1 00:00:00,857 --> 00:00:04,324 Let's say that you wanted to conduct an experiment. 2 00:00:05,000 --> 00:00:06,151 In this experiment, 3 00:00:06,175 --> 00:00:09,571 you randomly assign people to live in blasting zones 4 00:00:10,133 --> 00:00:15,276 or in control locations without explosives going off over their heads. 5 00:00:16,300 --> 00:00:18,072 They live in the community for years, 6 00:00:18,096 --> 00:00:20,026 just downwind and downstream 7 00:00:20,050 --> 00:00:23,521 from sites where tons of explosives are used almost daily. 8 00:00:24,093 --> 00:00:26,728 And millions of gallons of water contaminated. 9 00:00:27,323 --> 00:00:30,823 With random assignment, you could carefully study 10 00:00:30,847 --> 00:00:34,890 the long-term health effects of living in these blasting communities 11 00:00:34,914 --> 00:00:38,300 without a bunch of annoying confounders and covariates. 12 00:00:39,061 --> 00:00:41,323 Random assignment does wonders. 13 00:00:42,782 --> 00:00:46,561 That would be a rigorous, powerful scientific inquiry 14 00:00:46,585 --> 00:00:49,354 into the effects of these environmental exposures. 15 00:00:49,838 --> 00:00:52,456 Of course, such a study could never be done. 16 00:00:52,895 --> 00:00:55,537 Most scientists wouldn't have the stomach for it. 17 00:00:55,942 --> 00:00:58,483 The institutional review board would never approve it; 18 00:00:58,507 --> 00:01:00,581 it would never pass human subjects review, 19 00:01:00,605 --> 00:01:03,205 because it would be unethical, immoral. 20 00:01:04,257 --> 00:01:07,102 And yet in effect, it is happening right now. 21 00:01:08,503 --> 00:01:10,776 In my mind, this prompts some questions. 22 00:01:10,800 --> 00:01:12,298 What is the ethical obligation 23 00:01:12,322 --> 00:01:15,522 of the scientists who believes populations are in danger? 24 00:01:16,592 --> 00:01:20,552 How much evidence is enough to be confident of our conclusions? 25 00:01:21,179 --> 00:01:26,083 Where is the line between scientific certainty and the need to act? 26 00:01:27,131 --> 00:01:29,566 The unplanned experiment that is happening right now 27 00:01:29,590 --> 00:01:31,585 is called mountaintop removal. 28 00:01:31,609 --> 00:01:33,823 The abbreviation for it is MTR. 29 00:01:34,371 --> 00:01:36,236 It is a form of surface coal mining 30 00:01:36,260 --> 00:01:39,271 that takes place in Appalachia, here in the United States. 31 00:01:40,276 --> 00:01:45,323 MTR occurs in four states: Virginia, West Virginia, Kentucky and Tennessee. 32 00:01:46,208 --> 00:01:50,358 Over 1.2 million acres have been mined in this way. 33 00:01:50,382 --> 00:01:52,977 This is an area about the size of Delaware 34 00:01:53,001 --> 00:01:55,300 but it is spread over a footprint 35 00:01:55,324 --> 00:01:58,203 as large as Vermont and New Hampshire combined. 36 00:01:59,465 --> 00:02:03,590 The process involves clear-cutting ancient Appalachian forest, 37 00:02:03,614 --> 00:02:06,285 home to some of the richest biodiversity on the planet. 38 00:02:07,037 --> 00:02:10,615 The trees are typically burned or dumped into adjacent valleys. 39 00:02:11,450 --> 00:02:14,530 Then, to reach the buried coal seams, 40 00:02:14,554 --> 00:02:20,309 explosives are used to remove up to 800 feet of mountain elevation. 41 00:02:21,458 --> 00:02:23,895 Over 1,500 tons of explosives 42 00:02:23,919 --> 00:02:26,656 are used for coal mining in West Virginia alone. 43 00:02:27,339 --> 00:02:29,037 Every day. 44 00:02:30,123 --> 00:02:32,607 Rock and soil debris is dumped over the valley sides 45 00:02:32,631 --> 00:02:35,315 where it permanently buries headwater streams. 46 00:02:35,339 --> 00:02:39,978 So far, over 500 mountains have been destroyed. 47 00:02:41,091 --> 00:02:44,646 About 2,000 miles of streams have been permanently buried. 48 00:02:44,670 --> 00:02:48,376 Water emerging from the base of the valley fills is highly contaminated 49 00:02:48,400 --> 00:02:50,867 and remains contaminated for decades. 50 00:02:51,489 --> 00:02:53,498 The coal then has to be chemically treated, 51 00:02:53,522 --> 00:02:57,527 crushed and washed before it can be transported to power plants and burned. 52 00:02:58,276 --> 00:03:00,409 This cleaning takes place on-site. 53 00:03:00,807 --> 00:03:03,895 The process produces more air pollution 54 00:03:03,919 --> 00:03:07,617 and contaminates billions of gallons of water with metals, 55 00:03:07,641 --> 00:03:11,224 sulfates, cleaning chemicals and other impurities. 56 00:03:12,219 --> 00:03:17,664 All of this to produce three percent of US electricity demand -- 57 00:03:17,688 --> 00:03:21,140 only three percent of US electricity demand. 58 00:03:22,544 --> 00:03:26,075 As you can appreciate, this prompts all sorts of other questions. 59 00:03:26,099 --> 00:03:28,885 What are the health impacts of mountaintop-removal mining? 60 00:03:28,909 --> 00:03:33,929 There are over a million people who live in counties where MTR takes place 61 00:03:33,953 --> 00:03:37,405 and millions more downstream and downwind. 62 00:03:38,223 --> 00:03:40,778 What has been the response of industry and government 63 00:03:40,802 --> 00:03:43,275 when these issues are documented? 64 00:03:43,299 --> 00:03:46,847 And again, what is the ethical obligation of science 65 00:03:46,871 --> 00:03:49,275 when faced with this disturbing situation? 66 00:03:50,760 --> 00:03:53,537 I began to research this issue in 2006. 67 00:03:53,966 --> 00:03:56,474 I had just taken a job at West Virginia University. 68 00:03:56,498 --> 00:03:59,911 Before then, I hadn't done any research related to coal. 69 00:04:00,812 --> 00:04:02,923 But I started to hear stories 70 00:04:02,947 --> 00:04:05,828 from people who lived in these mining communities. 71 00:04:05,852 --> 00:04:09,149 They said that the water they drank was not clean, 72 00:04:09,173 --> 00:04:11,529 that the air they breathed was polluted. 73 00:04:12,244 --> 00:04:14,299 They would tell me about their own illnesses 74 00:04:14,323 --> 00:04:16,298 or illnesses in their family. 75 00:04:16,322 --> 00:04:20,070 They were worried about how common cancer was in their neighborhoods. 76 00:04:20,394 --> 00:04:22,649 I met with many people in southern West Virginia 77 00:04:22,673 --> 00:04:24,006 and eastern Kentucky 78 00:04:24,030 --> 00:04:26,701 to listen to those stories and hear their concerns. 79 00:04:26,725 --> 00:04:28,923 I searched the scientific literature 80 00:04:28,947 --> 00:04:31,859 and was surprised to learn that nothing had been published 81 00:04:31,883 --> 00:04:35,696 on the public health effects of coal mining in the United States. 82 00:04:35,720 --> 00:04:36,879 Let me say that again -- 83 00:04:36,903 --> 00:04:39,569 nothing had been published on the public health effects 84 00:04:39,593 --> 00:04:41,260 of coal mining in the US. 85 00:04:42,038 --> 00:04:45,268 So I thought, "I can make a new contribution, 86 00:04:45,292 --> 00:04:46,758 no matter what I find, 87 00:04:47,617 --> 00:04:51,196 to either confirm these concerns or to alleviate them." 88 00:04:51,523 --> 00:04:54,456 I had no personal or organizational agenda. 89 00:04:55,515 --> 00:04:58,062 Many of my colleagues initially were skeptical 90 00:04:58,086 --> 00:05:01,220 that there would be any link between public health and mining. 91 00:05:01,244 --> 00:05:05,466 They predicted that the health problems could be explained by poverty 92 00:05:05,490 --> 00:05:08,410 or by lifestyle issues, like smoking and obesity. 93 00:05:09,196 --> 00:05:12,283 When I started, I thought maybe they would be right. 94 00:05:13,204 --> 00:05:15,773 We started by analyzing existing databases 95 00:05:15,797 --> 00:05:19,490 that allowed us to link population health to mining activity 96 00:05:19,514 --> 00:05:25,062 and to control statistically for age, sex, race, smoking, obesity, poverty, 97 00:05:25,086 --> 00:05:28,565 education, health insurance and others we could measure. 98 00:05:29,847 --> 00:05:33,260 We found evidence that confirmed the concerns of the residents, 99 00:05:33,284 --> 00:05:35,450 and we started to publish our findings. 100 00:05:36,514 --> 00:05:38,014 As a very brief summary, 101 00:05:38,038 --> 00:05:41,927 we found that people who live where mountaintop removal takes place 102 00:05:41,951 --> 00:05:46,086 have significantly higher levels of cardiovascular disease, 103 00:05:46,110 --> 00:05:49,575 kidney disease and chronic lung disease like COPD. 104 00:05:50,482 --> 00:05:53,260 Death rates from cancer are significantly elevated, 105 00:05:53,284 --> 00:05:55,084 especially for lung cancer. 106 00:05:55,680 --> 00:05:58,244 We've seen evidence for higher rates of birth defects 107 00:05:58,268 --> 00:06:00,458 and for babies born at low birth weight. 108 00:06:01,172 --> 00:06:05,664 The difference in total mortality equates to about 1,200 excess deaths 109 00:06:05,688 --> 00:06:09,910 every year in MTR areas, controlling for other risks. 110 00:06:09,934 --> 00:06:12,817 Twelve hundred excess deaths every year. 111 00:06:13,855 --> 00:06:15,395 Not only are death rates higher, 112 00:06:15,419 --> 00:06:17,664 but they increase as the levels of mining go up 113 00:06:17,688 --> 00:06:19,422 in a dose-response manner. 114 00:06:19,863 --> 00:06:23,458 Next, we started to conduct community door-to-door health surveys. 115 00:06:23,482 --> 00:06:27,024 We surveyed people living within a few miles of MTR 116 00:06:27,048 --> 00:06:29,410 versus similar rural communities without mining. 117 00:06:30,188 --> 00:06:34,173 Survey results show higher levels of personal and family illness, 118 00:06:34,197 --> 00:06:36,418 self-reported health status is poorer, 119 00:06:36,442 --> 00:06:39,956 and illness symptoms across a broad spectrum are more common. 120 00:06:40,879 --> 00:06:43,402 These studies are only associational. 121 00:06:44,268 --> 00:06:47,577 We all know that correlation does not prove causation. 122 00:06:48,315 --> 00:06:49,951 These studies did not include data 123 00:06:49,975 --> 00:06:52,855 on the actual environmental conditions in mining communities. 124 00:06:52,879 --> 00:06:56,500 So we started to collect and report on that. 125 00:06:57,609 --> 00:07:00,379 We found that violations of public drinking-water standards 126 00:07:00,403 --> 00:07:04,745 are seven times more common in MTR areas versus non-mining areas. 127 00:07:05,266 --> 00:07:07,156 We collected air samples 128 00:07:07,180 --> 00:07:10,386 and found that particulate matter is elevated in mining communities, 129 00:07:10,410 --> 00:07:12,278 especially in the ultra-fine range. 130 00:07:12,629 --> 00:07:16,660 The dust in mining communities contains a complex mixture, 131 00:07:16,684 --> 00:07:20,795 but includes high levels of silica, a known lung carcinogen, 132 00:07:20,819 --> 00:07:23,688 and potentially harmful organic compounds. 133 00:07:23,712 --> 00:07:26,260 We used the dust in laboratory experiments 134 00:07:26,284 --> 00:07:29,958 and found that it induced cardiovascular dysfunction in rats. 135 00:07:30,482 --> 00:07:32,339 The dust also promoted the development 136 00:07:32,363 --> 00:07:35,875 of lung cancer in human in vitro lung cells. 137 00:07:37,141 --> 00:07:40,040 This is just a quick summary of some of our studies. 138 00:07:41,194 --> 00:07:44,727 The coal industry does not like what we have to say. 139 00:07:46,242 --> 00:07:48,805 Neither does the government in coal country. 140 00:07:49,203 --> 00:07:52,228 Just like the tobacco industry paid for research 141 00:07:52,252 --> 00:07:54,410 to defend the safety of smoking, 142 00:07:54,434 --> 00:07:56,545 so the coal industry has tried to do the same 143 00:07:56,569 --> 00:08:00,282 by paying people to write papers claiming that MTR is safe. 144 00:08:00,913 --> 00:08:04,992 Lawyers have sent me harassing demands under the Freedom of Information Act, 145 00:08:05,016 --> 00:08:07,149 eventually denied by the courts. 146 00:08:07,754 --> 00:08:11,125 I'd been attacked at public testimony at a Congressional hearing 147 00:08:11,149 --> 00:08:14,122 by a congressman with ties to the energy industry. 148 00:08:14,863 --> 00:08:19,432 One governor has publicly declared that he refuses to read the research. 149 00:08:20,238 --> 00:08:23,976 And after a meeting with a member of Congress, 150 00:08:24,000 --> 00:08:26,233 in which I specifically shared my research, 151 00:08:26,257 --> 00:08:29,746 I later heard that representative say they knew nothing about it. 152 00:08:30,855 --> 00:08:33,395 I worked with scientists at the US Geological Survey 153 00:08:33,419 --> 00:08:36,260 on environmental sampling for more than two years. 154 00:08:36,284 --> 00:08:38,966 And just as they were starting to publish their findings, 155 00:08:38,990 --> 00:08:41,244 they were suddenly instructed by their superiors 156 00:08:41,268 --> 00:08:43,201 to stop work on this project. 157 00:08:43,751 --> 00:08:47,840 In August of this year, the National Academy of Sciences 158 00:08:47,864 --> 00:08:50,236 was suddenly instructed by the federal government 159 00:08:50,260 --> 00:08:52,522 to stop their independent review 160 00:08:52,546 --> 00:08:55,274 of the public health consequences of surface mining. 161 00:08:56,037 --> 00:08:58,907 These actions are politically motivated, in my view. 162 00:09:00,323 --> 00:09:03,457 But there is opposition from researchers, too. 163 00:09:04,236 --> 00:09:07,204 At conferences or meetings, they express skepticism. 164 00:09:07,695 --> 00:09:11,499 OK, we are all taught, as scientists, to be skeptical. 165 00:09:12,141 --> 00:09:15,355 They ask, "What about this possible explanation?" 166 00:09:15,379 --> 00:09:18,402 "Have you considered that alternative interpretation?" 167 00:09:18,712 --> 00:09:22,196 They wonder, "There must be some confounder that we missed. 168 00:09:22,220 --> 00:09:25,389 Some other variable we haven't accounted for." 169 00:09:25,863 --> 00:09:28,403 "An in vitro study, what does that prove?" 170 00:09:28,427 --> 00:09:33,173 "A rat study -- how do we know the same effects would be found in people?" 171 00:09:34,433 --> 00:09:35,583 Maybe so. 172 00:09:36,107 --> 00:09:39,019 Technically, you have to acknowledge that they could be right, 173 00:09:39,043 --> 00:09:42,917 but you know, maybe these health problems 174 00:09:42,941 --> 00:09:45,664 are not the result of some unmeasured confound. 175 00:09:46,545 --> 00:09:49,291 Maybe they result from blowing up mountains 176 00:09:49,315 --> 00:09:51,029 over people's heads. 177 00:09:51,053 --> 00:09:53,397 (Laughter) 178 00:09:53,421 --> 00:10:00,167 (Applause) 179 00:10:00,191 --> 00:10:03,577 There can always be doubt, if doubt is what you seek. 180 00:10:03,601 --> 00:10:06,220 Because we can never do that defining experiment. 181 00:10:06,244 --> 00:10:09,691 Any next study must always be associational. 182 00:10:10,720 --> 00:10:13,506 So perhaps you can understand why I've started to wonder, 183 00:10:13,530 --> 00:10:15,895 how much evidence is enough? 184 00:10:15,919 --> 00:10:19,319 I've published over 30 papers on this topic so far. 185 00:10:19,760 --> 00:10:23,061 Along with my coauthors, other researchers have added to the evidence, 186 00:10:23,085 --> 00:10:25,347 yet government doesn't want to listen, 187 00:10:25,371 --> 00:10:28,283 and the industry says it's only correlational. 188 00:10:28,307 --> 00:10:30,973 They say Appalachians have lifestyle issues. 189 00:10:30,997 --> 00:10:32,772 As though it had never occurred to us 190 00:10:32,796 --> 00:10:35,474 to control for smoking or obesity or poverty or education 191 00:10:35,498 --> 00:10:36,831 or health insurance. 192 00:10:37,442 --> 00:10:39,609 We controlled for all of those and more. 193 00:10:40,903 --> 00:10:44,402 There comes a point where we don't need more research, 194 00:10:44,784 --> 00:10:48,244 where we can't ask people to be unwilling research subjects 195 00:10:48,268 --> 00:10:50,996 so we can do the next study. 196 00:10:52,817 --> 00:10:55,198 As scientists, we follow the data wherever it goes, 197 00:10:55,222 --> 00:10:57,246 but sometimes data can only take us so far 198 00:10:57,270 --> 00:11:00,260 and we have to decide, as thinking, feeling human beings, 199 00:11:00,284 --> 00:11:03,017 what it means and when it is time to act. 200 00:11:03,775 --> 00:11:06,927 I think that is true, not only for MTR but for other situations 201 00:11:06,951 --> 00:11:11,243 where evidence is strong and concerning but imperfect. 202 00:11:11,934 --> 00:11:15,983 And when failing to act if you're wrong means people's lives. 203 00:11:17,721 --> 00:11:20,508 It may seem strange that there is any controversy 204 00:11:20,532 --> 00:11:23,620 over the health effects of mountaintop-removal mining. 205 00:11:24,332 --> 00:11:26,174 But somehow, this subject has wound up 206 00:11:26,198 --> 00:11:28,536 in a scientific and political twilight zone 207 00:11:28,560 --> 00:11:30,681 alongside the debate over climate change 208 00:11:30,705 --> 00:11:32,120 or the argument years ago 209 00:11:32,144 --> 00:11:34,739 about whether or not smoking caused cancer. 210 00:11:35,865 --> 00:11:39,468 In this twilight zone, much of the data seems to point to one conclusion. 211 00:11:39,492 --> 00:11:42,778 But the economics or the politics or the prevailing public view 212 00:11:42,802 --> 00:11:45,068 insist on the opposite conclusion. 213 00:11:46,180 --> 00:11:49,101 When you're a scientist and you think you have a valid insight 214 00:11:49,125 --> 00:11:51,476 where the health of entire populations is at stake 215 00:11:51,510 --> 00:11:53,823 but you find yourself trapped 216 00:11:53,847 --> 00:11:57,355 in this twilight zone of denial and disbelief, 217 00:11:57,379 --> 00:12:00,179 what is your moral and ethical obligation? 218 00:12:01,625 --> 00:12:05,609 Obviously, scientists are responsible for telling the truth as they see it, 219 00:12:05,633 --> 00:12:06,942 based on evidence. 220 00:12:07,331 --> 00:12:10,408 Simply stated, we have an obligation to stand up for the data. 221 00:12:11,625 --> 00:12:14,693 It can be extremely frustrating to wait around for public opinion 222 00:12:14,717 --> 00:12:17,950 or political consensus to catch up to the scientific understanding. 223 00:12:17,974 --> 00:12:22,140 But the more controversial the subject and the more frustrating the debate, 224 00:12:22,164 --> 00:12:26,029 the more critical it is for scientists to preserve our objectivity 225 00:12:26,053 --> 00:12:28,253 and our reputation for integrity. 226 00:12:28,823 --> 00:12:31,363 Because integrity is the coin of the realm 227 00:12:31,387 --> 00:12:33,879 in scientific and public policy debate. 228 00:12:33,903 --> 00:12:35,118 In the long run, 229 00:12:35,142 --> 00:12:38,871 our reputation for integrity is the most powerful tool that we have, 230 00:12:38,895 --> 00:12:41,838 even more powerful than the data itself. 231 00:12:42,535 --> 00:12:45,346 Without an acknowledged integrity on the part of scientists, 232 00:12:45,370 --> 00:12:47,488 no amount of data will ever convince people 233 00:12:47,512 --> 00:12:50,112 to believe painful or difficult truths. 234 00:12:50,958 --> 00:12:56,085 But when we cultivate and guard our reputation for integrity, 235 00:12:56,109 --> 00:12:59,260 when we patiently stand up for the data and keep doing the studies 236 00:12:59,284 --> 00:13:02,006 and keep calmly bringing the results to the public, 237 00:13:02,030 --> 00:13:04,474 that's when we have our greatest impact. 238 00:13:05,585 --> 00:13:11,781 Eventually, scientific truth does and will win out. 239 00:13:13,141 --> 00:13:15,941 How many lives will be lost while we wait? 240 00:13:16,433 --> 00:13:17,583 Too many already. 241 00:13:18,218 --> 00:13:20,090 But prevail we will. 242 00:13:21,004 --> 00:13:22,185 Thank you. 243 00:13:22,209 --> 00:13:29,094 (Applause)