General mortality patterns in appalachian coal-mining and non-coal-mining counties

Area of Science:

• Environmental epidemiology
• Public health
• Occupational health

Background:

• Appalachia faces significant mortality disparities.
• The role of coal mining in these disparities requires investigation.

Purpose of the Study:

• To assess the association between coal mining and mortality rates in Appalachia.
• To differentiate the impact of coal mining from other contributing factors.

Main Methods:

• Utilized rate ratio models (unadjusted and covariate-adjusted) from 1960-2009.
• Compared mortality rates (total, external, cancer) in coal-mining vs. non-coal-mining counties.
• Analyzed data based on cumulative total, surface, and underground coal production.

Main Results:

• No statistically significant elevations in total or all external mortality linked to coal mining.
• Covariate adjustments reduced rate ratios across all coal mining levels.
• Significant associations found between all forms of coal production and increased all cancer mortality (4-6% excess in highest quartiles).

Conclusions:

• Coal production does not appear to be a significant factor for total or external mortality in Appalachia.
• Cancer mortality warrants further investigation concerning coal production.
• Other potential causes of death should be considered in mortality disparities.