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Coal’s unpaid health bill in Serbia estimated at €4 billion a year

National press release SERBIA

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- Serbia is responsible for almost half of the public health costs from polluted air from existing coal-fired power plants in the Western Balkan region

- Air pollution is a serious health problem in Serbia causing unnecessarily high rates of premature death, chronic lung disease, heart conditions and asthma

- Phasing out coal for electricity generation would improve air quality and health and reduce carbon emissions

Belgrade, 18 March 2016 – First-ever estimates of the health costs associated with air pollution from coal power plants in Serbia appear in a new report covering the Western Balkans region produced by the Health and Environment Alliance, a European non-profit alliance. (1)

“The Unpaid Health Bill - How coal power plants in the Western Balkans make us sick” (1) puts the costs to health from existing coal plants in Serbia at up to 4 EUR billion per year. (2) The costs for the Western Balkan region as a whole are estimated at up to 8.5 EUR billion.

The calculation of health costs directly related to air pollution from coal-fired electricity plants takes into account premature deaths, respiratory and cardiovascular hospital admissions, new cases of chronic bronchitis and lower respiratory problems, medication use and days of restricted activity due to ill-health, including lost working days. The costs, which are paid by individuals and governments and not by the coal industry, include both health costs for the Western Balkans as well as for the European region because wind carries pollutants across national borders. (3)

“Our new report quantifies the huge damage to health associated coal power plants both in Serbia and in other countries of the Western Balkan region,” says Vlatka Matkovic Puljic, Health and Energy Officer, Balkans Region, Health and Environment Alliance (HEAL). “We hope that the findings will encourage the Serbian government to reconsider national energy plans for coal and lignite and to increase investment in wind and solar power alternatives.”

The region is heavily dependent on coal and lignite (the most polluting form of coal) for its energy production. Using coal to generate electricity adds very significantly to air pollution, which is a major health risk in the Western Balkans. Four of these biggest emitters of sulphur dioxide (SO2) are located in Serbia. (4)

The combination of coal and other exhaust from industrial, transport and domestic sources in the air robs countries of health and prosperity. Figures from the World Health Organization (WHO) show the economic cost of early deaths from air pollution in Serbia 33.5% of national GDP compared with 4.5% in Germany. (5)

Top health leaders in Serbia signed a statement in June 2014 on the opportunity for reducing chronic disease by cutting the dependency on fossil fuels. (6)

The report is aimed at providing strong health evidence for phasing out coal and investing in renewable sources of energy. “Many senior health professionals in Serbia are already aware and active for clean air and a healthy energy future, joining colleagues from all over the world. We hope these findings will help them advance their case,” says Anne Stauffer, Deputy Director, Health and Environment Alliance (HEAL).

HEAL is calling for an end to coal in Europe by 2040 in order to both promote health through cleaner air and reduce carbon emissions that fuel climate change. Partner organisation, Climate Action Network Europe also supports a phasing out of coal. “The Paris Agreement means that there is no long-term future for the global coal industry,” says Dragana Mileusnic of Climate Action Network Europe. “We hope the European Union will support Serbia in moves to phase out coal. If the EU is to true climate leader, it must ensure that its immediate neighbours break out of coal dependency and reap the health, economic and other co-benefits of low-carbon transformation.”

Vlatka Matkovic Puljic, Health and Energy Officer, Balkans Region, Health and Environment Alliance (HEAL), mobile: +32474894953, tel: +32 2 234 36 42 (Brussels office), Email:

Diana Smith, HEAL Communications and Media Adviser,, mobile: +33 6 33 04 2943

Marina Maksimović, Media Consultant, Health and Environment Alliance (HEAL), mobile: +32489452017, email:

Notes for Journalists:
1. The new report, “The unpaid health bill, How coal power plants in Western Balkans make us sick” is available here ( It was released on Tuesday 15 March in Brussels and Sarajevo. Vlatka Matkovic Puljic, Health and Energy Officer, Balkans Region, Health and Environment Alliance (HEAL) is in Belgrade today to promote the findings.

Health costs for coal plants in the West Balkans region are estimated at up to 8.5 EUR billion annually. This total is made up of health costs from coal plants in the five Western Balkan countries covered by the report. They are: Bosnia and Herzegovina with health costs of up to 3,145 in EUR millions; Kosovo up to 352 in EUR millions; Macedonia up to 720 in EUR millions; Montenegro up to 257 in EUR millions; and, Serbia up to 4,086 in EUR millions. Albania would normally be included in this region, however, it has been excluded since there are no coal plants there.

2. The report package includes separate documents devoted to Serbia and the four other countries in the Western Balkans featured in the report. Testimonies of leading health policy makers and medical experts are included in the Serbian report.

3. Not all the health costs caused by the Serbian plants are borne by residents of the country or even the Western Balkans region. Of the total of up to 8.5 EUR billion damages from the region’s plants, only 3.5 EUR billion of the damages fall on the populations in countries of the Western Balkan region. About 5.0 EUR billion in health damages falls on EU28 member states plus Albania, Belarus, Moldova, Norway, the Western regions of Russia, Switzerland, and Ukraine.

4. Coal power plants with the biggest emissions of SO2 in Europe

Emissions data: EEA 2013 European Pollutant Release and Transfer Register for EU plants.
For data sources for Western Balkan plants, see Methodology at Glance box of the report

5. World Health Organization (WHO): Annex: Economic cost of deaths from air pollution (outdoor and indoor) per country, as a percentage of GDP: WHO estimated the economic cost of early deaths from air pollution in Serbia at 33.5% of its GDP; Bosnia and Herzegovina 21.5%, Macedonia 19.9% and Montenegro 14.5%. By comparison, Germany is losing 4.5% and the UK 3.7%.

6. Clean air would promote better health in Serbia

Originally posted on 18 March 2016

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The Health and Environment Alliance (HEAL) is a leading European not-for-profit organisation addressing how the environment affects health in the European Union (EU). We demonstrate how policy changes can help protect health and enhance people’s quality of life. Read more »


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