Hendryx Michael, Ahern Melissa M, Nurkiewicz Timothy R
Department of Community Medicine and Institute for Health Policy Research, West Virginia University, Morgantown, West Virginia 26506, USA.
J Toxicol Environ Health A. 2007 Dec;70(24):2064-70. doi: 10.1080/15287390701601236.
The goal of this study was to test whether the volume of coal mining was related to population hospitalization risk for diseases postulated to be sensitive or insensitive to coal mining by-products. The study was a retrospective analysis of 2001 adult hospitalization data (n = 93,952) for West Virginia, Kentucky, and Pennsylvania, merged with county-level coal production figures. Hospitalization data were obtained from the Health Care Utilization Project National Inpatient Sample. Diagnoses postulated to be sensitive to coal mining by-product exposure were contrasted with diagnoses postulated to be insensitive to exposure. Data were analyzed using hierarchical nonlinear models, controlling for patient age, gender, insurance, comorbidities, hospital teaching status, county poverty, and county social capital. Controlling for covariates, the volume of coal mining was significantly related to hospitalization risk for two conditions postulated to be sensitive to exposure: hypertension and chronic obstructive pulmonary disease (COPD). The odds for a COPD hospitalization increased 1% for each 1462 tons of coal, and the odds for a hypertension hospitalization increased 1% for each 1873 tons of coal. Other conditions were not related to mining volume. Exposure to particulates or other pollutants generated by coal mining activities may be linked to increased risk of COPD and hypertension hospitalizations. Limitations in the data likely result in an underestimate of associations.
本研究的目的是检验煤炭开采量是否与假定对煤炭开采副产品敏感或不敏感的疾病的人群住院风险相关。该研究对西弗吉尼亚州、肯塔基州和宾夕法尼亚州2001年的成人住院数据（n = 93,952）进行了回顾性分析，并与县级煤炭产量数据相结合。住院数据来自医疗保健利用项目全国住院样本。将假定对煤炭开采副产品暴露敏感的诊断与假定对暴露不敏感的诊断进行对比。使用分层非线性模型对数据进行分析，同时控制患者年龄、性别、保险、合并症、医院教学状况、县贫困程度和县社会资本。在控制协变量的情况下，煤炭开采量与假定对暴露敏感的两种疾病的住院风险显著相关：高血压和慢性阻塞性肺疾病（COPD）。每开采1462吨煤炭，COPD住院几率增加1%；每开采1873吨煤炭，高血压住院几率增加1%。其他疾病与开采量无关。接触煤炭开采活动产生的颗粒物或其他污染物可能与COPD和高血压住院风险增加有关。数据中的局限性可能导致对关联的低估。
