Mountaintop removal mining and multiple illness symptoms: A latent class analysis.

BACKGROUND: Mountaintop removal mining has been associated with multiple types of disease outcomes for populations living nearby. The current study tested whether latent classes identifying people with symptoms from multiple organ systems were associated with residence in mountaintop mining communities.

METHODS: We used data from three cross-sectional household community surveys conducted in three Appalachian states (N = 2756). The surveys contained information on 29 recent illness symptoms grouped into eight organ systems (respiratory, cardiovascular, gastrointestinal, musculoskeletal, skin, eye-ear-nose-throat, neurological, and other.) We identified latent classes, and then tested whether classes with higher probabilities of multiple symptoms would be associated with residence in mountaintop removal areas after control for covariates.

RESULTS: Three latent classes were identified, including a low-symptom referent class, an intermediate class, and a class with high symptom probability across organ systems. Controlling for covariates, latent classes characterized by intermediate and high multi-symptom probabilities were significantly associated with residence near mountaintop removal mining, with the highest odds ratio for the MTR versus control condition for the high multi-symptom group (OR = 2.17, 95% CI = 1.80-2.61).

CONCLUSIONS: Symptoms across multiple organ systems were related to residential proximity to mountaintop removal mining. Prior research has established multiple environmental contaminants related to mining that may contribute to poor population health through more than one exposure route or chemical of concern.