Bulgaria is one of the most polluted countries in Europe. In Bulgaria, concentrations of nitrogen dioxide (NO2), and particulate matter less than 10 μm (PM10), and 2.5 μm (PM2.5) exceed the guideline values set out by the World Health Organization (WHO) (European Environment Agency, 2023) and Sofia and other major Bulgarian cities have some of the highest death rates due to exposure to air pollution among EU cities.

In this health impact assessment (HIA), CREA’s findings show that, as a result of air pollutant levels due to coal-fired power plants (CFPPs), present-day air pollution from Bulgarian CFPPs leads to 333 (202–552) deaths each year. Overall, these deaths as well as other non-fatal illnesses cost EUR 742 (456–1,303) million each year. This is equivalent to 0.9% of Bulgaria’s GDP, and is comparable to Bulgaria’s military and defence budget (EUR 1.3 billion – 1.5% of GDP in 2022).

Not only are these pollutants sustained throughout the whole of Bulgaria, they also impact neighbouring countries, including Serbia, North Macedonia, Greece, and Turkey. As a consequence, these power plants contribute to increased pollutant exposure for millions of humans.

Key findings

● We calculated the air quality impacts from Bulgaria’s coal-fired power plants (CFPPs) cumulated over 2023–2038 under three scenarios of different phase-out pathways.
● In the first scenario (Scenario 1), phase out is delayed until 2038 and all Bulgarian CFPPs maintain current power capacities throughout the time period.
● Under Scenario 1, air pollution from Bulgarian CFPPs will have a devastating impact on public health and the economy, including 5,500 (3,400–9,100) premature deaths; 4,600 (440–8,700) hospital admissions; 132,000 (29,000–237,000) cases of asthma symptoms in children; 13,600 (-3,600–30,800) cases of bronchitis in children; 2,700 (950–4,200) cases of bronchitis in adults; 1,150 (360–2,000) low birth weights; 2,100 (1,000–2,300) preterm births; 12 (6–21) postneonatal deaths; 4,600 (900–24,000) IQ points lost; and 1.4 (1.2–1.7) million days of work absences.
● As a result of the health impacts of Scenario 1, air pollution from these CFPPs will cost EUR 14 (9–23) billion.
● In the second scenario (Scenario 2), CFPPs follow an accelerated phase out where the capacity of electricity-only units (3,300 megawatts, MW) decreases by 26% by 2026; by 41% by 2030; and by 100% by 2035, and capacities for combined heat and power (CHP) and industrial units are fixed at present-days values throughout the
time period.
● Under Scenario 2, air pollution from Bulgarian CFPPs decreases in line with decreased capacity, leading to a lower public health and economic burden.
● Compared to Scenario 1 where phase out is delayed until 2038, the accelerated phase out of Scenario 2 leads to lower pollutant levels, which prevents 3,300 premature deaths; 2,400 hospital admissions; 69,000 cases of asthma symptoms in children; 7,100 cases of bronchitis in children; 1,400 cases of chronic bronchitis in adults; 610 low birth weights; 1,100 preterm births; 6 postneonatal deaths; 2,600 lost IQ points; and 740,000 work absences.
● The prevention of these health outcomes corresponds to an economic saving of EUR 9 billion.
● In the third scenario (Scenario 3), the accelerated phase out is extended to include electricity-only and CHP units, where the percentage reductions for electricity units outlined in Scenario 2 are applied to both electricity-only and CHP units, and industrial units maintain current power capacities throughout the time period.
● Compared to Scenario 1 where phase out is delayed until 2038, this accelerated phase out of Scenario 3 that includes electricity-only and CHP units prevents 3,600 premature deaths; 2,700 hospital admissions; 77,000 cases of asthma symptoms in children; 7,900 cases of bronchitis in children; 1,600 cases of chronic bronchitis in
adults; 680 low birth weights; 1,230 preterm births; 7 postneonatal deaths; 2,900 lost IQ points; and 820,000 days of work absences.
● The prevention of these health outcomes corresponds to an economic saving of EUR 10 billion.
● Overall, we conclude that an accelerated phase out of Bulgaria’s CFPPs will have huge benefits to air quality, public health, and the economy, including the prevention of thousands of deaths and saving billions of euros in health costs.