Deadly Air Pollution Killing Thousands in Bosnia and Herzegovina

Human Rights Watch

(Sarajevo) - Bosnia and Herzegovina's authorities have failed to tackle the country's horrific air pollution, which kills thousands of people prematurely each year and is detrimental to the health of thousands more, Human Rights Watch said today.

The country's reliance on coal and wood for heat and coal for electricity generation makes cities in Bosnia and Herzegovina some of the world's most polluted during the winter months. The country has the fifth-highest mortality rate from air pollution.

"An outdated reliance on coal in Bosnia and Herzegovina is killing thousands every year, while the authorities do little to prevent the problem or even to warn people of the risk to their health," said Felix Horne, senior environment researcher at Human Rights Watch. "With air pollution season just a few months away, there is no time to waste to start making changes."

During winter months, levels of fine particulate matter, nitrous dioxide, sulfur dioxide and other deadly pollutants regularly exceed what the World Health Organization says is safe for human health. Every year, an estimated 3,300 people in the country die prematurely from exposure to air pollution - 9 percent of all deaths, according to the World Bank. Thousands more live with increased respiratory and cardiovascular conditions. Older people and children are particularly at risk.

Bosnia and Herzegovina produces electricity by burning lignite, a low-quality polluting type of coal found in abundance throughout the country, in outdated coal plants. Poor building insulation and using coal, wood, and other plant materials for heating contributes to pollution. And winter air pollution is exacerbated by inversion, with pollutants effectively trapped in narrow river valleys where many cities are located. Outdated and polluting vehicles also contribute to the deadly air.

Between December 2020 and April 2021, Human Rights Watch interviewed 35 people about their experiences with pollution, 22 of them over age 65 in addition to local government officials, academics, health professionals, and local civil society activists. Human Rights Watch also reviewed air quality data and official government documents. Human Rights Watch wrote letters to relevant entity ministries, the electricity companies in both Republika Srpska and the Federation of Bosnia and Herzegovina, and local governments. Sarajevo canton, the Ministry of Mining and Energy in Republika Srpska, and Elektroprivreda Republika Srpska had responded by time of publishing.

One physician who spoke on the condition of anonymity due to the strong links between the coal industry and the authorities said, "Many more people come in during winter with problems breathing. This community [neighborhood] has high rates of cancers and various cardiovascular problems. Children regularly have asthma."

Residents living near some of the country's five coal plants said that friends, family, and neighbors had died from cancer and cardiovascular, or respiratory ailments that they believe were attributable or exacerbated by the pollution from the nearby plants. Healthcare workers described seeing increased rates of respiratory problems in areas near the plants.

Parents described the difficulties in caring for children with asthma and bronchitis. Some said their children could not safely leave the house during the winter without suffering acute respiratory symptoms. Some had kept children home because of the problem, in one case for 25 consecutive days, causing them to miss school, sports, playing with friends, or other activities. Older people, many of whom have been breathing polluted air for decades, were especially affected. Health professionals said they were frustrated at the scant attention given to air pollution in diagnoses or public health responses. And young Bosnian and Herzegovinians living in the European Union expressed fears about the health of older family members still living in the country. "I left four years ago, and regularly send money for my aging parents, who won't leave their village," said a 26-year-old man. "They don't go outside for weeks during winter and when I talk to them, I hear them coughing more and more.… It's terrible but they won't leave."

The complex governance system presents difficulties in tackling air pollution with no national environment body and a slew of standards and regulations, with little coordination between the various tiers of government. Each of the two entities has its own separate legal frameworks, organizational structures, and air quality networks, making it more difficult to coordinate approaches to air quality management.

Local government officials said that the country's 17 air pollution monitoring stations sometimes are out of service, particularly in Republika Srpska, one of the two entities in the country, and that many do not adequately monitor particulate matter 2.5, one of the main pollutants of concern. Warnings to avoid outdoor activities or to limit vehicular transport on bad air days are largely limited to the capital, Sarajevo.

Burning of coal is a major contributor to both climate change, responsible for 20 percent of greenhouse gas emissions, and to the air pollution that globally kills an estimated seven million people annually. An urgent shift toward renewable energy, more efficient technologies for heating homes, including improved building standards, and better public transportation can change the situation, while creating thousands of sustainable, well-paying jobs in the process, including for former coal workers, Human Rights Watch said.

"The world is in the midst of a climate crisis, and governments should be rapidly transitioning away from the burning of fossil fuels, not investing billions into new infrastructure to further burn some of the dirtiest fossil fuels on the planet," Horne said. "The EU should use its considerable leverage to shift Bosnia and Herzegovina's reliance on coal while simultaneously tackling toxic air and the climate crisis."

For additional details about air pollution and the situation in Bosnia and Herzegovina, please see below.

Air Pollution - A Global Problem

The WHO has identified air pollution as the "single biggest environmental threat to human health," with estimates of over seven million people dying prematurely from it annually, including 4.2 million from outdoor (or ambient) air pollution. The major pollutants of concern globally and in Bosnia and Herzegovina are particulate matter of less than 2.5 micrometers (pm2.5), sulfur dioxide (SO2), and nitrous oxides (NOx).

Air pollution comes from a number of sources, including burning of fossil fuels for transportation, heating fuel, waste burning, electricity generation, and other industrial activities. Air pollution and climate change are directly linked as many of the drivers of air pollution, namely burning of fossil fuels, are also sources of considerable greenhouse gas emissions.

Coal, Health, and Climate Change

Globally, coal is one of the most widely used and dirtiest fossil fuels in use. Burning coal is responsible for over 20 percent of the world's greenhouse gas emissions - a major factor contributing to the climate crisis. Burning coal, and in particular lignite, essentially a low-quality coal, releases significant pollutants including pm2.5, SO2, NOx, and heavy metals, each of which can have significant impacts on human health depending on levels of exposure.

The impact of pm2.5 on human health is well documented, due to both short- and long-term exposure. The pm2.5 particles can reach deep into the lower respiratory tract, leading to serious increase in potential for respiratory and cardiovascular problem, and can easily enter the bloodstream and penetrate the lungs. It is responsible for the most deaths worldwide of any pollutant.

Some governments around the world have recognized the dire impacts of coal and are scaling back, pledging to phase out coal, and committing to a transition to renewable energy. Coal-fired power plants have been on the decline globally since the first half of 2020. But some very large economies with considerable growth in energy demand, including China and India, continue to plan for coal-fired electricity generation in their energy mixes.

Energy in Bosnia and Herzegovina

Bosnia and Herzegovina has significant deposits of lignite, and over half of its electricity production comes from burning it. Many cities and towns developed around the exploitation of these coal reserves in the former Yugoslavia. Four of the current five coal-fired power plants have been operational for decades and are owned and operated by the governments of the two entities, the Federation of Bosnia and Herzegovina and Republika Srpska. Technologies in existing plants that could reduce emissions are outdated. The fifth plant, Uglevik power plant, in Republika Srpska, is owned by a United Kingdom-based Serbian businessman.

Bosnia and Herzegovina exports millions of euro worth of coal-fired electricity into the EU without paying a carbon price, unlike coal-fired electricity produced inside the EU. The imminent introduction of an EU carbon tax for carbon-intensive goods produced outside of the EU, the Carbon Border Adjustment Mechanism, could address this issue and has led to increased commitments in Bosnia and Herzegovina for a domestic carbon tax that should make the production of coal-fired electricity for export less financially attractive, saving lives.

The country had planned for a significant increase in coal capacity, but the plans are on hold due to financing and regulatory constraints, at least for the time being. However, the Federation of Bosnia and Herzegovina government plans to extend the life of two of its highest polluting power plants beyond their legislated end dates in contravention of the Energy Community Treaty requirements. This would also increase the burden on the country's population, which is aging as more young people emigrate, with more deadly air and would prevent the country from reaching its Paris Agreement goals.

Many households across the country rely on burning low-quality and relatively inexpensive coal, wood, or waste in inefficient stoves to produce heat in poorly insulated homes during winter months, in part due to poverty. Some cities, including Sarajevo, Banja Luka, and Tuzla, have central heating systems that could reduce air pollution from household heating but not all buildings are connected, in part because of cost. Sarajevo is supplied with natural gas via pipeline from Russia through Serbia and Republika Srpska, providing some heat but given spatial limits on gas infrastructure, the high cost of connecting to the grid, and the high prevalence of informal homes, many households continue to heat their home with wood or coal.

Natural gas does not contribute as much pollution as coal or wood to the local air but is a significant contributor to greenhouse gas emissions. Despite EU commitments to tackle climate change, gas infrastructure remains high on the list of EU priorities for the country in part because of energy security. Diplomats in Sarajevo told Human Rights Watch that energy security is critical for the country given the Balkan wars and its complicated relations with its neighbors.

"We understand the issues about bad air and environmental concerns in general," one diplomat said. "But for us our primary concern is energy security and ensuring politics doesn't get in the way of energy provision across the country." In a letter to Human Rights Watch, the Republika Srpska Minister of Energy and Mining underscored the importance of energy security describing how an "'exit from coal' … must be implemented gradually and in stages, in order to preserve the stability and safety of our power system, which is our priority."

While there are a number of renewable energy projects at various stages of development, the country has considerable renewable energy potential, largely unrealized, including from wind and solar sources, Human Rights Watch said.

Causes of Bosnia and Herzegovina's Air Pollution

Bosnia and Herzegovina's air pollution is at its worst between October and February, when its cities and surrounding areas are some of the most polluted in the world. Burning of wood and low-quality coal in outdated stoves for heating in buildings with poor insulation along with coal-fired power plants are major contributors to air pollution during the winter.

Many cities have central heating systems, but few buildings are connected, in part because of cost and the prevalence of low-quality/low-cost coal, wood, or waste. Low vehicle fuel quality standards, aging industrial plants, lack of effective public transportation and older diesel vehicles also contribute. Geography also plays an important part. Many of the cities are in valleys and during winter temperatures can reach - 10 degrees Celsius with little wind, resulting in inversions, effectively trapping polluted air in the valley, creating smog.

Transboundary air pollution also plays a role with the World Bank estimating about 20 percent of the country's pm2.5 originates from other countries.

Health Impacts from Air Pollution

Levels of pm2.5, NOx, SO2, and other pollutants in Bosnia and Herzegovina regularly exceed what WHO says is safe for human health. The country has the fifth-highest mortality rate from air pollution worldwide, based on 2022 WHO figures. Nine percent of the country's deaths are due to air pollution and an estimated 3,300 people die prematurely every year as a result of exposure to ambient PM2.5 air pollution, based on 2019 World Bank figures. Air pollution is estimated to reduce the country's GDP by 21.5 percent through lost work and school days, and healthcare and fuel costs.

Air pollution affects everyone but there is a disproportionate impact on older people, children, and those with preexisting respiratory or cardiovascular problems. Older people interviewed described the health toll of air pollution, but also the difficulties in leaving the house and socializing on high air pollution days leading to feelings of isolation and depression.

Hassan, 68, lives within a kilometer of a coal-fired power plant, in Tuzla. "I have bronchitis and have been hospitalized 30 times," he said. "During the winter, it's hard to breathe and I have chest pain. My brother and sister died of lung disease. Another brother has cancer and so he moved to Croatia, near the sea. Another sister in Germany has cancer, my one son was sent to hospital yesterday with breathing problems."

Enes, 81, described the impact of winter air pollution in Tuzla: "For five days I haven't left the house. If I need groceries or medication, [neighbor] gets it for me. Without him I'd be lost."

Tarik, 42, whose parents live in a village next to a coal-fired power plant, said, "The older people in this village are desperate. They put up with this air for months. They don't get out, they don't socialize, they can't get groceries or medication. It's a terrible existence. Their children have moved away, and so they are left with this existence. And the government doesn't respond to their needs."

Dejan Bokonjić, a pediatric pulmonologist in Republika Srpska said, "We have an increase in the number of children suffering from asthma, lung disease, bronchitis, a lot of patients, what they themselves say in the winter months, as soon as the smog falls, they can't breathe, that's very clear."

Air pollution has particular effects on children in part because their bodies and brains are still developing, and they breathe more rapidly than adults. Globally almost 1 in 10 deaths of children under age 5 is due to air pollution and in 2016, 600,000 children died from the effects of air pollution, according to WHO.

Teachers and young parents described the toll on their children's health and well-being. One mother from Tuzla said, "We haven't let our two children [ages 3 and 6] outside in 10 days. They asked again if they can be let outside to play. They both have developed asthma in the last two years.… When they go outside, they have a very hard time breathing, so they stay inside. It's heartbreaking but I get tired of taking them to the hospital for asthma attacks."

A 17-year-old boy in Kakanj described his asthma and breathing problems he has experienced for much of his childhood. "I simply couldn't breathe, I would sometimes cough up blood from all the coughing, would easily get short of breath. I try not to go outside in the winter when the air is too polluted if I don't have to."

The situation is exacerbated by poor site planning of schools and playgrounds. One parent described the situation in a school across the road, less than 300 meters from Tuzla power plant's cooling towers: "I can prevent them going outside when they are home. But they have to go to school and the school is right next to the power plant. They play outside at recess. They are supposed to be learning and developing, but instead they breathe horrible air."

Because air pollutants easily travel across borders, the impacts of the country's polluted air extend into the EU. A 2019 study using 2016 data found that there are 3,000 premature deaths in the EU from Western Balkans air pollution, and is estimated to cost the EU between 3.1 and 5.8 billion euro each year.

Failure to Address Air Pollution and Its Impacts

Bosnia and Herzegovina has a human rights responsibility to address air pollution as part of its responsibility to protect the right to health and life. The United Nations Committee on Economic, Social and Cultural Rights - which interprets and monitors compliance with the International Covenant on Economic, Social and Cultural Rights, which the country has ratified - has stated that governments should adopt measures against environmental health threats, including by enacting and enforcing laws to prevent air pollution.

Despite the health and climate impacts, the government has remained steadfastly committed to use of coal, particularly for electricity. The Federation of Bosnia and Herzegovina has extended the life of two outdated and highly polluting coal plants, Tuzla 4 and Kakanj 5, despite regulatory requirements in the Energy Community Treaty that these plants close by the end of 2023.

Municipal and cantonal governments, including in Sarajevo and Banja Luka, have taken some initial steps to provide more efficient residential heating options, including heat pumps, financially supporting connections to municipal heating grids for households, and developing further strategies to move buildings away from coal and wood heating, particularly in Sarajevo and to a lesser degree in Tuzla. But considerably more needs to be done to tackle residential heating emissions.

Many people interviewed said they were aware of the health impacts from household burning of coal or wood but said the cost of alternatives was a key barrier. One professor who works in both entities said, "There are easy solutions, many cities have CHS [central heating systems] and stoves [for heating] are horribly outdated and should be replaced, but older people can't afford these solutions. They use wood or coal in these stoves because it's what they can afford."

The country's many tiers of government also do not take adequate steps to inform citizens of the risks to their health from air pollution or how they can mitigate those risks. Sarajevo canton took some steps to warn citizens of health risks and to reduce those risks. In a letter to Human Rights Watch, the cantonal government described publishing warnings on the Institute for Public Health of Sarajevo Canton's website and using the media to communicate health risks. This has included limiting heavily polluting vehicles in high-traffic areas, communicating health risks, and restricting or warning against some outdoor activities. On rare occasions local governments have closed schools. Human Rights Watch was not able to find any concrete steps that other cities or municipal governments had taken to address air pollution risks.

Air pollution monitoring stations are often not working or are unavailable, particularly in Republika Srpska, officials said. Local government officials, particularly outside of Sarajevo, said they had inadequate budgets and not enough personnel sufficiently trained to maintain stations and report the data. Sarajevo is generally well served, with seven official stations along with a station at both the US and Swedish embassies, although concerns persist about limited data collection of pm2.5.

In the absence of adequate government monitoring and communication, a series of citizen-run sensors fill the gap in Tuzla and elsewhere. Many young people said they regularly use apps or websites that report on air quality, some of them operated by civil society. Others receive air quality updates from television and radio, while others, particularly older people, say they assess air quality based on the smell or the appearance of the air, neither of which is appropriate to determine extent of pollution or assess risks to health. "My grandson shows me the color on his phone," said Milan, 85. "If it's red it's dangerous, but I don't need those things, I just look outside and know. It's been this way for as long as I can remember."

The country's air quality standards are generally in line with those in the EU, but local officials tasked with various aspects of air quality management said they weren't enforced. The country's laws require major polluters, such as coal-fired power plants, to monitor their own air quality and submit reports to the relevant government entity. But none of this data is publicly available, making it difficult for citizens to understand the risks from living adjacent to these sites.

One local government official tasked with managing air reflected the pessimism many expressed about the government's ability to tackle the issue: "People here are very sick. We have cancers, respiratory and cardio issues. We are unable to solve this air problem. I advise children here to go to the EU and that's what happens. I advise them to learn foreign languages and leave this horrible air. They send money back to their parents and [the parents] breathe in the pollution until they die. It is the way."

European Union and Carbon Pricing

Bosnia and Herzegovina is currently considered a "potential candidate country" by the EU. As such, it must adopt and carry out all EU legislation (known as the EU acquis), including a variety of legislation and standards around air pollution and environmental protection. In its 2021 report on Bosnia and Herzegovina, the European Commission stated that "alignment with the EU acquis on air quality remains limited." The Commission pressed Bosnia and Herzegovina to establish a well-functioning countrywide harmonized air monitoring network and to implement a decarbonization strategy.

As part of these requirements, the Commission's Western Balkans Strategy emphasizes the transition to sustainable energy as a precondition for membership and stresses that relevant provisions of the Energy Community Treaty, which apply EU energy and environmental law across the region, must be translated into concrete policy.

An increase of domestic coal capacity is not in line with the EU's position on energy, and Bosnia and Herzegovina's use of government funds to guarantee a Chinese loan for the construction of the Tuzla 7 coal plant contravenes EU Energy Community Treaty guidelines. Likely due to the noncompliance, the Federation recently decided to reverse their support for the loan. And for the last four years, it has breached Energy Community Treatment standards on emissions (for pm2.5, NOx, and SO2) from prescribed coal-fired power plants. In 2020 the plants were emitting almost 10 times as much SO2 as is permitted.

The country exported 424 million euro worth of electricity in 2021 into the EU, largely via Croatia, a 66.9 percent increase from 2020. Given that the country has no carbon pricing mechanism, power is exported without having to pay any price for the significant amounts of CO2 emitted through its generation. By contrast, electricity produced inside the EU is charged a price for carbon in line with the EU's Emissions Trading System (ETS) - currently 89.24€ per ton.

In effect, the lack of a carbon price means that Bosnia and Herzegovina is generating high-polluting and high-emitting electricity for export to EU that falls below the cost to produce electricity inside the EU. An EU Carbon Border Adjustment Mechanism (CBAM), in its final stages of approval, could change that. It would require an importer to "buy carbon certificates corresponding to the carbon price that would have been paid, had the goods been produced under the EU's carbon pricing rules."

Bosnia and Herzegovina's lack of a carbon price charged on its energy exports and proximity to EU power markets incentivizes further coal development and provides an unfair competitive advantage over power producers in the EU who must pay a carbon price. As the EU Commission president Ursula von der Leyen has stated, the adjustment mechanism "should motivate foreign producers and EU importers to reduce their carbon emissions." The mechanism could make it less financially attractive for Bosnia and Herzegovina to produce coal-fired electricity to export to EU markets and incentivize cleaner energy production for export in Bosnia and Herzegovina and other exporting countries. Bosnia and Herzegovina has indicated it will put in place its own carbon pricing system by January 2026 to avoid participating in the mechanism.

Bosnia and Herzegovina's Energy/Air Pollution Future

A more rapid shift toward renewable energy, alongside improved building and vehicle standards and widespread adoption of more efficient home heating solutions, can simultaneously address air pollution, meet the country's emissions commitments under the Paris Agreement, and move it one step closer on EU accession.

While energy security is important, the Federation of Bosnia and Herzegovina government should urgently reconsider extending the life of Tuzla 4 and Kakanj 5, and instead speed up the transition to clean energy.

Coal mines and power plants provide lucrative jobs for many people in otherwise economically disadvantaged areas. The country is struggling financially, and many young people live and work in the EU. If the country embraces renewable energy opportunities and transitions away from reliance on coal, it is critically important to provide assurances to people in the country's coal regions that their needs are being met, including with training for the renewable energy jobs that will be created.

The European Union should push ahead with its border adjustment mechanism and provide further support for development of renewable energy, especially solar and wind, to meet both climate goals and to reduce the air pollution that claims lives both in Bosnia and Herzegovina and the EU. It should also reconsider supporting any further development of gas infrastructure in Bosnia and Herzegovina, in part because of climate impacts, and should help Bosnia and Herzegovina improve building insulation and support development of other strategies to reduce air pollution and emissions from heating buildings.

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