Global site-specific health impacts of fossil energy, steel mills, oil refineries and cement plants

Climate change and particulate matter air pollution present major threats to human well-being by causing impacts on human health. Both are connected to key air pollutants such as carbon dioxide (CO[Formula: see text] ), primary fine particulate matter (PM[Formula: see text] ), sulfur dioxide (SO[Formula: see text] ), nitrogen oxides (NO[Formula: see text] ) and ammonia (NH[Formula: see text] ), which are primarily emitted from energy-intensive industrial sectors. We present the first study to consistently link a broad range of emission measurements for these substances with site-specific technical data, emission models, and atmospheric fate and effect models to quantify health impacts caused by nearly all global fossil power plants, steel mills, oil refineries and cement plants. The resulting health impact patterns differ substantially from far less detailed earlier studies due to the high resolution of included data, highlighting in particular the key role of emission abatement at individual coal-consuming industrial sites in densely populated areas of Asia (Northern and North-Eastern India, Java in Indonesia, Eastern China), Western Europe (Germany, Belgium, Netherlands) as well as in the US. Of greatest health concern are the high SO[Formula: see text] emissions in India, which stand out due to missing flue gas treatment and cause a particularly high share of local health impacts despite a limited number of emission sites. At the same time, the massive infrastructure and export capacity build-up in China in recent years is taking a substantial toll on regional and global health and requires more stringent regulation than in the rest of the world due to unfavorable environmental conditions and high population densities. The current phase-out of highly emitting industries in Europe is found not to have started with sites having the greatest health impacts. Our detailed site-specific emission and impact inventory is able to highlight more effective alternatives and to track future progress.