Opencast coal mining releases a mixture of air pollutants that pose significant risks to surrounding communities. This cross-sectional epidemiological study assessed the respiratory health of residents living within a 10-kilometer radius of the Bashundhara West opencast coal mine in Odisha, India, with particular focus on chronic obstructive pulmonary disease (COPD). Pulmonary function tests revealed an overall COPD prevalence of 31%, with a disproportionately higher burden among women (39.8%) compared to men (20.7%). Geographical disparities were also evident: Zone 2 (3 to 10 km from the mine) exhibited a COPD prevalence of 36.1%, substantially higher than Zone 1 (within 3 km, 24%). Notably, relative risk (0.66) and odds ratio (0.56) analyses indicated a lower likelihood of COPD among residents living closer to the mine, a counterintuitive finding that may reflect modifying factors such as household biomass smoke exposure, forest cover acting as a natural buffer, or individual susceptibility patterns. In addition, high rates of tuberculosis and smoking were observed, compounding respiratory health risks in the study area. Using annual mean PM2.5 concentrations (31.9 µg m⁻³), an estimated five deaths (1.7% of all-cause mortality) were attributable to air pollution-related cardiovascular impacts. These findings demonstrate a high burden of COPD in coalfield communities, with clear gender and spatial disparities, and highlight the interaction between ambient emissions and indoor exposures. The results emphasize the urgent need for expanded rural air quality monitoring, stronger clean fuel adoption programs, community-based screening for COPD, and integration of ecological buffers into mine management to protect vulnerable populations.
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