Potential public health impacts of air pollution from municipal solid waste management in Addis Ababa, Ethiopia

Urban cities in developing countries face significant air pollution problems due to poor waste management practices, yet the associated health impacts are rarely quantified to inform proactive policies. This study assesses the potential public health impacts of air pollution arising from municipal solid waste management practices in Addis Ababa, Ethiopia. It evaluates the impacts of open burning, open dumping, and waste combustion under a hypothetical scenario of ‘no emission control’ measures. Four alternative scenarios—ceasing open burning, ceasing open dumping, increasing combustion, and increasing composting and recycling—were developed and compared with a business-as-usual (BAU) for the period 2024–2030. Emissions were quantified using the Solid Waste Emissions Estimation Tool developed by the US Environmental Protection Agency. Health impacts were evaluated with the World Health Organization’s AirQ+ model. The results indicate that 201 (95% CI: 163–218) premature deaths may have been attributable to air pollution from the waste sector in 2024. This number would increase to 305 (95% CI: 247–331) by 2030 under BAU. By 2030, ending open burning would reduce deaths to 136 (95% CI: 109–146), representing a 55% reduction compared with BAU. Ceasing open dumping would reduce deaths to 285 (95% CI: 230–308), a 7% reduction, while increased composting and recycling would result in 297 (95% CI: 240–322) deaths, a 3% reduction. In contrast, increasing combustion without emission controls would raise the burden to 713 (95% CI: 574–775) deaths—an increase of 134% relative to BAU. The ‘no emission control’ combustion represents a hypothetical worst-case scenario intended to highlight regulatory importance; it is not a realistic projection from the available waste incineration facility. The findings underscore the critical importance of ending open burning and enforcing strict emission controls on waste incineration to protect air quality and public health.