Coal’s unpaid health bill

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HEAL’s European coal and health campaign

In March 2013, HEAL launched the first ‘Unpaid Health Bill – How coal power plants make us sick’, highlighting that the health costs of coal-fired power stations add a financial burden to the European population of up to €42.8 billion a year.

The report includes testimonies from leading health advocates, medical experts and policy makers on why they are concerned about coal, as well as developing recommendations for policy-makers and the health community on how to address the unpaid health bill and ensure that it is taken into account in future energy decisions.

- Download the full report here - EN- DE - POL - RO
- Download the Executive Summary here - EN - DE - POL - RO
- Download the coal and health postcard here - EN - POL
- Press release EN - FR - ES - IT - RO - DU - DE - POL
- Media coverage updated 2 April 2013 here
- Check out our Facebook page on coal and help us grow the network by liking our page!

Prof Jean-Paul Sculier, Secretary for European Affairs, European Respiratory Society (ERS), author of the Preface says,

“Addressing air pollution from coal power plants alone has the potential to yield significant savings to health budgets, especially given that an average coal power plant operates for at least forty years. As 2013 is the European Year of Air where a review of EU air quality policy will take place, this is the right time to act.”

Birgit Beger, Secretary General, Standing Committee of European Doctors (CPME)
“European doctors know air pollution to be an important risk factor for health, and the CPME has a long-standing interest in this topic. Health professionals are committed to bringing new evidence-based information to the public as well as to decision makers and using their voice to bring about policy changes.”

Further testimonies available here

The Unpaid Health Bill marked the beginning of a coal and health campaign in which HEAL continues to work closely with medical, health and climate advocacy groups, especially in countries where coal is a particular threat to health. Since the start of the campaign, the report has been launched in Romania (December 2013), Poland (June 2013), Germany (April 2013) and most recently in Turkey (May 2015).

The Unpaid Health Bill - How coal power plants in the Western Balkans make us sick

In 2016, HEAL released the first-ever estimates of the huge health costs associated with air pollution from coal power plants in the Western Balkans. The report provides an estimate of the total health damage from air pollution released from existing coal power plants in five Western Balkans for the European region, and for Serbia, Bosnia and Herzegovina, Macedonia, Montenegro and Kosovo. The estimated health costs of future coal plants in the Western Balkans are also given.

Currently home to 15 existing coal plants with an installed capacity of 8.1 gigawatt (GW), the Western Balkans could see the installation of 24 new projects with 7.8 GW capacity.

The costings of the significant health damage should prompt a rethink on the EU’s policy approach to the region, with European decision-makers increasing financial support for a healthy energy future and pulling their weight for air quality and pollution control in the region. The Western Balkan policy-makers should now make decarbonisation their priority and support the rapid phase out of coal power generation.

Download the full technical report here (English - Serbian). You can download the EU factsheet of the Unpaid Health Bill here (English - Serbian).

A complete list of resources, including press releases, reports and factsheets, can be downloaded from our project page of ’The Unpaid Health Bill - How coal power plants in the Western Balkans are making us sick’ (Available in English, Serbian, Bosnian, Macedonian, Montenegrin, and Albanian).

The Unpaid Health Bill - How coal power plants in Turkey make us sick

Wednesday, 20 May 2015, Coal power plant capacity in Turkey is set to almost double over the next four years adding significantly to already high health costs, according to a new HEAL report launched.

The report provides the first-ever figures on the costs to public health from existing coal power plants in Turkey, revealing that the total costs are up to 3.6 billion EUR per year (10.72 billion Turkish Lira) covering costs of premature death, chronic lung disease and heart conditions associated with exposure to polluted air from coal plants.

- Download the full report here - English - Turkish
- Download the Executive Summary here - English - Turkish
- Press release - English - Turkish

The report is endorsed by six leading medical and health associations in Turkey, including the Turkish Medical Association, Doctors for the Environment Turkey, Turkish Occupational Medicine Society, Turkish Respiratory Society, Turkish Society of Public Health Specialists, and Turkish Thoracic Society.

Medical leaders in Turkey say that to protect people’s health and the climate, Turkey’s drive for coal has to be reversed. Dr.Bayazıt İlhan, President of the Central Council of Turkish Medical Association (below left), who wrote the preface to the report, says:

“A large coal-fired power plant emits several thousand tons of hazardous air pollutants every year and has an average lifetime of at least 40 years. The plans for a massive increase in investment would mean that coal’s contribution to respiratory and cardiovascular disease would continue for decades. This unhealthy future has to be avoided. We would like to see the Turkish government detaching itself from this polluted and outmoded source of energy.”

Further testimonies available here - English - Turkish

The Unpaid Health Bill in Romania, December 2013

9 December 2013, HEAL and Bankwatch Romanian launched the Romanian version of the Unpaid Health Bill. Out of 10,000 industrial facilities in Europe, coal power plants are the top 20 most damaging to health and environment. Among these 20, Romania has five including power plants in Turceni (second place), Drobeta Turnu-Severin, Craiova-Isalnita and Mintia-Deva.

Emissions from coal power plants in Europe cause over 18,000 premature deaths, approximately 8,600 new cases of chronic bronchitis and over 4 million lost working days each year. The health impact in Europe is estimated at EUR 43 billion per year.

Altogether, coal power plants in Poland, Romania and Germany are responsible for more than half of the health impacts. Romania takes second place for the top coal power plants pollution, alongside Germany. Pollution impacts in Romania stand at 2,731 premature deaths, approximately 1,284 new cases of chronic bronchitis and over 619,660 lost working days each year. The health impacts of coal power plants in Romania are estimated at up to EUR 6.4 billion per year.

- Download the full report here
- Press release EN - RO

The Unpaid Health Bill in Poland, June 2013

Jaki wpływ na nasze zdrowie mają elektrownie węglowe?

3 czerwca 2013 roku opublikowana została polska wersja nowego raportu Health and Environment Alliance (HEAL). Raport prezentuje dowody naukowe na temat wpływu skażenia powietrza na zdrowie, i udziału w nim emisji pochodzących z elektrowni węglowych. Zawiera także pierwszą ekonomiczną ocenę kosztów zdrowotnych związanych z zanieczyszczeniem powietrza przez elektrownie węglowe w Europie oraz wyjaśnienia autorytetów w dziedzinie ochrony zdrowia, ekspertów sektora medycznego i decydentów dotyczące ich obaw związanych z wpływem węgla.

Raport przedstawia też rekomendacje dla władz i sektora zdrowia na temat sposobów zaradzenia problemowi “niezapłaconego rachunku za zdrowie” oraz uwzględnienia go w przyszłych decyzjach dotyczących energetyki.

Polska pełna wersja raportu do pobrania tutaj
Polska pełna wersja raportu do pobrania tutaj
Polskie streszczenie raportu do pobrania tutaj- EN language version of PR here

The Unpaid Health Bill in Germany, April 2013

Wie schädigen Kohlekraftwerke unsere Gesundheit?

Ein neuer Bericht der Health and Environment Alliance (HEAL) wurde am 24. April 2013 auch in deutscher Sprache veröffentlicht. Er möchte einen Überblick über die wissenschaftlichen Erkenntnisse zu Gesundheitsschäden durch Luftverschmutzung und zum Beitrag von Kohlekraftwerken geben. Darüber hinaus beihaltet der Bericht die erstmalige Berechnung der gesundheitlichen Kosten, die infolge der Luftverschmutzung durch Kohlekraftwerke in Europa entstehen, sowie Stellungnahmen von führenden Gesundheitsexperten, medizinischen Fachleuten und Politikern zu ihren Bedenken im Hinblick auf Kohlestrom.

Der Bericht leitet daraus Empfehlungen an die Politik sowie an Gesundheitsfachleute ab, wie die durch Kohlestrom verursachten externen Kosten reduziert werden können und wie die wirklichen Kosten von Kohlestrom bei energiepolitischen Entscheidungen berücksichtigt werden sollten.

Download des vollständigen Berichts hier
Zusammenfassung Download hier
Presseerklärung Download hier

Information on the coal report in EN here

About HEAL

The Health and Environment Alliance (HEAL) is the leading not-for-profit organisation addressing how the environment affects human health in the European Union (EU) and beyond. HEAL works to shape laws and policies that promote planetary and human health and protect those most affected by pollution, and raise awareness on the benefits of environmental action for health. Read more »


HEAL has over 70 member organisations, representing health professionals, not-for-profit health insurers, doctors, nurses, cancer and asthma groups, citizens, women’s groups, youth groups, environmental NGOs, scientists and public health institutes. Members include international and Europe-wide organisations, as well as national and local groups. Read more »

Contact us

Health and Environment Alliance (HEAL)
28 Boulevard Charlemagne
B1000 Brussels, Belgium
Phone: +32 2 234 3640
Fax: +32 2 234 3649
Press: Elke Zander

Direct telephone numbers: HEAL team page.

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