Background Italy generates some 32.5 million tonnes/yr of municipal solid waste (MSW), of which 45% goes to landfill, whilst some 11% is incinerated. If the country’s landfill sites incorporated the best available technologies (BAT), it could not only minimise the impact on soil and groundwater, but landfill waste could represent a source of energy if combined with biogas production. A similar argument applies to incineration plants, where adopting BAT could reduce atmospheric emissions and improve the efficiency of energy production. Local community support for such processes helps to ensure their success and Local Agenda 21 (LA 21) approaches promote this type of citizen involvement in environmental management initiatives. Objectives The HIA21 LIFE project’s key objectives focus on applying Health Impact Assessment (HIA) procedures into waste cycle management systems. Integrating HIA with LA 21 will better enable citizens, particularly disadvantaged ones, to share in decision-making processes around the location, construction and operation of waste-handling plants, as well as waste reuse and recycling issues. The project will identify examples of existing waste treatment plants in Italy and apply a retrospective HIA – to be managed by LA 21 forums working in the area – at two different types of waste treatment plant. The HIA will be applied at the following facilities: An MSW landfill site in Lanciano – Chieti. Established in 1995, this is the main landfill site in Abruzzo, handling 54 000 m3/yr of waste, covering 13 ha and with a residual capacity for 2012 of 200 000-550 000 m3 of waste; and An MSW incinerator in Arezzo (Tuscany). Established in the late 1980s, this currently burns 40 000 tonnes/yr of waste, and is expected to double its capacity to 80 000 tonnes/yr in the near future. Expected results: To create and develop a new tool for the investigation and evaluation of health, environmental and socio-economic effects caused by incinerators and municipal solid waste landfills; To provide recommendations and, if possible, guidelines for the application of HIA and LA 21 to the waste cycle. This will allow a comparison between different waste treatment methods, assessing their advantages and disadvantages from technological, cost and management perspectives; To expand assessment methodologies at a local, national and community level, creating a strong territorial expertise and knowledge; To create a set of health, environmental, economic and social indicators for the study area, which is to be updated yearly throughout the project; To test the efficiency of the intervention in relation to citizen support and the subsequent involvement of citizen in decision-making processes; To draw up two reports for decision-makers, one for each kind of waste treatment plant, thereby helping local public administrations in defining future territorial planning policies; and To create an international network to share the results obtained by this and similar projects. It is hoped that this network can be extended after the LIFE project.