BACKGROUND In North Carolina, coal-burning power plants remain the major source of electrical production. Coal burning generates coal ash that is stored in landfills and slurry ponds that are often located near residential communities, signifying high potential for environmental contamination and increasing health risks. We reviewed the literature on potential health effects of coal-burning plants to summarize current knowledge on health risks.METHODS We searched English-language publications issued between January 1, 1987, and December 31, 2017, on PubMed and Google Scholar.RESULTS The algorithm of identification, screening, eligibility, and inclusion/exclusion we used provided 113 peer-reviewed publications selected for the review. Over the past 30 years, scientists reported that the people living in close proximity to coal-fired plants had higher rates of all-cause and premature mortality, increased risk of respiratory disease and lung cancer, cardiovascular disease, poorer child health, and higher infant mortality. The elevated health risk was associated with exposure to air pollutants from the power plant emissions and to a spectrum of heavy metals and radioactive isotopes in coal ash.CONCLUSION In North Carolina, further studies are required to profile the severity of the cumulative impacts of multiple air, water, and soil contaminants related to coal-burning power plants and coal ash impoundments on human health and the environment. Prioritized study directions on evaluation of health impacts of coal-burning power plants in North Carolina are suggested.
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