0:00:00.857,0:00:04.324
Let's say that you wanted[br]to conduct an experiment.

0:00:05.000,0:00:06.151
In this experiment,

0:00:06.175,0:00:09.571
you randomly assign people[br]to live in blasting zones

0:00:10.133,0:00:15.276
or in control locations without explosives[br]going off over their heads.

0:00:16.300,0:00:18.072
They live in the community for years,

0:00:18.096,0:00:20.026
just downwind and downstream

0:00:20.050,0:00:23.521
from sites where tons of explosives[br]are used almost daily.

0:00:24.093,0:00:26.728
And millions of gallons[br]of water contaminated.

0:00:27.323,0:00:30.823
With random assignment,[br]you could carefully study

0:00:30.847,0:00:34.890
the long-term health effects[br]of living in these blasting communities

0:00:34.914,0:00:38.300
without a bunch of annoying[br]confounders and covariates.

0:00:39.061,0:00:41.323
Random assignment does wonders.

0:00:42.782,0:00:46.561
That would be a rigorous,[br]powerful scientific inquiry

0:00:46.585,0:00:49.354
into the effects of these[br]environmental exposures.

0:00:49.838,0:00:52.456
Of course, such a study[br]could never be done.

0:00:52.895,0:00:55.537
Most scientists wouldn't have[br]the stomach for it.

0:00:55.942,0:00:58.483
The institutional review board[br]would never approve it;

0:00:58.507,0:01:00.581
it would never pass human subjects review,

0:01:00.605,0:01:03.205
because it would be unethical, immoral.

0:01:04.257,0:01:07.102
And yet in effect,[br]it is happening right now.

0:01:08.503,0:01:10.776
In my mind, it's prompted some questions.

0:01:10.800,0:01:12.298
What is the ethical obligation

0:01:12.322,0:01:15.522
of the scientists who believes[br]populations are in danger?

0:01:16.592,0:01:20.552
How much evidence is enough[br]to be confident of our conclusions?

0:01:21.179,0:01:26.083
Where is the line between[br]scientific certainty and the need to act?

0:01:27.131,0:01:29.566
The unplanned experiment[br]that is happening right now

0:01:29.590,0:01:31.585
is called mountaintop removal.

0:01:31.609,0:01:33.823
The abbreviation for it is MTR.

0:01:34.371,0:01:36.236
It is a form of surface coal mining

0:01:36.260,0:01:39.271
that takes place in Appalachia,[br]here in the United States.

0:01:40.276,0:01:45.323
MTR occurs in four states: Virginia,[br]West Virginia, Kentucky and Tennessee.

0:01:46.208,0:01:50.358
Over 1.2 million acres[br]have been mined in this way.

0:01:50.382,0:01:52.977
This is an area about the size of Delaware

0:01:53.001,0:01:55.300
but it is spread over a footprint

0:01:55.324,0:01:58.203
as large as Vermont[br]and New Hampshire combined.

0:01:59.465,0:02:03.590
The process involves clear-cutting[br]ancient Appalachian forest,

0:02:03.614,0:02:06.285
home to some of the richest[br]biodiversity on the planet.

0:02:07.037,0:02:10.615
The trees are typically burned[br]or dumped into adjacent valleys.

0:02:11.450,0:02:14.530
Then, to reach the buried coal seams,

0:02:14.554,0:02:20.309
explosives are used to remove[br]up to 800 feet of mountain elevation.

0:02:21.458,0:02:23.895
Over 1500 tons of explosives

0:02:23.919,0:02:26.656
are used for coal mining[br]in West Virginia alone.

0:02:27.339,0:02:29.037
Every day.

0:02:30.123,0:02:32.607
Rock and soil debris[br]is dumped over the valley sides,

0:02:32.631,0:02:35.315
where it permanently buries[br]headwater streams.

0:02:35.339,0:02:39.978
So far, over 500 mountains[br]have been destroyed.

0:02:41.091,0:02:44.646
About 2,000 miles of streams[br]have been permanently buried.

0:02:44.670,0:02:48.376
Water emerging from the base[br]of the valley fills is highly contaminated

0:02:48.400,0:02:50.867
and remains contaminated for decades.

0:02:51.489,0:02:53.498
The coal then has to be[br]chemically treated,

0:02:53.522,0:02:57.527
crushed and washed before it can be[br]transported to power plants and burned.

0:02:58.276,0:03:00.409
This cleaning takes place on-site.

0:03:00.807,0:03:03.895
The process produces more air pollution

0:03:03.919,0:03:07.617
and contaminates billions[br]of gallons of water with metals,

0:03:07.641,0:03:11.224
sulfates, cleaning chemicals[br]and other impurities.

0:03:12.219,0:03:17.664
All of this to produce three percent[br]of US electricity demand --

0:03:17.688,0:03:21.140
only three percent[br]of US electricity demand.

0:03:22.544,0:03:26.075
As you can appreciate, this prompts[br]all sorts of other questions.

0:03:26.099,0:03:28.885
What are the health impacts[br]of mountaintop-removal mining?

0:03:28.909,0:03:33.929
There are over a million people[br]who live in counties where MTR takes place

0:03:33.953,0:03:37.405
and millions more downstream and downwind.

0:03:38.223,0:03:40.778
What has been the response[br]of industry and government

0:03:40.802,0:03:43.275
when these issues are documented?

0:03:43.299,0:03:46.847
And again, what is the ethical[br]obligation of science

0:03:46.871,0:03:49.275
when faced with this disturbing situation?

0:03:50.760,0:03:53.537
I began to research this issue in 2006.

0:03:53.966,0:03:56.474
I had just taken a job[br]at West Virginia University.

0:03:56.498,0:03:59.911
Before then, I hadn't done[br]any research related to coal.

0:04:00.812,0:04:02.923
But I started to hear stories

0:04:02.947,0:04:05.828
from people who lived[br]in these mining communities.

0:04:05.852,0:04:09.149
They said that the water[br]they drank was not clean,

0:04:09.173,0:04:11.529
that the air they breathed was polluted.

0:04:12.244,0:04:14.299
They would tell me[br]about their own illnesses

0:04:14.323,0:04:16.298
or illnesses in their family.

0:04:16.322,0:04:20.070
They were worried about how common[br]cancer was in their neighborhoods.

0:04:20.394,0:04:22.649
I met with many people[br]in southern West Virginia

0:04:22.673,0:04:24.006
and eastern Kentucky

0:04:24.030,0:04:26.701
to listen to those stories[br]and hear their concerns.

0:04:26.725,0:04:28.923
I searched the scientific literature

0:04:28.947,0:04:31.859
and was surprised to learn[br]that nothing had been published

0:04:31.883,0:04:35.696
on the public health effects[br]of coal mining in the United States.

0:04:35.720,0:04:36.879
Let me say that again --

0:04:36.903,0:04:39.569
nothing had been published[br]on the public health effects

0:04:39.593,0:04:41.260
of coal mining in the US.

0:04:42.038,0:04:45.268
So I thought, "I can make[br]a new contribution,

0:04:45.292,0:04:46.758
no matter what I find.

0:04:47.617,0:04:51.196
To either confirm these concerns[br]or to alleviate them.

0:04:51.523,0:04:54.456
I had no personal[br]or organizational agenda.

0:04:55.515,0:04:58.062
Many of my colleague[br]initially were skeptical

0:04:58.086,0:05:01.220
that there would be any link[br]between public health and mining.

0:05:01.244,0:05:05.466
They predicted that the health problems[br]could be explained by poverty

0:05:05.490,0:05:08.410
or by lifestyle issues,[br]like smoking and obesity.

0:05:09.196,0:05:12.283
When I started, I thought[br]maybe they would be right.

0:05:13.204,0:05:15.773
We started by analyzing existing databases

0:05:15.797,0:05:19.490
that allowed us to link[br]population health to mining activity

0:05:19.514,0:05:25.062
and to control statistically for age, sex,[br]race, smoking, obesity, poverty,

0:05:25.086,0:05:28.565
education, health insurance[br]and others we could measure.

0:05:29.847,0:05:33.260
We found evidence that confirmed[br]the concerns of the residents

0:05:33.284,0:05:35.450
and we started to publish our findings.

0:05:36.514,0:05:38.014
As a very brief summary,

0:05:38.038,0:05:41.927
we found that people who live[br]where mountaintop removal takes place

0:05:41.951,0:05:46.086
have significantly higher levels[br]of cardiovascular disease,

0:05:46.110,0:05:49.575
kidney disease and chronic[br]lung disease like COPD.

0:05:50.482,0:05:53.260
Death rates from cancer[br]are significantly elevated,

0:05:53.284,0:05:55.084
especially for lung cancer.

0:05:55.680,0:05:58.244
We've seen evidence[br]for higher rates of birth defects

0:05:58.268,0:06:00.458
and for babies born at low birth weight.

0:06:01.172,0:06:05.664
The difference in total mortality[br]equates to about 1200 excess deaths

0:06:05.688,0:06:09.910
every year in MTR areas,[br]controlling for other risks.

0:06:09.934,0:06:12.817
Twelve hundred excess deaths every year.

0:06:13.855,0:06:15.395
Not only are death rates higher,

0:06:15.419,0:06:17.664
but they increase[br]as the levels of mining go up

0:06:17.688,0:06:19.422
in a dose-response manner.

0:06:19.863,0:06:23.458
Next, we started to conduct[br]community door-to-door health surveys.

0:06:23.482,0:06:27.024
We surveyed people[br]living within a few miles of MTR

0:06:27.048,0:06:29.410
versus similar rural[br]communities without mining.

0:06:30.188,0:06:34.173
Survey results show higher levels[br]of personal and family illness,

0:06:34.197,0:06:36.418
self-reported health status is poorer

0:06:36.442,0:06:39.956
and illness symptoms across[br]a broad spectrum are more common.

0:06:40.879,0:06:43.402
These studies are only associational.

0:06:44.268,0:06:47.577
We all know that correlation[br]does not prove causation.

0:06:48.315,0:06:49.951
These studies did not include data

0:06:49.975,0:06:52.855
on the actual environmental conditions[br]in mining communities.

0:06:52.879,0:06:56.500
So we started to collect[br]and report on that.

0:06:57.609,0:07:00.379
We found that violations[br]of public drinking-water standards

0:07:00.403,0:07:04.745
are seven times more common[br]in MTR areas versus non-mining areas.

0:07:05.266,0:07:07.156
We collected air samples

0:07:07.180,0:07:10.386
and found that particulate matter[br]is elevated in mining communities,

0:07:10.410,0:07:12.278
especially in the ultra-fine range.

0:07:12.629,0:07:16.660
The dust in mining communities[br]contains a complex mixture,

0:07:16.684,0:07:20.795
but includes high levels of silica,[br]a known lung carcinogen,

0:07:20.819,0:07:23.688
and potentially harmful organic compounds.

0:07:23.712,0:07:26.260
We used the dust in laboratory experiments

0:07:26.284,0:07:29.958
and found that it induced[br]cardiovascular dysfunction in rats.

0:07:30.482,0:07:32.339
The dust also promoted the development

0:07:32.363,0:07:35.875
of lung cancer in human[br]in vitro lung cells.

0:07:37.141,0:07:40.040
This is just a quick summary[br]of some of our studies.

0:07:41.194,0:07:44.727
The coal industry does not like[br]what we have to say.

0:07:46.242,0:07:48.805
Neither does the government[br]in coal country.

0:07:49.203,0:07:52.228
Just like the tobacco industry[br]paid for research

0:07:52.252,0:07:54.410
to defend the safety of smoking,

0:07:54.434,0:07:56.545
so the coal industry[br]has tried to do the same

0:07:56.569,0:08:00.282
by paying people to write papers[br]claiming that MTR is safe.

0:08:00.913,0:08:04.992
Lawyers have sent me harassing demands[br]under the Freedom of Information Act,

0:08:05.016,0:08:07.149
eventually denied by the courts.

0:08:07.754,0:08:11.125
I'd been attacked at public testimony[br]at a Congressional hearing

0:08:11.149,0:08:14.122
by a congressman[br]with ties to the energy industry.

0:08:14.863,0:08:19.432
One governor has publicly declared[br]that he refuses to read the research.

0:08:20.238,0:08:23.976
And after a meeting[br]with a member of Congress,

0:08:24.000,0:08:26.233
in which I specifically[br]shared my research,

0:08:26.257,0:08:29.746
I later heard that representative say[br]they knew nothing about it.

0:08:30.855,0:08:33.395
I worked with scientists[br]at the US Geological Survey

0:08:33.419,0:08:36.260
on environmental sampling[br]for more than two years.

0:08:36.284,0:08:38.966
And just as they were starting[br]to publish their findings,

0:08:38.990,0:08:41.244
they were suddenly instructed[br]by their superiors

0:08:41.268,0:08:43.201
to stop work on this project.

0:08:43.751,0:08:47.840
In August of this year,[br]the National Academy of Sciences

0:08:47.864,0:08:50.236
was suddenly instructed[br]by the federal government

0:08:50.260,0:08:52.522
to stop their independent review

0:08:52.546,0:08:55.274
of the public health consequences[br]of surface mining.

0:08:56.037,0:08:58.907
These actions are politically[br]motivated, in my view.

0:09:00.323,0:09:03.457
But there is opposition[br]from researchers, too.

0:09:04.236,0:09:07.204
At conferences or meetings,[br]they express skepticism.

0:09:07.695,0:09:11.499
OK, we are all taught,[br]as scientists, to be skeptical.

0:09:12.141,0:09:15.355
They ask, "What about[br]this possible explanation?"

0:09:15.379,0:09:18.402
"Have you considered[br]that alternative interpretation?"

0:09:18.712,0:09:22.196
They wonder, "There must be[br]some confounder that we missed.

0:09:22.220,0:09:25.389
Some other variable[br]we haven't accounted for."

0:09:25.863,0:09:28.403
"An in vitro study, what does that prove?"

0:09:28.427,0:09:33.173
"A rat study -- how do we know the same[br]effects would be found in people?"

0:09:34.433,0:09:35.583
Maybe so.

0:09:36.107,0:09:39.019
Technically, you have to acknowledge[br]that they could be right,

0:09:39.043,0:09:42.917
but you know, maybe these health problems

0:09:42.941,0:09:45.664
are not the result[br]of some unmeasured confound.

0:09:46.545,0:09:49.291
Maybe they result[br]from blowing up mountains

0:09:49.315,0:09:51.029
over people's heads.

0:09:51.053,0:09:53.397
(Laughter)

0:09:53.421,0:10:00.167
(Applause)

0:10:00.191,0:10:03.577
There can always be doubt,[br]if doubt is what you seek.

0:10:03.601,0:10:06.220
Because we can never do that[br]defining experiment.

0:10:06.244,0:10:09.691
Any next study[br]must always be associational.

0:10:10.720,0:10:13.506
So perhaps you can understand[br]why I've started to wonder,

0:10:13.530,0:10:15.895
how much evidence is enough?

0:10:15.919,0:10:19.319
I've published over 30 papers[br]on this topic so far.

0:10:19.760,0:10:23.061
Along with my coauthors, other researchers[br]have added to the evidence,

0:10:23.085,0:10:25.347
yet government doesn't want to listen

0:10:25.371,0:10:28.283
and the industry says[br]it's only correlational.

0:10:28.307,0:10:30.973
They say Appalachians[br]have lifestyle issues.

0:10:30.997,0:10:32.772
As though it had never occurred to us

0:10:32.796,0:10:35.474
to control for smoking or obesity[br]or poverty or education

0:10:35.498,0:10:36.831
or health insurance.

0:10:37.442,0:10:39.609
We controlled for all of those and more.

0:10:40.903,0:10:44.402
There comes a point[br]where we don't need more research.

0:10:44.784,0:10:48.244
Where we can't ask people[br]to be unwilling research subjects

0:10:48.268,0:10:50.996
so we can do the next study.

0:10:52.817,0:10:55.198
As scientists, we follow[br]the data wherever it goes,

0:10:55.222,0:10:57.246
but sometimes data can only take us so far

0:10:57.270,0:11:00.260
and we have to decide,[br]as thinking, feeling human beings,

0:11:00.284,0:11:03.017
what it means and when it is time to act.

0:11:03.775,0:11:06.927
I think that is true, not only for MTR[br]but for other situations

0:11:06.951,0:11:11.243
where evidence is strong[br]and concerning but imperfect.

0:11:11.934,0:11:15.983
And when failing to act if you're wrong[br]means people's lives.

0:11:17.721,0:11:20.508
It may seem strange[br]that there is any controversy

0:11:20.532,0:11:23.620
over the health effects[br]of mountaintop-removal mining.

0:11:24.332,0:11:26.174
But somehow, this subject has wound up

0:11:26.198,0:11:28.536
in a scientific[br]and political twilight zone

0:11:28.560,0:11:30.681
alongside the debate over climate change

0:11:30.705,0:11:32.120
or the argument years ago

0:11:32.144,0:11:34.739
about whether or not[br]smoking caused cancer.

0:11:35.865,0:11:39.468
In this twilight zone, much of the data[br]seems to point to one conclusion.

0:11:39.492,0:11:42.778
But the economics or the politics[br]or the prevailing public view

0:11:42.802,0:11:45.068
insist on the opposite conclusion.

0:11:46.180,0:11:49.101
When you're a scientist[br]and you think you have a valid insight

0:11:49.125,0:11:51.426
where the health[br]of entire population is at stake

0:11:51.450,0:11:53.823
but you find yourself trapped

0:11:53.847,0:11:57.355
in this twilight zone[br]of denial and disbelief,

0:11:57.379,0:12:00.179
what is your moral and ethical obligation?

0:12:01.625,0:12:05.609
Obviously, scientists are responsible[br]for telling the truth as they see it,

0:12:05.633,0:12:06.942
based on evidence.

0:12:07.331,0:12:10.408
Simply stated, we have an obligation[br]to stand up for the data.

0:12:11.625,0:12:14.693
It can be extremely frustrating[br]to wait around for public opinion

0:12:14.717,0:12:17.950
or political consensus to catch up[br]to the scientific understanding.

0:12:17.974,0:12:22.140
But the more controversial the subject[br]and the more frustrating the debate,

0:12:22.164,0:12:26.029
the more critical it is for scientists[br]to preserve our objectivity

0:12:26.053,0:12:28.253
and our reputation for integrity.

0:12:28.823,0:12:31.363
Because integrity is the coin of the realm

0:12:31.387,0:12:33.879
in scientific and public policy debate.

0:12:33.903,0:12:35.118
In the long run,

0:12:35.142,0:12:38.871
our reputation for integrity[br]is the most powerful tool that we have,

0:12:38.895,0:12:41.838
even more powerful than the data itself.

0:12:42.535,0:12:45.346
Without an acknowledged integrity[br]on the part of scientists,

0:12:45.370,0:12:47.488
no amount of data[br]will ever convince people

0:12:47.512,0:12:50.112
to believe painful or difficult truths.

0:12:50.958,0:12:56.085
But when we cultivate and guard[br]our reputation for integrity,

0:12:56.109,0:12:59.260
when we patiently stand up for the data[br]and keep doing the studies

0:12:59.284,0:13:02.006
and keep calmly bringing[br]the results to the public,

0:13:02.030,0:13:04.474
that's when we have our greatest impact.

0:13:05.585,0:13:11.781
Eventually, scientific truth[br]does and will win out.

0:13:13.141,0:13:15.941
How many lives will be lost while we wait?

0:13:16.433,0:13:17.583
Too many already.

0:13:18.218,0:13:20.090
But prevail we will.

0:13:21.004,0:13:22.185
Thank you.

0:13:22.209,0:13:29.094
(Applause)