Vector: Coal Mining, Climate Change and the Global Impacts on Health, Examining Adani’s Proposed Carmichael Coal Mine

The proposed Adani-owned Carmichael coal mine in central Queensland is currently in the final stages of planning with the support of both the Queensland and Australian governments. It is in the interest of human health, locally and abroad, for the medical profession to advocate on behalf of the community and lobby our legislators to reject this project.

The Carmichael site will be the world’s largest export coal venture and the biggest mining site in Australia, consisting of six open cut pits and five underground mines. Mined in the Galilee Basin, 160km north-west of Clermont, coal will then be transported on a new railway network before connecting to shipping terminals bound for India via the Great Barrier Reef Marine Park.[1] Adani has stated that it plans to mine 60 million tonnes of coal every year over the expected 60 year lifespan of the Carmichael mine site.[2] The estimated annual average emissions of the proposed Adani coal mine are equivalent to the annual emissions of Malaysia, Vietnam or Sri Lanka.[3]

The Carmichael mine is a highly politicised topic with widespread implications. This article considers some of the impacts on Australia’s economy, our natural environment (and that of our regional neighbours), and crucially; the seriousness of the Carmichael mine’s contribution to climate change and its effect on human health.

Health Implications on a Global Scale

The World Health Organization (WHO) has said that climate change is the greatest threat to human health this century.[4] This gigantic coal mine is set to contribute significantly to climate change. It will adversely affect population health through greenhouse gas emissions, waterway damage and land clearing. A report recently published in The Lancet has condemned the planned Adani Carmichael project as a “public health disaster”, arguing that the health impacts and environmental damage will be significant for Australia and its regional neighbours.[5]

The net effect of obtaining and using coal from the Carmichael site is estimated to release 4.7 billion tonnes of greenhouse gas emissions,[6] which will contribute to climate change. This will result in increased human exposure to pollen, moulds and air pollution, reducing air quality and increase the incidence of respiratory diseases.[7] Ambient pollution in Australia is primarily derived from fossil fuel powered electricity generation, heavy industry and wood or coal based home heating.[8] Annually, 3000 Australians die due to urban air pollution, more than the national road toll.[9] In its current state, the air pollution problem is already being insufficiently addressed. Additionally, exposure to ozone is linked with increased hospital admissions for respiratory diseases amongst both children and the elderly.[10] Our legislators must act decisively and commit meaningful action to reduce the impact of climate change as it will affect the health of future generations and our present vulnerable elderly population.

Currently, 5% of the population will experience an allergic respiratory response to airborne moulds during their lifetime.[11] Changes in global precipitation are likely to increase the prevalence of airborne moulds.[7] Additionally, ambient air pollutants and allergens are most likely to exacerbate respiratory disease in individuals with pre-existing respiratory conditions.[12] Climate change associated air pollution will undoubtedly worsen the quality of life of patients living with chronic airway diseases.

Coal combustion affects the water as well as the air. Rising water temperatures linked to climate change will cause further aerosolisation of marine toxins, thereby increasing respiratory disease prevalence globally.[7] Asthmatics exposed to the harmful algal bloom Karenia brevis’ marine aerosols on the south east coast of the United States of America (USA) experienced respiratory symptoms after just one hour of exposure. Inland residents experienced an average of 3.49 symptoms, more than coastal residents, who experienced an average of 2.24 symptoms.[13] This suggests that aerosolisation of marine toxins will increase respiratory morbidity as climate change related aerosols proliferate and distribute further afield.

The cardiovascular burden of disease will worsen in the future if action is not taken now to reduce the impacts of climate change.[7] Airborne particulate matter is associated with compromised heart function, atherosclerotic disease, deep vein thrombosis,[14] and pulmonary embolism.[15] The particulates contributing to air pollution include black carbon, sulphates, nitrates, a complex mixture of metals and other by-products from the incomplete combustion of fossil fuels.[16] In areas with long term exposure to high levels of particulate matter air pollution, it was found that an increase of just 10 ug/m3 is associated with a 70% increase in DVT risk.[15] Ozone is another key pollutant – exposure to a 10g/m3 increment has demonstrated an increase in the risk of cardiopulmonary mortality by 1.014 times.[14] Both particulate matter and ozone type air pollution cause adverse cardiovascular outcomes.

Increased global temperatures will exacerbate heat related deaths due to an increased frequency of heat stress events.[7] Untreated heat exhaustion can progress to heat stroke,[17] of which 15% of cases are fatal.[18] Heat related health events typically occur on the same day as initial exposure.[19] Emergency departments (ED) in Brisbane have demonstrated that during days ≥35°C, elderly patients were 1.9 times as likely to present to the ED and 3.75 times as likely to present due to heat-related complications specifically.[20] Based on current modelling of Brisbane’s population growth, ED presentations on days ≥35°C and the projected climate change related temperature increases, it is predicted to cause a 125-2065% increase in excess visits by 2060.[20] Consequently, political inaction now will continue to worsen the burden on public ED services.

The psychological impacts of climate change are generally indirect and have only recently been considered as part of the widespread impacts of climate change on health. Extreme weather events can lead to mental health disorders associated with loss, displacement and social disruption. This can increase anxiety about the future, with already-disadvantaged communities most likely to suffer the most severe consequences.[21] Two hundred million people will be displaced by climate change by 2050.[22] This emerging group of environmentally displaced people will need support to cope.[23] Climate change has the potential to create disasters beyond the capacity of developing nations’ public health systems.[24] Action must be taken to reduce the impact of climate change for the sake of public health. The global community is interconnected and each nation has the responsibility to reduce its contributions to climate change. Consequently, the impact of the planned Carmichael mine site and its extensive environmental damage will have substantial impact on human health into the future.

Locally, coal worker’s pneumoconiosis has re-emerged in Queensland with at least 20 cases recently diagnosed, highlighting the lack of appropriate health protection within the Queensland coal industry.[25] If the Queensland and Australian governments can’t manage these Occupational Health and Safety issues at home, how can they contribute to the ‘safe’ delivery and burning of this coal in Adani’s power stations in India – a country where air pollution already kills an estimated 1.1 million people annually.[26] If the mine proceeds, the flow on effects of poor governing locally will have detrimental health impacts on a global scale.

Environmental Implications

The establishment of the proposed Carmichael coal mine and its shipping impact will damage vital ecosystems and reshape the lives and health of the people reliant on waterways and reefs. More than 500 million people around the planet rely on coral reefs for food, income and storm protection.[29] Climate related changes in waves, ocean circulation, cyclone frequency, temperature and precipitation will impact fisheries in tropical Queensland and further north.[30] Additionally, fisheries in our region may be contaminated by chemicals released into seawater by the mine and from increased shipping traffic. This will have economic, social and health implications and affect the productivity of the seafood industry in Australia and surrounding nations, especially those that rely on it as a major industry and cultural cornerstone.[30] Climate change associated contamination of food staples is also likely to impact on nutrition and human development.[7] In parallel, the social aspects of recreational fishing are also highly sensitive to climate change.[30] Thus, along with the state of the environment, multiple social determinants of health are at risk of declining for our coastal communities.

Implications for Australia

In Central Queensland, the proposed Adani mine will see more than 10,000 hectares of native bushland cleared from around the Galilee Basin. Combined with the Carmichael mine’s generous water licence enabling unlimited groundwater use from the Great Artesian Basin,[31] this has huge potential for irreversible environmental damage.

The Great Artesian Basin is a drought-prone area that is critically responsible for supplying an estimated 200 towns and settlements with irrigation and drinking water.[31] The construction of the world’s largest coal mine at this site could risk the livelihoods and lives of Australian primary producers in this region. The importance of water security in drought-prone areas is tantamount and supporting this mine renders these remote Australians even more vulnerable. Australians living in rural and remote settings already have a lower standard of health service provision and are more likely to suffer worse health outcomes as a consequence of their social determinants.[32] The health impacts from the proposed mine are likely to impact rural Australians to an even greater magnitude.

Massive quantities of coal will be shipped overseas through the Great Barrier Reef.[3] It is feared that this will exacerbate the already extensive coral bleaching. This will impact Australian coastal communities as the Great Barrier Reef and other coral reefs provide protection from wave and storm damage.[33]

Implications for Australia’s regional neighbours

Climate change is projected to slow economic growth, erode food security and hinder poverty reduction. The negative effects will be most felt by those who are already disadvantaged.[34] This is especially pertinent for our regional neighbours, predominately developing countries.

Many of our regional neighbours are already suffering from the effects of climate change. Bangladesh has experienced increased temperatures, swollen rivers and sea level rises; all which threaten infrastructure, livelihoods and homes and undermining the region’s development.[35] Climate change is now making cyclones on many of our neighbouring Pacific Islands even more powerful and destructive. In 2016, Tropical Cyclone Winston hit Fiji, affecting more than half a million people and decreasing its national GDP by one-fifth.[36] As a developed nation, our government has a responsibility to contribute to the prosperity, safety and health of our region by supporting these developing nations. This begins with reducing our carbon footprint by stopping the expansion of our fossil fuel industry, including the proposed Carmichael coal mine.

The climate impacts of the proposed Carmichael coal mine go against Australia’s international commitment to promote a sustainable future by limiting increases in global temperatures. The United Nations Framework Convention on Climate Change (UNFCCC) promotes the work of the Paris Agreement to limit a global temperature rise this century to below 2°C above pre-industrial levels.[27] Many of our regional neighbours do not believe this goes far enough. The “1point5toStayAlive” movement by the Caribbean and their partner states is fighting to prevent the temperature associated rises in sea levels in order to prevent their nations going underwater. A 2°C goal requires a 40-70% reduction in greenhouse gas emissions compared with 2010 levels, whereas a 1.5°C increase will require a 70-95% reduction.[28] As one of the most influential developed countries in our region, Australia has a responsibility to support the continuing development of our regional peers. This begins with supporting their call for action to reduce the global temperature rise to 1.5°C. There is simply no room for the proposed Carmichael coal mine and its extensive pollution in a sustainable future – a future that needs action now.


Economic and Political implications

The proposed Carmichael mine project has struggled to achieve financing. Nineteen banks (including Australia’s ‘Big Four’) have refused to fund the venture due to ethical concerns, environmental policies, or the likelihood that renewable energy will outprice fossil fuels over the proposed life of the mine. The use of Australian mined coal in Indian power plants will also inevitably become economically foolhardy.[37] Both the Australian and Queensland governments should not continue to support this proposal as it will create few lasting jobs and crucially it will increase the loss of human life and burden of disease locally and abroad.

The continued approval of Adani’s Carmichael mine by the Australian and Queensland governments is unwise as the economic return on taxpayer investment is questionable. The Northern Australia Infrastructure Facility (NAIF) has proposed a $1 billion AUD loan to Adani for the North Galilee Basin Rail Project – a 310km rail link from the mine site to the Abbot Point export terminal. Despite widespread coverage, little information was publicly available at the time of writing; only four documents were published on NAIF’s website, with none focussing explicitly on coal mining in the Galilee Basin.[38-41] Both Adani and the former Minister for Resources and Northern Development have suggested that the loan is “not critical” and consequently the mine should be ineligible for NAIF funding.[42] Other requirements for NAIF funding include public benefit and commercial viability, both of which are questionable.[42]

Adani continues to claim that the Carmichael mine will create 10,000 direct and indirect jobs. However, reef industries threatened by the mine provide approximately 69,000 jobs.[43] The proposed “10,000 jobs” is even more questionable because Adani has, under oath, stated only 1,464 jobs will be created.[42] A loan of this magnitude seems wasteful for taxpayers. In September 2016, the Minister for Resources and Northern Australia Matthew Canavan stated that opening the Galilee Basin for coal mining would “not damage the environment”.[38] The political mismanagement and fabrications surrounding the Carmichael mine site are a disservice to Australian taxpayers.

The lifespan of the proposed Carmichael coal mine is 60 years.[2] Australian coal is expected to be burnt in India, a country where the Power Minister plans to ban coal imports. India’s draft National Electricity plan states that until 2022, India will not require an increase of coal from its current rate of supply.[44] India is also a signatory to the Paris Agreement and has declared commitment to utilising emerging “cleaner sources of energy” as they become feasible.[45] The long term profitability of Adani’s Carmichael coal mine is even more questionable as there is growing public discontent in India with coal-based power sources and its resulting air pollution. Whilst there was an absolute increase in the use of coal in India, renewable generation grew at over six times the rate of conventional sources. Between April-October 2016, 28% of Indian energy production came from renewable resources.[44] This demonstrates that the global trend towards increasing utilisation of renewable energy sources is extending to India and the coal industry is declining.

The United Nations (UN) recognises that climate change is a threat to human health and rights.[4] In 2016, Australia ratified the Paris Agreement with a declaration to work towards combatting climate change. Yet due to the export nature of the proposed Adani Carmichael coal mine, these Australian sourced emissions will not count as part of our Intended Nationally Determined Contributions. The UN’s Committee on Economic, Social and Cultural Rights (CESCR) stated that Australia’s increasing carbon footprint is “at risk of worsening in the coming years”[46] which would undermine the vision of the Paris Agreement and its predecessor, the Kyoto Protocol, both of which we are signatories to. The CESCR’s panel of international human rights experts has recommended Australian politicians “review (their) position in support of coal mines and coal export”.[46] In light of the USA’s recent withdrawal from the Paris Agreement, it is of increased importance for Australia and other developed countries to consider the impact of our carbon footprint beyond our national border.


The real cost of Australia enabling the continuing burning of coal will be measured in health impacts, hunger and humanitarian disasters. Therefore, the Australian and Queensland governments must act now to preserve the health of Australian and global citizens into the future. The medical profession has a long and proud history of protecting public health. We must add our voices to the wave of protest to stop the construction of the world’s largest coal mine, and for the sake of our patients’ health, to make coal history.

John E Morgan

John Evan Morgan is a fourth year medical student at James Cook University. He is passionate about advocacy, climate change and issues facing the developing countries within our region. He is a member of Doctors for the Environment and AMSA’s Mental Health Campaign. Based in Cairns, he loves bushwalking and camping (and so far hasn’t had any crocodiles up close).

Conflict of Interest: None declared


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