Mountaintop removal mining is the main method for extracting coal in the approximately 200 surface mines actively producing in the Central Appalachia region (KY, TN, WV, and VA). This mining method blasts off the top layer of a mountain to expose the underlying coal seam resulting in dust and fly-rock and necessitating disposal of the 'overburden' into spoil piles and of slurry into underground stores. Human health impacts in the communities surrounding these mines may arise from drinking contaminated groundwater, contact with contaminated streams, and inhalation of airborne chemicals and dust.
In January 2015, NTP received a nomination to review the potential health effects of MTR mining. In response, OHAT is conducting a systematic review of published studies of MTR mining and community health, occupational studies of MTR mining, and any available animal and in vitro experimental studies to investigate the effects of exposures to MTR mining-related mixtures. The protocol, which outlines the process for this systematic review, and lists of the included and excluded studies are available below.