煤炭在印尼人的生活中扮演著非常重要的角色，影響著印尼許多經(jīng)濟(jì)和社會(huì)方面。印度尼西亞是世界五大煤炭生產(chǎn)國(guó)和第二大煤炭出口國(guó)（國(guó)際能源署，2017年）。印尼60%以上的電力來自煤炭發(fā)電廠，預(yù)計(jì)到2027年，煤炭發(fā)電量將幾乎翻一番（MEMR，2018）。該國(guó)大多數(shù)燃煤電廠位于人口稠密的爪哇島，其次是蘇門答臘島。2017年，雅加達(dá)100公里范圍內(nèi)有22個(gè)燃煤發(fā)電廠機(jī)組在運(yùn)行，計(jì)劃增加22個(gè)機(jī)組（綠色和平組織，2017年）。 煤被證明對(duì)人類健康有非常有害的作用。燃煤發(fā)電或熱釋放小顆粒（PM2.51和更?。┖团c心血管、呼吸系統(tǒng)疾病和癌癥有關(guān)的不同有毒元素。煤炭造成的空氣污染被認(rèn)為是幾種非傳染性疾病（NCD）的直接原因，這些疾病在2015年導(dǎo)致印度尼西亞130萬(wàn)人死亡（世界衛(wèi)生組織[WHO]，2015年）。如果不認(rèn)識(shí)和解決這些外部因素，可能會(huì)對(duì)印尼人的健康產(chǎn)生非常負(fù)面的影響。 其他大型煤炭消費(fèi)國(guó)，如中國(guó)和印度正在采取措施減少對(duì)煤炭的依賴，限制空氣污染及其對(duì)人口的有害影響。據(jù)估計(jì)，2013年中國(guó)（清華大學(xué)，2016年）和2015年印度（印度理工學(xué)院[IIT]、健康影響研究院[HEI]和健康計(jì)量與評(píng)估研究院[IHME]，2018年）因煤驅(qū)動(dòng)的空氣污染導(dǎo)致的過早死亡人數(shù)分別超過241000人和169000人。印度尼西亞的一項(xiàng)研究估計(jì)，2011年有7500人因煤炭過早死亡，如果不采取措施，預(yù)計(jì)到2030年，這一數(shù)字將增加到25000人（Koplitz、Jacob、Sulprizio、Myllyvirta和Reid，2017年）。印度尼西亞空氣污染引起的非傳染性疾病是該國(guó)過早死亡的主要原因之一（衛(wèi)生計(jì)量和評(píng)價(jià)研究所，新罕布什爾州）。 印尼政府已采取措施減少霧霾造成的空氣污染，改善公共交通。但它也繼續(xù)支持煤炭，并認(rèn)為煤炭是印尼的主要電力來源。國(guó)際可持續(xù)發(fā)展研究所（IISD）的研究（Attwood等人，2017年）估計(jì)，2014年印度尼西亞對(duì)煤炭生產(chǎn)的補(bǔ)貼達(dá)到9.46億美元（12.4萬(wàn)億印尼盾），幾乎占2013年印度尼西亞公共衛(wèi)生支出的10%。這使得煤炭成為一種昂貴的發(fā)電資源，特別是考慮到可再生能源的價(jià)格正在大幅下降。 以下各節(jié)概述了與煤炭燃燒相關(guān)的主要非傳染性疾病、主要受影響人口群體以及對(duì)印度尼西亞空氣污染造成的損失的估計(jì)。
Coal plays a very important role in the life of Indonesians, affecting many economic and social aspects in the country. Indonesia is among the world’s five largest coal producers and the second largest coal exporter (International Energy Agency, 2017). More than 60 per cent of the electricity produced in Indonesia is sourced from coal power plants, and the amount of coal power is expected to almost double by 2027 (MEMR, 2018). The majority of coal power plants in the country are located on the highly populated island of Java, followed by Sumatra. In 2017, there were 22 coal power plant units operating within 100 kilometres of Jakarta, with 22 more units planned (Greenpeace, 2017). Coal is proven to have very noxious effects on human health. Burning coal to produce electricity or heat releases small particles (PM2.51 and smaller) and different toxic elements that are related to cardiovascular and respiratory diseases and cancer. Air pollution from coal is considered a direct cause of several noncommunicable diseases (NCDs) which in 2015 caused 1.3 million deaths in Indonesia (World Health Organization [WHO], 2015). Failing to recognize and address these externalities can have a very negative impact on the health of Indonesians. Other large coal consumers such as China and India are taking measures to reduce their reliance on coal, limiting air pollution and its noxious effects on their populations. Coal-driven air pollution was estimated to cause over 241,000 premature deaths in China in 2013 (Tsinghua University, 2016) and 169,000 in India in 2015 ( Indian Institute of Technology [IIT], the Health Effects Institute [HEI] and the Institute for Health Metrics and Evaluation [IHME], 2018). One study in Indonesia estimated 7,500 premature deaths due to coal in 2011 and expected this number to increase to 25,000 by 2030 if no measures are taken (Koplitz, Jacob, Sulprizio, Myllyvirta, & Reid, 2017). NCDs caused by air pollution in Indonesia are among the main causes of premature death in the country (Institute for Health Metrics and Evaluation [IHME], n.d.). The Indonesian government has taken steps to reduce air pollution from haze and to improve public transit. But it also continues to support coal and considers it a main source of electricity for Indonesia. Research by the International Institute for Sustainable Development (IISD) (Attwood, et al., 2017) estimates that subsidies to coal production in Indonesia reached USD 946 million (IDR 12.4 trillion) in 2014, almost 10 per cent of Indonesia’s public health expenditure in 2013. This makes coal an expensive source of electricity generation, especially considering that the price of renewable energy is going down significantly. The following sections outline the main NCDs associated with coal combustion, the primary affected population groups and an estimate of how much air pollution is costing Indonesians.
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