The association of respiratory hospitalization rates in WV counties, total, underground, and surface coal production and sociodemographic covariates.

Background: Exposures associated with coal mining have long been linked to occupational disease. More recently, investigators have suggested that this industry may affect community health.

Methods: We explored associations between age-adjusted, county-level respiratory disease hospitalization rates (RHRs) in West Virginia and total, surface, and underground coal production, taking into account relevant sociodemographic and behavioral covariates. RHRs were calculated for 2005 to 2009, and analyses were performed to assess the effect of coal production after adjusting for sociodemographic factors.

Results: After controlling for percent below poverty, percent urban, and smoking, neither total nor underground tonnage was associated with RHR. Surface coal production, however, was significantly related with RHR (P < 0.05).

Conclusions: Surface coal production makes a small but significant contribution to RHR in West Virginia after accounting for other important sociodemographic and behavioral determinants of health.