A case study of long-term disease burden in a rural community near an open burn facility.

Open burning and open detonation (OB/OD) of explosive and hazardous wastes creates various toxic waste products, including particulate matter, that is released into the atmosphere and capable of generating significant health impacts upon exposure. The last commercially run OB/OD thermal treatment facility in operation in the United States is located near the rural community of Colfax in central Louisiana. To evaluate the community's concerns about the potential health impacts from air pollution due to the facility's regular open burning of explosive and hazardous wastes, we examined the disease burden in Colfax compared to the surrounding parish and state. In a cross-sectional study, we analyzed hospitalizations and mortality (2000-2018) where a primary or secondary disease code was associated with cardiovascular, respiratory, thyroid and skin disease. After adjusting for age, sex and race, morbidity and mortality due to cardiovascular and respiratory diseases were significantly higher in Colfax compared to the surrounding areas. In addition, comparing age-adjusted rates across geographies, stratified by race and sex, revealed place-based differences within sub-populations. The higher estimated prevalence of disease conditions is consistent with long-term particulate matter exposure and suggests a need for comprehensive exposure studies within the community. Our data further stress the need for enhanced epidemiological studies and tailored statistical methods to address exposures and environmental health impacts in rural populations, with fewer than 2,500 individuals, like Colfax.