Evaluation Soil and Dust Exposure in Coal Mining Communities in Kentucky

Kentucky’s 29 “Distressed” or “At-Risk” Appalachian counties in the 5th Congressional District across the southeastern portion of the state have the highest death rate for lung cancer for both men and women of all congressional districts. Tobacco smoking is a significant risk for lung cancer, but a majority of counties in the 5th district report smoking rates at or below the average smoking rate (29%) for adults and high school students in Kentucky (25%). We have hypothesized that there are additional environmental cancer risks affecting the population in this high production coal mining district. Coal mining has been a major industry in the region for over 150 years; the high quality bituminous coal is naturally associated with pyrite containing a variety of trace metals, including arsenic, chromium, nickel and selenium. Environmental carcinogens can promote carcinogenesis by several mechanisms, including increased oxidative stress, inflammation, DNA damage, and reduced DNA repair efficiency. A pilot study found higher levels of arsenic, chromium and nickel in toenails collected from Appalachian Kentucky residents compared with other Kentuckians.(1) (Table 1) A large population-based, case-control study is currently being conducted in Appalachian Kentucky to investigate the role of trace elements in the development of lung cancer in this region. Persons with an incident diagnosis of lung cancer and matched controls will be identified; lay health workers will visit their homes and collect epidemiologic information, including environmental soil samples and global positioning system (GPS) coordinates to allow for spatial analysis of these subjects. We will use soil samples collected from this recently approved lung cancer casecontrol study in the present application. Matched control samples will be obtained in Wilmore, KY. Wilmore is a small town (pop. 5876; 2.6 sq miles) eighteen miles southeast of Lexington, KY. Since the founding of Asbury College in 1890, Wilmore has always been a college town with little to no other industry. The growth and development of Wilmore closely parallels the growth and development of the coal towns to the east. Wilmore was an accessible location with a depot on the railroad as were all the coal towns. It is a destination town: the main road through town ends a few miles past at a rail bridge on the Kentucky River. The college operated coal-fired boilers for most of their existence. Town boundaries have remained relatively constrained for the entire 20th century; historic buildings are still in use while other buildings were demolished and rebuilt with little developmental sprawl. Tobacco, cattle and horse farms surround the outskirts of town. Wilmore is a useful comparison site because its infrastructure, including a rail line, coal-fired power plant for the college and seminary, and limited use of automobiles up through the 1930s, matches that of many coal towns. The growth of population and building structures in Wilmore very nearly parallels the growth of its contemporary coal towns in Eastern Kentucky.