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Previous research on public health consequences of mountaintop removal (MTR) coal mining has been limited by the observational nature of the data. The current study used propensity scores, a method designed to overcome this limitation, to draw more confident causal inferences about mining effects on respiratory health using non-experimental data. These data come from a health survey of 682 adults residing in two rural areas of Virginia, USA characterized by the presence or absence of MTR mining. Persons with a history of occupational exposure as coal miners were excluded. Nine covariates including age, sex, current and former smoking, overweight, obesity, high school education, college education, and exposure to coal as a home-heating source were selected to estimate propensity scores. Propensity scores were tested for balance and then used as weights to create quasi-experimental exposed and unexposed groups. Results indicated that persons in the mountaintop mining group had significantly (p < 0.0001) elevated prevalence of respiratory symptoms and chronic obstructive pulmonary disease. The results suggest that impaired respiratory health results from exposure to MTR environments and not from other risks. [ABSTRACT FROM AUTHOR]

Background: Mountaintop removal mining has been associated with multiple types of disease outcomes for populations living nearby. The current study tested whether latent classes identifying people with symptoms from multiple organ systems were associated with residence in mountaintop mining communities., Methods: We used data from three cross-sectional household community surveys conducted in three Appalachian states (N = 2756). The surveys contained information on 29 recent illness symptoms grouped into eight organ systems (respiratory, cardiovascular, gastrointestinal, musculoskeletal, skin, eye-ear-nose-throat, neurological, and other.) We identified latent classes, and then tested whether classes with higher probabilities of multiple symptoms would be associated with residence in mountaintop removal areas after control for covariates., Results: Three latent classes were identified, including a low-symptom referent class, an intermediate class, and a class with high symptom probability across organ systems. Controlling for covariates, latent classes characterized by intermediate and high multi-symptom probabilities were significantly associated with residence near mountaintop removal mining, with the highest odds ratio for the MTR versus control condition for the high multi-symptom group (OR = 2.17, 95% CI = 1.80-2.61)., Conclusions: Symptoms across multiple organ systems were related to residential proximity to mountaintop removal mining. Prior research has established multiple environmental contaminants related to mining that may contribute to poor population health through more than one exposure route or chemical of concern., (Copyright © 2018. Published by Elsevier B.V.)