Assessing the impact of the 1918/1919 influenza pandemic in Missouri counties heavily involved in lead-zinc mining

Abstract

Occupational concentrations within regions have the capability to influence infectious disease transmission as they shape the way humans interact within a community. The 1918 influenza pandemic is widely discussed as the "World's Most Deadly Pandemic" (Feehan and Apostolopoulos, 2021), but little is known about how rural communities were impacted by the pandemic. Through historical data collection and analysis, this project assesses the impact of the occupational risk of mining on influenza transmission and severity during the pandemic within three rural mining districts in the state of Missouri, USA: the Tri-State District, Central District, and Old Lead Belt. Missouri mines supplied much of the lead produced during this time, with many Missourians working in closed workspaces in close proximity to each other within the mining operations. Although each district had similar high prevalences of the same occupation, they varied substantially in socioeconomic and demographic characteristics such as population density and access to healthcare. This study suggests that factors such as these allowed for variation in disease burden between mining districts to develop. The Tri-State District experienced the largest disease burden of all mining districts, followed by the Old Lead Belt. The Central District experienced the least and was the only mining district to have lower standardized mortality outcomes on average compared to the state of Missouri. These results indicate that the presence of mining may have increased disease prevalence in certain areas, in conjunction with additional demographic factors that influence disease spread. The results and methodologies from this study have the potential to be applied to other real-world situations, such as the ongoing COVID-19 pandemic, and provide insight for public health officials to make informed decisions that have the potential to improve population-level health outcomes.