Abstract
Written for a broad audience ranging from physicians and scientists, to politicians, policy makers, power company executives, urban planners, educators, and all who care about health and the environment, Doctor Lockwood, a physician with expertise in neurology and nuclear medicine, systematically describes the extent of coal usage and the resultant pollutants and their impacts.
Humans are in the midst of a silent epidemic, caused by exposure to coal-derived pollutants. It is silent because too few people are aware of the relationship between coal and health. As the effects of global warming become more pronounced, and the determinants of ill health more precise, coal-derived pollution has been found to impact asthma, chronic pulmonary disease, lung and other cancers, heart attacks, and an ever lengthening list of fatal diseases.
The early chapters provide a description of coal, and the evolution and extent of coal production and utilization. The era of coal-fired power plants in the United States began in 1882 when Thomas Edison threw a switch that turned on the lights in J. Pierpont Morgan’s office.
By composition, coal has large levels of carbon and, in coal formed close to volcanoes, a significant amount of mercury. A 1998 Environmental Protection Agency (EPA) report identified no fewer than sixty-seven hazardous pollutants in the emissions from coal-sourced utilities.
World coal reserves are enormous, totaling over 908 billion tons. The World Energy Council in 2010 estimates that coal supplies should last for at least 150 years. Just over 28 percent of proven coal reserves are in the United States, 13.5 percent are in China, and over 18.5 percent are in the Russian Federation.
In a chapter examining the main coal-generated pollutants, Dr. Lockwood catalogs and quantifies arsenic, oxides of sulfur and nitrogen, ground-level ozone, particulate matter, and mercury. For example, merely from the coal it burns to generate electricity, China releases more mercury into the atmosphere than twice the summed emissions from all sources in the United States and India combined.
Mining coal is also a hazardous undertaking, not just in its removal from the earth, but at every stage of production from washing, to transportation, to burning, to disposal of its waste. Lockwood provides examples for each step.
The middle chapters detail “pathophysiology”—how pollution damages cells and tissues.
The air pollution alone (a complex mix of gasses, liquids, droplets, and particles) created as the result of mining and burning coal contributes to many diverse disorders. Dr. Lockwood catalogs these in separate chapters as diseases of the respiratory system, the cardiovascular system, and the nervous system. Also examined are the effects of these pollutants on other aspects of general health, including infant mortality and effects during the neonatal period, neurodegenerative diseases, diabetes, and possibly Alzheimer’s disease.
The author offers statistics to establish all these hazards and their implications, along time lines that stretch from the 1950s to date.
One chapter draws correlations between coal’s contribution to global warming through increased levels of atmospheric carbon dioxide and the concentration of long-lived greenhouse gasses, such as methane.
The remaining chapters examine efforts to mitigate coal’s noxious influence, compare cost benefits and tradeoffs between the energy and health care economies, and consider various policy implications. Dr. Lockwood asserts, “The days of wanton discharges of pollutants into the air are over. Air quality is improving steadily due to regulations that have mandated the installation of pollution control devices at power plants, requirements for cleaner fuels, and other measures” (p. 67).
Mitigation efforts to date have centered on the control of particulates and sulfur oxides, carbon dioxide capture and storage, carbon capture, carbon dioxide transport, and the isolation of carbon dioxide from the atmosphere. These are affected by international policies and mandates, national government policies, and industry-appointed regulatory bodies.
Dr. Lockwood also looks closely at the economic tradeoffs between cleaner energy and health care. While estimating and quantifying are complex, an EPA study of the health effects avoided by the Clean Air Act from 1970 to 1990 puts the estimated benefits at $22.2 trillion dollars. During that same period, the costs incurred to comply with the act are estimated to have been approximately $0.5 trillion dollars—a huge difference.
The final chapter discusses policy implications. It begins with the serious observation by the author that “Whether we are able to develop safe, clean, renewable sources of energy that pose minimal threats to health and the environment may be the most important determinant of the trajectory of our civilization” (p. 207).
What will be required are more effective rules imposed by federal agencies and supported by Congressional activity, better enforcement of existing rules by legal actions, and national and international agreements to set and enforce air quality standards. Included is a special plea to physicians to become more actively involved in leading coal pollution preventive efforts, in preference to focusing solely on treatment. “Prevention spares individuals from the rigors of disease and is almost always less expensive than treatment” (p. 215).
[Note: Coal Kills. While the hazards of using coal were long suspected, it is only since the Air Pollution Act of 1955 came into effect that mounting scientific evidence of coal’s enormous threat to global human health has become clear.
Dr. Lockwood, a neurology and nuclear medicine physician describes and documents with great clarity the adverse health affects of burning coal, and then outlines numerous policy approaches to combat this ever increasing form of pollution. While eminently doable, implementing these will require determined and long-term commitment from the wide range of audiences at whom this book is aimed.
Lockwood is cautiously optimistic that this particular cause of health deterioration can be minimized in the future.]