Recent Study Purports to Link
Mountaintop Mining with
Increased Rate of Birth
Defects
Jun.28.2011
Last week, researchers from West Virginia University and Washington
State University released a study, entitled The Association Between
Mountaintop Mining and Birth Defects Among Live Births in Central
Appalachia, 1996-2003, that reports a purported link between
community birth defects and mountaintop mining. The study tracked
the prevalence of birth defects in both mining and non-mining
communities in central Appalachia. The study findings are weak, but
the authors conclude that a higher prevalence of various birth defects,
particularly respiratory effects, exists in counties with mountaintop
mining operations, as compared to those with other types of coal
mining or no mining at all.1 The study is receiving considerable media
attention and may instigate further investigations or lawsuits.
Study Overview
The retrospective study investigated almost 1.9 million live births over
eight years in Kentucky, Tennessee, Virginia, and West Virginia. The
authors recognized that birth defects may arise from genetic or nongenetic factors, but are often multifactorial. The study design purports
to control for the higher level of socioeconomic disadvantage in the
study areas, including factors such as smoking, obesity, and education
level.
The authors cited to a number of other studies documenting various
environmental pollutants, including mercury, lead, selenium, and
arsenic, that the authors state are attributed to mountaintop mining
activities and linked to birth defects or impaired fetal development in
animals or humans. The study hypothesized that these pollutants
would produce a higher incidence of birth defects in counties where
mountaintop mining occurred. Using geographic mapping information,
the authors isolated counties with mountaintop mining activity, past or
present, and compared the rates of a wide array of birth defects
between 1996 and 2003 in those counties with the rates in counties
where only surface mining or no mining at all took place. Any resulting
associations with environmental pollutants were either weak or not
statistically significant. Regardless, the authors attributed an increased
incidence of birth defects to mountaintop mining:
“Results extend previous research on low-birth-weight outcomes and
on adult morbidity and mortality in mining areas by demonstrating

 increased rates of birth defects as an additional public health effect
related to coal mining in Appalachia. Results also offer one of the first
indications that disparities are concentrated specifically in mountaintop
mining areas, and have become more pronounced as this type of
mining activity has expanded.”
Potential Impact
A number of previous studies by this same group of researchers have
targeted coal mining and mountaintop mining as a source of health
effects. This new study extends those claims to birth defects and is
attracting media coverage from both scientific publications and
mainstream press such as USA Today. This study and the authors’
conclusions are subject to a number of criticisms that are not being
reported in the press, such as:
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The study is an “ecological” design, the
weakest form of epidemiology study.
The study lumps together a wide array of
individual birth defects into large “organ
system” categories, which masks the
reality that the study likely would have
found no increased incidence of any
specific birth defect in mountaintop mining
areas.
The rates for mountaintop mining are not
dramatically different from those for other
mining areas or non-mining areas (e.g., for
urogenital effects the rate for mountaintop
mining of 1.35 percent is almost identical
to that for other mining areas (1.32)).
The study could only compare “counties”
that contain mountaintop mining activity
to those that did not, and thus could not
identify any birth defects actually
occurring in geographic proximity to such a
mine, or that any birth defect actually
resulted from exposure to mine pollutants.

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

The study failed to account for
consanquinity, one of the most prominent
sources of birth defects.
The study did not identify a dose-response
relationship (e.g., higher rates in counties
with more mountaintop mining activity), a
key component of any causation
conclusion.

Despite the study limitations, the authors’ strong, conclusory language
may encourage new activity from the plaintiffs’ bar. Litigation alleging
injury to community health often requires advance investigation and
planning, as well as a robust defense in the community and otherwise,
to counter unfounded claims of injury or disease. Crowell & Moring has
significant and experience in both community and birth defect
litigation and can address both the strategies and science involved. To
further discuss this study or your company’s environmental litigation
defense strategy, please contact any of the attorneys listed on this
alert.
1
Ahern, M.M., et al., The association between mountaintop mining and
birth defects among live births in central Appalachia, 1996-2003.
Environ. Res. (2011), doi:10.1016/j.envres.2011.05.019.
For more information, please contact the professional(s) listed below,
or your regular Crowell & Moring contact.

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