Air pollution from coal-fired power stations could result in public health costs of up to €8.5bn for governments in the Western Balkans, a study from Brussels-based NGO the Health and Environment Alliance (HEAL) has revealed.

Coal is an important source of energy for almost all countries in the Western Balkans, and several governments in the region are considering investing into new power plants, despite opposition from environmental groups.

The €8.5bn is made up of costs directly related to air pollution from coal power stations, including from premature deaths, respiratory and cardiovascular hospital admissions, new cases of chronic bronchitis and respiratory problems, medication and days of restricted activity due to ill-health, including lost working days, HEAL said in a March 15 press release. The report covers Bosnia & Herzegovina, Kosovo, Macedonia, Montenegro and Serbia.

According to the World Health Organization (WHO), the economic cost of early deaths from air pollution is a staggering 33.5% of Serbia’s GDP. As the bneChart below shows, the cost as a percentage of GDP is 21.5% in Bosnia, 19.9% in Macedonia and 14.5% in Montenegro, compared to just 4.5% of GDP in Germany and 3.7% in the UK. In 2010 - the year used in the WHO’s calculations - the estimated economic cost of deaths from air pollution was $28bn in Serbia, $7.2bn in Bosnia, $4.7bn in Macedonia and $1.2bn in Macedonia.

The situation is worst in Serbia, where 1,057 deaths are attributable to emissions every year, followed by 1,004 in Bosnia. The death toll is lower elsewhere in the region; 269 deaths are attributed to emissions in Macedonia, 189 in Kosovo and 124 in Montenegro.

The study points out that the region is “heavily dependent” on coal and lignite, which is the most polluting form of coal, for electricity production. It is also home to seven of the 10 most polluting coal-fired power stations in Europe, with the Ugljevik plant in Bosnia topping the list of Europe’s largest producers of sulphur dioxide. Only Albania, which has abundant hydropower resources, has no coal power stations.

Air pollutants are already up to two and a half times above national air quality safety limits and well above World Health Organization recommendations, HEAL says. However, several governments in the region are still planning investments into new coal power stations or new capacity at exiting plants.

This includes the €1bn Kosova e Re power plant near Pristina, for which the Kosovan government recently signed a deal with international energy company ContourGlobal, and the 350MW Banovici thermal power plant project in Bosnia.

However, the study shows that the overall cost - taking into account the impact on public health - could be much higher than the cost of building new coal power plants

“Our new report quantifies the huge health costs associated with coal power generation in the Western Balkans, and uncovers the myth that coal is the cheapest form of energy,” said HEAL’s deputy director Anne Stauffer.

The NGO has called for a re-think of the EU’s policy approach to energy in the region’s aspiring EU entrants. It also warns of an impact on the wider European region, as pollution from Western Balkans power station is carried across the continent.

While not covered by the study, the two existing EU member states in the region - Croatia and Slovenia - have also invested into coal power. Holding Slovenian Power Plants (HSE) is struggling financially because of its €1.4bn investment into a new unit at the Sosanj Thermal Power Plant, although Croatia’s new government has indicated it may drop plans for a new 500-megawatt block at the Plomin thermal plant amid a re-evaluation of its energy policy.