Princess Health and UK research project will create strategies to improve respiratory health for those living in Appalachian Kentucky.Princessiccia

Princess Health and UK research project will create strategies to improve respiratory health for those living in Appalachian Kentucky.Princessiccia

air pollution Appalachia asthma chronic disease environment public health research respiratory illness University of Kentucky

Gusty 10:48 Add Comment

Public health researchers at the University of Kentucky will undertake a five-year long research project called "Community-Engaged Research and Action to Reduce Respiratory Disease in Appalachia," Sarah Noble writes in a UK press release.

Funded by the National Institutes of Health's National Institute of Environmental Health Sciences, the project will involve creating strategies to improve respiratory and environmental public health. Kentuckians living in Appalachian counties have the state's highest rates of serious respiratory illness.

"Adults in Appalachian Kentucky are 50 percent more likely to develop asthma or chronic obstructive pulmonary disease than the overall U.S. population," Noble writes. "As many as one in five adults in the region have received a diagnosis of asthma, and rates of COPD are nearly two-and-a-half fold the incidence of the disease in other parts of the country.

Although studies show associations between respiratory health problems and environmental contaminants, data doesn't yet include individual-level assessments or behavioral risk factors common in the area�such as smoking, poor diet and insufficient physical activity. The "Community Response to Environmental Exposures in Eastern Kentucky" project will fill those gaps.

The CREEEK project will include three steps. A community-based assessment will "identify the relationships between indoor air pollutants, behavioral and social determinants and the effects these factors have on risk of respiratory disease," Noble writes. That information "will be shared with local stakeholders in an effort to increase understanding of the environmental exposures present in the region," then the project will put in place "an environmental public health action strategy and will evaluate that strategy's ability to impact short-and long-term outcomes for respiratory health."

Princess Health and Princess Health andIn selling proposed limits on CO2, Obama administration emphasizes health improvement, not climate-change fight.Princessiccia

Princess Health and Princess Health andIn selling proposed limits on CO2, Obama administration emphasizes health improvement, not climate-change fight.Princessiccia

air pollution asthma children's health climate change environmental health global warming president

Gusty 10:58 Add Comment

By Melissa Landon and Al Cross
Kentucky Health News

As it announced its plan to reduce carbon dioxide emissions from power plants by 30 percent by 2030, the Obama administration emphasized the health angle, not climate change, which has been the driving force for the proposed regulations but is a more controversial cause than improving health.

"For the sake of our families' health and our kids' future, we have a moral obligation to act on climate," EPA administrator Gina McCarthy said in her announcement.

Juliet Eilperin and Steven Mufson note in The Washington Post that when a climate bill stalled in the Senate four years ago, environmental and public health activists began pressuring Preisdent Obama to mandate carbon limits. Opponents to the measure include coal producers, some utilities and many Republicans, who say that the EPA has not proposed a plan that can work using current technology.

Under the new rules, states would use different strategies�such as energy efficiency, shifting from coal to natural gas, investing in renewable energy and making power plant upgrades�to achieve state-by-state goals. The reductions will be measured from 2005 levels; Environmental Protection Agency data reveal that power plants in the U.S. have already diminished carbon dioxide emissions by almost 13 percent since 2005, The Associated Press reports.

EPA estimates the rules will prevent as many as 6,600 premature deaths, 150,000 asthma attacks in children, up to 490,000 missed work and school days�saving $93 billion, Connie Hedegaard writes for EurActiv. The federal Centers for Disease Control reports that "exposure to particle pollution may cause worsening asthma symptoms, breathing problems, adverse birth outcomes, lung cancer and early death," Healio reports.

The new rules are intended to assist Washington in achieving international obligations to reduce U.S. greenhouse gas emissions deemed responsible for global warming, but Obama is focusing on the human health benefits to encourage Americans to adopt the movement, Jeff Mason wres for Reuters.

Although federal law has been employed to regulate other pollutants�such as soot, mercury and lead�this is the first time it has been applied to greenhouse gases, Fox News reports, quoting Obama: "We limit the amount of toxic chemicals like mercury, sulfur and arsenic that power plants put in our air and water. But they can dump unlimited amounts of carbon pollution into the air. It's not smart, it's not safe, and it doesn't make sense."

Princess Health and Kentuckians tell pollsters they are concerned about air quality, but don't seem to put their concern into action.Princessiccia

Princess Health and Kentuckians tell pollsters they are concerned about air quality, but don't seem to put their concern into action.Princessiccia

air pollution Foundation for a Healthy Kentucky poll public health

Gusty 14:08 Add Comment

A recent poll shows that more than half of Kentucky adults, especially women, are concerned about air quality in their community, but only 48 percent say they change their behavior when an air quality alert is issued.

Perhaps they have never heard of an air quality alert, which is issued by a local or state air-pollution authority to protect the public's health from air pollution. The U.S. Environmental Protection Agency monitors air quality and uses an Air Quality Index to warn the public when the amount of particle pollution or ozone in the air may harm their health.
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When pollution gets to a level of concern, alerts or action days are issued in participating areas, which in Kentucky are Louisville, Lexington and the Mammoth Cave area (primarily Edmonson County). This could explain why almost 30 percent of poll respondents from Louisville said they were very concerned about air quality in their community, and only 13 percent of respondents from Appalachia indicated this level of concern.

Almost 60 percent of Appalachians said they are not concerned at all about the air quality in their community, compared to 26 percent of Louisville respondents that aren't at all concerned. Few Eastern Kentucky counties are part of an air-quality monitoring program. In addition to the areas monitoring for alerts or action days, 37 Kentucky counties (colored in the map) participate in the monitoring program. Click here to compare counties.?

Counties covered by an air-quality monitoring program are colored.

The poll indicated that just 20 percent of Kentucky adults said they change or limit their activities a lot when air quality alerts are issued, and about 30 percent said they change their behavior a little.  Respondents from the Louisville region were most likely to change or limit their activities, while those in the Lexington area were the most likely to not change or limit their behavior at all. 

When air quality is at an unhealthy level, people can protect themselves by limiting outdoor activities or avoiding heavy exertion.  These protective measures are even more important for those sensitive to air pollution, such as people with heart or lung disease, the elderly and children.

�The quality of our air impacts all of us, but is particularly important for sensitive groups, such as children with asthma. When an air quality alert is issued, we can protect ourselves and our families by avoiding heavy exertion and limiting outdoor activities,� said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll. �We can also do our part to limit emissions and protect our neighbors by turning off our car�s engine while we are waiting.� 

Almost 30 percent of Kentucky adults and 40 percent of Western Kentucky adults said they never turn their car�s engine off when waiting in their car and not moving, as in a traffic jam, train crossing or drive-through. Including those who never turn off their cars, more 60 percent said they wait at least four minutes before turning off their car�s engine when waiting in the car and not moving. Experts recommend turning off a waiting car�s engine after just ten seconds in order to save gas and limit emissions.

The poll was funded by the foundation and the Health Foundation of Greater Cincinnati and was conducted last year from Sept. 20 to Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone, including landlines and cell phones and the poll has a margin of error of plus or minus 2.5 percentage points.

Princess Health and Study suggesting that coal is a cause of health problems in E. Ky. is disputed by industry and politicians, defended by researcher.Princessiccia

Princess Health and Study suggesting that coal is a cause of health problems in E. Ky. is disputed by industry and politicians, defended by researcher.Princessiccia

air pollution Appalachia environmental health health outcomes research rural health

Gusty 11:24 Add Comment

By Molly Burchett
Kentucky Health News

A heated debate centers on new research showing that residents in Floyd County, where coal is stripped from the tops of mountains and ridges, report more health problems than those in two nearby communities without such mines, Elliott and Rowan.

The study, published in the online Journal of Rural Health, is the latest by Dr. Michael Hendryx of West Virginia University to suggest that residents of mining areas have poorer health conditions and experience more serious illness. It is available to readers of Kentucky Health News by clicking here.

Unlike some of his West Virginia research, Hendryx does not say there is a correlation between mining and poorer health outcomes in Eastern Kentucky. He does suggest the possibility of a connection by showing residents' self-reported health problems like asthma, chronic obstructive pulmonary disorder and hypertension are more common in mining areas. And in an interview, he said he believes there is a connection.

Stonecrest Golf Course at Prestonsburg in Floyd County,
built on a reclaimed mountaintop-removal coal mine.

The study and its critics highlight the challenges and pitfalls of discussing and reporting such research. The study's underlying motives and methodology are contested. The president of the Kentucky Coal Association, Bill Bissett, said Hendryx has reached a conclusion and is seeking evidence to support it.

"Bissett's accusation is completely false," Hendryx replied. "On the contrary, he is obviously the one with the biased perspective and has a strong financial motivation to try to discredit this work."

Bissett questions the study's use of self-reported health measures that did not consider medical history. Self-reporting is susceptible to bias, which can be reduced by using other sources of data/. This study only included data collected from interviews conducted by volunteers, which may have introduced more bias, Bissett said.

Hendryx replied, "We used undergraduate students from Christian colleges who were trained to be fair and objective in the survey procedures, and to use the same procedures in both the mining and non-mining communities." He said Peter Illyn, who runs the Christian organization Restoring Eden, approached him to do the survey because Illyn "wanted to give the students this experience, and he wanted to replicate the survey that we had done the previous year in West Virginia, this time in Kentucky."

The volunteers interviewed 544 participants lived in Floyd County and 351 in Rowan and Elliot counties, where coal is not mined. It used standard statistical devices to control for factors that might influence health status: age, sex, education, marital status, work as a coal miner, weight and tobacco habits. However, there was no consideration of health behaviors such as drug and alcohol use, wellness measures, exercise or other healthy lifestyle habits that could have positive influences.

"The survey had to be brief with the time and resources we had," said Hendryx. "We did measure overweight and obesity, which is a reflection of diet and exercise. We measured tobacco use. We did not measure alcohol use in this survey but in other studies we have found that heavy alcohol use is not common and is not an explanation for the findings."

Kentucky House Speaker Greg Stumbo, who is from Floyd County, said he disagreed with the use of Rowan County, home of Morehead State University, as a control group due to the higher rates of education attainment and per capita income, reported Ronnie Ellis of Community Newspaper Holdings Inc.

Stumbo told Ellis, �Everybody in the world knows that you can take a population that is less well educated and that has a lower per capita income and you�ll see their health habits are (worse) and hence their rates of diseases are attributable to those two things.� Rowan has a much better health status than surrounding counties, according to the latest national County Health Rankings.

Hendryx defended his research controls and the process of relying on self-reported medical histories. He said the health problems may be caused by tiny particles of dust from coal mining, which have been linked to health problems, can penetrate the lungs to cause health impacts, reported James Bruggers of The Courier-Journal. Hendryx said there are also concerns about polluted water and soil.

The study's data only hint at a connection between surface coal mining and poor health. Hendryx said he can�t prove that mountaintop removal is causing people to get sick, but he believes it is. What is needed, he told Bruggers, is a more thorough and expensive �gold standard� study of air and water quality near residences, and samples of blood, hair and toenails that can reveal exposure to pollutants.

Kentucky Health News is an independent news service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.