Considering environmental factors in community health needs assessments

An examination of environmental factors as they relate to disease etiology, health status, and quality of life is an important component of any community health needs assessment. In many of the coalfield communities of Appalachia, the dust generated from strip and long-wall mining is pervasive, diminishing the quality of life there. In addition, the mountainous terrain constrains many residents to live immediately adjacent to unpaved public roads which are also used for hauling coal. This study was prompted by concern about potential public health threat to residents living along unpaved coal haul roads posed by sustained high levels of dust exposure. Respirable dust concentrations (PM-10) were measured periodically over nine months along both paved and unpaved segments of a public road used for hauling coal. On the paved road segment, dust levels remained within safe limits. On the unpaved road segment, dust levels often exceeded EPA standards, creating a public health risk. Recommendations for behavioral and non-behavioral strategies to reduce community health risk associated with environmental exposures are discussed.