Date on Master's Thesis/Doctoral Dissertation


Document Type

Master's Thesis

Degree Name



Epidemiology and Population Health

Committee Chair

Zierold, Kristina M.

Committee Co-Chair (if applicable)

Brock, Guy

Committee Member

Brock, Guy

Committee Member

Polivka, Barbara


Coal ash--Health aspects; Coal ash sites--Environmental aspects; Sleep disorders in children


Kentucky is the fifth largest producer of coal ash, a by-product of coal combustion. The small spherical coal ash particles contain heavy metals like arsenic, lead, mercury, and cadmium. Coal ash is currently classified as nonhazardous by the EPA, which allows it to be stored in open-air impoundments near low-income communities. The primary object of the study is to determine the prevalence of sleep disruptive behaviors in children exposed to coal ash, compared to a group of demographically similar non-exposed children. Parents or guardians from five neighborhoods surrounding a coal ash storage facility, and one non-exposed community, participated in a cross-sectional survey about the health and sleep of children living in their home. Delay in sleep onset (p= 0.007), frequent night awakenings (p= 0.0001), teeth grinding (p= 0.03), lip smacking (p=0.006), snoring (p= 0.002), and complaint of leg cramps while resting (p= 0.0004) were significantly greater in the exposed group compared to the non-exposed group. When controlling for both health and environmental factors, the odds of frequent night awakenings were significantly greater in the exposed group compared to the non-exposed group (OR= 6.9, CI= 2.2-21). It is important to further evaluate the association between frequent night awakenings and coal ash exposure because of the potential long-term cognitive and biological impacts on children.

Included in

Epidemiology Commons