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€8.5 billion in health costs from Balkan coal plants prompt call for EU policy rethink

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- New study quantifies the public health costs of polluted air from existing coal-fired power plants in the Western Balkans at up to 8.5 EUR billion per year

- The region is home to seven of the 10 most polluting coal-fired power stations in Europe. Fumes from these plants contribute to air pollution, which is a serious health risk in these countries. Polluted air is associated with unnecessarily high rates of premature death, chronic lung disease, heart conditions and asthma

- Europe’s leaders should support countries in the region by encouraging a move away from coal to improve health and tackle climate change

Brussels/Sarajevo, 15 March 2016 – First-ever estimates of the huge health costs associated with air pollution from coal power plants in the Western Balkans are released today. (1) The costings of health damage should prompt a rethink on the EU’s policy approach to the region, according to report’s authors, the Health and Environment Alliance (HEAL).

“The Unpaid Health Bill - How coal power plants in the Western Balkans make us sick” (3) puts the costs to health of existing coal plants in five Western Balkan countries (2) at up to 8.5 EUR billion per year. The calculation is made up of costs directly related to air pollution from coal-fired electricity plants, including from 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 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. The region is home to seven of the 10 most polluting coal-fired power stations in Europe. (4) Air pollutants in countries of the Western Balkans are at levels that are up to two and a half times above national air quality safety limits and well beyond what the World Health Organization recommends. The combination of coal and other exhaust from industrial, transport and domestic sources in the air robs the countries of health and prosperity. Figures from the World Health Organization (WHO) show the economic cost of early deaths from air pollution in Serbia at 33.5% of national GDP compared with 4.5% in Germany. (5)

“Our new report quantifies the huge health costs associated with coal power generation in the Western Balkans, and uncovers the myth that coal is the cheapest form of energy,” says Anne Stauffer, Deputy Director, Health and Environment Alliance (HEAL).

She continues: “Opting out of coal offers the prospect of a healthier and more prosperous future. The European Union should encourage the change to a healthy energy future by significantly increasing financial support for renewables and energy savings - for example, under the pre-accession programme. It would improve air quality and help tackle climate change in both the Western Balkans and in the rest of Europe.” (6)

The report shows that a significant proportion of the pollution from the coal-fired power plants in the Western Balkans is borne by the population of the European region due to pollutants being carried in the wind and causing transboundary effects. (7) The EU’s current efforts for cleaner air in member countries should not stop at its borders. EU policy-makers should also put their weight behind pushing for strong air quality and pollution control measures in Western Balkan neighbours.

European policy makers will find strong support for phasing out coal among leading health policy makers in the Western Balkans. Serbian State Secretary for Health, Prof. dr. Berislav Vekić says: “Reducing the level of pollutants in the air would produce very significant health benefits. This potential for a major improvement in population health should be taken into account when developing energy policies.”

Many health professionals, patients with asthma and heart and breathing problems, as well as grassroots organisations, would also back a move towards clean and healthy alternatives, such as wind and solar power. Garret Tankosic-Kelly of SEE Change Net states: “Choosing cleaner air is a no brainer. Our expert energy models clearly show that the enormous potential for solar, wind and biomass - combined with much more energy efficiency - would lead to a cleaner, fairer, and more efficient energy system in South East Europe, and for the same cost as the currently planned investments in dirty lignite." (8)

HEAL and SEE Change Network want to see an end to coal throughout Europe by 2040 in order to promote health through cleaner air and to reduce carbon emissions that fuel climate change. They are therefore urging governments, including those in the Western Balkans, to close existing coal plants and not to build any new ones.

Anne Stauffer, Deputy Director, HEAL, Mobile: +49 173 10 70 712, +32 473 711092, tel: +32 2 234 36 43 (Brussels office), Email:

Vlatka Matkovic Puljic, Health and Energy Officer, Balkans Region, Health and Environment Alliance (HEAL), Mobile: +32474894953. Email:

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

Notes for journalists
1. The report is being released today at 11 am in English in Brussels and at a press conference at 11 am in Sarajevo, Bosnia and Herzegovina.
2. Countries in the Western Balkan region comprise Bosnia and Herzegovina, Kosovo, Macedonia, Montenegro and Serbia. Albania would normally be included in this region, however, it has been excluded since there are no coal plants there.
3. The new report, “The unpaid health bill, How coal power plants in Western Balkans make us sick” is available here ( It follows the approach of HEAL’s original report “The unpaid health bill” (2013) covering health costs from coal in the Europe Union.
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. Taken together, the countries of Macedonia, Kosovo, Montenegro and Serbia currently receive approximately 22.5 EUR million in financing under the pre-accession programme. This financial support includes overall environmental and climate protection as well as support to the energy sector. Such programmes should not allow the financing of coal power plants through the back door.
7. In this context, Europe includes EU28 member states plus Albania, Belarus, Moldova, Norway, the Western regions of Russia, Switzerland, Ukraine, Bosnia and Herzegovina, Kosovo, Macedonia, Montenegro and Serbia.
8. Press release, SEE Change Network, June 2015, EU energy roadmap more cost effective for South East Europe than current policies, shows new energy model,

Originally posted on 15 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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