Mortality risk from United States coal electricity generation

Policy-makers seeking to limit the impact of coal electricity-generating units (EGUs, also known as power plants) on air quality and climate justify regulations by quantifying the health burden attributable to exposure from these sources. We defined “coal PM2.5” as fine particulate matter associated with coal EGU sulfur dioxide emissions and estimated annual exposure to coal PM2.5 from 480 EGUs in the US. We estimated the number of deaths attributable to coal PM2.5 from 1999 to 2020 using individual-level Medicare death records representing 650 million person-years. Exposure to coal PM2.5 was associated with 2.1 times greater mortality risk than exposure to PM2.5 from all sources. A total of 460,000 deaths were attributable to coal PM2.5, representing 25% of all PM2.5-related Medicare deaths before 2009 and 7% after 2012. Here, we quantify and visualize the contribution of individual EGUs to mortality.