“When I was getting ready to graduate high school, I realized that I didn’t have the grades nor the money to go to college, so I was kind of stuck here,” Walk says. “Like everybody else in that situation around here, I only had a few options: go to work for the coal industry, sell prescription drugs, or join the military.” West Virginia has the highest drug overdose mortality rate of all fifty states. It also has one of the largest veteran populations per capita, and the lowest rate of adults with college degrees.

For Walk, the decision seemed simple. “I went to work for the coal industry.” However, within months of working at a coal prep plant in the nearby town of Sylvester, he began having second thoughts.

“Some days I would be in the plant basement waist deep in this coal sludge, the same stuff that contaminated my water when I was a kid, preparing it to be pumped up to a slurry dam.” He feared prolonged exposure to the slurry would be harmful to his health. Walk also says he was asked to violate safety regulations on a regular basis, except when the state inspectors were coming. “We always knew when the inspectors were coming,” he alleges. “They always called ahead.”

After six months, the combination of concerns for his personal health and a guilty conscience led Walk to quit his job. He began anonymously writing about what he had seen for an environmental newsletter and was eventually hired by the Coal River Mountain Watch.

“My whole life, I’ve seen this pattern of industry being allowed to do what it wants in this state,” Walk says, reflecting on the Elk River spill one year later. “My first reaction when I heard about it was that this is business as usual for West Virginia.”

To Walk, the Charleston spill was just the latest symptom of a deep-seated problem in the Mountain State. Throughout his life, from his time attending a now abandoned elementary school that was situated a few yards from a coal processing plant and slurry impoundment to his experience working for a coal company, Walk has lived through many of these symptoms, though he didn’t always realize there was anything extraordinary about them. “I thought everyone had big piles of coal right next to their playground at school. I thought it was normal not to be able to drink your own tap water.”

Other symptoms can be more catastrophic. On the afternoon of April 5, 2010, the Walk family home was shaken by an explosion at the nearby Upper Big Branch coal mine. Twenty-nine miners died in what was the deadliest American mining disaster in decades. A federal investigation found the explosion was the direct result of Massey Energy executives willfully and systematically skirting safety regulations.

“These aren’t all isolated incidents. They’re interconnected,” Walk insists. “The same loose regulatory environment that produced Upper Big Branch, that poisoned my well water growing up, that poisons the air surrounding these surface mines everyday also gave us the Elk River spill.”

Michael Hendryx, a public health researcher at Indiana University who studies the health effects of coal mining in West Virginia, also wasn’t surprised when he heard about the spill. Hendryx co-authored a series of studies that linked a number of troubling health outcomes to the areas with heavy coal mining. His research found that residents of West Virginia’s mining counties were more likely to suffer from kidney disease, obstructive lung diseases, and high blood pressure than their counterparts in non-mining counties. Other studies found higher rates of mortality, cancer, birth defects, total poverty, and child poverty in the areas surrounding mountaintop-removal coal mining sites.