1

Slurry pond

Edge of mine

Elementary School

Coal processingplant

Mountaintop Removal Mining• Removes the entire tops of

mountains and ridges• Explosives and draglines

reach coal seams hundreds of feet deep

• Spoil is deposited into adjacent valleys

• Has permanently buried over 1,200 miles of streams

• Occurs in Central Appalachia, USA, over an area about 50,000 square km

2

Explosion over the town of Dorothy

3

4

Well water in the town of Rawl, West Virginia

5Photo: Antrim Casky, 2008 Photo: Nat Geographic, 2006

Figure 1. Total Age-Adjusted Mortality per 100,000 for the Years 1979-2005, by County Group

700

800

900

1000

1100

1200

Coal mining counties Other Appalachian counties Rest of Nation

6

Age-adjusted total mortality rates per 100,000 by MTR status

2000 2001 2002 2003 2004 2005 2006700

800

900

1000

1100

MTMOther Ap-palachianNon-Ap-palachain

Year

Rate

7Hendryx, JHDRP 2011

8

0

10

20

30

40

50

60

70

80

Coal-Mining Other Appalachia Nation

Age-Adjusted Lung Cancer Mortality per 100,000, years 2000-2004

Hendryx, O’Donnell, Horn, Lung Cancer, 2008

2000-2004 Age-Adjusted Heart Disease Mortality per 100,000

Mining > 4 million Mining up to 4 million Non-mining 0

50

100

150

200

250

300

350

MaleFemale

9Hendryx, IAOEH 2009

Disease Symptoms in MTR Areas

5+ symptoms Respiratory CardiovascularGastrointestinal Neurological Skin Musculoskeletal EENT Other0

0.5

1

1.5

2

2.5

3

MTMSmokingObesity

10

Prevalence ratios controlling for age, sex, education, marital status, current and former smoking, overweight and obesity, occupational exposure. Hendryx, J Rural Health 2013

Family Illness in MTR Areas

Serious household illness Household cancer death0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

MTMSmokingObesity

11

Prevalence ratios controlling for age, sex, education, marital status, current and former smoking, overweight and obesity, occupational exposure. (JRH 2013)

Adjusted Prevalence Ratios (PR) of Birth Defects are High in MTR Areas

0

0.5

1

1.5

2

2.5

3

Circulatory CNS Gastroin. Urogen. Musculo. Chrom. Other Any defect

PR

Environmental Samples

• These findings prompted environmental sampling studies

14

Mountaintop Mining (MTM) Dust in People’s Yards

• MTM dust is primarily silicon, sulfur, other elements (e.g., Al, Fe, Ti) and organics

MTM

No MTM

Blank

Ultrafines

Total Count /cm3 Deposited count/cm3

MTR 6830 3082

Control in WV 4770 2315

15

• Particulate matter <o.1µ• High surface to volume toxicity, high deposition rate

Kurth, et al. J Exposure Science & Environmental Epidemiology 2014

MTR dust accelerates cancer development in human lung cells

Day 0 Day 2 Day 50

5

10

15

20

25

PM CON

PM MTR

Coun

ts (x

10 4

Cel

ls)

Luanpitpong et al., Environmental Science and Technology, 2014

Public Water Uncertainties• From 2001 through

2009, there were 17,362 water quality violations reported to the EPA from West Virginia:– 86 per facility in

MTR areas– 15 per facility in rest

of the stateHendryx, Fulk and McGinley, Water Quality, Exposure & Health, 2012

17

18

Conductivity in Water

• The EPA established that water from MTR sites should have maximum conductivity of 500 microsiemens/cm. (A healthy mountain stream will average about 100.)

• We found ….• Drinking water samples NOT MTR = 267• Drinking water samples MTR = 552• Former MTR ground water drinking samples = 1,614• MTR stream samples (non-drinking) = 1,234 • Non-MTR streams (non-drinking) = 95

Summary: MTR and Public Health

• Poor health concentrated in MTR areas• Impacts stronger as mining levels increase• Present for women, men, and children• Present across multiple data sources and health

outcomes– Cancer, cardiovascular disease, respiratory disease, birth

defects, others• Become stronger in closer proximity to MTR• Air and water pollution exists in mining communities• Strong environmental and public health evidence

that MTR should be halted– Political resistance!

19