WEBVTT

00:00:00.857 --> 00:00:04.324
Let's say that you wanted
to conduct an experiment.

00:00:05.000 --> 00:00:06.151
In this experiment,

00:00:06.175 --> 00:00:09.571
you randomly assign people
to live in blasting zones

00:00:10.133 --> 00:00:15.276
or in control locations without explosives
going off over their heads.

00:00:16.300 --> 00:00:18.072
They live in the community for years,

00:00:18.096 --> 00:00:20.026
just downwind and downstream

00:00:20.050 --> 00:00:23.521
from sites where tons of explosives
are used almost daily.

00:00:24.093 --> 00:00:26.728
And millions of gallons
of water contaminated.

00:00:27.323 --> 00:00:30.823
With random assignment,
you could carefully study

00:00:30.847 --> 00:00:34.890
the long-term health effects
of living in these blasting communities

00:00:34.914 --> 00:00:38.300
without a bunch of annoying
confounders and covariates.

00:00:39.061 --> 00:00:41.323
Random assignment does wonders.

NOTE Paragraph

00:00:42.782 --> 00:00:46.561
That would be a rigorous,
powerful scientific inquiry

00:00:46.585 --> 00:00:49.354
into the effects of these
environmental exposures.

00:00:49.838 --> 00:00:52.456
Of course, such a study
could never be done.

00:00:52.895 --> 00:00:55.537
Most scientists wouldn't have
the stomach for it.

00:00:55.942 --> 00:00:58.483
The institutional review board
would never approve it;

00:00:58.507 --> 00:01:00.581
it would never pass human subjects review,

00:01:00.605 --> 00:01:03.205
because it would be unethical, immoral.

00:01:04.257 --> 00:01:07.102
And yet in effect,
it is happening right now.

00:01:08.503 --> 00:01:10.776
In my mind, this prompts some questions.

00:01:10.800 --> 00:01:12.298
What is the ethical obligation

00:01:12.322 --> 00:01:15.522
of the scientists who believes
populations are in danger?

00:01:16.592 --> 00:01:20.552
How much evidence is enough
to be confident of our conclusions?

00:01:21.179 --> 00:01:26.083
Where is the line between
scientific certainty and the need to act?

NOTE Paragraph

00:01:27.131 --> 00:01:29.566
The unplanned experiment
that is happening right now

00:01:29.590 --> 00:01:31.585
is called mountaintop removal.

00:01:31.609 --> 00:01:33.823
The abbreviation for it is MTR.

00:01:34.371 --> 00:01:36.236
It is a form of surface coal mining

00:01:36.260 --> 00:01:39.271
that takes place in Appalachia,
here in the United States.

00:01:40.276 --> 00:01:45.323
MTR occurs in four states: Virginia,
West Virginia, Kentucky and Tennessee.

00:01:46.208 --> 00:01:50.358
Over 1.2 million acres
have been mined in this way.

00:01:50.382 --> 00:01:52.977
This is an area about the size of Delaware

00:01:53.001 --> 00:01:55.300
but it is spread over a footprint

00:01:55.324 --> 00:01:58.203
as large as Vermont
and New Hampshire combined.

00:01:59.465 --> 00:02:03.590
The process involves clear-cutting
ancient Appalachian forest,

00:02:03.614 --> 00:02:06.285
home to some of the richest
biodiversity on the planet.

00:02:07.037 --> 00:02:10.615
The trees are typically burned
or dumped into adjacent valleys.

00:02:11.450 --> 00:02:14.530
Then, to reach the buried coal seams,

00:02:14.554 --> 00:02:20.309
explosives are used to remove
up to 800 feet of mountain elevation.

00:02:21.458 --> 00:02:23.895
Over 1,500 tons of explosives

00:02:23.919 --> 00:02:26.656
are used for coal mining
in West Virginia alone.

00:02:27.339 --> 00:02:29.037
Every day.

NOTE Paragraph

00:02:30.123 --> 00:02:32.607
Rock and soil debris
is dumped over the valley sides

00:02:32.631 --> 00:02:35.315
where it permanently buries
headwater streams.

00:02:35.339 --> 00:02:39.978
So far, over 500 mountains
have been destroyed.

00:02:41.091 --> 00:02:44.646
About 2,000 miles of streams
have been permanently buried.

00:02:44.670 --> 00:02:48.376
Water emerging from the base
of the valley fills is highly contaminated

00:02:48.400 --> 00:02:50.867
and remains contaminated for decades.

00:02:51.489 --> 00:02:53.498
The coal then has to be
chemically treated,

00:02:53.522 --> 00:02:57.527
crushed and washed before it can be
transported to power plants and burned.

00:02:58.276 --> 00:03:00.409
This cleaning takes place on-site.

00:03:00.807 --> 00:03:03.895
The process produces more air pollution

00:03:03.919 --> 00:03:07.617
and contaminates billions
of gallons of water with metals,

00:03:07.641 --> 00:03:11.224
sulfates, cleaning chemicals
and other impurities.

00:03:12.219 --> 00:03:17.664
All of this to produce three percent
of US electricity demand --

00:03:17.688 --> 00:03:21.140
only three percent
of US electricity demand.

NOTE Paragraph

00:03:22.544 --> 00:03:26.075
As you can appreciate, this prompts
all sorts of other questions.

00:03:26.099 --> 00:03:28.885
What are the health impacts
of mountaintop-removal mining?

00:03:28.909 --> 00:03:33.929
There are over a million people
who live in counties where MTR takes place

00:03:33.953 --> 00:03:37.405
and millions more downstream and downwind.

00:03:38.223 --> 00:03:40.778
What has been the response
of industry and government

00:03:40.802 --> 00:03:43.275
when these issues are documented?

00:03:43.299 --> 00:03:46.847
And again, what is the ethical
obligation of science

00:03:46.871 --> 00:03:49.275
when faced with this disturbing situation?

NOTE Paragraph

00:03:50.760 --> 00:03:53.537
I began to research this issue in 2006.

00:03:53.966 --> 00:03:56.474
I had just taken a job
at West Virginia University.

00:03:56.498 --> 00:03:59.911
Before then, I hadn't done
any research related to coal.

00:04:00.812 --> 00:04:02.923
But I started to hear stories

00:04:02.947 --> 00:04:05.828
from people who lived
in these mining communities.

00:04:05.852 --> 00:04:09.149
They said that the water
they drank was not clean,

00:04:09.173 --> 00:04:11.529
that the air they breathed was polluted.

00:04:12.244 --> 00:04:14.299
They would tell me
about their own illnesses

00:04:14.323 --> 00:04:16.298
or illnesses in their family.

00:04:16.322 --> 00:04:20.070
They were worried about how common
cancer was in their neighborhoods.

00:04:20.394 --> 00:04:22.649
I met with many people
in southern West Virginia

00:04:22.673 --> 00:04:24.006
and eastern Kentucky

00:04:24.030 --> 00:04:26.701
to listen to those stories
and hear their concerns.

00:04:26.725 --> 00:04:28.923
I searched the scientific literature

00:04:28.947 --> 00:04:31.859
and was surprised to learn
that nothing had been published

00:04:31.883 --> 00:04:35.696
on the public health effects
of coal mining in the United States.

00:04:35.720 --> 00:04:36.879
Let me say that again --

00:04:36.903 --> 00:04:39.569
nothing had been published
on the public health effects

00:04:39.593 --> 00:04:41.260
of coal mining in the US.

NOTE Paragraph

00:04:42.038 --> 00:04:45.268
So I thought, "I can make
a new contribution,

00:04:45.292 --> 00:04:46.758
no matter what I find,

00:04:47.617 --> 00:04:51.196
to either confirm these concerns
or to alleviate them."

00:04:51.523 --> 00:04:54.456
I had no personal
or organizational agenda.

00:04:55.515 --> 00:04:58.062
Many of my colleagues
initially were skeptical

00:04:58.086 --> 00:05:01.220
that there would be any link
between public health and mining.

00:05:01.244 --> 00:05:05.466
They predicted that the health problems
could be explained by poverty

00:05:05.490 --> 00:05:08.410
or by lifestyle issues,
like smoking and obesity.

00:05:09.196 --> 00:05:12.283
When I started, I thought
maybe they would be right.

00:05:13.204 --> 00:05:15.773
We started by analyzing existing databases

00:05:15.797 --> 00:05:19.490
that allowed us to link
population health to mining activity

00:05:19.514 --> 00:05:25.062
and to control statistically for age, sex,
race, smoking, obesity, poverty,

00:05:25.086 --> 00:05:28.565
education, health insurance
and others we could measure.

00:05:29.847 --> 00:05:33.260
We found evidence that confirmed
the concerns of the residents,

00:05:33.284 --> 00:05:35.450
and we started to publish our findings.

NOTE Paragraph

00:05:36.514 --> 00:05:38.014
As a very brief summary,

00:05:38.038 --> 00:05:41.927
we found that people who live
where mountaintop removal takes place

00:05:41.951 --> 00:05:46.086
have significantly higher levels
of cardiovascular disease,

00:05:46.110 --> 00:05:49.575
kidney disease and chronic
lung disease like COPD.

00:05:50.482 --> 00:05:53.260
Death rates from cancer
are significantly elevated,

00:05:53.284 --> 00:05:55.084
especially for lung cancer.

00:05:55.680 --> 00:05:58.244
We've seen evidence
for higher rates of birth defects

00:05:58.268 --> 00:06:00.458
and for babies born at low birth weight.

00:06:01.172 --> 00:06:05.664
The difference in total mortality
equates to about 1,200 excess deaths

00:06:05.688 --> 00:06:09.910
every year in MTR areas,
controlling for other risks.

00:06:09.934 --> 00:06:12.817
Twelve hundred excess deaths every year.

00:06:13.855 --> 00:06:15.395
Not only are death rates higher,

00:06:15.419 --> 00:06:17.664
but they increase
as the levels of mining go up

00:06:17.688 --> 00:06:19.422
in a dose-response manner.

00:06:19.863 --> 00:06:23.458
Next, we started to conduct
community door-to-door health surveys.

00:06:23.482 --> 00:06:27.024
We surveyed people
living within a few miles of MTR

00:06:27.048 --> 00:06:29.410
versus similar rural
communities without mining.

00:06:30.188 --> 00:06:34.173
Survey results show higher levels
of personal and family illness,

00:06:34.197 --> 00:06:36.418
self-reported health status is poorer,

00:06:36.442 --> 00:06:39.956
and illness symptoms across
a broad spectrum are more common.

NOTE Paragraph

00:06:40.879 --> 00:06:43.402
These studies are only associational.

00:06:44.268 --> 00:06:47.577
We all know that correlation
does not prove causation.

00:06:48.315 --> 00:06:49.951
These studies did not include data

00:06:49.975 --> 00:06:52.855
on the actual environmental conditions
in mining communities.

00:06:52.879 --> 00:06:56.500
So we started to collect
and report on that.

00:06:57.609 --> 00:07:00.379
We found that violations
of public drinking-water standards

00:07:00.403 --> 00:07:04.745
are seven times more common
in MTR areas versus non-mining areas.

00:07:05.266 --> 00:07:07.156
We collected air samples

00:07:07.180 --> 00:07:10.386
and found that particulate matter
is elevated in mining communities,

00:07:10.410 --> 00:07:12.278
especially in the ultra-fine range.

00:07:12.629 --> 00:07:16.660
The dust in mining communities
contains a complex mixture,

00:07:16.684 --> 00:07:20.795
but includes high levels of silica,
a known lung carcinogen,

00:07:20.819 --> 00:07:23.688
and potentially harmful organic compounds.

00:07:23.712 --> 00:07:26.260
We used the dust in laboratory experiments

00:07:26.284 --> 00:07:29.958
and found that it induced
cardiovascular dysfunction in rats.

00:07:30.482 --> 00:07:32.339
The dust also promoted the development

00:07:32.363 --> 00:07:35.875
of lung cancer in human
in vitro lung cells.

00:07:37.141 --> 00:07:40.040
This is just a quick summary
of some of our studies.

NOTE Paragraph

00:07:41.194 --> 00:07:44.727
The coal industry does not like
what we have to say.

00:07:46.242 --> 00:07:48.805
Neither does the government
in coal country.

00:07:49.203 --> 00:07:52.228
Just like the tobacco industry
paid for research

00:07:52.252 --> 00:07:54.410
to defend the safety of smoking,

00:07:54.434 --> 00:07:56.545
so the coal industry
has tried to do the same

00:07:56.569 --> 00:08:00.282
by paying people to write papers
claiming that MTR is safe.

00:08:00.913 --> 00:08:04.992
Lawyers have sent me harassing demands
under the Freedom of Information Act,

00:08:05.016 --> 00:08:07.149
eventually denied by the courts.

00:08:07.754 --> 00:08:11.125
I'd been attacked at public testimony
at a Congressional hearing

00:08:11.149 --> 00:08:14.122
by a congressman
with ties to the energy industry.

00:08:14.863 --> 00:08:19.432
One governor has publicly declared
that he refuses to read the research.

00:08:20.238 --> 00:08:23.976
And after a meeting
with a member of Congress,

00:08:24.000 --> 00:08:26.233
in which I specifically
shared my research,

00:08:26.257 --> 00:08:29.746
I later heard that representative say
they knew nothing about it.

NOTE Paragraph

00:08:30.855 --> 00:08:33.395
I worked with scientists
at the US Geological Survey

00:08:33.419 --> 00:08:36.260
on environmental sampling
for more than two years.

00:08:36.284 --> 00:08:38.966
And just as they were starting
to publish their findings,

00:08:38.990 --> 00:08:41.244
they were suddenly instructed
by their superiors

00:08:41.268 --> 00:08:43.201
to stop work on this project.

00:08:43.751 --> 00:08:47.840
In August of this year,
the National Academy of Sciences

00:08:47.864 --> 00:08:50.236
was suddenly instructed
by the federal government

00:08:50.260 --> 00:08:52.522
to stop their independent review

00:08:52.546 --> 00:08:55.274
of the public health consequences
of surface mining.

00:08:56.037 --> 00:08:58.907
These actions are politically
motivated, in my view.

NOTE Paragraph

00:09:00.323 --> 00:09:03.457
But there is opposition
from researchers, too.

00:09:04.236 --> 00:09:07.204
At conferences or meetings,
they express skepticism.

00:09:07.695 --> 00:09:11.499
OK, we are all taught,
as scientists, to be skeptical.

00:09:12.141 --> 00:09:15.355
They ask, "What about
this possible explanation?"

00:09:15.379 --> 00:09:18.402
"Have you considered
that alternative interpretation?"

00:09:18.712 --> 00:09:22.196
They wonder, "There must be
some confounder that we missed.

00:09:22.220 --> 00:09:25.389
Some other variable
we haven't accounted for."

00:09:25.863 --> 00:09:28.403
"An in vitro study, what does that prove?"

00:09:28.427 --> 00:09:33.173
"A rat study -- how do we know the same
effects would be found in people?"

00:09:34.433 --> 00:09:35.583
Maybe so.

00:09:36.107 --> 00:09:39.019
Technically, you have to acknowledge
that they could be right,

00:09:39.043 --> 00:09:42.917
but you know, maybe these health problems

00:09:42.941 --> 00:09:45.664
are not the result
of some unmeasured confound.

00:09:46.545 --> 00:09:49.291
Maybe they result
from blowing up mountains

00:09:49.315 --> 00:09:51.029
over people's heads.

NOTE Paragraph

00:09:51.053 --> 00:09:53.397
(Laughter)

NOTE Paragraph

00:09:53.421 --> 00:10:00.167
(Applause)

NOTE Paragraph

00:10:00.191 --> 00:10:03.577
There can always be doubt,
if doubt is what you seek.

00:10:03.601 --> 00:10:06.220
Because we can never do that
defining experiment.

00:10:06.244 --> 00:10:09.691
Any next study
must always be associational.

00:10:10.720 --> 00:10:13.506
So perhaps you can understand
why I've started to wonder,

00:10:13.530 --> 00:10:15.895
how much evidence is enough?

00:10:15.919 --> 00:10:19.319
I've published over 30 papers
on this topic so far.

00:10:19.760 --> 00:10:23.061
Along with my coauthors, other researchers
have added to the evidence,

00:10:23.085 --> 00:10:25.347
yet government doesn't want to listen,

00:10:25.371 --> 00:10:28.283
and the industry says
it's only correlational.

00:10:28.307 --> 00:10:30.973
They say Appalachians
have lifestyle issues.

00:10:30.997 --> 00:10:32.772
As though it had never occurred to us

00:10:32.796 --> 00:10:35.474
to control for smoking or obesity
or poverty or education

00:10:35.498 --> 00:10:36.831
or health insurance.

00:10:37.442 --> 00:10:39.609
We controlled for all of those and more.

NOTE Paragraph

00:10:40.903 --> 00:10:44.402
There comes a point
where we don't need more research,

00:10:44.784 --> 00:10:48.244
where we can't ask people
to be unwilling research subjects

00:10:48.268 --> 00:10:50.996
so we can do the next study.

00:10:52.817 --> 00:10:55.198
As scientists, we follow
the data wherever it goes,

00:10:55.222 --> 00:10:57.246
but sometimes data can only take us so far

00:10:57.270 --> 00:11:00.260
and we have to decide,
as thinking, feeling human beings,

00:11:00.284 --> 00:11:03.017
what it means and when it is time to act.

00:11:03.775 --> 00:11:06.927
I think that is true, not only for MTR
but for other situations

00:11:06.951 --> 00:11:11.243
where evidence is strong
and concerning but imperfect.

00:11:11.934 --> 00:11:15.983
And when failing to act if you're wrong
means people's lives.

NOTE Paragraph

00:11:17.721 --> 00:11:20.508
It may seem strange
that there is any controversy

00:11:20.532 --> 00:11:23.620
over the health effects
of mountaintop-removal mining.

00:11:24.332 --> 00:11:26.174
But somehow, this subject has wound up

00:11:26.198 --> 00:11:28.536
in a scientific
and political twilight zone

00:11:28.560 --> 00:11:30.681
alongside the debate over climate change

00:11:30.705 --> 00:11:32.120
or the argument years ago

00:11:32.144 --> 00:11:34.739
about whether or not
smoking caused cancer.

00:11:35.865 --> 00:11:39.468
In this twilight zone, much of the data
seems to point to one conclusion.

00:11:39.492 --> 00:11:42.778
But the economics or the politics
or the prevailing public view

00:11:42.802 --> 00:11:45.068
insist on the opposite conclusion.

00:11:46.180 --> 00:11:49.101
When you're a scientist
and you think you have a valid insight

00:11:49.125 --> 00:11:51.476
where the health
of entire populations is at stake

00:11:51.510 --> 00:11:53.823
but you find yourself trapped

00:11:53.847 --> 00:11:57.355
in this twilight zone
of denial and disbelief,

00:11:57.379 --> 00:12:00.179
what is your moral and ethical obligation?

NOTE Paragraph

00:12:01.625 --> 00:12:05.609
Obviously, scientists are responsible
for telling the truth as they see it,

00:12:05.633 --> 00:12:06.942
based on evidence.

00:12:07.331 --> 00:12:10.408
Simply stated, we have an obligation
to stand up for the data.

00:12:11.625 --> 00:12:14.693
It can be extremely frustrating
to wait around for public opinion

00:12:14.717 --> 00:12:17.950
or political consensus to catch up
to the scientific understanding.

00:12:17.974 --> 00:12:22.140
But the more controversial the subject
and the more frustrating the debate,

00:12:22.164 --> 00:12:26.029
the more critical it is for scientists
to preserve our objectivity

00:12:26.053 --> 00:12:28.253
and our reputation for integrity.

00:12:28.823 --> 00:12:31.363
Because integrity is the coin of the realm

00:12:31.387 --> 00:12:33.879
in scientific and public policy debate.

NOTE Paragraph

00:12:33.903 --> 00:12:35.118
In the long run,

00:12:35.142 --> 00:12:38.871
our reputation for integrity
is the most powerful tool that we have,

00:12:38.895 --> 00:12:41.838
even more powerful than the data itself.

00:12:42.535 --> 00:12:45.346
Without an acknowledged integrity
on the part of scientists,

00:12:45.370 --> 00:12:47.488
no amount of data
will ever convince people

00:12:47.512 --> 00:12:50.112
to believe painful or difficult truths.

00:12:50.958 --> 00:12:56.085
But when we cultivate and guard
our reputation for integrity,

00:12:56.109 --> 00:12:59.260
when we patiently stand up for the data
and keep doing the studies

00:12:59.284 --> 00:13:02.006
and keep calmly bringing
the results to the public,

00:13:02.030 --> 00:13:04.474
that's when we have our greatest impact.

NOTE Paragraph

00:13:05.585 --> 00:13:11.781
Eventually, scientific truth
does and will win out.

00:13:13.141 --> 00:13:15.941
How many lives will be lost while we wait?

00:13:16.433 --> 00:13:17.583
Too many already.

00:13:18.218 --> 00:13:20.090
But prevail we will.

NOTE Paragraph

00:13:21.004 --> 00:13:22.185
Thank you.

NOTE Paragraph

00:13:22.209 --> 00:13:29.094
(Applause)