Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, United States of America.
PLoS One. 2022 Aug 11;17(8):e0272998. doi: 10.1371/journal.pone.0272998. eCollection 2022.
Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape. Explosive blasts, exposed rock, and coal washing have the potential to pollute air and water. Previous research suggests that infants born to mothers living in areas with MTR have a higher prevalence of birth defects. In this cross-sectional study, we further examine the relationship between MTR activity and several types of birth defects. Maternal exposure to MTR was assessed using remote sensing data from Skytruth, which captures MTR activity in the Central Appalachian region of the United States. Active MTR area was quantified within a five-kilometer buffer surrounding geocoded maternal address captured on birth records for live births to Appalachian Kentucky mothers between 1997 and 2003 (N = 95,581). We assigned high, medium, and low exposure based on the tertile of total MTR area within 5-km, and births with no MTR within this buffer were assigned zero exposure. The presence or absence of a birth defect grouped into six major organ systems was identified using birth records alone. Finally, we applied conditional multiple imputation for variables with missing values before conducting separate multivariable log-binomial regression models for each birth defect group. Prevalence ratio (PR) estimates were adjusted for individual level covariates from birth records. The prevalence of gastro-intestinal defects was significantly higher in birth records with high and low active MTR exposure compared to records with no exposure. (High exposure: PR = 1.99, 95% CI = 1.14-3.47; low exposure PR = 1.88, 95% CI = 1.06-3.31). This study supports some of the existing findings of previous ecological studies. Research addressing the relationship between gastro-intestinal birth defects and MTR coal mining is warranted but should carefully consider temporal dimensions of exposure.
通过山体开采（MTR）采煤会改变景观的许多方面。爆炸、暴露的岩石和洗煤都有可能污染空气和水。先前的研究表明，生活在 MTR 地区的母亲所生的婴儿出生缺陷的患病率更高。在这项横断面研究中，我们进一步研究了 MTR 活动与几种类型的出生缺陷之间的关系。通过使用 Skytruth 的遥感数据来评估母体对 MTR 的暴露，该数据捕捉了美国阿巴拉契亚中部地区的 MTR 活动。在阿巴拉契亚肯塔基州母亲的活产出生记录中，以出生记录中的地理编码的母体地址为中心，在 5 公里缓冲区范围内量化了活跃的 MTR 区域，该记录范围在 1997 年至 2003 年之间（N = 95,581）。我们根据 5 公里范围内的总 MTR 区域的 tertile 将暴露分为高、中、低三种，并将缓冲区内没有 MTR 的出生分配为零暴露。仅使用出生记录确定存在或不存在六个主要器官系统的出生缺陷。最后，我们对缺失值变量进行了条件多重插补，然后分别对每个出生缺陷组进行了多变量对数二项式回归模型。个体水平出生记录中的协变量调整了患病率比（PR）估计值。与无暴露记录相比，高暴露（PR = 1.99，95%CI = 1.14-3.47）和低暴露（PR = 1.88，95%CI = 1.06-3.31）的出生记录中胃肠道缺陷的患病率明显更高。这项研究支持了先前一些生态研究的发现。需要研究胃肠道出生缺陷与 MTR 采煤之间的关系，但应仔细考虑暴露的时间维度。
