Residence in coal-mining areas and low-birth-weight outcomes.

The objective of this study was to estimate the association between residence in coal mining environments and low birth weight. We conducted a cross-sectional, retrospective analysis of the association between low birth weight and mother's residence in coal mining areas in West Virginia. Birth data were obtained from the West Virginia Birthscore Dataset, 2005-2007 (n = 42,770). Data on coal mining were from the US Department of Energy. Covariates regarding mothers' demographics, behaviors, and insurance coverage were included. We used nested logistic regression (SUDAAN Proc Multilog) to conduct the study. Mothers who were older, unmarried, less educated, smoked, did not receive prenatal care, were on Medicaid, and had recorded medical risks had a greater risk of low birth weight. After controlling for covariates, residence in coal mining areas of West Virginia posed an independent risk of low birth weight. Odds ratios for both unadjusted and adjusted findings suggest a dose-response effect. Adjusted findings show that living in areas with high levels of coal mining elevates the odds of a low-birth-weight infant by 16%, and by 14% in areas with lower mining levels, relative to counties with no coal mining. After covariate adjustment, the persistence of a mining effect on low-birth-weight outcomes suggests an environmental effect resulting from pollution from mining activities. Air and water quality assessments have been largely missing from mining communities, but the need for them is indicated by these findings.