“We want to make it mandatory Health Impact Assessments (HIA) for licensing of coal mines”.

We are the Medicine on Alert network. We work based on scientific evidence and highlight special concern with diseases caused or aggravated by air pollution.

We are medical professionals and, for some years, we have studied the different impacts of climate change on humans and on the planet’s health. We decided to join forces and expand our operations. Thus, we created the group Medicine on Alert.

Scientific studies show that it is necessary to act immediately, otherwise there will be a serious upsurge in diseases directly caused by air pollution. It is worth remembering that air pollution is directly linked to climate change and that Porto Alegre, on several days, has levels of pollution above that recommended by the WHO. Air pollution, according to scientific literature, causes a considerable number of diseases.

Some studies led by WHO, Breathelife, UN Environment and Climate and Clean Air Coalition are highlighted by the group and show that air pollution causes 29% of lung cancer deaths; 24% of stroke deaths; 25% of deaths from heart disease; and 43% of deaths from lung diseases. Worldwide, air pollution was responsible for 7 million deaths in 2016, a number comparable to tobacco, which had the same number of deaths in the same year (source: WHO and GBD 2016).

In Rio Grande do Sul, the Medicine on Alert network is looking towards the possible impacts that the Guaíba Mine may cause (a project in the licensing phase that intends to explore coal for more than two decades).

Guaíba Mine

Concerned about the impacts that the mining of coal from the Guaíba Mine may cause on about 4.5 million people living in the metropolitan region of Porto Alegre, the professionals, in face of what promises to be the largest open air mine for mining coal in Latin America, warned the Regional Council of Medicine of Rio Grande do Sul (CREMERS).

To CREMERS, doctors of the group submitted technical opinions from six medical societies and two health societies, requesting that the Council, in the face of the evidence gathered and of researches recognized worldwide, explain to society the fundamental need for a Health Impact Assessment (HIA) of the Guaíba Mine. The entities ask for a HIA that is “independent, without conflicts of interest and within the standards defined by the World Health Organization” Read the dossier with the opinions here.

Sign the document: Brazilian Society of Medical Genetics and Genomics (SBGM); Neurology and Neurosurgery Society of Rio Grande do Sul (SNNRS); Association of Psychiatry of Rio Grande do Sul (APRS); Rio-Grandense Society of Bioethics (SORBI), Regional Rio Grande do Sul of the Brazilian Society of Bioethics (SBB); Gaucho Association of Family and Community Medicine (AGMFC); Society of Cardiology of the State of Rio Grande do Sul (SOCERGS); Pediatric Society of Rio Grande do Sul (SPRS); Brazilian Association of Workers’ Health(ABRASTT).

The same movement was made with the Medical Association of Rio Grande do Sul (AMRIGS), which publicly expressed the need for Health Impact Assessment (HIA) in the project to install coal mining mines in the region. Read the position published on 01/19/21 on the AMRIGS website.

According to AMRIGS, “the specialty of Family and Community Medicine has increasingly called attention to the effects of environmental changes in relation to health, in view of robust evidence on the increase of pollutants in the air that open air coal mines result in the morbidity and mortality of nearby populations ”.

According to one of the opinions, “pollution has a significant impact on the incidence of neurological diseases in general, with emphasis on cerebrovascular and neuropsychiatric diseases. Exposure to particulate substances results in damage to the central nervous system, (…) increasing the population risk of diseases such as stroke, Parkinson’s disease, developmental disorders, cognitive impairment, depression, etc. ”.

Another opinion says that the installation of the mine “is likely to lead to increased demand for outpatient and emergency medical services, as well as an increase in long-term chronic diseases and an increase in short-term mortality.”

Health Impact Assessment (HIA): a useful technical document to measure the risks involved

According to what the entities ask, the  Health Impact Assessment (HIA) should estimate the effects of air pollution and other risks produced by the mine, such as the probable contamination of fresh / drinking water, possible earthquakes and the sound volume / noise, producing science-based estimates of the main health impacts of the entire population that lives and can be achieved by the actions of this project. This makes a health surveillance system resulting from this enterprise essential.

The HIA should also clarify the expected health impacts at all stages of the development of the coal mine and the Carbochemical Pole including prospecting, excavation, extraction (explosions), other operations, transport of coal by diesel vehicles, deactivation of the mine , as well as the impacts of coal processing.

Doctors also argue that the HIA should clarify the intensity and risk associated with the exposure of different population groups, including workers and people living in Porto Alegre and its metropolitan region, such as children, the elderly, people with comorbidities cardiovascular, pulmonary, among others.

The HIA should specify when health effects are to be expected, taking into account exposure windows and time-lag between exposure and disease manifestation for different populations and specific contaminants.

Another fundamental point that the entities request to be included in the HIA is an analysis of costs for the public health system resulting from the diagnosis and treatment of diseases caused or that has its evolution worsened by air pollution and / or water contamination resulting from the enterprise in the population of the metropolitan area of ​​Porto Alegre. The exposure time must be incorporated into the analysis.

The costs for occupational disease (mine workers) and for populations in areas located close to the mine, whose exposure is greater, must be individualized. Indirect costs such as absenteeism from work, disability, early retirement or premature death should also be considered in the estimate. Doctors suggest that an impact analysis be included in DALYs / Disease Adjusted Life Years.

The Health Impact Assessment should include, among other aspects, the following:

  • Effects of air pollution;;
  • Effects of water contamination;
  • Sound effects;
  • Segmentation of impacts in different affected population groups;
  • Estimation of the latency time of population effects and identify sentinel phenomena;
  • Estimation of costs to Public Health Services;
  • Estimation of costs in Occupational Health;
  • Estimation of indirect costs and life expectancy corrected by disability.

The serious health risks of the Guaíba Mine


For the doctors in the Medicine on Alert network, the risks of installing the Guaíba Mine to the health of the population living in the vicinity of the area to be explored are striking. Evidence shows that there is a risk of death and serious illnesses as a result of the undertaking. That is why they understand that the entities representing health professionals must clearly present to society the risks and possible impacts on the health of an enterprise like this.

Licensing of the Guaíba Mine

Currently, the previous licensing of the Guaíba Mine is suspended by the Federal Court due to the exclusion of the indigenous component in the Guaíba Mine Study and Environmental Impact Report (EIA-RIMA).

Request an independent Health Impact Assessment for the Guaíba Mine project

Six medical societies and two health societies from Rio Grande do Sul issued technical opinions requesting an independent Health Impact Assessment (HIA) in accordance with WHO (World Health Organization) criteria for the coal mining project at the Guaíba Mine (see the dossier here).
AMRIGS (Medical Association of Rio Grande do Sul) has also positioned itself (read here) about the risks that the Guaíba Mine project can offer to health. Join them and sign the petition for the HIA.

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