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Surface mining has become a major method of coal mining in Central Appalachiaalongside the traditional underground mining. Concerns have been raised aboutthe health effects of this surface mining, particularly mountaintop removalmining where coal is mined upon steep mountaintops by removing the mountaintopthrough clearcutting forests and explosives. We have designed a matchedobservational study to assess the effects of surface mining in CentralAppalachia on adverse birth outcomes. This protocol describes for the study thebackground and motivation, the sample selection and the analysis plan.

Protocol for a Study of the Effect of Surface Mining in Central Appalachia on Adverse Birth Outcomes