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The Association of Respiratory Hospitalization Rates in WV Counties, Total, Underground, and Surface Coal Production and Sociodemographic Covariates

Brink, LuAnn L. PhD; Talbott, Evelyn O. DrPH, MPH; Stacy, Shaina MPH; Marshall, Lynne P. MS; Sharma, Ravi K. PhD; Buchanich, Jeanine PhD, MPH

Journal of Occupational and Environmental Medicine: November 2014 - Volume 56 - Issue 11 - p 1179–1188
doi: 10.1097/JOM.0000000000000246
Original Articles

Background: Exposures associated with coal mining have long been linked to occupational disease. More recently, investigators have suggested that this industry may affect community health.

Methods: We explored associations between age-adjusted, county-level respiratory disease hospitalization rates (RHRs) in West Virginia and total, surface, and underground coal production, taking into account relevant sociodemographic and behavioral covariates. RHRs were calculated for 2005 to 2009, and analyses were performed to assess the effect of coal production after adjusting for sociodemographic factors.

Results: After controlling for percent below poverty, percent urban, and smoking, neither total nor underground tonnage was associated with RHR. Surface coal production, however, was significantly related with RHR (P < 0.05).

Conclusions: Surface coal production makes a small but significant contribution to RHR in West Virginia after accounting for other important sociodemographic and behavioral determinants of health.

From the Graduate School of Public Health, University of Pittsburgh, Pa.

Address correspondence to: Evelyn O. Talbott, MPH, DrPH, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A526 Crabtree, Pittsburgh, PA 15261 (

The authors declare no conflicts of interest.

This study was sponsored by the Appalachian Research Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions, and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers, or industrial members. Information about ARIES can be found at

Copyright © 2014 by the American College of Occupational and Environmental Medicine