The public health impacts of surface coal mining

• Surface coal mining causes local air and water pollution.
• Epidemiological data demonstrate that populations in mining communities have poor health.
• Environmental and public health impacts are pronounced in mountaintop removal mining areas.
• Additional studies of exposure, dose, and biological impact are needed.
• The preponderance of evidence indicates that mountaintop removal mining should be discontinued.

The current paper reviews published evidence on the public health impacts of surface coal mining. Particular attention is paid to recent evidence for a form of surface mining practiced in the United States, namely mountaintop removal mining. Studies from other parts of the world are also briefly described. Evidence is presented that documents epidemiological disease patterns for populations living in proximity to surface mining. Environmental evidence has shown that surface waters and biota are harmed by mountaintop removal, while other environmental studies have shown water and air pollution exist in residential areas close to mining. Studies that are able to directly link environmental exposure, dose, and biological impact are urgently needed. Although direct mechanistic links are not well understood, the weight of the evidence reinforces previous science-based calls to discontinue mountaintop removal mining due to its environmental and public health risks.