Self-Reported Cardiovascular and Respiratory Illness in Counties with and without Coal Mining

Background: Mining industry activities contribute to local air and water quality problems and raise the possibility of related illnesses affecting cardiovascular and respiratory health among exposed populations. This study tests whether cardiovascular disease and asthma risk are higher in coal mining versus non-mining counties using the 2006 national BRFSS (N=236,890).

Methods: Dependent variables were self-reported dichotomous measures of ever 1) being diagnosed with a stroke, 2) diagnosed with a heart attack, 3) having angina or coronary heart disease (CHD), or 4) having asthma. Independent variables included the presence of coal mining, Appalachian residence, metropolitan status, primary care physician supply, behaviors (i.e., smoking, BMI, drinking) and demographics (i.e., age, sex, race/ethnicity, education, marital status, income.) SUDAAN multilog models were estimated to account for the complex sampling design, with odds ratios to test for Appalachian coal mining effects before and after adjusting for covariates.

Results: People in Appalachian coal mining areas reported significantly higher risk of angina or CHD (odds ratio=1.26, 95% CI=1.17-1.37) and heart attack (odds ratio=1.17, 95% CI=1.08-1.28) after control for covariates. The odds of reporting asthma or stroke were not higher in coal mining areas after adjusting for covariates.

Discussion: Cardiovascular diseases have been linked by prior research to both air and water contamination in ways consistent with toxicants found in coal and coal processing. Additional conditions (e.g., COPD) should be investigated. Air and water quality in coal mining communities in Appalachia should be monitored, and corresponding environmental standards established as indicated.