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Coal and Wood Heating Is Making Thousands of Americans Sick

For years, the effects of burning solid fuels indoors have been associated with poor and developing countries like China and India. But a study suggests that in many parts of the United States, the rural poor are experiencing many of the same health...

by Peter Moskowitz
Sep 19 2014, 5:50pm


Vicki Shelton and her son, Nathan, in front of their West Virginia home. Both suffered chronic health issues from heating their home with coal.

Vicki Shelton, 57, lives in a house in the woods in Clay County, West Virginia. The county is exceedingly rural and poor—26 percent of its 9,000 residents live in poverty. The average income hovers around $16,000.

Shelton still uses wood heating to weather the cold West Virginia winters, where temperatures often drop to 20 degrees Farenheit. For her and her son Nathan, wood and coal are the only affordable approaches to heating their home, a small cordwood house they built themselves with the help of a few friends. So every so often, Nathan goes out into the surrounding woods and chops up lumber. “We were just talking about how we need to start splitting the logs now before winter comes,” she said. “Hopefully the pile lasts through the season.”

Shelton used to use coal to heat her home, but for years she suffered from debilitating headaches. She finally decided coal might be the reason. After switching to wood, her headaches went away. She says she knows there might be longer-term health effects from using wood, but as of now it’s her best option. “We have no utilities, so right now that’s pretty much the only way to heat the house,” she said. “Even if we had other options, that’s probably what we’d do because we’re limited in the budget area.”

People like Vicki and Nathan, who use wood, coal, and other solid fuels to heat their homes, are a dying breed. But a new study found that 6.5 million Americans are still doing it. And the findings suggest that this use can often lead to serious health consequences.

The study, published in last month’s Environmental Health Perspectives, shows for the first time that using solid fuels to heat your home is tightly linked with rural poverty. And its authors are the first to crunch the data and estimate how many Americans in rural and poor areas could be exposed to elevated levels of Household Air Pollutants (HAPs) because of what they use to heat their homes. Up to 600,000 people could be experiencing health problems associated with HAPs, problems like asthma, respiratory issues, and cancers.

For years, the effects of indoor use of coal and wood have been associated with poor and developing countries. But this study suggests that in many parts of the United States, the rural poor are experiencing many of the same issues as the rural poor of China and India.


Map courtesy of Environmental Health Perspectives

“There’s a lot of interest in indoor air pollution, but this issue mostly gets attention in the developing world,”  Pauline Mendola, one of the study’s authors, told me over the phone. She's also an epidemiological investigator at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, so her opinion on home heating bears a bit of weight. “There are pockets here and in other developed countries that haven’t been studied as much.”

By overlaying federal poverty data with census data about home heating, Mendola and her fellow researchers found 117 counties across the US that had high incidents of poverty, and high incidents of solid fuel use—counties that were therefore more likely to experience the health effects of HAPs.

The researchers then extrapolated the data from studies on the health effects of solid fuels to fit their national dataset, and found that a whopping 600,000 people could be at risk because of their heating choices.

Those people live where you might expect: rural places that get cold during the winter (Alaska, and the more rural parts of New Mexico, Arizona, Utah, and Colorado), and throughout the Appalachian region (mainly West Virginia and Kentucky).

Burning solid fuels indoors is particularly dangerous because it creates particulate matter small enough to get way down deep into people’s lungs and even into their bloodstream without being rejected by the body. A buildup of that kind of particulate matter can cause inflammation, asthma, low birth weight, childhood pneumonia, cataracts, heart disease and lung cancer.


The largest coal breaker constructed in North America, the Huber Breaker dominates the landscape of the little town of Ashley, PA. The breaker was used to break large chunks of anthracite coal into smaller chunks for use as home heating fuel. Photo by Flickr user John Morgan

The health effects of using coal and wood are less extreme in the U.S. than elsewhere because the vast majority of people who use solid fuels here have stoves like Shelton. Those stoves are designed to funnel most of smoke outside. But researchers say fugitive emissions are still a major concern.

Still, for some people, the risks are worth it.

“I would take the health effects before I would take the dependence on big evil energy corporations,” said Katherine Grossman, who lives in rural Western Pennsylvania and blogs about self-reliance. “I can heat my home just from the sticks in my front yard. Why pay somebody else to do what I can do myself?”

Plus, Grossman said, the health benefits from doing everything herself probably outweigh the risks of indoor air pollution. “I never have to see the doctor,” she said. “Maybe it’s because I have to gather wood and don’t sit on my ass all day.”

There’s not enough research to know exactly what role household particulate matter is playing in areas where lots of people use solid fuels in their houses. Other confounding factors that are associated with the rural poor, like higher smoking rates and poor nutrition, make figuring it out nearly impossible. But it’s worth noting that the average death rate from lower respiratory diseases in the at-risk counties identified by Mendola’s study was twice the national average.

“The stoves minimize the pollution in the house, but you’re always going to generate particulate matter,” said Robert Finkelman, a professor at the University of Texas at Dallas who has studied coal-based heating and cooking extensively in China as well as in the United States.

Finkelman’s work in China has focused on areas with some of the highest rates of lung cancer in the world, thanks in large part to the coal locals use to heat and cook in their homes.

What’s most concerning to Finkelman and others is that there’s rarely another option for those who use solid fuels to heat their homes.  From coal country in West Virginia to villages in the most remote sections of China, there’s one commonality for people who use solid fuels: poverty.

“Whether it’s Navajos in Arizona, or people in Appalachia, or people in China, their choices are limited,” Finkelman said. “They’re the poorest of the poor, so they use the cheapest option.”

Follow Peter Moskowitz on Twitter.

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