Hello. I am Dr. Marti Doyle. I am a professor at a faith based health science college in Iowa. I

have traveled here today to remind you of the importance of the EPA exercising its regulatory authority for the protection of public health. While the EPA's recognition of the impact of smokestack emissions on health is a good start , this recognition should represent the beginning of the EPA's assessment of the entire fuel cycle including drilling, mining, transportation, and waste management. I ask that this assessment also include the human cost of mountaintop removal coal mining.
In March of this year I traveled with a group of health care students to West Virginia to participate in the Appalachian Community Health Research Project. The purpose of this project was to conduct health surveys in mountaintop removal and non-mountain top coal removal communities. The data from these surveys is being used by Dr. Michael Hendryx to continue his research comparing the health of individuals in these two types of communities.
When I first explored the possible of this trip, I approached the experience with an unbiased academic perspective. I thought that this would be great opportunity for students to both experience a different part of the country and have an opportunity to participate in research. I examined the two peer-reviewed journal articles based on data from previous health surveys, as well as similar research. I learned that cancer and disease rates are twice as high in mountaintop removal mining communities compared to non- mountaintop mining communities. I also learned that researchers have found significantly higher prevalence of birth defects in regions where there were mountain top removal sites. I was unprepared, however; for what I and the students would experience firsthand while conducting the surveys.The first thing that happened was that I fell in love with the land and the people of West

Virginia! The individuals and families that opened their doors and homes to us were some of the most welcoming people I have ever met. They are people of strong faith. They are hardworking, tough, and resilient. It is clear that their families are the most important part of their lives.
The second thing that happened is that I found myself becoming troubled as day after day I saw these people struggling with health challenges. After a few days of conducting surveys I found myself unsure if I was ready to see another individual struggling with a serious lung disease. The women that were my age stood out to me the most. They should be able to enjoy their lives, their children and grandchildren-to be able to live life fully. Instead they were struggling just to breathe.
After conducting a survey with an young man who told me that he had endured multiple surgeries to correct a heart defect, I thought of the story that I had heard from a student who had participated in last year's health survey. She and her fellow students had stopped at a house and asked the woman who answer the door if she had time to complete the survey. The woman answered that she was willing to participate but was getting ready to put her child down for a nap. She told the students that she always rocked her child to sleep because he had been born with a severe heart defect. When the students returned a few days later to complete the survey, they talked to the grandmother of that child and found out that the day they had talked with the mother; the child had died while taking his nap.

### I ask you to remember that these individuals represent the human costs of our country's failure to

properly invest in renewable energy sources. The suffering of the people of Appalachia must not be overlooked in any discussions of energy policy. These good people deserve better. They deserve to know the impact oft* coal mining on their and their family's health. They love and trust their country. We CAN NOT let them down. Thank you.
Marti Doyle PhD, MSW mdoylegmercydesmoines.org Office: 515-643-6774 Cell: 515-210-9321 Sources
Ahern, M.; Hendryx, M. Conley, J.; Fedorko, E.; Ducatman, A. & Zulling, K. ( 2011) . The association between mountaintop mining and birth defects among live births in central Appalachia, 1996-2003. Environ. Res. doi:10.1016/j .envres.2011.05.
Hendryx. M. (2013). Personal and Family Health in Rural Areas of Kentucky With and Without Mountaintop Coal Mining. Journal of Rural Health DOI 10.111.jrh.12016.
Hendryx, M. ; Wolfe, L.; Luo, J. & Webb, B. (2011) . Self-Reported Cancer Rates in Two Rural Areas of West Virginia with and Without Mountaintop Coal Mining. J Community Health. DOI 10.1007/s10900-011-9448-5