Public health impact of coal-fired power plants: a critical systematic review of the epidemiological literature

Coal-based energy production is the most utilized method of electricity production worldwide and releases the highest concentration of gaseous, particulate, and metallic pollutants. Toxicological research has shown that coal combustion by-products are carcinogens, endocrine disruptors, and cardiorespiratory toxins. This article aims to systematically review the epidemiological literature on the impact emissions from coal-based power production has on morbidity and mortality worldwide. Two thousand one hundred and fifty-two articles were retrieved based on search criteria. Word search of abstract and article text filtered the results to 95 articles. Forty articles were included after screening. The literature indicates a significant adverse effect from particulate matter and polyaromatic hydrocarbon emissions on morbidity and mortality. There is a lack of consistency of exposure assessment and inadequate control of significant potential confounders such as social economic status. Future research should focus on improving exposure assessment models, specifically source-apportionment and geographic information system methods to model power plant-specific emissions.