There is much debate around promoting waste to energy incineration facilities in many communities globally, mainly because of social opposition against potential negative health effects of the operation of these installations close to urban areas. In this paper, a novel decision support approach is developed and its applicability is demonstrated for the greater Thessaloniki area, Greece. In this area, the incineration facilities are hotly debated, mainly due to the "Not In My Back Yard" syndrome related with health considerations. The exclusive method of treatment is landfilling. Health impacts and corresponding externalities attributed to the operation of an incineration facility are reliably estimated. Three potential alternative sites and three scenarios of emission rates are considered, depending on the abatement technology used. The estimated externalities are compared to the corresponding ones attributed to other pressures in the area. The "Years of Life Lost (YOLL)" indicator attributed to the operation of the facility is 2.8 YOLL in the worst-case scenario. This corresponds to a minimal added implication in comparison with the 11,044 YOLL estimated for the area due to the other environmental pressures (road traffic, space heating, industrial activity). The externalities ratio (externalities due to incineration facility/total externalities) for the region is approximately 0.03%. Thus, the impact of this operation on human health is negligible -and preferable to landfilling- even in the case that maximum emission rates are considered. Efforts should be targeted towards enhancing public awareness and militating the widely acknowledged "Not In My Back Yard" syndrome by local communities.

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http://dx.doi.org/10.1016/j.wasman.2020.06.015DOI Listing

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