Health impact assessment of mountaintop mining in Mingo County, West Virginia

Background: Mountaintop mining (MTM), a high profile environmental issue in the US, has human and ecological impacts that continue to be studied.  MTM also is an environmental justice (EJ) issue given high poverty rates in impacted areas. Health impacts of MTM are not well summarized, with reports being mostly descriptive.  Health Impact Assessment (HIA), an analysis of all available health data, can assist communities, health officials and policy makers to understand and mitigate health risks of MTM.

Methods: A literature review assessed current research regarding MTM impacts on human health, focusing on Mingo County, West Virginia (WV).  Related health information was obtained from Mingo County Health Department and WV Department of Health and Human Resources.  An HIA was performed according to WHO guidelines.  Using spatial epidemiological analysis, we mapped and correlated MTM sites with health risks.  

Results: Results of 21 epidemiological studies suggest increased rates of lung, kidney and cardiovascular diseases, birth defects, overall mortality, disability, cancer and poor quality of life in MTM areas.  Studies have not addressed individual-level exposure or specific health outcome data, and most disease data are self-reported.  Mapping analysis identified loss of land, impaired water quality and reported poor quality of life in MTM areas.  Higher poverty and mortality rates occur around MTM sites.

Conclusions:  Epidemiological and environmental studies and mapping analysis suggest health effects from MTM, and it is an EJ issue.  Specifying MTM’s health impacts requires studies that assess individual level exposure, such as retrospective cohort and case control designs using environmental monitoring data of air and drinking water. HIA is a valid approach with MTM.