South African scientists plan to examine about 8.5-million death certificates to ascertain how many people the country’s dependence on coal for electricity is killing.

The review is the first of its kind in Africa in that it will depend on actual data rather than modeling the effects of air pollution on health. It’s the latest attempt to understand the health impacts of the country’s fleet of 14 coal-fired power plants that supply more than 80% of the nation’s power.

“We are going to provide the most comprehensive review. We are going to analyze mortality,” said Caradee Wright, the researcher leading the study. “We will look at all causes, respiratory related diseases and cardio.”

Previous studies have modeled the annual number of deaths caused by pollution from the state power company, Eskom Holdings, at more than 2 000 a year, while the utility’s own research puts the death toll at 330.

South Africa’s dependence on coal has given the country of 62 million people the most carbon-intensive economy of any nation with a population of more than four million.

The survey is being carried out by scientists from the state-linked South African Medical Research Council where Wright is head of the Climate Change and Health Research Programme. It will look at deaths between 1997 and 2021.

It’s being funded by the UK’s Foreign, Commonwealth and Development Office under a $9.3-billion climate finance pact between South Africa and some of the world’s richest nations.

The study will aim to tie mortality to the emission of pollutants such as particulate matter and sulfur dioxide in areas around power plants compared with areas with similar climates that are some distance from the power generation facilities.

It will also assess morbidity in the form of the incidence of pneumonia in children under the age of five as well as the prevalence of tuberculosis, as air pollution suppresses the immune systems of those exposed to it.

The review, results of which may be released in the middle of this year, comes as South Africa delays the planned decommissioning of coal-fired power plants because it can’t meet electricity demand. It also comes at a time when particulate matter pollution from Eskom is at a 31-year-high because of malfunctioning equipment.

Power plant emissions have been tied to diseases and health impacts ranging from asthma and emphysema to heart attacks and strokes as well as cancer and stillbirths.