Public Health Costs

Turkey’s coal expansion plans cause alarm as health costs quantified

A new study quantifies the public health costs of polluted air from existing coal-fired power plants in Turkey up to €3.6 billion per year and shows why massive future investment plans (80 new plants) are a major concern. The air pollution from burning coal for electricity generation in Turkey already causes premature deaths, chronic lung disease and heart conditions - moving away from fossil fuels would save lives and boost health. Thousands of Turkish health experts say that Turkey should follow the example of other developed countries in recognising that quitting coal protects health and reduces carbon emissions.

Coal-fired power plant
Coal-fired power plant
Source: shutterstock

Coal power plant capacity in Turkey is set to almost double over the next four years adding significantly to already high health costs, according to a new report from the Health and Environment Alliance (HEAL).

“The Unpaid Health Bill - How coal power plants in Turkey make us sick” (1) provides the first-ever figures on the costs to public health from existing coal power plants in Turkey. The total costs are up to €3.6 billion per year (10.72 billion Turkish Lira) covering costs of premature death, chronic lung disease and heart conditions associated with exposure to polluted air from coal plants. The report is endorsed by six leading medical and health associations in Turkey. (2).

“More and more health professionals around the world are calling for divestment from coal to improve health and help prevent climate change, giving the clear message that coal doesn’t have a future. Turkey’s plans to quadruple the number of coal-fired plants would lead to skyrocketing health costs for current and future generations,” says Anne Stauffer, HEAL Deputy Director.

A significant contribution to pollution

Coal power generation makes a significant contribution to the country’s already huge problem with air pollution. More than 97% of the urban population in Turkey is exposed to unhealthy levels of particulate matter, which is the most harmful pollutant for health. (3)

Medical leaders in Turkey say that to protect people’s health and the climate, Turkey’s drive for coal has to be reversed. Dr.Bayazıt İlhan, President of the Central Council of Turkish Medical Association, who wrote the preface to the report, says: “A large coal-fired power plant emits several thousand tons of hazardous air pollutants every year and has an average lifetime of at least 40 years. The plans for a massive increase in investment would mean that coal’s contribution to respiratory and cardiovascular disease would continue for decades. This unhealthy future has to be avoided. We would like to see the Turkish government detaching itself from this polluted and outmoded source of energy.”

The Turkish Medical Association represents 80% of physicians in Turkey. Other organisations supporting the report are Doctors for the Environment Turkey, Turkish Occupational Medicine Society, Turkish Respiratory Society, Turkish Society of Public Health Specialists, and Turkish Thoracic Society. They join compatriots in professional associations in the UK, Poland, Serbia and the World Federation of Public Health Associations (4) in calling for the hidden health costs (externalities) of coal to be considered in energy decisions.

Coal and health costs highlighted at World Health Assembly

HEAL’s work on the health costs associated with coal in Europe and Turkey will be shared with country delegates at the World Health Assembly (18-26 May 2015) in Geneva where the first-ever World Health Organization (WHO) resolution on air pollution is due to be voted. WHO recognises air pollution as one of the main avoidable causes of disease and death globally. (5)

HEAL’s Executive Director, Génon K. Jensen will speak to individual health ministers and other delegates about how certain energy decisions affect public health. “Quitting coal will clean up the air we breathe, quickly reduce health problems (6), including asthma and COPD, and help us tackle climate change.  No wonder medical and health experts in Europe and elsewhere are calling on their governments to stop supporting coal and instead pursue energy choices that are healthy for all.” (7)



Anne Stauffer, Deputy Director, HEAL, Email:, Mobile: +49 173 10 70 712, +32 473 711092

Deniz Gumusel, Air Pollution and Energy Consultant, HEAL, Ankara, Turkey, Email: ; , Mobile: +90 533 6205838

Diana Smith, Communications and Media Adviser, HEAL, Email:, Mobile: +33 6 33 04 2943


1. The new report, “The unpaid health bill, How coal power plants in Turkey make us sick” available at estimates exposure to coal fumes from 19 plants at up to €3.6 billion per year covering 2,876 premature deaths; 3,823 cases of chronic bronchitis in adults; 4,311 hospital admissions and 637,643 lost working days per year.

HEAL’s original report “The unpaid health bill” (2013) covering health costs from coal in the Europe Union estimated 18,000 premature deaths and four million lost working days each year at a cost of up to €43 billion annually. The health costs fall on individuals, families and governments rather than being covered in the price of coal-powered electricity generation. They are “externalities” representing an “unpaid health bill”. (The Turkish costs in the new report reflect a different pricing methodology and are therefore not directly comparable.)

2. The report is endorsed by the Turkish Medical Association, Doctors for the Environment Turkey, Turkish Occupational Medicine Society, Turkish Respiratory Society, Turkish Society of Public Health Specialists, and Turkish Thoracic Society.

3. European Environment Agency (2014b), Air pollution fact sheet 2014: Turkey. No figures are available for the percentage of the total population exposed to harmful air pollution nor on hazardous pollutants of ozone and nitrogen dioxide.

4. See “The Kolkata Call to Action”, WFPHA co-sponsored by World Health Organization,    

5. World Health Assembly 2015, A68/18, Health and the environment: addressing the health impact of air pollution. The Secretariat report recognises air pollution as one of the main avoidable causes of disease and death globally.

6. Changes in energy policy can have almost immediate effects on health. For example, within five years of the ban on coal burning in Dublin, Ireland in 1990, deaths from respiratory disease had fallen by 15% and deaths from cardiovascular disease by 10%. See “Effect of air-pollution control on death rates in Dublin, Ireland: an intervention study”, The Lancet, October 2002,

7. See “World’s public health leaders call for an end to coal”, Healthy Energy Initiative,

Source: Press release


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