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The Silent Epidemic

The Silent Epidemic: Coal and the Hidden Threat to Health

Alan H. Lockwood
Copyright Date: 2012
Published by: MIT Press
Pages: 248
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  • Book Info
    The Silent Epidemic
    Book Description:

    We will not find "exposure to burning coal" listed as the cause of death on a single death certificate, but tens of thousands of deaths from asthma, chronic obstructive pulmonary disease, lung cancer, heart attacks, strokes, and other illnesses are clearly linked to coal-derived pollution. As politicians and advertising campaigns extol the virtues of "clean coal," the dirty secret is that coal kills. In The Silent Epidemic, Alan Lockwood, a physician, describes and documents the adverse health effects of burning coal. Lockwood's comprehensive treatment examines every aspect of coal, from its complex chemical makeup to details of mining, transporting, burning, and disposal--each of which generates significant health concerns. He describes coal pollution's effects on the respiratory, cardiovascular, and nervous systems, and how these problems will only get worse; explains the impact of global warming on coal-related health problems; and discusses possible policy approaches to combat coal pollution. Coal fueled the industrial revolution and has become a major source of energy in virtually every country. In the United States, almost half of the energy used to generate electricity comes from burning coal. Relatively few people are aware of the health threats posed by coal-derived pollutants, and those who are aware lack the political clout of the coal industry. Lockwood's straightforward description of coal as a health hazard is especially timely, given the barrage of marketing efforts to promote coal as part of "energy independence." His message is clear and urgent: "Coal-fired plants make people sick and die, particularly children and those with chronic illnesses, and they cost society huge amounts of money desperately needed for other purposes."

    eISBN: 978-0-262-30541-9
    Subjects: Health Sciences, Environmental Science

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Preface and Acknowledgments
    (pp. ix-xii)
    Alan H. Lockwood
  4. 1 Introduction
    (pp. 1-8)

    We are in the midst of a silent epidemic caused by the exposure to coal-derived pollutants. I refer to this as a silent epidemic because too few of us are aware of the relationship between coal and health, the focus of this book. Each year this epidemic claims the lives of tens of thousands of Americans and causes hundreds of thousands of serious and minor illnesses. You will not find “exposure to coal-derived pollution” on a single death certificate. The same is true for smoking cigarettes, yet the links to both are there, but much less visible and well known...

  5. 2 Coal
    (pp. 9-16)

    This quotation is an incomplete but good start at describing the essential features of coal. Coal is not a single, well-defined entity. Coals form a family of extraordinarily complex minerals composed primarily of carbon, but also containing a long list of elements and compounds. Thus there are many different forms of coal whose compositions reflect the conditions under which they were formed. Coals are typically assigned to one of four different ranks, as described in table 2.1.

    The different ranks of coal were formed during many geological eras. The largest amount of coal began its journey to the present during...

  6. 3 The Pollutants
    (pp. 17-46)

    Although carbon is the principal element found in coal, coal is actually a complex mixture of numerous elements and compounds. Many of these are released into the atmosphere as hazardous air pollutants when coal is burned and many of them are harmful to health. Studies done by the EPA have identified some 67 hazardous pollutants that are discharged into the air by coal-fired utilities [1].

    An individual or a population must be exposed to a pollutant before it can exert its effect. Although this is axiomatic, numerous critical factors play complex roles between the time that a pollutant is released...

  7. 4 From Mine to Ash
    (pp. 47-66)

    The era of coal-fired power plants in the United States began at 3:00 pm on September 4, 1882, when Thomas Edison threw a switch that turned on the lights in J. Pierpont Morgan’s office. This began the delivery of electricity from the Pearl Street Station, located about a half mile away. This generating station operated until 1890, when, ironically, it burned down. Soon huge amounts of coal were needed to fuel the boilers and large amounts of ash were produced. This is how the modern life cycle of coal began: from mine to ash. Although most discussions of coal and...

  8. 5 Mitigation of Pollutants from Burning Coal
    (pp. 67-84)

    When Edison’s Pearl Street Power Station went on line in 1882 all of the pollution from the coal boilers went straight into the air. Times have changed. Thanks largely to the Clean Air Act, passed by Congress in 1963 and amended significantly in 1970 and 1990, 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. This chapter will describe some of the technologies currently employed to perform this task.


  9. 6 Pathophysiology: How Pollution Damages Cells and Tissues
    (pp. 85-98)

    This Hopi word provides us with a good description of what happens when people are exposed to coal-derived air pollutants—the normal states of equilibrium that characterize essential biochemical and physiological processes are pushed out of balance by the stresses imposed by pollutants. Imbalance disrupts cellular functions and leads to the production of symptoms, tissue injury, and disease. This is the essence of how pollution leads to disease. The devil is in the details. To avoid confronting the devil, skip to the next chapter!

    The air pollution that arises as a result of burning coal is a complex mixture of...

  10. 7 Basic Health Considerations
    (pp. 99-110)

    This simple, elegant statement has stood the test of over sixty years of time. It recognizes the fact that even if you are not sick, in the traditional medical sense of suffering from a disease, you may not be healthy! This may seem paradoxical to many.

    Beginning with this definition, it is possible to broaden our understanding of what determines health. The determinants begin with the individual and expand out to the society in which we individuals and groups of individuals live. We begin with ourselves—our personal behavioral characteristics, attitudes, and values. Moving from the individual to the group,...

  11. 8 Diseases of the Respiratory System
    (pp. 111-130)

    It is almost intuitively obvious that air pollutants will have important effects on respiratory health. Virtually all airborne pollutants gain access to the body via the respiratory tract. Thus it is no surprise that this important system is affected significantly by pollutants discharged into the atmosphere by electrical utilities that burn coal. These effects include de novo production of a condition that did not exist prior to an exposure, such as asthma, chronic bronchitis, emphysema, or cancer and/or exacerbation of a previously existing illness. Pollutants commonly trigger exacerbations of asthma, as well as of chronic bronchitis and emphysema, which usually...

  12. 9 Diseases of the Cardiovascular System
    (pp. 131-140)

    Diseases of the heart were the leading cause of death in the United States in 2008, according to the preliminary analysis compiled by the Centers for Disease Control [1]. Even though this represented a 2.2% decrease from 2007, 617,527 Americans died from heart disease in that year. This represents a rate of 203.1 deaths per 100,000 individuals. For those over 65, the rate was substantially higher, at 1,277.8 per 100,000.

    The American Heart Association estimates that 82.6 million Americans, or about one out of every three Americans, has some form of cardiovascular disease, according to 2007 data [2]. This is...

  13. 10 Diseases of the Nervous System
    (pp. 141-154)

    It is easy to understand that burning coal is likely to have an adverse impact on respiratory health—we inhale the products of combustion. It is less obvious that burning coal has important effects on the nervous system, particularly the brain. Cerebral vascular disease, namely stroke, and loss of intellectual capacity due to mercury, are the two most important neurological consequences of burning coal.

    Our brain is the organ that most clearly distinguishes us from other species. Our abilities to use language, think abstractly, produce and enjoy music, art and literature, to inquire about the nature of the universe and...

  14. 11 Health Effects on the Horizon
    (pp. 155-164)

    It is hard to imagine that there was a time when chimneys belching clouds of black acrid smoke were seen as a sign of industrial prowess and economic vigor rather than a threat to health. At one time physicians appeared in advertisements touting the benefits of smoking cigarettes! Advances in knowledge change the way we look at our environment and how it impacts health. Where are the holes in our vision and what surprises are ahead? This chapter addresses that question using very early, sometimes provocative data to discuss what might emerge in the future and be placed on the...

  15. 12 Coal, Global Warming, and Health
    (pp. 165-192)

    Charles David Keeling, like many scientists, was a man driven by the compulsion to be right. In the 1950s he focused his talents on measuring the very low levels of CO2in the atmosphere with great accuracy and precision. After perfecting his technique, he established a sampling site at the Mauna Loa Observatory in Hawaii. Each hour the successors to his early device churn out the current CO2concentration in the atmosphere. The time concentration graph, now known worldwide as the Keeling Curve, is shown in figure 12.1. It is recognized as one of the major accomplishments in all of...

  16. 13 Energy and Health Care Economics
    (pp. 193-206)

    We are caught in the winds of a perfect storm. Health care costs are rising faster than any other major segment of the economy, the national debt threatens to become unmanageable, the gap between the rich and the poor is getting wider, and the number of people living below the poverty line in the United States is higher than ever. All of this is occurring at a time when we are struggling to emerge from the worst financial crisis since the Great Depression. Congressional pressures to slash funds from discretionary portions of governmental budgets have become irresistible. This, in turn,...

  17. 14 Policy Implications
    (pp. 207-220)

    This is a book about health. More specifically, it is book about coal, its use, and how its use affects health. There are serious, adverse health effects associated with every aspect of using coal. Yet at the moment we depend on coal for almost half of the electricity used in the United States. Without this electricity, modern society could not thrive and the health care system would not exist. Our dilemma is that we need electricity, but we are clearly hurting ourselves now and in the future by using coal to generate it. Whether we are able to develop safe,...

  18. Glossary
    (pp. 221-224)
  19. Index
    (pp. 225-230)