Background. We examine the association between cancer mortality rates in three types of counties in central Appalachia: those with mountaintop coal mining (MTM), those with other surface or underground mining, or those with no coal mining. Mountaintop mining is associated with greater levels of water and air disturbance compared to other mining types. In addition, studies have found significant health disparities in coal mining counties in Appalachia. Methods. Linear regression analyses were used to conduct county-level analyses to determine the association between age-adjusted cancer mortality rates and MTM mining for two periods of time: 1999-2002 and 2003-2007. County-level covariates include smoking, health care access, adult obesity, poverty, and education.
Results. Mortality rates for lung, colon, and bladder cancer and leukemia in MTM counties were significantly greater than those in non-mining areas in 2003-2007 (lung cancer mortality rates were also significantly greater than non-mining areas in 1999-2002). Kidney cancer mortality rates in MTM areas were marginally significantly greater (p < .06) than those in non-mining counties in 2003-2007.
Conclusions. Mortality rates from lung, colon, bladder, and kidney cancer and leukemia are significantly associated with MTM mining areas (vs. non-mining counties) in 2003-2007. Results may indicate either that water and air exposures from MTM activity in earlier years have accumulated, or that contamination in MTM counties may have worsened in more recent years.
Keywords: mountaintop mining, water and air pollution, cancer mortality rates, Appalachian communities