title: The association between mountaintop mining and birth defects among live births in central Appalachia, 1996-2003.
abstract: Birth defects are examined in mountaintop coal mining areas compared to other coal mining areas and non-mining areas of central Appalachia. The study hypothesis is that higher birth-defect rates are present in mountaintop mining areas. National Center for Health Statistics natality files were used to analyze 1996-2003 live births in four Central Appalachian states (N=1,889,071). Poisson regression models that control for covariates compare birth defect prevalence rates associated with maternal residence in county mining type: mountaintop mining areas, other mining areas, or non-mining areas. The prevalence rate ratio (PRR) for any birth defect was significantly higher in mountaintop mining areas compared to non-mining areas (PRR=1.26, 95% CI=1.21, 1.32), after controlling for covariates. Rates were significantly higher in mountaintop mining areas for six of seven types of defects: circulatory/respiratory, central nervous system, musculoskeletal, gastrointestinal, urogenital, and 'other'. There was evidence that mountaintop mining effects became more pronounced in the latter years (2000-2003) versus earlier years (1996-1999.) Spatial correlation between mountaintop mining and birth defects was also present, suggesting effects of mountaintop mining in a focal county on birth defects in neighboring counties. Elevated birth defect rates are partly a function of socioeconomic disadvantage, but remain elevated after controlling for those risks. Both socioeconomic and environmental influences in mountaintop mining areas may be contributing factors.
authors.affiliation: Department of Pharmacotherapy, College of Pharmacy, Washington State University, P.O. Box 1495, Spokane, WA 99210, USA. ahernm@wsu.edu
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Ahern
authors.forename: Michael
authors.initials: M
authors.lastname: Hendryx
authors.forename: Jamison
authors.initials: J
authors.lastname: Conley
authors.forename: Evan
authors.initials: E
authors.lastname: Fedorko
authors.forename: Alan
authors.initials: A
authors.lastname: Ducatman
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Zullig
mesh_terms: D001061:Appalachian Region / Q000453:epidemiology; D003032:Coal Mining / Q000706:statistics & numerical data*; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth / Q000453:epidemiology*; D008297:Male; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D011295:Prenatal Care / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D012306:Risk; D012923:Social Class