Study suggesting that coal is a cause of health problems in E. Ky. is disputed by industry and politicians, defended by researcher

By Molly Burchett
Kentucky Health News

A heated debate centers on new research showing that residents in Floyd County, where coal is stripped from the tops of mountains and ridges, report more health problems than those in two nearby communities without such mines, Elliott and Rowan.

The study, published in the online Journal of Rural Health, is the latest by Dr. Michael Hendryx of West Virginia University to suggest that residents of mining areas have poorer health conditions and experience more serious illness. It is available to readers of Kentucky Health News by clicking here.

Unlike some of his West Virginia research, Hendryx does not say there is a correlation between mining and poorer health outcomes in Eastern Kentucky. He does suggest the possibility of a connection by showing residents' self-reported health problems like asthma, chronic obstructive pulmonary disorder and hypertension are more common in mining areas. And in an interview, he said he believes there is a connection.

Stonecrest Golf Course at Prestonsburg in Floyd County,
built on a reclaimed mountaintop-removal coal mine.

The study and its critics highlight the challenges and pitfalls of discussing and reporting such research. The study's underlying motives and methodology are contested. The president of the Kentucky Coal Association, Bill Bissett, said Hendryx has reached a conclusion and is seeking evidence to support it.

"Bissett's accusation is completely false," Hendryx replied. "On the contrary, he is obviously the one with the biased perspective and has a strong financial motivation to try to discredit this work."

Bissett questions the study's use of self-reported health measures that did not consider medical history. Self-reporting is susceptible to bias, which can be reduced by using other sources of data/. This study only included data collected from interviews conducted by volunteers, which may have introduced more bias, Bissett said.

Hendryx replied, "We used undergraduate students from Christian colleges who were trained to be fair and objective in the survey procedures, and to use the same procedures in both the mining and non-mining communities." He said Peter Illyn, who runs the Christian organization Restoring Eden, approached him to do the survey because Illyn "wanted to give the students this experience, and he wanted to replicate the survey that we had done the previous year in West Virginia, this time in Kentucky."

The volunteers interviewed 544 participants lived in Floyd County and 351 in Rowan and Elliot counties, where coal is not mined. It used standard statistical devices to control for factors that might influence health status: age, sex, education, marital status, work as a coal miner, weight and tobacco habits. However, there was no consideration of health behaviors such as drug and alcohol use, wellness measures, exercise or other healthy lifestyle habits that could have positive influences.

"The survey had to be brief with the time and resources we had," said Hendryx. "We did measure overweight and obesity, which is a reflection of diet and exercise. We measured tobacco use. We did not measure alcohol use in this survey but in other studies we have found that heavy alcohol use is not common and is not an explanation for the findings."

Kentucky House Speaker Greg Stumbo, who is from Floyd County, said he disagreed with the use of Rowan County, home of Morehead State University, as a control group due to the higher rates of education attainment and per capita income, reported Ronnie Ellis of Community Newspaper Holdings Inc.

Stumbo told Ellis, “Everybody in the world knows that you can take a population that is less well educated and that has a lower per capita income and you’ll see their health habits are (worse) and hence their rates of diseases are attributable to those two things.” Rowan has a much better health status than surrounding counties, according to the latest national County Health Rankings.

Hendryx defended his research controls and the process of relying on self-reported medical histories. He said the health problems may be caused by tiny particles of dust from coal mining, which have been linked to health problems, can penetrate the lungs to cause health impacts, reported James Bruggers of The Courier-Journal. Hendryx said there are also concerns about polluted water and soil.

The study's data only hint at a connection between surface coal mining and poor health. Hendryx said he can’t prove that mountaintop removal is causing people to get sick, but he believes it is. What is needed, he told Bruggers, is a more thorough and expensive “gold standard” study of air and water quality near residences, and samples of blood, hair and toenails that can reveal exposure to pollutants.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Health agencies in Rockcastle, Jackson, Clay, Harlan to lose 14 employees, some environmental and food-safety inspections

In the latest example of Medicaid changes' impact on local health departments, environmental and food-safety inspections will be reduced by layoffs in four counties served by the Cumberland Valley District Health Department, Nola Sizemore of the Harlan Daily Enterprise reports. Health departments in Harlan, Rockcastle, Clay and Jackson counties will lose a total of 14 employees later this month. (Enterprise photo: Harlan County Health Department)

Health Department Interim Director Lynett Renner told Sizemore said the layoffs, along with furlough days, are a result of decreased funding and the "advent of managed care organizations" in November 2011. The agency has almost $1 million in outstanding accounts because payments from those organizations have been slow to come in. "Also, one of the things that affected the health departments tremendously is we’re the only provider in the state required to pay a Medicaid match, which means for every service we provide for a client who has Medicaid, we have to pay the state back 20 percent and that recently increased to 28 percent," Renner said.

Renner told Sizemore that environmental services and restaurant health inspections would be most affected, adding that public health is often taken for granted by the local community. "So much is done behind the scenes to ensure the health and safety of every citizens," she told Sizemore. "My fear is they're reducing the ability of the public health infrastructure to be able to maintain that level of service that provides protection." (Read more)

Two Kentucky moms participate in Duke study that found potentially toxic and unnecessary chemicals in most couches

Two Central Kentucky mothers participated in a Duke University-led study published today that shows that a vast majority of U.S. couches contain potentially toxic flame retardants that pose risks to humans. Wendy Koch of USA Today reports that the risks occur when the chemicals migrate from furniture foam into house dust.

The closely watched study revealed that more than 40 percent of the foam in the 102 couches tested contained the carcinogen chlorinated Tris, a substance that was ordered removed from children's pajamas 35 years ago. Another 17 percent of the couches contained pentaBDE, a globally banned substance. More than 85 percent were treated with a potentially toxic flame retardant, which researchers and experts say amounted to more than a pound of chemicals per couch. Flame retardants have been linked to hormone disruption, cancer and neurological toxicity in hundreds of animal and human studies. A fire specialist told Koch that the chemicals are not effective in suppressing fires.

The two Kentuckians, both women concerned about their family's health, sent samples from their couches to be analyzed and both expressed horror at the findings. Dr. David A. Atwood, a chemist at the University of Kentucky, said a systematic shift in chemical regulation is necessary to protect public health. “We have made an enormous mistake assuming that a chemical should be used freely until it is determined to have adverse health effects, rather than taking the position that all chemicals should be avoided unless it is absolutely certain that the chemical is safe." In New York, legislation is already in motion that would ban chlorinated Tris. According to the Kentucky Environmental Foundation, efforts will begin next year to restrict the toxic chemical. (Read more)

White children exposed to high levels of chemical BPA are five times more likely to be obese, study concludes

White children exposed to high levels of bisphenol A, better known as BPA, are five times more likely to be obese than children with low levels, according to a study published last week in the Journal of the American Medical Association. The study by the New York University School of Medicine is the first to link the chemical to obesity in children, which is especially prevalent in Kentucky.

Environment Health News reporter Brien Bienkowski reports that scientists found traces of BPA, which are used in some canned food and beverages, paper receipts and dental sealants, "are found in virtually every U.S. adult and child. In the study of body mass and BPA data from 2,838 youths aged 6 to 19, only white children were found to have significant increases in obesity prevalence as their BPA levels increased. Those with the highest concentrations in their urine were five times more likely to be obese than children with the lowest levels. Black children with higher BPA levels were 1.25 times more likely to be obese than those with lower levels, which the scientists said is not statistically significant. Hispanic children had the same rates of obesity at the highest and lowest levels."

Bienkowski reports that "representatives from the chemical industry said the study had too many weaknesses to prove any connection. Steven Hentges, from the American Chemistry Council's Polycarbonate/BPA Global Group, said that attempts 'to link our national obesity problem to minute exposures to chemicals found in common, everyday products are a distraction from the real efforts underway to address this important national health issue.' "

One study of preschoolers in North Carolina and Ohio found that 99 percent of BPA exposure was through food. But since the chemical is in many plastics and other products, this is difficult for scientists to pin down. “People are always told if you just stop eating or exercise more, you will lose weight. But there may be more to it … and I think there is,” said Retha Newbold, a visiting scientist at the National Institute of Environmental Health Sciences, who specializes in BPA and other endocrine-disrupting chemicals.  (Read more)

James Bruggers, environmental writer for The Courier-Journal, noted the report here.

Kentucky rated worst in country for power-plant pollution

Kentucky was ranked first in the country for the amount of pollution from power plants in 2009 and 2010, a study by the Natural Resources Defense Council found.

The Paradise Fossil Plant in Muhlenberg County, left, run by the Tennessee Valley Authority, was ranked the nation's top power-plant polluter in 2010. American Electric Power's Big Sandy plant in Lawrence County was ranked fifth, and the Mill Creek station of Louisville Gas & Electric was seventh.

The NRDC's initial report showed a huge increase in Kentucky power-plant emissions from 2009 to 2010, but after The Courier-Journal raised questions about it, the report was corrected. The corrected figures showed that the state remained No. 1 in power-plant pollution. (Read more)

Study indicates risk of fatal birth defects is higher in counties with mountaintop-removal coal mining

"Children born in counties home to mountaintop coal mines had a 26 percent higher risk of suffering" a fatal birth defect "compared to ones born in non-mining regions," according to a new study, Dan Vergano of USA Today reports. The study, led by health economist Melissa Ahern of Washington State University in Spokane, will appear in the upcoming Environmental Research Journal. (Map shows counties with coal mines in 1996-2003, with "mountaintop" mining counties in darker gray)
Air and water pollution from mountaintop mining led Ahern and her colleagues "to look for health effects on infants" in West Virginia, Kentucky, Tennessee, and Virginia, Vergano writes. The researchers found birth defects in mountaintop mining areas were elevated above non-mining areas in six of seven categories, including heart, lung and gastrointestinal. Because of an already established connection between poverty and birth defects, the researchers then "controlled for social factors such as smoking, drinking, mother's education, race and other poverty-related factors" and found a 26 percent increased risk of fatal birth defects in mountaintop-mining counties, Vergano reports.

A spokesman for the National Mining Association "suggested adding more demographic factors to the study might remove the elevated birth defects," Vergano writes, then quotes environmental and pediatric-health expert Lynn Goldman of George Washington University as saying "It isn't proof of cause and effect" and paraphrases her: "Because the study is the first of its kind, public health researchers will need to reproduce the study results to feel confident it has uncovered a real link, she cautions. Further studies will be needed to show how exposures in mountaintop mining communities could lead to more birth defects." (Read more)