Date on Master's Thesis/Doctoral Dissertation


Document Type

Master's Thesis

Degree Name



Epidemiology and Population Health

Degree Program

Epidemiology, MSE

Committee Chair

Zierold, Kristina

Committee Co-Chair (if applicable)

Baumgartner, Kathy

Committee Member

Baumgartner, Kathy

Committee Member

Sears, Lonnie

Committee Member

Lorenz, Doug

Committee Member

Hanchette, Carol

Author's Keywords

fly ash; coal fly ash and neurobehavioral health; coal fly ash and children


Coal ash, a byproduct of coal combustion,is reduced in 47 U.S. states andfrequently contains heavy metals, some of which are known neurotoxins. An estimated 1.5 million children live near sites where coal ash is produced andstored, yet there have been no studies assessing coal ash exposure and children’s neuro behavioral health. This study is part of a larger cross-sectional study, Coal Ash and Neuro behavioral Symptoms in Children Aged 6- 14 Years Old, and aimed to determine the relationship between children’s memory and fine motor skill test performance and the proximity of the home to coal ash storage sites, the participants’ heavy metal body burdens, and presence of fly ash in the home. Children aged 6 to14 years who lived near coal ash storage sites in Louisville, Kentucky were recruited to participate. Participation involved the completion of a battery of neurobehavioral tests, the collection of toenails and fingernails, and air and lift sampling inthe home. Neurobehavioral test data and home distance to ash landfill were available for 55 participants, while nail analysis was available for 32 participants and fly ash data were available for 49 participants. The results of this study were impacted by a small sample size; however, several patterns were identified. Though not significant, the odds of abnormal or low performance on five neurobehavioral tests were higher among those who lived closer to an ash landfill (OR range = 1.035 -4.549). The presence of titanium, manganese, and strontium in nail samples were each significantly related to abnormal performance on certain neurobehavioral tests, while higher levels of zinc and copper were significantly related to abnormal or low test performance. Fly ash was confirmed in 42.9% of homes, and though not significant, the odds of abnormal or low performance on seven neurobehavioral tests were higher among those with fly ash in their homes (AOR range = 1.150-2.134). The relationship between memory and fine motor skill test performance should be further evaluated as the overarching study’s sample size continues to grow.

Included in

Epidemiology Commons