Fossil fuels are not only fuelling the climate crisis but also unleashing a public health emergency, with impacts spanning “from the womb to old age,” according to a landmark new report released Tuesday by the Global Climate and Health Alliance (GCHA). The study, ‘Cradle to Grave: The Health Toll of Fossil Fuels and the Imperative for a Just Transition,’ is the first comprehensive global overview of fossil fuel harms across their lifecycle and the human lifespan.
The report lands weeks before the COP30 climate summit in Brazil, where governments will face growing calls from the health community to treat fossil fuel dependence as a driver of disease, not just of global warming. India’s coal belt and industrial hubs provide testimonies of how fossil fuel dependence damages health. In Korba, Chhattisgarh, one of the country’s largest coal-producing districts, health workers report alarming rates of childhood asthma, bronchitis, tuberculosis, and congenital disorders linked to contaminated air and water. In Jharia, Jharkhand, underground coal seam fires that have burned for over a century continue to blanket communities in toxic smoke, displacing families and leaving residents with chronic respiratory and skin illnesses.
Along India’s eastern coast, refineries and power plants intersect with cyclone-prone zones, amplifying risks of toxic leaks during extreme weather. In Ennore, North Chennai, oil spills and coal ash have poisoned waterways, devastating fisheries and forcing traditional fishing families into precarious work. “Our waters are not just our livelihood, they are the essence of our identity. Pollution has erased our way of life,” said Ennore fisherman RL Srinivasan, quoted in the report. “These stories are emblematic of a wider crisis,” said Shweta Narayan, campaign lead at GCHA and one of the report’s authors. “We are talking about the entire industrial life cycle of fossil fuels — from the exploration stage, even before extraction, all the way to the disposal of coal ash ponds. At every stage, the harms are both to the environment and to health.”
The report maps health impacts from extraction to disposal. Pregnant women exposed to coal dust, refinery fumes or traffic pollution face elevated risks of miscarriage, preterm birth, and babies born with low birth weight or congenital defects. Children are especially vulnerable, with studies linking proximity to petroleum facilities and highways to acute lymphoblastic leukemia and asthma. For adults, exposure to fine particulate matter (PM2.5), benzene, sulphur dioxide and other pollutants drives up risks of cardiovascular disease, strokes, diabetes, neurological disorders, and cancers. The elderly, already weakened by chronic illness, face premature mortality from polluted air and water. “Fossil fuels are a direct assault on health, causing miscarriages, childhood leukemia, asthma, strokes and cancer,” Narayan said. “At different stages of life, from pregnancy to elderhood, people are particularly vulnerable depending on their circumstances.”
The harms endure long after operations cease. Pollutants such as arsenic, lead, and mercury remain in soil, rivers, and food chains for decades, causing chronic neurological damage, kidney failure, and cancers across generations. “The chemicals discharged from fossil fuel infrastructure can persist for decades, sometimes forever,” Narayan explained. “A factory may shut down, but its legacy continues. For policymakers this is critical: the healthcare costs are intergenerational. Cancer, for instance, may only emerge decades later — who pays for that treatment? This is why evidence-based planning and the polluter pays principle are so important.”
In Ennore, she added, coal ash ponds will remain hazardous long after power plants have run their course. “Even if the plant stops operations, the chemicals in the soil, water and air will continue to harm people. That is why continuous monitoring of both environment and health is vital.”
The study stresses that fossil fuel pollution is unevenly distributed, with the heaviest toll falling on marginalised groups — Indigenous peoples, low-income families, and workers often forced to live near mines, refineries, and coal plants. These “sacrifice zones” lock communities into cycles of disease, poverty, and displacement. Neha Mahant, a health worker in Korba, described the reality: “Living near coal mines means living with disease. Asthma in children is alarmingly high. Coal doesn’t just generate electricity — it generates suffering.”
Beyond human suffering, the economic costs are staggering. The International Monetary Fund estimates global fossil fuel subsidies reached US$7 trillion in 2022, of which only US$1.3 trillion were direct subsidies such as tax breaks and price caps. The rest reflected unpriced damages to health, ecosystems, and infrastructure. “Every day of delay raises the cost of inaction,” said Dr Jemilah Mahmood, executive director of the Sunway Centre for Planetary Health, Malaysia. “A just transition is not only imperative but possible — a prescription for cleaner air, healthier communities, and intergenerational justice.” The report calls for urgent policy shifts: halting all new oil, gas, and coal projects, phasing out subsidies, enforcing the “polluter pays” principle, and banning fossil fuel lobbying and advertising — similar to restrictions placed on the tobacco industry. Christiana Figueres, former UN climate chief and architect of the Paris Agreement, said: “The age of fossil fuels has poisoned our air, broken health, and fractured dignity. We must choose a just transition without delay to safeguard life, restore justice, and secure a healthier future for all.”
GCHA’s executive director, Dr Jeni Miller, urged leaders to act decisively at COP30: “Political leaders already know the solutions for ending fossil fuel dependence. Further delay is indefensible — all that is required is political courage.” With oil and gas demand projected to peak before 2030, and renewable energy already cheaper than fossil fuels, health advocates argue the moment is ripe for change. “When the hidden health costs are considered, the case for transition becomes undeniable,” the report says.
For India, one of the most climate-vulnerable nations, the findings hold particular resonance. From Korba’s coal fields to Ennore’s refineries and Jharia’s underground fires, the health price of fossil fuels is already painfully clear. As COP30 approaches, campaigners say New Delhi must seize the opportunity to align climate ambition with a public health agenda. “Fossil fuels are not just an environmental issue,” Narayan said.