A message “From Cradle to Grave: The Fossil Fuel Health Tax and the Just Transition Imperative” by the Global Climate and Health Alliance (GCHA) presents a comprehensive global overview health consequences associated with the use of fossil fuels at every stage of their life cycleThis report highlights that fossil fuels are “silent architects of suffering,” claiming lives and undermining the quality of life of countless others, from initial extraction to final emissions.

Comprehensive impact on human health The impact of fossil fuels on human health begins long before combustion and continues long after. Each phase – from mining oil, coal and gas from the ground, through refining, transportation and distribution, to the eventual shutdown and cleanup of industrial sites – leaves a mark on human health and the environment. Air and water pollution, habitat destruction, toxic waste and long-term public health crises are woven into the value chain of fossil fuel production.

Health risks by life cycle stage:

• Mining (e.g. fracking, coal mining, offshore mining): It releases benzene, heavy metals, radioactive materials, and particulate matter, which increases the incidence of respiratory diseases, cardiovascular diseases, cancer, adverse birth outcomes, and neurological disorders in surrounding populations. For example, coal seam fires in Jharia, India, have been burning for more than a century, releasing a toxic mixture of gases that are linked to respiratory diseases and life-threatening conditions such as strokes and pulmonary heart disease.
• Processing and refining: They have been shown to emit carcinogenic chemicals such as benzene, toluene and volatile organic compounds (VOCs), posing a serious risk to workers and nearby residents, especially in densely populated industrial areas. An example is “Cancer Alley” in Louisiana, USA, an 85-mile stretch along the Mississippi River with numerous petrochemical plants and refineries where residents face high incidences of cancer and respiratory diseases.
• Transportation and storage: They pose risks of chemical spills and oil spills that contaminate air and water and cause acute and chronic health effects, including respiratory and neurological damage. A 2010 gas pipeline explosion in San Bruno, California, killed eight people, injured dozens, and destroyed 38 homes, highlighting the risks of aging infrastructure.
• Incineration and utilization: Whether in power plants, vehicles or homes, it generates PM2.5 fine particles, nitrogen oxides and other pollutants, which significantly increase the risk of asthma, heart disease, stroke, cancer, dementia and premature mortality. In London, deadly pollution from traffic led to the death of a child from asthma, with excess emissions from traffic cited as the cause of death. Burning coal in homes for cooking and heating is associated with adverse health outcomes, including increased risk of lung cancer and cardiovascular disease.
• Waste and decommissioning: Combustion waste (e.g., coal ash, gas flaring) continues to expose communities to heavy metals and toxins, contributing to long-term environmental degradation and chronic diseases. People living near coal ash landfills may have up to a 1 in 50 chance of developing cancer from drinking water contaminated with arsenic.

Impact across life stages and communities Fossil fuel-related pollution affects every stage of life, from fetal development to old age. Exposure is associated with increased risk of low birth weight, childhood cancer, asthma, neurological disorders, cardiovascular disease, and premature death. Children are particularly vulnerable due to their faster breathing rates, narrower airways, and developing organs, with exposure linked to leukemia and asthma. Older adults face unique vulnerabilities due to reduced organ function and pre-existing chronic diseases.

These health damages are not evenly distributed. Marginalized communities, including indigenous peoples, racial minorities, and low-income groups, disproportionately live near polluting infrastructure and face increased risks of respiratory diseases, cancer, and cardiovascular disease, often in so-called “victim zones.” Workers in the fossil fuel industry are also at high risk, with miners, for example, suffering from pneumoconiosis (black lung) and cancer.

The urgency of a just transition It is undeniable that dependence on fossil fuels is the main source of greenhouse gas emissions that are driving the climate crisis. Therefore, it is a rapid and just transition away from fossil fuels – towards clean, renewable energy – essential for health. Moving away from fossil fuels is not only an environmental imperative, but also a moral one.

Key policy recommendations include:

1. Halting new fossil fuel exploration and development.
2. Ending fossil fuel subsidies and redirecting savings to healthcare.
3. Clean up existing fossil fuel production, with a focus on reducing emissions of methane and toxic chemicals.
4. Internalizing the health costs of fossil fuels through the "polluter pays" principleto ensure that companies responsible for pollution bear the associated costs.
5. Initiating community-led health studies and measures for areas affected by fossil fuels.
6. Combating influence, advertising and disinformation from the fossil fuel industry.
7. Ending fossil fuel financing and aligning global institutions with climate goals.
8. Exemplary leadership from the healthcare sector through decarbonization and sustainable practices.

In conclusion, despite a clear scientific consensus and the availability of cleaner alternatives, fossil fuel development continues. However, the world stands at a crossroads. The falling costs of renewables and battery storage have made clean electricity cheaper than fossil fuels in much of the world, and the International Energy Agency (IEA) projects that demand for oil and gas will peak before 2030. This moment requires bold leadership to transition to a healthier, fairer and more sustainable future for all. JRi