Using human epidemiological analyses to support the assessment of the impacts of coal mining on health.

The potential impacts of coal mining on health have been addressed by the application of impact assessment methodologies that use the results of qualitative and quantitative analyses to support their conclusions and recommendations. Although human epidemiological analyses can provide the most relevant measures of risk of health outcomes in populations exposed to coal mining by-products, this kind of studies are seldom implemented as part of the impact assessment methods. To review the use of human epidemiological analyses in the methods used to assess the impacts of coal mining, a systematic search in the peer review literature was implemented following the PRISMA protocol. A synthesis analysis identified the methods and the measures used in the selected publications to develop a thematic review and discussion. The major methodological approaches to assess the impacts of coal mining are environmental impact assessment (EIA), health impact assessment (HIA), social impact assessment (SIA) and environmental health impact assessment (EHIA). The measures used to assess the impacts of coal mining on health were classified as the estimates from non-human-based studies such as health risk assessment (HRA) and the measures of risk from human epidemiological analyses. The inclusion of human epidemiological estimates of the populations exposed, especially the general populations in the vicinity of the mining activities, is seldom found in impact assessment applications for coal mining. These methods rather incorporate HRA measures or other sources of evidence such as qualitative analyses and surveys. The implementation of impact assessment methods without estimates of the risk of health outcomes relevant to the potentially exposed populations affects their reliability to address the environmental and health impacts of coal mining. This is particularly important for EIA applications because these are incorporated in regulatory frameworks globally. The effective characterization of the impacts of coal mining on health requires quantitative estimates of the risk, including the risk measures from epidemiological analyses of relevant human health data.