Mortality from heart, respiratory, and kidney disease in coal mining areas of Appalachia
Mortality from heart, respiratory, and kidney disease in coal mining areas of Appalachia
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DOI：
10.1007/s00420-008-0328-y
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发表时间：
2009-01-01
影响因子：
3
通讯作者：
Hendryx, Michael
中科院分区：
文献类型：
--
作者：
Hendryx, Michael
本研究的目的是检验在控制其他疾病危险因素后，阿巴拉契亚煤矿开采水平是否会提高心脏、呼吸系统和肾脏疾病的人口死亡率。该研究调查了2000-2004年各县级的年龄调整后的心脏病、呼吸系统疾病和肾脏疾病死亡率与采煤吨数的关系。研究人员对四组县进行了比较：2000年至2004年，阿巴拉契亚县的煤炭开采量超过400万吨；阿巴拉契亚地区的县，开采量在400万吨以下，非阿巴拉契亚地区的县有煤矿，以及全国其他非煤矿县。慢性病的形式与急性病作了对比。泊松回归模型分别分析了男性和女性死亡率。协变量包括男性人口百分比、大学和高中教育比率、贫困率、种族/民族比率、初级保健医生供应、城乡状况、吸烟率和南方地区变量。就男性和女性而言，在煤矿开采水平最高的阿巴拉契亚县，慢性心脏、呼吸系统和肾脏疾病的死亡率明显高于非矿区，但急性疾病的死亡率并不高于非矿区。非阿巴拉契亚煤矿县的急性心脏和呼吸系统死亡率较高。煤矿矿区慢性心脏、呼吸系统和肾脏疾病死亡率较高，可能部分反映了环境暴露于煤炭中存在并在开采和加工过程中释放的颗粒物质或有毒物质。阿巴拉契亚地区和非阿巴拉契亚地区之间的差异可能反映了不同的采矿实践、人口统计数据或死亡率编码差异。
The purpose of this study was to test whether population mortality rates from heart, respiratory and kidney disease were higher as a function of levels of Appalachian coal mining after control for other disease risk factors.The study investigated county-level, age-adjusted mortality rates for the years 2000-2004 for heart, respiratory and kidney disease in relation to tons of coal mined. Four groups of counties were compared: Appalachian counties with more than 4 million tons of coal mined from 2000 to 2004; Appalachian counties with mining at less than 4 million tons, non-Appalachian counties with coal mining, and other non-coal mining counties across the nation. Forms of chronic illness were contrasted with acute illness. Poisson regression models were analyzed separately for male and female mortality rates. Covariates included percent male population, college and high school education rates, poverty rates, race/ethnicity rates, primary care physician supply, rural-urban status, smoking rates and a Southern regional variable.For both males and females, mortality rates in Appalachian counties with the highest level of coal mining were significantly higher relative to non-mining areas for chronic heart, respiratory and kidney disease, but were not higher for acute forms of illness. Higher rates of acute heart and respiratory mortality were found for non-Appalachian coal mining counties.Higher chronic heart, respiratory and kidney disease mortality in coal mining areas may partially reflect environmental exposure to particulate matter or toxic agents present in coal and released in its mining and processing. Differences between Appalachian and non-Appalachian areas may reflect different mining practices, population demographics, or mortality coding variability.