Governments are rightly concerned about the delivery of health services through hospitals and clinics. Equally important is the prevention of ill health (preventative medicine) through such measures as vaccination, cessation of smoking, healthy life style and removal of carcinogens and pollutants from our environment
Doctors use the term co-benefit when we can have a health win, commensurate with a government decision on another need. For example development of good public transport has been shown to improve health because people get out of their cars and walk to the bus. There is less pollution of cities and greenhouse emissions. There are cost savings to health which can be offset against the cost of public transport infrastructure.
The greatest co-benefit for global and national health would be a reduction in the mining of coal and in its use for power generation. Taking all externalities into account, including the health burden of coal in Australia estimated by the Australian Academy of Technological Sciences and Engineering to be $2.6 billion per annum, it is likely that coal is the most expensive fuel. Yet under our present accounting system it is the cheapest, and an unfair competitor for renewable energy.
Coal is a Health Hazard
This statement is based on firm scientific evidence.
Pollution from coal affects all major body organ systems and contributes to four of the five leading causes of mortality in the U.S. heart disease, cancer, stroke, and chronic lower respiratory disease and asthma. It interferes with lung development, increases the risk of heart attacks. Read the report of Physicians for Social Responsibility
Each step of the coal life cycle—mining, transportation, washing, combustion, and disposing of post-combustion wastes— has additional impacts human health.
In Australia there has been limited research into the impacts of air pollution from coal, compared to Europe and the USA. However, current evidence suggests that the health impacts of air pollution are similar to those reported from other developed countries. We do know from the National Pollutant Inventory that there is considerable pollution from coal-related sources.
There are a number of air pollutants arising from power generation which have been identified as injurious to humans. Some of these such as sulphur dioxide, a strong respiratory irritant, have been reduced over time. The most harmful pollutants are the smallest particles (PM 2.5) and coal combustion contributes to these. They are inhaled deep into the lungs to cause inflammation and damage and large quantities are being produced in mining and power generation. In the US, exposure to these particles, some of which originate from coal combustion, has been shown to reduce life expectancy and in Canada they are estimated to cause 5000 deaths each year.
Many toxic elements are released with coal combustion - arsenic, mercury, fluorine, cadmium, lead, selenium and zinc. Of these mercury is perhaps of greatest concern. It enters the environment and is transformed into toxic forms which can accumulate up the food chain, particularly in fish, and affect the human nervous system. Exposure during pregnancy is of most concern, because it may harm the development of the unborn child’s brain.
It must be asked why in a wealthy, developed country like Australia, which reaps billions of dollars from the export of coal, we are neglecting the health and well being of entire mining communities.
We therefore request that the federal government
Review the National Environmental Protection Measures (NEPM) for Air Quality to ensure they are sufficient to protect public health based on the best available evidence. For example why is there only an advisory standard for PM 2.5 pollution in Australia, not an enforceable standard as in the USA? We note that the federal government has now issued a discussion paper on PM 2.5
Develop health assessment and care for regional communities at present disregarded or denied by some state governments.
Other environmental impacts of coal which affect health
With a projected world crisis in food production, the continued approval of open cast mining of productive agricultural land is madness. In the long term national interest we ask that a new federal government adopt mechanisms to prevent the use of productive agricultural land for open cast mining.
Coal combustion is a major source of greenhouse gases; it causes climate change and threatens the foundations of good health.
According to the World Health Organization, climate change is one of the greatest threats to public health and it will affect, in profoundly adverse ways, some of the most fundamental pre-requisites for good health: clean air and water, sufficient food, adequate shelter and freedom from disease.
These health impacts are also beginning to occur in Australia. The elderly, the very young and those with existing heart and respiratory disease have been shown to be vulnerable to the increase in heat waves. Farming communities, particularly in the Murray Darling Basin, are suffering from stress, social disruption and depression. We can expect more extreme weather events, threats to food and water security, sea level rises, changes in vector-borne, food and water borne disease, exacerbation of air pollution, increases in aeroallergens, mental health and refugee health impacts.
There is accumulating scientific evidence that urgent action is needed to reduce green house emissions if dangerous temperature rises are to be avoided. In making an Australian contribution to this reduction we note that coal combustion is responsible for 31% of emissions and 12 new coal mines are approves or planned
The Policy of Doctors for the Environment Australia is
To request an immediate tax on carbon without any concession to the coal industry. Concessions rendered the CPRS ineffective according to a report from the Grattan Institute. Read here
We are often asked if our position is not unrealistic. Our position is clear. Civilised society must have a primacy for human health not just for our own citizens, but for all those less fortunate than us. This said, the economic considerations of state and national governments that determine the export of more coal, in order to have royalties to balance their budgets in an already wealthy society, is a secondary consideration. Any of our elected representatives experiencing the anguish of ill health in their own family will understand the fundamental truth underlying our position.
We are often told--- "well if we don’t export the coal someone else will"--- this is not the point. Yes others will, but someone has to offer leadership, someone has to take the first step, someone has to have the conviction to wrench the handle off the Broad Street pump (which stopped the epidemic of cholera in London). The morale imperative is for the most fortunate to offer this leadership.
Quite simply, the measures we recommend are public health measures necessary for the health, well being and indeed the ultimate survival of humanity. These measures stand side by side with our life long professional endeavours to treat ill health and comfort the stricken. The two are indivisible.