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Bell County, Kentucky: environmental and disease records

Cancer mortality in Bell County is 220 deaths per 100,000 people per year against a U.S. rate of 143.2, a statistically significant excess. The strongest disease signals are Lung & bronchus deaths at 2.3 times the U.S. rate. Federal databases place 873 regulated facilities, sites and hazards inside the county, led by Industrial wastewater discharge (602), Rail grade crossing (119), NPDES wastewater discharge permit (90). EPA AirToxScreen estimates a lifetime cancer risk from outdoor air toxics of 30 in a million, driven mainly by formaldehyde.

Rates are age-adjusted per 100,000 people. A cancer signal is marked significant when the lower bound of its 95 percent confidence interval is above the U.S. rate. Facility counts use active federal records located inside the county boundary. Approximate county center: 36.7694, -83.6439.

How this county ranks in Kentucky

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Cancer deaths and new cases versus the United States

Source: NCI and CDC State Cancer Profiles, both sexes, all ages. Sorted by the ratio of the county rate to the U.S. rate.

Cancer rates for Bell County compared with the United States
Cancer	Measure	County rate	U.S. rate	Times U.S.	95% interval	Years
Lung & bronchus	Deaths	70.1	30.2	2.32xSignificant	57.9 to 84.5	2020-2024
Esophagus	New cases	10.2	4.6	2.22xSignificant	5.7 to 17	2019-2023
Lung & bronchus	New cases	96.6	51.8	1.86xSignificant	82.3 to 113	2019-2023
All cancer	Deaths	220	143.2	1.54xSignificant	197.8 to 244.2	2020-2024
Liver & bile duct	New cases	12.6	8.7	1.45x	7.4 to 20.2	2019-2023
Leukemia	New cases	19.2	14.5	1.32x	13 to 27.7	2019-2023
Kidney & renal pelvis	New cases	22.6	17.9	1.26x	16 to 31.5	2019-2023
All cancer	New cases	520.8	453.4	1.15xSignificant	484.8 to 558.9	2019-2023
Pancreas	Deaths	12.7	11.3	1.12x	8 to 19.6	2020-2024
Bladder	New cases	21	18.7	1.12x	14.7 to 29.4	2019-2023
Thyroid	New cases	14.3	13	1.1x	8 to 23.3	2019-2023
Pancreas	New cases	13.9	13.9	1x	8.9 to 21.1	2019-2023
Melanoma of the skin	New cases	18.7	23.8	0.79x	12.4 to 27.3	2019-2023
Non-Hodgkin lymphoma	New cases	13.3	18.5	0.72x	8.4 to 20.6	2019-2023

Mortality measures versus the U.S. county median

Source: County Health Rankings, built from CDC National Vital Statistics System death records. The comparison value is the median of all U.S. counties.

Mortality measures for Bell County
Measure	County	U.S. median	Difference	Unit
Premature death	19,303.4	9,842.6	+96%	years of life lost before age 75 per 100,000
Life expectancy	67.3	75.3	-11%	years
Child mortality	91.1	59.8	+52%	deaths under age 18 per 100,000
Infant mortality	n/a	6.2	n/a	deaths under age 1 per 1,000 live births
Injury deaths	137.8	96.9	+42%	deaths per 100,000
Drug overdose deaths	53.5	28.6	+87%	deaths per 100,000

Air toxics and air quality

EPA AirToxScreen 2020

Lifetime cancer risk from outdoor air toxics: 30 in a million. EPA treats 100 in a million as the upper end of acceptable risk and 1 in a million as the goal.

Formaldehyde18.12 per million
Carbon Tetrachloride2.83 per million
Acetaldehyde1.83 per million
Ethylene Oxide1.52 per million

EPA Air Quality Index 2025

Monitored on 361 days: 242 good, 1 unhealthy for sensitive groups or worse. Median AQI 42, peak 101.

Regulated facilities, sites and hazards by type

873 active records inside the county from EPA ECHO, TRI, Superfund, Brownfields, NPDES, EIA, FAA, FRA and corrections data.

Industrial wastewater discharge602
Rail grade crossing119
NPDES wastewater discharge permit90
Brownfield property35
Gas station (mapped facility)12
Combined sewer overflow outfall3
Heliport3
Air permit holder (minor source)2
Landfill (mapped facility)2
EPA air quality monitor1
Public airport1
Small hazardous waste generator1
Hazardous waste transporter1
Wastewater plant (mapped facility)1

Highest-severity records

The 25 records with the highest Envyrofax severity in the county, with the agency identifier to cite in a records request.

MIDDLESBORO, Middlesborough (corporate name for Middlesboro)
EPA air quality monitor.
Record ID 210130002 (U.S. EPA AirData)
Severity 5.4
Double Mountain Mining Llc, Middlesboro
NPDES wastewater discharge permit. Penalties $4,150,000.
EPA FRS registry ID 110041027402 (U.S. EPA ECHO) Agency record
Severity 5.3
Ddb Energy Resources Llc [Consolidated], Arjay
NPDES wastewater discharge permit. Penalties $86,000.
EPA FRS registry ID 110069216645 (U.S. EPA ECHO) Agency record
Severity 5.3
Pineville Stp, Pineville
NPDES wastewater discharge permit. Penalties $2,000.
EPA FRS registry ID 110006752273 (U.S. EPA ECHO) Agency record
Severity 4.8
Givens Coal Co, Middlesboro
NPDES wastewater discharge permit. Penalties $4,150,000.
EPA FRS registry ID 110007285669 (U.S. EPA ECHO) Agency record
Severity 4.5
Double Mountain Mining, Llc, Pruden
NPDES wastewater discharge permit. Penalties $4,150,000.
EPA FRS registry ID 110056398385 (U.S. EPA ECHO) Agency record
Severity 4.5
Cardinal Reclamation Co Llc, Middlesboro
NPDES wastewater discharge permit.
EPA FRS registry ID 110071448306 (U.S. EPA ECHO) Agency record
Severity 4.5
Ferndale Apts Inc, Pineville
NPDES wastewater discharge permit. Penalties $4,000.
EPA FRS registry ID 110009936819 (U.S. EPA ECHO) Agency record
Severity 4.3
Jmr Resources Llc [807-0466 & 807-0470], Jenson
NPDES wastewater discharge permit.
EPA FRS registry ID 110044888805 (U.S. EPA ECHO) Agency record
Severity 4.3
Nally & Hamilton Enterprises Inc (807-0467), Calvin
NPDES wastewater discharge permit. Penalties $14,000.
EPA FRS registry ID 110070047506 (U.S. EPA ECHO) Agency record
Severity 4
Double Mountain Mining Llc [807-5268], Davisburg
NPDES wastewater discharge permit.
EPA FRS registry ID 110071255188 (U.S. EPA ECHO) Agency record
Severity 4
Pineville Stp, Pineville
Combined sewer overflow outfall. Significant/Category I Noncompliance.
NPDES permit KY0024058:001 (U.S. EPA NPDES)
Severity 4
Pineville Stp, Pineville
Combined sewer overflow outfall. Significant/Category I Noncompliance.
NPDES permit KY0024058:002 (U.S. EPA NPDES)
Severity 4
Pineville Stp, Pineville
Combined sewer overflow outfall. Significant/Category I Noncompliance.
NPDES permit KY0024058:003 (U.S. EPA NPDES)
Severity 4
Middlesboro Stp, Middlesboro
NPDES wastewater discharge permit.
EPA FRS registry ID 110010784516 (U.S. EPA ECHO) Agency record
Severity 3.8
Nally & Hamilton Enterprises Inc (861-0500), Fourmile
NPDES wastewater discharge permit. Penalties $25,000.
EPA FRS registry ID 110038178478 (U.S. EPA ECHO) Agency record
Severity 3.8
Nally & Hamilton Enterprises Inc (807-0339 & 848-5546), Black Snake
NPDES wastewater discharge permit.
EPA FRS registry ID 110067588382 (U.S. EPA ECHO) Agency record
Severity 3.5
Ddb Energy Resources Llc 807-5260, Arjay
NPDES wastewater discharge permit.
EPA FRS registry ID 110070388674 (U.S. EPA ECHO) Agency record
Severity 3.5
Lee Oil Co Inc, Middlesboro
NPDES wastewater discharge permit.
EPA FRS registry ID 110006749448 (U.S. EPA ECHO) Agency record
Severity 3.3
Covol Fuels No 3 Llc [Consolidated], Arjay
NPDES wastewater discharge permit.
EPA FRS registry ID 110008977161 (U.S. EPA ECHO) Agency record
Severity 3.3
Covol Fuels No 3 Llc [807-5238], Field
NPDES wastewater discharge permit.
EPA FRS registry ID 110067184914 (U.S. EPA ECHO) Agency record
Severity 3.3
Kentucky Leather Co Middlesboro Tannery, Middlesboro
Brownfield property.
EPA FRS registry ID 110060454672 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Elks Building, Middlesboro
Brownfield property.
EPA FRS registry ID 110071966383 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Middlesboro City Hall, Middlesboro
Brownfield property.
EPA FRS registry ID 110071973601 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3
Middlesboro Street & Sewer Department, Middlesboro
Brownfield property.
EPA FRS registry ID 110071973602 (U.S. EPA Brownfields (ACRES)) Agency record
Severity 3

Correctional facilities

Prisons, jails and corrections operations with an EPA facility record, and the drinking water and wastewater compliance attached to them.

No correctional facility with an EPA record is located in this county.

Discovery / public records

Records to request for Bell County

Kentucky state cancer registry
Cancer incidence counts by census tract or ZIP code, by cancer type and year (de-identified). Any cancer cluster inquiries or investigations in Bell County, and their findings.
Kentucky vital statistics office
Death certificate counts by cause of death and residence tract or ZIP code, and the years behind the mortality measures above.
Kentucky health department, environmental epidemiology
Health consultations or assessments by ATSDR or the state health department covering the county, and any exposure investigations.
Kentucky environmental agency and the U.S. EPA regional office
Compliance history, inspection reports, notices of violation, penalties and enforcement actions for each facility above, cited by EPA FRS registry ID.
Kentucky drinking water program
Violation notices, sampling results and sanitary surveys for the public water systems serving the county, including any system serving a correctional facility.
Department of corrections or county sheriff
Water testing, grievances and environmental health inspections for the correctional facilities listed above.

Each Envyrofax address report includes a printable records request worksheet with the custodian and the exact request wording per finding.

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