Health impact assessment of mountaintop mining

Background: Mountaintop mining (MTM) is one of the most high profile environmental issues in the United States. The adverse environmental impacts of MTM have been determined after extensive litigation between citizen groups, government agencies, and industry as well as heavy opposition from environmental activists. However, there is little evidence on the human health effects caused by MTM. Environmental Justice (EJ) is also a pertinent issue when evaluating the impact of MTM on public health. A Health Impact Assessment was created to provide a tool for public health officials, policy makers, industries and community members to better understand the health impacts of MTM and aid in the development of policies that mitigate the health risks of this practice. Methods: An extensive literature review was conducted to establish the current status of MTM studies regarding impacts on human health. Inquiries were made to several academic institutions with known interest in studying the human health impacts of MTM including Duke University and West Virginia University. The specific EJ components of MTM were determined through meetings with EPA and CDC stakeholders, a literary analysis, as well as with a personal visit to West Virginia mining communities. Future study designs and interventions were based on an evaluation and critique of current literature by CDC officials and through the examination of current and prospective EPA Cumulative Impact Assessment projects. Results: Compiled literature shows weak evidence for various human health impacts of coal mining exposure including heart and kidney disease and certain cancers. However, there are no completed or active human health studies of MTM impacts available. EJ component of MTM has been confirmed based on Census data showing high poverty rates throughout most of Appalachia. There are several federal and academic efforts underway to evaluate the human health and EJ impacts of MTM. Conclusions: Based on scientific evidence regarding coal mining and human health impacts, an extensive EJ evaluation, and a thorough environmental impact assessment, epidemiologic studies are necessary to mitigate the human health risks of MTM. Collaborative efforts by the CDC, ATSDR, EPA, and academic institutions are necessary to connect environmental impacts with the health risks posed by MTM.