HEALTH IMPACTS OF COAL: FACTS, FALLACIES, AND SOME SOLUTIONS

Health problems caused by coal are derived from either the use of poor quality coal (high ash, high sulfur, or high content of toxic trace elements) or by the improper use of coal. When poor quality coal is used in an improper way the resultant health problems can be widespread and severe. In millions of houses in many developing countries coal and other biomass fuels are burned in unvented stoves causing severe indoor air pollution. In Guizhou Province, southwest China the situation is exacerbated by the villagers' use of coal that has extraordinary high concentrations of toxic elements. Thousands of people in this region are suffering from severe arsenic poisoning. More than 10 million people in Guizhou Province and surrounding areas suffer from dental and skeletal fluorosis. The fluorine exposure is due to the use of briquettes made from high-fluorine coals and high-fluorine clay binders. A preliminary geochemical survey indicates that low arsenic coals and low fluorine coals and clays are available. A simple, inexpensive field test kit has been developed to help the villagers identify low-arsenic coal. Not all of the health problems attributed to coal are caused by combustion. An unusual situation exists in the Balkans where there may be health problems caused by coal in the ground. Well waters containing polycyclic aromatic hydrocarbons leached from low-rank coals may be the cause of, or a contributing factor to, Balkan Endemic Nephropathy, an interstitial nephropathy, that is believed to have killed more than 100,000 people in the former Yugoslavia alone. Not all of the allegations of health problems caused by coal are legitimate. Concerns expressed about exposure to radioactivity from coal and coal combustion products are misplaced. The products of commercial coal combustion (fly ash, bottom ash) have uranium and thorium concentrations about 5-10 times higher than that of the coal. However, the uranium and thorium in the coal byproducts should not cause concern because they are mostly in insoluble forms at concentration levels similar to most soils.