A sweeping new report by a consortium of climate and health experts offers a global indictment of how fossil fuels harm populations – from extraction to emissions, devastating human health from cradle to grave. Treating the fossil fuel sector like the tobacco sector will help, recommends the study’s authors.

Fossil fuel advertisements should be banned, and the industry representatives barred from attending climate negotiations like the upcoming COP30, the 30th UN climate conference. There should be an immediate end to global fossil fuel subsidies, which reached an estimated $7 trillion in 2022. 

These are some of the recommendations contained in the report, ‘Cradle to Grave: The Health Toll of Fossil Fuels and the Imperative for a Just Transition’, which tracks the damage that fossil fuels do to humans, the environment, and the planet. 

Follows study linking specific heatwaves to fossil fuel extraction

This follows another study, published last week in Nature, which specifically linked over 200 extreme heatwaves reported between 2000-2023, linking the heatwaves to extraction activities by 180 fossil fuel and cement producers, and one-quarter of events directly to activities by 14 of the biggest ‘carbon majors’ – that is fossil fuel and cement producers.

These include extreme heatwaves such as the 2021 Pacific Northwest heat dome, the 2003 heatwave in France and southern Europe; as a 2013 event in eastern China and 2022 in India. The study relies on the expansion of a well-established event-based framework. Owing to global warming since 1850–1900, the median of the heatwaves during 2000–2009 became about 20 times more likely, and about 200 times more likely during 2010–2019, the report says. 

Cradle to Grave author, Shweta Narayan says it is not about chasing Net Zero at a future date, but “about acting decisively now…. A focus on ‘net zero by 2050’ risks turning into a distant accounting exercise, while people are losing their lives and livelihoods today.” 

The immediate action includes an end to fossil fuel subsidies, investments in clean air, safe energy and resilient health systems, Narayan says. Net zero means balancing the amount of planet-warming greenhouse gases released with the amount removed from the atmosphere by cutting emissions as much as possible, and, sometimes controversially, capturing or offsetting the remainder.

The report breaks down the effect of each stage of fossil fuels: at extraction, refining and processing, transport and storage, combustion, post-combustion waste, and legacy pollution. And parallelly, it traces impacts across the human lifespan, from foetal development to old age, showing how no stage of life is untouched.

The report is by the Global Climate and Health Alliance (GCHA), a consortium of more than 200 global health organisations and networks, across 125 countries, addressing climate change. 

While the peer-reviewed report offers no new data or evidence, it draws on multiple reports and case studies to paint a “richer picture” of the damage done by fossil fuels. GCHA’s core concern is that this “pattern” should not be repeated. 

‘Cradle to Grave’ is an indictment of the health harms of the fossil fuel sector.

In 2024, carbon dioxide emissions rose to a fresh record high exceeding the previous year’s 40.8 gigatonnes of carbon dioxide equivalent. Fossil fuel combustion and related industries contributed 90% of global carbon dioxide emissions. The planet has already breached the 1.5 C° global warming target set by the 2015 Paris Agreement by year’s end. Although it is yet to cross it over for a longer period, scientists predict that, too, will happen soon as emissions continue unabated.

Health harms from extraction to combustion

Starting from the beginning, extraction (e.g., fracking, coal mining, offshore drilling) releases benzene, heavy metals, radioactive materials, and particulates, driving up rates of respiratory disease, cardiovascular illness, cancers, adverse birth outcomes, and neurological disorders in surrounding populations. For chemicals like benzene, there is no safe level for cancer prevention that has been found. 

The infant mortality rate, for instance, in the oil and gas-producing delta in the Nigerian state of Bayelsa, is one of the highest in the country at 31 deaths per 1,000 live births. Cradle to Grave reports that oil spills across the Nigeria Delta are estimated to have caused over 16,000 additional neonatal deaths in 2012 alone.

Life expectancy in the region is approximately 50 years, compared to the country’s national average of 53 years and 80 years in rich, developed nations. Residents of oil-impacted areas recount how oil spills have led to widespread sickness and death, with inadequate relief efforts compounding their plight.

A young woman in Los Angeles, Nalleli Cobo, who lived near an oil well, suffered nosebleeds and asthma as a child. At age 15, Cobo and her family formed a group and sued the city of Los Angeles for environmental violations that allowed the well to operate in their neighbourhood, an area where most of the residents were Black, Latino and other people of colour. They won. But at age 19, Cobo developed Stage 2 cancer. 

Refining and processing of oil and gas have been shown to emit carcinogenic chemicals such as benzene, toluene, and volatile organic compounds (VOCs), posing serious risks to workers and residents in the proximity of refineries, especially in densely clustered industrial zones.

Transport and storage involve risks of chemical leaks and spills, which contaminate air and water and trigger acute and chronic health effects, including respiratory and neurological damage.

Combustion, whether in power plants, vehicles, or homes, generates particulate matter 2.5 (PM2.5), nitrogen oxides, and other pollutants, significantly increasing risks of asthma, heart disease, stroke, cancer, dementia, and premature mortality.

Pollutants released from burning fossil fuels can enter the human body in three ways. Contact or Absorption, where materials come in contact with and are absorbed through the skin and eyes; ingestion, when materials are swallowed and are absorbed by the digestive system; and inhalation, when materials are breathed in and are absorbed by the respiratory system. 

Post-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 disease.

Legacy pollution from abandoned fossil fuel sites causes sustained harm decades later.

The report also flags the threat from a phenomenon called biomagnification. Certain pollutants like lead and mercury accumulate in the body over time. Some fossil fuel processes, like fracking and firefighting operations, create what are commonly known as forever chemicals, per- and poly-fluoroalkyl substances (PFAS). These do not break down and persist in the soil and water. As these toxins move up the food chain, their concentration increases, which is known as biomagnification. 

How fossil fuel toxins enter the body

Cradle to Grave has singled out coal-fired power plants, in particular, for their health harms.  This is because coal combustion emits more particulate matter, pollutants and heavy metals per kilowatt hour than do other fossil fuels, resulting in increased health risks per unit of electricity. 

In 2024, global coal demand was 8.79 billion tons, the highest ever, in absolute terms. With falling renewable power costs, the CGHA team points out there is no reason to build any new coal power capacity. 

Only six countries are installing new capacity this year, according to the Global Coal Power Tracker, with China accounting for over two-thirds of new installations, and India the next highest. All the countries pursuing new coal power plants are in Asia, including Indonesia, Republic of Korea, Bangladesh, and the Philippines. 

Yet, as the report shows, it is in China’s Tongliang, where the health benefits of shutting down a coal-fired power plant are starkly visible in local communities. A cohort of children born after a local CFPP closure had larger head circumferences, lower levels of DNA showing signs of alteration by polycyclic aromatic hydrocarbons (PAHs) in their blood, and better overall neurocognitive development than the cohort of children born while the plant was still operating. 

Rising threat from plastic and agrochemicals 

The report also warns against spiking pollution from plastics and chemicals in agriculture. Fossil fuels are used in the production of chemical fertilisers and pesticides. While the role of oil and gas companies in the growing plastics crisis is well-documented, links between the fossil fuel and agrochemical industries have received far less attention. 

In plastics, recent studies have identified over 4,200 fossil-fuel derived chemicals as toxic from some 16,000 known chemicals. Plastic particles and their associated chemicals are now found throughout the human body, including in the brain, heart, lungs, and even in placenta and breast milk, leading to profound negative health impacts.

In 2019, the production of monomers and polymers, the building blocks of plastics, also generated 2.24 gigatons of CO2e (carbon dioxide equivalents), accounting for 5.3% of global greenhouse gas emissions (GHGs). The growth in plastics production is expected to increase by up to 4% annually, tripling by 2060. 

“​​Energy and transport remain the largest sources, but plastics and fertilizers are significant and fast-growing contributors. Plastics, almost entirely fossil fuel-based, generate widespread health harms through toxic exposures and microplastic contamination. Fertilizers and pesticides, derived largely from gas and oil, contribute to GHG emissions, with additional impacts from nitrous oxide release and water and soil contamination,” Narayan said at a press briefing just after the report’s publication. 

Carbon Capture and Storage CCS, a ‘dangerous distraction’

Cradle to Grave calls out carbon capture – essentially sucking CO2 out of the atmosphere and burying it – as a ‘dangerous distraction.’ By the end of 2023, no CCS project had met its CO2 capture targets. Nor does modelling show that it helps to remove CO2 sufficiently to advance net zero targets – contrary to governments and corporate interests that have promoted it as a ‘green’ solution for reducing CO2 emissions in “difficult  to abate” sectors. 

Reliance on CCS, moreover, allows fossil fuel use to persist, and with it, the range of associated health harms from extraction to combustion. An example from the US shows how dangerous the technology remains. Pipelines transporting compressed CO2 create so-called “kill zones,” as seen in a 2020 leak in Satartia, Mississippi, which caused vehicles to stall and led to hospitalisations from dizziness and nausea. 

Carbon capture provoked a sharp criticism from the International Energy Agency, which said it was “no silver bullet.” But the IEA has not called for scrapping it altogether, instead saying that after many years of research and development “but rather limited practical experience” it has to shift to a higher gear.

‘What governments need to do’

GCHA says it represents 46 million health workers in 125 countries. It wants this report to be treated by political leaders not as an environmental warning alone but as a public health mandate. 

The evidence shows fossil fuels cause harm from pregnancy through old age, driving asthma, cancers, heart disease, and premature deaths.

Stop the trillions of dollars of subsidies to the fossil fuel industry and move this to building public health systems, clean energy and justice for communities bearing the heaviest burdens. 

Finally, it calls for the regulation and restriction of fossil fuel lobbying, advertising, and “disinformation”, just as was done with tobacco.

Like tobacco, fossil fuels and the products they enable, such as automobiles, should not be treated as objects of  power and pleasure,  the authors highlight, saying: “Cancer is not sexy, asthma and strokes are not sexy, developmental issues in children are not sexy.” 

Image Credits: Stephen Amirtharaj/Global Climate and Health Alliance , Ishan Tankha and Clean Air Collective, UNICEF, Dylan Paul, Center for Environmental Rights, Global Climate and Health Alliance , Lung Care Foundation, India, Tamara Leigh Photography for the Goldman Environmental Prize), , Plastics Atlas, 2019.