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STUDY SAYS
COAL PLANT POLLUTION
KILLS 30,000 A YEAR

The Clean Air Task Force, on behalf of the Clear the Air campaign, commissioned Abt Associates to quantify the health impacts of fine particle air pollution, commonly known as soot, from power plants, as well as the expected benefits (avoidable deaths, hospitalizations, etc.) of policies that would reduce fine particle pollution from power plants. The health effects analyzed include death, hospitalizations, emergency room visits, asthma attacks, and a variety of lesser respiratory symptoms.

This report summarizes the findings of the Abt Associates study, reviews the contribution of power plants to fine particle pollution, and discusses policies that will reduce power plant fine particle pollution and thus save thousands of lives. Key findings include:

Fine particle pollution is responsible for increased risk of death and shortened life spans. Abt Associates' findings are based on a body of well-accepted scientific work on the health effects of fine particle pollution. The discussion at pages 12-16 of the report contains an extensive review of the scientific studies used by Abt Associates linking fine particle pollution to death and other health damages.

Recommendations

For over thirty years the oldest, dirtiest coal-burning power plants have circumvented the most protective air emissions standards required of modern plants. As a result, these so-called "grandfathered" power plants are permitted to emit as much as 10 times more nitrogen oxides and sulfur dioxide than modern coal plants. Polluting coal-fired power plants must be made to comply with modern emissions control standards. In addition, the nation's power fleet should be held to stringent caps on all four of the key power plant pollutants including nitrogen oxides, sulfur dioxide, mercury and carbon dioxide. The deaths, hospitalizations and lost work time caused by fine particles from power plants can be reduced comprehensively only when the Clean Air Act's 30-year loophole for old, dirty power plants is finally closed. Requirements such as these can ensure that U.S. energy policy better accounts for the public health and environmental costs associated with electricity production and will propel us toward a more sustainable energy future that relies increasingly on renewable energy resources and conservation.

Foreword

John D. Spengler, Professor of Environmental Health, Harvard School of Public Health (Boston, September2000)

On December 5, 1952, the residents of London, England awoke to the dawn of a five-day reign of death. Atemperature inversion had trapped the coal smoke from the city's furnaces, fireplaces, and industrialsmokestacks, creating a "killer fog" that hovered near the ground. People began to die from respiratoryand cardiopulmonary failure. Not until the weather system that had trapped London's pollution finallyloosened its grip and the soot-filled air cleared out did death rates return to normal. The end of theepisode saw more than three thousand dead; a five-fold increase over the normal death rate.

While incidents like London's "killer fog" of 1952 clearly demonstrate a link between air pollution anddeath, only in the past decade have tremendous advances in medical science and epidemiology allowedresearchers to quantify the health impacts of everyday air pollution levels. In studies conducted incities throughout the world, epidemiologists have consistently found that more people are hospitalizedand die from respiratory and cardiac failure in proportion to elevated levels of soot, or "fineparticles," and other pollutants. The consistent worldwide findings, combined with a much clearerunderstanding about how we are exposed to outdoor air pollution, have convinced most experts that theseresults are not a coincidence. In particular, two landmark studies established that people living in morepolluted areas suffer a higher risk of death from fine particle pollution than those living in lesspolluted areas.

These studies and many others formed the basis of U.S. EPA's 1997 decision to issue a new nationalambient air quality standard for "fine particles" known as PM2.5 and defined as particles smaller than2.5 microns-one millionth of a meter in diameter (less than one-hundredth of the width of a human hair).EPA estimated that attaining the annual fine particle levels required by the new standard would prevent15,000 deaths per year. And recent monitoring data suggests that if present air pollution levels persist, the health standard EPA established will be violated every year in hundreds of communities in the U.S. What is more, as EPA acknowledged, the science underlyingthe standard indicates that deaths occur even at levels below the standard. Indeed, the science now tellsus that health effects extend to lower levels of fine particles in our air, suggesting there is nodefinite threshold below which the air is safe to breathe.

Not surprisingly, industries that contribute to this air pollution, such as the electric utility industryand diesel trucking industry, are disputing EPA's decision and the science on which it was based. Theyclaim EPA relied on "junk science" and then sued in court to block the standards. They demanded access tothe data underlying the seminal studies to help refute the results. In the end, the Health EffectsInstitute, a research center co-funded by industry and EPA and founded to be a neutral arbiter forpolicy-related health science disputes, was called upon to reanalyze the studies.

This past summer, HEI announced the results of its reanalysis, which unequivocally confirmed the findingsof the two major studies underlying the fine particle standard. HEI also re-leased a new study thatfurther supports the link between particles and death. And while the fate of the fine particle standarditself awaits resolution in the courts, there is no longer any legitimate doubt that fine particles atlevels commonly experienced in many parts of the U.S. contribute significantly to death and disease.

Most of the coal used in this country today is burned by aging power plants for the production ofelectricity. In a variety of contexts, researchers have sought to quantify the contribution to fineparticle health impacts made by these plants. Health researchers have employed some assessment methods toestimate the relative contribution of power plants to total deaths. EPA's Regulatory Impact Analysis forthe PM2.5 National Ambient Air Quality Standard ("NAAQS") examined the contribution of power plantemissions to fine particle concentrations in our air. In addition, EPA's cost-benefit analyses of theClean Air Act included the benefits associated with expected reductions in power plant-generated fineparticle pollution, providing strong justification for the emission control costs imposed by the Act.More recently, in a study of two coal-fired power plants in Massachusetts, my Harvard School of PublicHealth colleague Jonathan Levy and I found that fine particle pollution from these two plants alone isassociated with over 100 deaths annually.

Now, employing the same analytic tools used by the U.S. EPA in a variety of policy-setting and regulatorydecisionmaking contexts, Abt Associates has provided the most rigorous look to date at the contributionof air emissions from the nation's power plants to fine particle levels and the impact of those emissionson human health. Abt Associates' work builds on methods used by the U.S. EPA in developing important airquality standards and assessing its air regulatory programs. Abt Associates finds that power plantpollution contributes to several thousand deaths each year. In short, these findings imply that ourregulatory strategies and priorities should be reconsidered. A variety of policies could help lower therisks posed by power plant pollution - from broader application of existing pollution controltechnologies, to use of cleaner fossil fuels, to ultimate replacement of the existing energyinfrastructure with more sustainable means of producing electricity. We can only hope the informationprovided through this study will help crystallize the policy debate around the need for actions to reducethe health risks posed by the pollution produced by our current energy system.

The Abt Associatesapproach enables us to combine information from many well-done studies to derive a quantitativerelationship between air pollution and health effects. These studies tell us that the concept of athreshold demarcating safe from unhealthy air is now outdated. They provide continuous damage functionsthat lead us to expect benefits from deeper and deeper reductions in air pollution. The insight derivedfrom this new analytical approach provides important information to the benefit side of the cost-benefitdebate. The debate over the policy consequences of this shift in thinking may be difficult andacrimonious in the near term as power companies, regulators, lawmakers, and citizens adjust to newconcepts of incorporating health damage costs into control strategies, weigh local impacts versusregional damage, and consider the appropriateness of emission reduction trading among pollution sources.The primary advantage of a quantitative method to assess air pollution effects with no threshold is thatit represents more accurately the biological reality. The old threshold concept appears even moreoutmoded when we consider the notion of "safe" levels for each of the hundreds of contaminants in theair. We will all benefit from this emerging methodology that brings air pollution health research intothe public decisionmaking process. All of us, throughout our lives, are susceptible to the adverseeffects of air pollution. Now, our health interests can be more directly incorporated into the debateover our energy, environmental, and economic future.

What are Fine Particles?

Fine particles are a mixture of a variety of different compounds and pollutants that originate primarilyfrom combustion sources such as power plants, diesel trucks and buses, cars, etc. They are sometimes referred to as PM2.5 (particulate matter smaller than 2.5 microns in diameter - less than one-hundredthof the width of a human hair). Fine particles are either emitted directly from these combustion sourcesor are formed in the atmosphere through complex oxidation reactions involving gases, such as sulfurdioxide (SO2) or nitrogen oxides (NOX). Among particles, fine particles are of gravest concern becausethey are so tiny that they can be inhaled deeply, thus evading the human lungs' natural defenses.

Death, Disease & Dirty Power

Mortality and Health Damage Due to Air Pollution from Power Plants

New Findings

Numerous studies over the years have linked fine particles to a variety of health damages, from increasedasthma attacks to hospital visits to death. Researchers estimate that as many as 60,000 people dieprematurely each year because of exposure to fine particles. And some researchers believethat this figure may even underestimate the total number of deaths due to fine particles in the U.S. The United StatesEnvironmental Protection Agency (EPA) estimates that attainment of the new health standard for fineparticles alone could save 15,000 lives each year.

However, to date there has been no definitive study quantifying the deaths and other health effectsattributable solely to fine particles from power plant pollution.

Now, for the first time, this report reveals the power industry's staggering share of the toll of deathand disease from fine particles in our air. Using peer-reviewed, state-of-the-art research methodology,Abt Associates finds over 30,000 deaths each year are attributable to fine particle pollution from U.S.power plants. The underlying research shows that these people are dying months or years earlier becauseof power plant air pollution. Further, the study finds that by requiring the nation's fleet of older,dirty power plants to cut their sulfur dioxide and nitrogen oxide emissions by 75 percent, consistentwith current legislative proposals, approximately two-thirds (over 18,000) of these deaths could be avoided.

The deaths from power plant pollution exceed the death toll from other causes commonly understood to bemajor public policy priorities. For instance, drunk driving causes nearly 16,000 deaths per year. There are over 17,000homicides in the U.S. each year. Moreover, the 18,000 deaths that could be avoided by cleaning up the nation'spower plants are three times the number of automobile fatalities avoided each year through the use ofsafety belts. Amongair pollution sources, the deaths attributable to power plants are rivaled only by those due to the fineparticle pollution from the combined total of all the diesel trucks, buses, locomotives, and constructionequipment in the U.S. which, according to the Abt Associates analysis, are responsible for approximately80 percent of the deaths attributable to power plants.

The Abt Associates report further shows that hundreds of thousands of Americans suffer from asthmaattacks, cardiac problems and upper and lower respiratory ailments associated with fine particles frompower plants. These health damages result in thousands of respiratory and cardiopulmonary-relatedhospitalizations and emergency room visits as well as hundreds of thousands of lost work and schooldays, many of which could be avoid-ed by cleaning up older power plants. For instance, the study findsthat power plant particle pollution causes more than 603,000 asthma attacks per year, 366,000 of whichcould be avoided by cleaning up power plants to modern standards.

Respiratory distress severe enough to require a trip to the emergency room can be a terrifyingexperience for patients and their families. Victims of asthma attacks say that during an attack theywonder if and when their next breath will come. In addition to these serious physical and emotionalcosts, air pollution also wracks up large monetary costs. Emergency room and hospital treatment costs cancripple a family financially. The average hospital stay for a respiratory ailment lasts about a week. Bouts of respiratoryillness and asthma attacks mean lost workdays for workers and lost productivity for their employers. And,although priceless, in a variety of contexts we place a monetary value on the loss of human life. Usingaccepted valuation methodology employed by EPA in its regulatory impact analyses, Abt Associates findsthat the total monetary benefits of cleaning up power plants to modern pollution standards would be over$100 billion per year.

National Power Plant Health Impacts
  Incidence (cases/year)
Health EffectStudyAvoided by 75%
Power Plant Reduction
Power
Plant Total
MortalityHEI, 2000 Pope Reanalysis
(Annual mean, All Cause)
18,70030,100
All Respiratory and Cardiovascular HospitalizationsPooled COPD+Respiratory+
Asthma+cardioVascular
12,20020,100
Asthma-Related Emergency Room VisitsSchwartz et al., 19934,3207,160
Chronic BronchitisPooled11,40018,600
Asthma AttacksWhittemore and Korn, 1980366,000603,000
Lost Word DaysOstro, 1987-WLDs3,190,0005,130,000
Minor Restricted Activity DaysOstro and Rothschild, 198916,40026,300,000

By modeling the impact of power plant pollution throughout the lower 48 states, Abt Associates developedhealth impact estimates for every state and major metropolitan area. Not surprisingly, states with largepopulations in close proximity to many coal-fired power plants fared the worst.

Conversely, states with large populations but without coal-fired plants fared much better. For example,California, which has the nation's largest population and some of its worst air quality, has veryfew coal or oil-fired power plants. Abt Associates estimates that only 259 deaths are attributable topower plant pollution in California and the state ranked almost last in per capita impact (1.4 deaths per100,000 adults). Kentucky, the state with the highest reliance on coal for production of electricityranked first in related per capita mortality at more than 44 deaths per 100,000 adults, over 30 timeshigher than California's per capita mortality rate.Note - For complete tables, see Appendix.

Similarly,metropolitan areas with large populations near coal-fired power plants feel their impacts most acutely.In large metropolitan areas, many hundreds of lives are shortened each year.

However, much smaller metropolitan areas in and around "coal country" suffer the greatest per capitaimpacts, such as Chattanooga, Tennessee; Gadsden, Alabama; Terre Haute, Indiana; Wheeling, West Virginia;and Owensboro, Kentucky. Their death rates are much higher, for example, than that of New York City.Compare Chattanooga at 49.3 deaths per 100,000 adults with New York at 19.3 per 100,000. (You can view a more complete list of metropolitan areas in "The Particulate-Related Health Benefits of Reducing Power Plant Emissions", the source report prepared by Abt Associates. Note: The Abt report is in PDF format.)

In fact,because these health effects estimates include only the effects from airborne fine particles, theysignificantly understate the total adverse impact on public health from power plants. Excluded from theseestimates are the health effects from other power plant pollutants, such as air emissions that result inozone smog, air toxics, global warming, and the impacts from the consumption of fish contaminated bypower plant mercury emissions.

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