Maternal Residential Proximity to Central Appalachian Surface Mining and Adverse Birth Outcomes

Background: Over the past 25 years in Central Appalachia, there have been major shifts in land use due to surface mining. Previous studies have reported increased adverse birth outcomes in Central Appalachian coalfields compared to other regions at a county-level scale. This study addresses gaps in knowledge of exposure by developing a fine-scale spatiotemporal characterization of adverse birth outcomes in Central Appalachia through use of satellite imagery and address-level birth records.Methods: Surface mining boundaries in Central Appalachia between 1989-2015 were delineated using Landsat satellite imagery. These boundaries were used to characterize land as pre, active, and post mining areas. Geocoded maternal addresses from VA, WV, KY, and TN birth records were assigned exposures based on the amount of surface mining within a 5km radius. Births were also assigned exposures based on the amount of surface mining within their residential zip code and county. Mining exposures were further categorized into quantiles of high, moderate, and low amounts or no exposure. Regression models determined the association between surface mining during gestation and birth weight, preterm birth (PTB), low birth weight (LBW), and term low birth weight (TLBW), adjusting for available demographic factors.Results: Preliminary models indicate that prenatal exposure to high amounts of post mining operations (1 to 33 sq. km of land within 5km) of residence is associated with a decrease in birth weight (26 g 95% CI:15 g, 38g). Zip code and county level analysis results were consistent with street level results. Pregnant women who resided in zip codes during high amounts of active surface mining (between 1.3 and 41% of land area) had significantly lower birth weights (31 g, 95% CI:24 g, 39 g) when compared to infants born prior to mining. Conclusions: These preliminary findings suggest Central Appalachian surface mining may be associated with increases in adverse birth outcomes.