Identifying exposure pathways mediating adverse birth outcomes near active surface mines in Central Appalachia

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dc.contributor.authorRuktanonchai, Corrine W.en
dc.contributor.authorMcKnight, Molly X.en
dc.contributor.authorButtling, Laurenen
dc.contributor.authorKolivras, Korine N.en
dc.contributor.authorKrometis, Leigh-Anne H.en
dc.contributor.authorGohlke, Juliaen
dc.coverage.countryUnited Statesen
dc.date.accessioned2022-06-09T13:05:41Zen
dc.date.available2022-06-09T13:05:41Zen
dc.date.issued2022-06en
dc.description.abstractBackground: Previous work has determined an association between proximity to active surface mining within Central Appalachia and an increased risk of preterm birth (PTB) and low birthweight (LBW). Multiple potential exposure pathways may exist; however, including inhalation of particulate matter (airshed exposure), or exposure to impacted surface waters (watershed exposure). We hypothesize that this relationship is mediated by exposure to contaminants along one or both of these pathways. Methods: We geolocated 194,084 birth records through health departments in WV, KY, VA, and TN between 1990 and 2015. We performed a mediation analysis, iteratively including within our models: (a) the percent of active surface mining within 5 km of maternal residence during gestation; (b) the cumulative surface mining airshed trajectories experienced during gestation; and (c) the percent of active surface mining occurring within the watershed of residency during gestation. Results: Our baseline models found that active surface mining was associated with an increased odds of PTB (1.09, 1.05-1.13) and LBW (1.06, 1.02-1.11), controlling for individual-level predictors. When mediators were added to the baseline model, the association between active mining and birth outcomes became nonsignificant (PTB: 0.48, 0.14-1.58; LBW 0.78, 0.19-3.00), whereas the association between PTB and LBW remained significant by airshed exposure (PTB: 1.14, 1.11-1.18; LBW: 1.06, 1.03-1.10). Conclusions: Our results found that surface mining airsheds at least partially explained the association between active mining and adverse birth outcomes, consistent with a hypothesis of mediation, while mediation via the watershed pathway was less evident.en
dc.description.notesSupported by the National Institute of Environmental Health Sciences (R21ES028396). Data use agreements with state health agencies prohibit authors from sharing birth record data used in the analysis. Satellite-derived datasets are publicly available, or available on request. Code required to replicate results are available upon request.en
dc.description.sponsorshipNational Institute of Environmental Health Sciences [R21ES028396]en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.1097/EE9.0000000000000208en
dc.identifier.eissn2474-7882en
dc.identifier.issue3en
dc.identifier.othere208en
dc.identifier.urihttp://hdl.handle.net/10919/110516en
dc.identifier.volume6en
dc.language.isoenen
dc.publisherLippincott Williams & Wilkinsen
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivatives 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectMediationen
dc.subjectSurface miningen
dc.subjectMaternal healthen
dc.subjectEnvironmental healthen
dc.subjectPreterm birthen
dc.subjectLow birthweighten
dc.subjectCoal miningen
dc.titleIdentifying exposure pathways mediating adverse birth outcomes near active surface mines in Central Appalachiaen
dc.title.serialEnvironmental Epidemiologyen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten

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