BIOLOGICAL TRACE ELEMENTS AND DISEASE IN DISTRESSED POPULATIONS: CONSIDERATIONS RELATIVE TO ENVIRONMENTAL EXPOSURE IN APPALACHIAN COAL MINING COMMUNITIES

Some researchers have hypothesized that coal mining activities in the Central Appalachian Basin are associated with environmental contamination, community exposure, and regional patterns of disease such as heart disease, stroke, diabetes mellitus, obesity, and chronic obstructive pulmonary disease. Deficiencies in certain trace elements are associated with the aforementioned diseases and conditions; arsenic and selenium, for example, have a biologically antagonistic relationship in disease. Some of these same elements, such as arsenic, chromium, nickel, cadmium, zinc, and selenium and manganese are among geological elements co-mingled with Central Appalachian coal with potential for release to the environment during blasting or cleaning and sorting operations. Potential exposure pathways include drinking water contamination, ingestion of soil and dust or food grown in contaminated soil, and inhalation of airborne particulate. Current chronic biological exposure is most frequently measured in toenail clippings, although urine measurements are also sometimes used. A summary of biological exposure concentrations associated with prevailing disease in Appalachian coal mining populations will be presented in context with exposure concentrations considered causal of disease.