one another.

There have been few epidemiologic studies in populations characterized as exposed to contaminants emitted by incineration facilities. Thus, there is a lack of evidence of any obvious health effects related specifically to incinerator exposure. That is, there have been few anecdotal reports that indicated any particular concern for incinerators (as opposed to air pollution in general, for example) or that generated testable hypotheses. Moreover, as discussed later in this chapter, it would be difficult to establish causality given the small populations available for study, the possible influence of factors such as variations in the susceptibility of individuals and emissions from other pollution sources, and the fact that effects might occur only infrequently or take many years to appear. The second section of the chapter summarizes what data are available, and discusses what conclusions can be drawn from those data.

The main information on potential health effects that might arise in populations potentially exposed to substances emitted by incineration facilities comes from risk assessments of individual chemicals emitted by incinerators, combined with monitoring of emissions from incinerators. Such assessments typically indicate that, of the many agents present in incinerator emissions and known to be toxic at high exposures, only a few are likely to contribute the majority of any health risks and such health risks are typically estimated to be very small. This chapter examines the toxic effects of such agents. It also illustrates ways to compare the expected ranges of environmental concentrations attributable to incineration with concentrations known to be toxic, and in the context of total exposures.

The toxic agents were selected for discussion on the basis of the current state of knowledge of the nature of emissions from incinerators and the results of various risk assessments. They are particulate matter (PM), carbon monoxide (CO), acidic gases (i.e., NOx, SO2, HCl) and acidic particles, certain metals (cadmium, lead, mercury, chromium, arsenic, and beryllium), dioxins and furans, polychlorinated biphenyls (PCBs), and polyaromatic hydrocarbons (PAHs). The emissions of most of those substances were considered in Chapter 3 and Chapter 4.

Particulate matter, CO, lead, and acidic gases and acidic particles have been under regulatory scrutiny for the longest period. Typically, there are well-defined statutory limits on their emission rates or allowable ambient concentrations or increments in ambient concentrations under federal or state statutes. In many risk assessments, such materials have been evaluated solely by comparisons with such statutorily defined limits, limits that have been designed to reduce certain risks from these pollutants below acceptable values. Although there are occupa-



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