Up to $242B in Health Costs of Coal Welcome Statistic but Alarming Toll

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If we needed another reason to be concerned about our heavy reliance on “cheap” coal for energy, we could find all we wanted in a recently released report from a team at the Harvard Medical School. “Full Cost Accounting for the Life Cycle of Coal” (Annals of the New York Academy of Sciences) catalogues virtually all the ways coal affects society, from fires in abandoned mines that burn for decades to the tourism implications of the environmentally devastating mining practice known by the chillingly matter-of-fact name “mountaintop removal.”

Harvard’s overall price tag for coal? Up to $500 billion. But what really got our attention was the $140 billion to $242 billion cost the report attached to its public health effects.

I've long understood that “environmental” issues are a subset of the overall public health domain, so I was heartened — and aghast — to see a study that affixes a public health price tag not just to illness caused by what are traditionally considered environmental issues (coal combustion and climate change, for example) but to the economy, to the taxpayer.

In each of the major stages of the life cycle of coal, from mining to transport to combustion, there are major health implications and therefore major costs.

These health problems start in mining communities and hit them hardest, and right from the beginning of life. Pregnant women in coal-mining areas of West Virginia are 16 percent more likely to have low-birth-weight babies than those in counties without coal mining. Low-birth-weight and preterm children fare worse in almost all neurological assessments, and as adults they have more chronic diseases, including hypertension and diabetes mellitus.

Heart, lung, and kidney disease are all worse in mining communities, even after controlling for smoking and diet.

When it comes to transport, again, people in mining communities bear the brunt. Moving coal around generates massive amounts of dust, which by itself can increase respiratory and cardiovascular disease. The authors even do the math on railroad fatalities. Seventy percent of U.S. rail traffic is devoted to moving coal, and 246 people were killed during coal transportation in 2007. Using the EPA standard “value of statistical life,” which values each human at $7.5 million, the total comes to $1.8 billion just for transport fatalities.

But, of course, the broadest health danger comes from converting coal to energy. Burning coal gives off CO2, methane, particulates and oxides of nitrogen, oxides of sulfur, mercury, and a wide range of carcinogenic chemicals and heavy metals. Those living within a 30-mile radius of a coal-fired power plant are two to five times more likely to have a respiratory illness than those living at a greater distance.

The impacts of SO2, a primary cause of acid rain, include wheezing, exacerbation of asthma, shortness of breath, nasal congestion, pulmonary inflammation, heart arrhythmia, low birth weight, and increased risk of infant death.

The nitrogen-containing emissions (common to the burning of all fossil fuels) cause damage through several pathways, including the forming of ground-level ozone (photochemical smog), which is corrosive to the lining of the lungs.

The report goes on to state, “Estimates of nonfatal health endpoints from coal-related pollutants vary, but are substantial — including 2,800 from lung cancer, 38,200 nonfatal heart attacks, and tens of thousands of emergency room visits, hospitalizations, and lost work days.”

It would be nice if we could agree as a society that these problems alone amply justified taking dramatic steps away from coal and toward renewable energy. But we generally don’t find the collective will to take those steps until someone “bottom lines” the economic cost for us. The new Harvard report provides a feast of evidence that, while coal may be plentiful (and even that assumption is questioned), it is hardly cheap. As the report’s authors write, “The economic implications go far beyond the prices we pay for electricity.”

Coal aside, the World Health Organization reports that “climate change affects the fundamental requirements for health — clean air, safe drinking water, sufficient food, and secure shelter.” Unfortunately, a survey commissioned by EnviroMedia last November shows nearly half of Americans don’t believe their personal energy use affects the health and living conditions of those in developing nations. And a quarter of Americans believe coal is a renewable resource. (See graphics showing the results of a telephone survey of 1,022 adults conducted by Opinion Research Corporation, +/- 3.2 percent margin of error.) While it’s sad to see this kind of disconnect among Americans, maybe the quarter-trillion-dollar health costs of coal will get the attention of U.S. households.

Valerie Davis is CEO and co-founder of EnviroMedia Social Marketing, which creates behavior-change campaigns for a healthier planet, with offices in Portland and Austin.

Environment + Energy Leader