The public health impacts of surface coal mining

Highlights

• Surface coal mining causes local air and water pollution.

• Epidemiological data demonstrate that populations in mining communities have poor health.

• Environmental and public health impacts are pronounced in mountaintop removal mining areas.

• Additional studies of exposure, dose, and biological impact are needed.

• The preponderance of evidence indicates that mountaintop removal mining should be discontinued.

Abstract

The current paper reviews published evidence on the public health impacts of surface coal mining. Particular attention is paid to recent evidence for a form of surface mining practiced in the United States, namely mountaintop removal mining. Studies from other parts of the world are also briefly described. Evidence is presented that documents epidemiological disease patterns for populations living in proximity to surface mining. Environmental evidence has shown that surface waters and biota are harmed by mountaintop removal, while other environmental studies have shown water and air pollution exist in residential areas close to mining. Studies that are able to directly link environmental exposure, dose, and biological impact are urgently needed. Although direct mechanistic links are not well understood, the weight of the evidence reinforces previous science-based calls to discontinue mountaintop removal mining due to its environmental and public health risks.

Introduction

“Dr. Diane Shafer, a busy orthopedic surgeon in Williamson, the Mingo County [WV] seat, noticed that a surprising number of her patients in their fifties were afflicted with early-onset dementia. In addition, she was hearing more and more complaints about kidney stones, thyroid problems, and gastrointestinal problems such as bellyaches and diarrhea. Incidents of cancer and birth defects seemed to be rising, too. She had no formal studies to back her up, but … she knew that many people who lived in the hills beyond the reach of the municipal water supply had problems with their water.” Jeff Goodell, Big Coal, pp. 40–41.

Jeff Goodell, a highly regarded journalist, published the book Big Coal in 2006 (Goodell, 2006). The book details the environmental and economic costs of America’s reliance on coal as an energy source. He also describes the public health harm caused by burning coal in power plants, for which there is considerable research evidence. Scattered here and there in the book’s pages are impressions of local mining community residents, such as Dr. Shafer, that the mining of coal, not just its burning, causes public health problems as well. But research evidence that could support or refute these impressions was lacking.

At that time the research evidence that was available on coal mining’s health impacts seemed to be limited to studies on occupational exposure, and to a few studies conducted in Great Britain on mining’s possible larger public health impacts. Regarding occupational exposures, underground coal mining is known to increase risk of pneumoconiosis, chronic obstructive pulmonary disease, lung cancer and perhaps other illnesses (Castranova and Vallyathan, 2000, Coggon and Taylor, 1998, Graber et al., 2014, Laney et al., 2012, Scott et al., 2004). These occupational diseases are related to inhalation of coal and rock dust and other mining related chemicals, that is, to air quality problems. The studies in Great Britain also focused on air quality, and examined possible respiratory problems for people, usually children, who lived near open-cast or surface coal mining sites (Brabin et al., 1994, Temple and Sykes, 1992). Yet, as suggested above by Dr. Shafer’s concern, the original focus in examining possible public health consequences of surface mining in the United States emphasized water quality issues.

The issue is complicated by the fact that mining populations, especially in Appalachia in the eastern United States, experience high levels of poverty, and often engage in poor health behavior reflected by high smoking and obesity rates. It is relatively easy to show that mining populations have poor public health outcomes, but more challenging to identify whether or not environmental conditions caused by mining contribute to those outcomes over and above socioeconomic and behavioral risks. The current paper reviews the literature on the public health consequences of coal mining, focusing especially but not exclusively on evidence since 2006 and evidence from mining in Appalachia. Appalachia is a focus because of the advent of mountaintop removal mining, a form of large scale surface coal mining that has major environmental impacts, occurs in close connection to human settlements and has been most clearly identified as a public health concern by local residents. The paper will review the evidence base and present questions that direct the next research and policy steps that should be undertaken to understand, and where indicated to reduce, the negative environmental impacts of coal mining on public health. Before beginning to review the health literature, the paper provides a brief description of mountaintop removal mining and its ecological impacts.