One of many Appalachian sites affected by MTR mining is Kayford, West Virginia. Once a bustling coal town, hardly any evidence remains of its former existence. A descendent of this town, the late Larry Gibson, led efforts to protect his family’s land at the top of Kayford Mountain and sparked the formation of a group called Keeper of the Mountains Foundation, which opposes MTR and advocates for the use of alternate energy sources including wind and solar energy.

Pulmonology Advisor interviewed Paul Corbit Brown, the current president and chair of the organization, and Michael Hendryx, PhD, professor in the department of environmental and occupational health at the Indiana University School of Public Health-Bloomington, who coauthored several of the studies mentioned above.

Pulmonology Advisor: How has Kayford, West Virginia, been affected by MTR?

Mr Brown: Kayford was like many towns prior to MTR, with thousands of workers employed in underground mining. MTR dramatically reduced the need for laborers. Additionally, air quality in underground mining has been heavily regulated after black lung disease was confirmed. Unfortunately, those same air quality standards do not exist on MTR sites, and the toxic dust from those sites affects not only the workers but people living in the surrounding communities.

Pulmonology Advisor: What is known thus far about the respiratory effects of MTR mining, and what are believed to be the underlying mechanisms?

Dr Hendryx: We know that people living near MTR have higher rates of chronic lung disease like chronic obstructive pulmonary disease and higher death rates from respiratory disease and lung cancer. These health problems are not because of smoking, age, occupational exposure, poverty, or other risks, but exist after accounting for those risks statistically. Poor health outcomes exist in relationship to greater amounts of mining. Mechanisms involve air pollution that results from surface mining operations — evidence shows that air quality in mining communities is impaired by high levels of silica, other earth elements, and polycyclic aromatic hydrocarbons. Also, we have seen elevated levels of ultrafine particle counts.2

Pulmonology Advisor: What is the US government currently doing to study these effects and limit harm associated with them?

Dr Hendryx: Nothing. The US government is actively encouraging these harms through procoal policies, antiregulatory steps, and elimination of the National Academies of Sciences study that had been initiated under the previous administration.

Pulmonology Advisor: What are the relevant treatment implications for clinicians, and what could physicians do to advocate for patients in this regard?

Dr Hendryx: To be aware that respiratory or other illnesses may be related to environmental conditions in mining communities, and not just to patient level factors like smoking.  To advocate, physicians could publicly support the end of MTR because of its public health harms.

Pulmonology Advisor: What should be next steps in this area in terms of research, policy, education, or otherwise?

Dr Hendryx: MTR should be stopped. Alternative sustainable economic models should be developed for mining communities.

Mr Brown: The remaining needs in terms of governmental policy include the need for lawmakers — both state and federal — to acknowledge 27 peer-reviewed studies that show the devastating effects not just on our environments but on community members surrounding MTR sites. And they need to recognize MTR as a fully preventable health crisis that affects thousands of people every year. For no foreseeable future will there ever be an end to the toxins leeching into the waters that originate on these sites. More than 2000 miles of headwaters of streams and rivers have been forever destroyed by the practice of MTR.3

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  1. Boyles AL, Blain RB, Rochester JR, et al. Systematic review of community health impacts of mountaintop removal mining. Environ Int. 2017;107:163-172.
  2. Hendryx M, Yonts SD, Li Y, Luo J. Mountaintop removal mining and multiple illness symptoms: a latent class analysis. Sci Total Environ. 2019;657:764-769.
  3. Hendryx M, Luo J. An examination of the effects of mountaintop removal coal mining on respiratory symptoms and COPD using propensity scores. Int J Environ Health Res. 2015;25(3):265-276.
  4. Hendryx M, Entwhistle J. Association between residence near surface coal mining and blood inflammation. Extr Ind Soc. 2015;2(2):246-251.
  5. Fears D. Trump administration halted a study of mountaintop coal mining’s health effects. Washington Post. August 21, 2017. Accessed May 28, 2019.