Incineration: health and environmental consequences. Gochfeld M UMDNJ-Robert Wood Johnson Medical School, Piscataway, USA. Incineration is considered one of the four primary ways to manage solid wastes, in conjunction with source reduction and reuse, recycling-composting, and landfilling. Incineration is currently used to destroy household and institutional solid waste, hazardous chemical waste, and medical and biological waste by reducing volume and destroying some harmful constituents. The process of incineration induces chemical changes that may produce harmful products that can escape through the stack, causing air pollution, or that can remain in the bottom ash, eventually finding a way into landfills. Although sound engineering design and operation can theoretically eliminate most harmful pollutants, strong institutional controls are required to assure that incinerators are maintained and operated according to specifications. Incineration is often viewed as a "cop-out," avoiding the socioeconomically complex changes required to reduce the generation of solid waste. Incineration should be incorporated on a limited basis into a context of comprehensive approaches to source reduction, recycling, and reuse