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N C Med J. 2011 Mar-Apr;72(2):98-104.

Suitability of public records for evaluating health effects of treated sewage sludge in North Carolina.

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Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599-7435, USA.



Exposure to potentially harmful agents because of waste disposal practices is receiving increased attention. Treated sewage sludge (TSS), or biosolid material, is the solid waste generated during domestic sewage treatment after it has undergone processes to reduce the number of pathogens and vector attractants. Application of TSS to land, which is the most common method for disposal, is promoted as a soil amendment and fertilizer. Few studies have examined the effects of land application on the health and quality of life of neighboring populations. We describe and summarize publicly available records that could be used to study the public health impact of practices associated with land application in North Carolina.


We abstracted public records from the North Carolina Department of Natural Resources Division of Water Quality, to determine the following activities associated with land application of TSS in 8 counties in central North Carolina: the process for obtaining permits, reported applications, violations, documented concerns of residents, and penalties assessed.


The Division of Water Quality routinely collects records of permits and approvals for land application of TSS, amounts applied, and reported pollutant levels. Documentation was useful in summarizing land application practices, but lack of standardization in reporting was a concern. Research into the public health impacts of the land application program is hindered by inconsistency in documenting inspections and resident concerns.


We were not able to validate state records with direct observation of land application of TSS.


Records from the Division of Water Quality would be of limited use in epidemiologic studies of the health effects of land application of biosolids. Information about locations, amounts, and dates of application are relevant to exposure potential, but additional information is needed for health investigations.

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