Air. All methods of mining affect air quality. Particulate matter is released in surface mining when overburden is stripped from the site and stored or returned to the pit. When the soil is removed, vegetation is also removed, exposing the soil to the weather, causing particulates to become airborne through wind erosion and road traffic. Particulate matter can be composed of such noxious materials as arsenic, cadmium, and lead. In general, particulates affect human health adversely by contributing to illnesses relating to the respiratory tract, such as emphysema, but they also can be ingested or absorbed into the skin.
This is just one study. There are plenty more.
Cardiac and Mitochondrial dysfunction following acute pulmonary exposure to mountaintop removal mining exposure
Abstract (click here)