ANDREW FOWLER, REPORTER: It's Australia's biggest export industry, creating super profits for big companies and filling the Government's coffers to overflowing. The amount of money is staggering.

ASSOC PROFESSOR NICK HIGGINBOTHAM, UNIVERSITY OF NEWCASTLE: It could be well over $1 billion... $1.4 billion.

ANDREW FOWLER: Australia's riding a coal boom like never before, but there's another side to this economic bonanza.

ANNE DRINAN, BEEF FARMER: It's a sort of dark underbelly.

DR TUAN AU: If we ignore the problems and we do nothing about it's the same as... as murder.

ANDREW FOWLER: In an area of Australia which for years was better known for its white wine than its black coal many are frightened and angry.

DI SNEDDEN, EDITOR, SINGLETON ARGUS: Sense of place is important to me; not easy to just go.

ANDREW FOWLER: Tonight on Four Corners - a dirty business: the hidden costs of the coal boom, and dark deeds in a once green and pleasant land.

(On screen text: A DIRTY BUSINESS, Reporter: Andrew Fowler)

It's a crisp early autumn morning here at Jerry's Plains in the upper Hunter Valley of New South Wales.

The local GP is on his rounds. He's been to this property many times before. There are three children here with breathing problems; one of them in particular has been seriously ill.

(On screen: footage inside Gee household)

Inside the house it's pandemonium. Di Gee is trying to get her five children ready for school.

DI GEE, DAIRY FARMER, JERRY'S PLAIN: Door.

CHILD: Mum, do I get it?

DI GEE: It doesn't matter who gets it.

(To Dr Tuan Au): Hi, how you going?

DR TUAN AU, SINGLETON GP and OBSTETRICIAN: Hello Di, how are you? Hello everybody.

CHILDREN (in unison): Hi.

ANDREW FOWLER: Dr Tuan Au is most concerned about Courtney, who's on a cocktail of drugs to help control her condition.

DR TAUN AU (to Di Gee): How often does she have to use ventolin now?

DI GEE: Ah, she's on the ventolin every day - morning and afternoon, and she also has... she has the seretide every morning and then the ventolin and then the seretide and her ventolin of an afternoon, or before she goes to bed.

ANDREW FOWLER: Last year she lost three months off school because of asthma. It disappeared while she was on holiday on the coast, but returned when she came back home.

DI GEE (to Dr Tuan Au): She was good.

DR TAUN AU: She was good.

DI GEE: Yeah, yep, yep, no. She had no trouble. She even said that she had felt a lot better within herself.

(End of footage)

ANDREW FOWLER: The Gee family have every reason to fear for their children's health. Just six weeks ago a huge orange cloud came sweeping up the valley over their dairy farm.

(On screen: footage of orange cloud of smoke in the distance).

It left a light dust on the ground and two of the children fighting for breath.

(End of footage)

DI GEE: Well, Shane Anne come up to me one day a couple of days after and she said 'Oh mum'... she said 'I've had trouble breathing' and so I just said to her to take her medication.

ANDREW FOWLER: The cloud also had a serious impact on Courtney's health.

DI GEE: Courtney came out and she had like headaches; she had a runny nose, watery eyes. She just wasn't right at all.

She gets she gets really upset which makes it worse of course. She... after she has her medication and she still can't breathe she stresses a bit, which isn't really good... which makes her asthma worse.

(On screen: footage of Dr Tuan Au with Courtney Gee)

DR TUAN AU (to Courtney Gee): Now, if you can take a big breath in.

ANDREW FOWLER: Courtney's just one of a large and increasing number of people reportedly suffering from asthma in the Upper Hunter. They all tell a similar story.

DR TUAN AU: Well, initially they said... they ask me why when they go away on holiday they feel much better.

Their children doesn't need to have a lot of the puffers or the asthma improve; they can smell better, they can breathe better and when they come back their asthma getting worse.

(End of footage)

(On screen: re-enactment of Colin Stapleton driving truck through yellow dust)

ANDREW FOWLER: For others there's been a more direct and unexpected assault on their health. The driver of a truck on a highway further up the valley near Muswellbrook reckons he's lucky to be breathing at all.

Ten months ago his driver's cabin filled with toxic gas as he drove through a yellowy orange cloud which suddenly blew across the road from a nearby mine. Semi-conscious he still managed to keep his ten tonne truck under control.

COLIN STAPLETON, TRUCK DRIVER, CAMBERWELL: As soon as I drove into the dust cloud I got an instant headache from this yellow dust, and generally feeling not very well and felt like I was losing control, but I managed to ah stay on the road.

ANDREW FOWLER: Colin Stapleton's been driving trucks for 20 years. He says the cloud - thought to contain nitrous oxide - came from a blast at the Drayton open cut mine.

The operators of the Drayton mine told Four Corners that an abnormal blast had created the cloud, but they declined to say what was in it. The Department of Environment told Four Corners Drayton's hadn't broken any rules.

(End of re-enactment)

COLIN STAPLETON: After getting out of the cloud it only took a few minutes for it to... for me to come back okay. I phoned the mines involved and let them know and also the Department of Environment and the mines were sorry about it and said they would try not to let it happen again.

ANDREW FOWLER: No one warned Stapleton the toxins in the cloud were dangerous, but later he received a mysterious call from a senior departmental officer.

COLIN STAPLETON: About a fortnight later I got a call back from the Department of Environment. They didn't want to go on record; they wanted an off record report to me to say to get my health checked over after going through this yellow cloud as the effects could have been quite serious.

ANDREW FOWLER: So clearly somebody in the Environment Department thought there was a serious danger that you'd been placed in and yet they weren't prepared to tell you that on the record publicly.

COLIN STAPLETON: No, definitely not. It was definitely a keep this quiet sort of call.

(On screen: footage of 4WD driving along a dirt road)

PETER KENNEDY, COAL MINER, MUSWELLBROOK: We're on an access track leading up the summit of the highest outlook in the Hunter Valley - or the Muswellbrook area - known to the locals as Mt Arthur.

ANDREW FOWLER: If you want to understand why at times there's a fear of speaking out in the Hunter Valley, take a trip with Peter Kennedy.

He works for a large open cut coal miner. Despite being threatened with the sack if he identifies his employer, he's decided to speak out.

As we drive up a track towards the summit of Mt Arthur near Muswellbrook, you begin to get a glimpse of how much coal dominates the Upper Hunter Valley.

Our guide for the day certainly knows the territory well.

(To Peter Kennedy) So what have we got here Peter?

PETER KENNEDY: This is a large open cut mining operation just on the outskirts of Muswellbrook.

ANDREW FOWLER: The view from the top reveals its true magnitude. This area of Australia now has 14 open cut mines - pumping out 99 million tonnes of coal a year for the furnaces of Japan, India and China.

A little over 100 kilometres to the south the port of Newcastle has become the biggest black coal exporter in the world, and the mines are about to get a whole lot bigger. In the next six years, according to one estimate, the output will double.

(End of footage)

(On screen: graphic of Hunter Valley region of New South Wales map)

It's a daunting prospect for the 40,000 people who live in the Upper Hunter. From Muswellbrook in the north to Singleton in the south, already there's nowhere to run from the mines.

(End of footage)

(On screen: footage of Andrew Fowler and Peter Kennedy at Mt Arthur)

PETER KENNEDY: Over my shoulder in this general direction over here is another massive development that's planned to be undertaken in the next few years.

Rio Tinto plan to mine an area known as Mt Pleasant and that's going to be a huge development. And further over my shoulder down this way... down in this part of the valley Xstrata are currently developing another 10.5 million tonne per annum open pit mine known as Mangoola Coal.

ANDREW FOWLER: So this whole area surrounding us, all the way around, is going to be an open cut coalmine?

PETER KENNEDY: Eventually. Eventually all mined, yes.

(Editor's Note: For more details of coal mines in the Upper Hunter, see abc.net.au/4corners)

ANDREW FOWLER (voiceover): It's the nightmare scenario Peter Kennedy fears most. More mines might be good for business, but they also mean more pollution; tonnes of it.

Latest yearly statistics show a total of 108 tonnes of toxic metals, including arsenic, cadmium, chromium, cobalt and lead, poured into the air of the Upper Hunter from mines and power stations, along with 122,000 tonnes of sulphur dioxide.

Up here on Mount Arthur there's a ringside view.

(To Peter Kennedy, pointing at dust cloud in the distance) I mean look at that. That's going up quite high isn't it?

PETER KENNEDY: It is indeed. That's way above what is... normally would be acceptable.

ANDREW FOWLER: So where's that dust going?

PETER KENNEDY: Well, with the wind direction that we're experiencing at the moment that would be blowing in the general direction of the township of Muswellbrook.

ANDREW FOWLER: That's rather a lot of it too.

PETER KENNEDY: It is, it is, and it'll get worse as the day goes on.

ANDREW FOWLER (voiceover): The dust is rising as a gusting wind whips across the tops of the mines. Water trucks have been trying to keep the dust down with little effect.

Downwind, Muswellbrook cops it sweet.

PETER KENNEDY: It's having a fairly detrimental effect on the health of the local community. We are seeing rising levels of asthma and bronchitis, and whilst ever this practice is allowed to continue those figures will continue to rise.

ANDREW FOWLER: And we can some water trucks over there; they're spraying water down. Is that having much of an effect? Does that work?

PETER KENNEDY: Ah yes, to a certain degree, but you have to keep at it and at it to keep the keep the dust down, and the wind the wind gets stronger generally in the afternoon and they lose the effect of watering down the over-burden dumps and the haul loads leading in and out of the pit.

(End of footage)

ANDREW FOWLER: Everyone knows the dust is dangerous. The mining companies are compelled to operate a series of dust monitors throughout the region.

Deidre Olofsson has one in her Camberwell backyard. It's right next door to the Ashton mine, which she says causes her most trouble.

The operators of the Ashton mine told Four Corners it complies with the highest environmental standards.

(On screen: footage of Deidre Olofsson on her property)

DEIDRE OLOFSSON: It's that bad that you can't go outside some days; it's just thick and you can taste it in your mouth and it's in your eyes and you've got to wipe it away from your face.

There was a blast here once and I was down just feeding my old horse, I couldn't see the old horse because it was that thick.

ANDREW FOWLER: When the dust comes, so too does the asthma. Both Deidre and her son Bjorn are on medication.

DEIDRE OLOFSSON: Well it... it gives you a cough continually, so now you've got a cough at night and you cough during the day. And now Bjorn's got a cough. Now, he's started in the last three years; he's had a cough... coughing and coughing.

And that's where he's had... he's been on puffers, steroid tablets, antibiotics till he shakes and rattles and rolls and then it gets... then it just makes him feel more depressed because they're coughing all the time and they're missing school.

So it's a just a domino effect and you just can't... you can't get around it. And everybody tells you 'It's environmental, you've got to move', and that's it.

ANDREW FOWLER: When the dust gets too heavy the monitor sends out an automatic electronic warning.

DEIDRE OLOFSSON (to interviewer): That's the radio link.

ANDREW FOWLER: Right.

DEIDRE OLOFSSON: Yeah, with the SMS signal, which sends it back to the Glendell mine.

(End of footage)

(On screen: footage of Deidre driving)

ANDREW FOWLER (voiceover): But the Glendell mine is kilometres away - almost certainly not the source of all of the dust. There are three open cut mines much closer to her property.

The Glendell mine is operated by Xstrata. The mine's holding one of its community consultation meetings today; Deidre's going along. She reckons she might be able to get some straight answers.

Xstrata is seen by many as one of the better mines in the Upper Hunter. Deidre Olofsson's not against mining or the electricity generating industry. In fact, she works as an electrician at a local power station.

Her inside knowledge makes her a dangerous adversary, though she knows they'll be some difficult areas to negotiate. She's been swotting up on dust emissions from the mines.

(End of footage)

(On screen: footage of Xstrata community consultation meeting)

It's a well attended meeting. Others are equally concerned about dust levels in the valley. Deidre points out that the levels on one particular day shoot through the red line marking excessive exposure. The safety level is 50 micrograms * per cubic metre, but on this day it was much higher.

DEIDRE OLOFSSON: But it's pretty high; like it's 80. So you're saying that's coming from somewhere else? Do you shut down when it gets to that much, even if it's coming from somewhere else?

UNIDENTIFIED MINE REPRESENTATIVE: Yep. What we do is we have our...

DEIDRE OLOFSSON: Because I mean, it's a lot of dust.

UNIDENTIFIED MINE REPRESENTATIVE: Yep.

(End of footage)

ANDREW FOWLER: Although the reading's high on Xstrata's monitor in Deidre's backyard, there's no evidence that the dust came from their mine, In fact, there's no evidence which mine the dust came from at all.

DEIDRE OLOFSSON: Sometimes it was up to 80 and 100. Now that's beyond health... that's a health issue, and yet they won't be charged that because it's not their whole... it's not all their contribution.

The problem is it's a cumulative impact and nobody gets charged on a cumulative.

ANDREW FOWLER: For a system designed to protect the health of local residents it's a frightening muddle.

Many of the people from Camberwell village have already given up and moved out. In all 100 of the population of 150 have gone. Nearby, farmers too have found themselves badly affected by the mines.

(On screen: footage of Andrew Fowler speaking with Wendy Bowman)

WENDY BOWMAN, FORMER DAIRY FARMER: And they started virtually on our boundary and we were covered in dust and we then found that we were... our milk was being rejected because of dust.

ANDREW FOWLER (voiceover): The dust and pollution forced Wendy Bowman out. She moved to another property away from the mine. Now the miners are coming again.

(To Wendy Bowman) You're not prepared to take the money and run? You're going to...

WENDY BOWMAN: I've taken the money twice. They sent us broke on the first one. I took it took it there because I couldn't stay there any longer with the noise and the dust.

I don't need any more money. Why? I don't I don't want anymore. They offered me about 2.5 times what this place is worth. I said no. I'd rather save it for the future.

ANDREW FOWLER: So you're going to stand here and fight.

WENDY BOWMAN: Yeah.

ANDREW FOWLER (voiceover): Wendy Bowman's stamina to fight the mines has not been dimmed by recent news from her doctor. It seems the milk wasn't the only place the dust ended up.

WENDY BOWMAN: I've got dust in my lungs. I've had them... I had a CT scan last year because I kept getting this funny raspy little cough.

And we all say it's a dust cough; it's only people who've got it in Singleton. Definitely I have dust in my lungs.

And I then went to a specialist and he told me I've lost 20 per cent of the use of my air tubes and my lungs. It's not affecting me, except I puff a bit more going up the hill.

ANDREW FOWLER: Could he show that the dust definitely came from the mines?

WENDY BOWMAN: Well, he's just said where else would it come from? I've lived here... I've lived in the Singleton district on the land for 50 years and this has only happened in the last 10, while I was living down at Ricks's Creek where the dust was so bad.

I was so much closer to a mine down there and whenever they'd blast, the dust would just blow into the house; a bit like inside where it comes in.

(End of footage)

(On screen: footage of Andrew Fowler speaking with Alan Noble on his farm)

ANDREW FOWLER: Just three kilometres away on the other side of Camberwell village, the mines and their dust have already defeated Alan Noble.

ALAN NOBLE, FORMER DAIRY FARMER: Now, that's what they used to use for rolling over. They'd tap that into a log and pull it and roll it over.

ANDREW FOWLER: He's packing up and getting ready to leave; quitting the land his forebears have farmed since the early 1800s.

The mines have been steadily closing in on Alan Noble's property over the years. Now, they're just on the other side of the creek.

ALAN NOBLE: Here, when that breeze was blowing, but the fumes and that were coming. It's not just the coal dust, in my books it's the fumes and all the other things that come with it that's... that's making the dam... doing the damage.

ANDREW FOWLER: He's feeling encircled, and he's right.

ALAN NOBLE: I'm leaving because of the coal mines, and I don't mind admitting it. I've got a Xstrata mines, I've got Ravenswood East, I've got Glendell, I've got Urana, I've got Ravenswood West and a couple of others back in the Westerly side, which all comes back in through here cause they're just about north west of me.

I've got Victor's Creek down this way down here and then Camberwell, which is now Veil or Integra, and now they've started another one on the south east of me, which is the north pit of Integra. And you get the south easterly winds and they just come straight through here.

ANDREW FOWLER (voiceover): Alan Noble has put out his childhood toys for anyone who wants them.

(To Alan Noble, pointing to rusted children's bicycles): And what about that one there?

ALAN NOBLE: That one where, that that's definitely the one I used to ride when I was... would be 70 years ago I'd say.

ANDREW FOWLER: He reckons they're rustier than they should be because of pollution from the mines, and it's most just the bikes that have been hit.

ALAN NOBLE: I've had I've had bladder cancer. Now that I've got prostate cancer I honestly believe that it is partly hooked up to the... what's in the atmosphere around here.

And you're... even breathing some of my family that live in the area are having asthma problems we've never ever had in my family never before.

ANDREW FOWLER: For Alan Noble, walking away from a farm his family's owned for six generations will be difficult. But he argues the air is so polluted it's not worth staying.

ALAN NOBLE: I'm very suspicious about what it'll do to people's health in years to come. I'd like to see all my grandkids right out of Singleton actually and at somewhere away from the coal mine area.

(End of footage)

(On screen: footage of Andrew Fowler speaking with Nick Higginbotham)

From near his cliff top home in Newcastle Nick Higginbotham may have a grand view of the ships that carry the coal, but it's as close as he wants to get.

ASSOC PROFESSOR NICK HIGGINBOTHAM: I think we can see probably 25 to 30 ships at the moment, but they go all the way down to the Central Coast..

ANDREW FOWLER: Wow.

ASSOC PROFESSOR NICK HIGGINBOTHAM: And so they're queuing up waiting to go into Newcastle Harbour, which is the highest black coal exporting harbour I think in the world now.

ANDREW FOWLER (voiceover): He's an expert in clinical epidemiology and biostatistics at the University of Newcastle.

(To Nick Higginbotham) Would you be prepared to live in the Upper Hunter?

ASSOC PROFESSOR NICK HIGGINBOTHAM: Well, that's an interesting question. I mean, I certainly wouldn't be prepared to raise a family or to personally live in a place that exposed to this much pollution.

ANDREW FOWLER (voiceover): Associate Professor Higginbotham has researched the impact of large scale mining development on the environment and people's health.

ASSOC PROFESSOR NICK HIGGINBOTHAM: In my opinion, the air in the Upper Hunter Valley is not very good at all. There's also quite a bit of pollution that comes out of the two power stations in the Upper Hunter.

And the combined the combined effects of the dust produced by mining processes and transport of coal and the two power stations has caused, over the last say ten or 15 years, quite a bit of distress among residents of the Upper Hunter, who are concerned whether being exposed to this much pollution has some kind of an impact on their health.

(End of footage)

ANDREW FOWLER: There's no better place to understand the tensions inflicted on the community by mining than the offices of the local newspaper - the Singleton Argus.

The paper's editor, Di Sneddon, walks a difficult line between the mines and those they affect.

DI SNEDDON: This debate has been going on for many, many years, with... probably back, maybe even 1992, that there's been a concern... because there is, you know, the power stations as well as the mining industry - heavy industry.

I think it's probably reached a peak now because there is so much expansion of mining industry.

ANDREW FOWLER: Recently her uncle's dairy farm was bought out by the mines. She's well aware of the pain mining can inflict.

(On screen: footage of Di Sneddon in Singleton Argus office)

ANDREW FOWLER (to Di Sneddon): What do you say to people who say 'look, if you're too close to the mine you should just pack up and move on'

DI SNEDDON: Okay. I knew you'd ask that. I'm a fourth generation Singletonian. A sense of place... sense of place is important to me; not easy to just go.

ANDREW FOWLER: So being able to be in Singleton; to see the place the way it is...

DI SNEDDON: Mmm.

ANDREW FOWLER: To see the mountains; to see the valley the way it is, is important to you?

DI SNEDDON (nodding head): Mmm.

(End of footage)

ANDREW FOWLER: Just 15 kilometres to the east of Singleton Dr John Drinan, a retired agricultural scientist, now runs a beef cattle farm.

Along with dozens of other locals he became concerned about what appeared to be increasing levels of ill health in the community.

Like any good scientist he set about gathering the evidence in a methodical way. He held a public meeting and put out a questionnaire.

(On screen: footage of Andrew Fowler speaking with Dr John Drinan)

DR JOHN DRINAN, BEEF FARMER and AGRICULTURAL SCIENTIST: First of all, the survey that we did of... it was put into chemists shops and schools and places like that, showed that... around about 350 responded.

They all confirmed what we'd heard at the public meeting. We believe our health is being adversely affected by what we're breathing.

ANDREW FOWLER: These are things like asthma...

DR JOHN DRINAN: Asthma, other sinusitis, other respiratory problems and allergies and eye problems, cancers and so on.

ANDREW FOWLER (voiceover): Based on detailed analysis of publicly available air quality statistics and their own research, Dr Drinan and the group drew up a submission.

It called for an independent investigation into health in the Upper Hunter. In November last year, they sent it to the New South Wales Government.

DR JOHN DRINAN: First of all, we want this to be done independently. Secondly, we want a health study which compares the health statistics of the Singleton shire - or if they like the Hunter region - against shires which do not have coal mining and power generation.

The third element is then to say well, we know what's in the air but are the concentrations of those nasties, the hydrochloric acids and the sulphuric acids, the mercuries, cadmiums and all those sorts of things, are they at levels which are in fact dangerous? And that we do not know.

ANNE DRINAN: It's a sort of dark underbelly that exists in the Upper Hunter which is something that we'd like to have investigated further by the health professionals.

Tell us if it is in fact as beautiful as we think it is, or this in fact is an area where we've got issues with our health that we need to be helped with.

ANDREW FOWLER (voiceover): Five months after the original submission and two follow-up letters - nothing. Not a word in response from the State Government.

DR JOHN DRINAN: We haven't had a thing. In other words, the matter is being ignored.

ANDREW FOWLER: So why do you think they're ignoring you?

DR JOHN DRINAN: Oh I think it I think there's 1,500 million little reasons why it's being ignored. I think, look...

ANDREW FOWLER: When you say 1,500 million reasons, you're saying 1.5...

DR JOHN DRINAN: Billion dollars. Yes.

ANDREW FOWLER: Of royalties that are paid?

DR JOHN DRINAN: Royalties and earnings from power stations and from coal transport. Now that's what... that's the only possible reason we can come up with. Now...

ANDREW FOWLER: Are you really saying then that the Government's putting the royalties it gets from power stations and coalmining ahead of the health concerns of the people of the Upper Hunter?

DR JOHN DRINAN: Well, I I can't be quite as... I can't be dogmatic about that, but I mean we can't see any other reasons why wouldn't they tell us what's going on.

(End of footage)

DI SNEDDON: It's not that it hasn't been asked for many, many times. Officially, in our paper, probably back as far as 2007 please can we have a study.

More officially by the local environment group here; November last year - beautiful letter, beautiful submission, very polite, a nice way to go, can we please look at this, these are the issues, very well researched.

Not even a response from the Government to say that they have heard, or that they've received the letter; no response at all.

So you sort of start to wonder then why they wouldn't bother to look at that. Whether it is, you know, 'What are they going on about, those country hicks? They've got no idea what they're asking for'; whether it's that.

But I think a response... I think that we're certainly... while there's a shadow of doubt, people have the right to know what that information... what that study might reveal.

ANDREW FOWLER: A day after Four Corners conducted these interviews word came down from the Premier's office. Yes, they had received the submission. No, there wouldn't be an independent inquiry.

Disgusted at what he saw as the shabby treatment of the people he cares for, a local Singleton GP stepped forward.

(On screen: footage of Dr Tuan Au and nurse with patients)

DR TUAN AU (to patient): Nearly there.

ANDREW FOWLER: If the State Government won't carry out the research into the affects of mining on health in the Upper Hunter Valley, then Dr Tuan Au will do a study himself.

Nearly 900 students are taking part in a test to see if they have asthma related problems.

UNIDENTIFIED NURSE: Okay, go. Well done.

UNIDENTIFIED NURSE 2: Next please. Hi, what's your name sweetie?

ALEXANDRA MATTSON, PATIENT: Alexandra Mattson.

UNIDENTIFIED NURSE 2: Alexandra Mattson. M-A-T-T-S-O-N. You're Mellissa's daughter?

ALEXANDRA MATTSON: Yep.

UNIDENTIFIED NURSE 2: Oh, lovely.

ANDREW FOWLER: For the students it's a welcome break from school routine, but it can still be hard work.

UNIDENTIFIED NURSE (to patient): Nah, not good enough. And you'll see why in a minute. That was... you need to get a peak. So, it's a really big effort to start this. So really...

(Patient sucks in breath sharply).

Much better.

ANDREW FOWLER: Once the tests are completed the information will compared with the lung function of children in rural areas where there are no mines or power stations.

DR TUAN AU: And we see if any kid here in Singleton around the Hunter compare to other kids in Foster or near the seaside area, we can compare to see any difference.

UNIDENTIFIED NURSE 2: Okay, who's next? Ho , come on in. What's your name?

UNIDENTIFIED PATIENT 2: Rachel.

UNIDENTIFIED NURSE 2: Rachel, do you get asthma at all?

PATIENT 2: When I have a cold.

UNIDENTIFIED NURSE 2: When you have a cold. So are you on puffers at all?

ANDREW FOWLER (to Dr Tuan Au): You've done this work with volunteers. Is it the job of a general practitioner in the country to do the work that the Government is paid to do?

DR TUAN AU: I think it's like with a general practice in the community here I'm more thinking about prevention, because nowadays we just concentrate on treating disease, but we're not really treating the cause of the problem.

So if we can prevent the disease happen in the first place, it is money well spent. Think of how much those costs of treating a certain type of disease like heart problem or respiration problem. If it can be prevented, it's cheaper.

ANDREW FOWLER: Are you angry at the Government for what they do?

DR TUAN AU: I'm not angry with the Government. I'm more disappointed at the Government there. They should protect the community. They should provide a good environment for everybody and especially the young children.

(End of footage)

DI GEE: I think what Dr Au's doing is really good. It makes you wonder sometimes whether... why is there no other support out there for him where he's got to do it on his own?

Why isn't anyone supporting him in what he's doing? So is that sort of saying, you know, there is something there and they don't want us to know?

ANDREW FOWLER: In the time we spent in the Upper Hunter Valley bronchial problems were by far the greatest concerns expressed to us, but another medical condition also repeatedly came up - cancer.

(On screen: footage of Andre Fowler accompanying Dr Tuan Au on home consultation)

DR TUAN AU: Now we're going to see Peter. He had a brain tumour about two years ago.

ANDREW FOWLER: What's so comforting for many of the cancer patients that Dr Au visits, is the community support that many of them receive.

DR TUAN AU (to Peter McMahon): Hello Peter, how are you,

PETER MCMAHON: Good. Howya going?

DR TUAN AU: Hi Narelle. How are you?

ANDREW FOWLER (voiceover): The friends and neighbours are there for them to help out. Peter and his wife Narelle have just been to the hospital in Sydney.

The news isn't good. The tumour's back, and this time it's inoperable.

NARELLE MCMAHON (to Dr Tuan Au): So, the chemo's not working, surgeries not working...

ANDREW FOWLER (to Peter and Narelle McMahon): We hear a lot of different stories of people having cancers and cancer problems in this area. Do you also hear those stories?

NARELLE MCMAHON, SINGLETON RESIDENT: We know quite a few. The house next door, there've been two people that have lived there over the years; one had bowel cancer.

We don't know if he's still alive - they moved away from the area. And an elderly woman she got throat cancer and she passed away.

There's been a few up the road. Recently there was another man who... he was diagnosed a week after Peter, and he only survived six months.

One of our old neighbours - Carol across the road - she had a benign tumour, and Peter across the road he had a benign tumour thirty years ago.

PETER NAGLOST, SINGLETON RESIDENT: The Government's reaping, you know, millions from royalties. The coal mines are making billions from the coal, but the least they can do is just try and find out whether of any of it's causing any health problems and everyone will be happy.

(End of footage)

(On screen: footage of Andrew Fowler and Peter McMahon inspecting Peter's vintage Buick car)

PETER MCMAHON, SINGLETON RESIDENT: Yeah, there's the old girl.

ANDREW FOWLER: It's fantastic.

PETER MCMAHON: it's a lot of work, but I enjoy it.

ANDREW FOWLER (voiceover): Peter McMahon spent years restoring his treasured Buick.

(To Peter McMahon) So, how does it feel?

PETER MCMAHON: Oh mate, it's good to drive. It's lovely.

ANDREW FOWLER: Do you think you'll get a chance to drive it again?

PETER MCMAHON: Well, I hope so, but with my chances I don't think so, but I'd like to.

ANDREW FOWLER (voiceover): Peter will hit the road tomorrow, but not in this car; travelling to Sydney for another round of treatment.

(End of footage)

(on screen: archive footage of Carmel Tebbutt)

We asked the NSW Minister for Health and Deputy Premier Carmel Tebbutt for an on camera interview to answer the questions raised in this program. She declined.

(End of footage)

In a written response the Minister rejected the call for the independent health study saying it would, and I quote, 'not be conclusive due to the relatively small population of the Upper Hunter Valley'.

It's a novel argument that may not go down too well with the 40,213 people who live there.

The best the NSW Government can offer for those demanding an independent inquiry is a plan to install more dust monitors.

Yet only three of the 14 will measure fine particles; the ones that get deep into the lungs and stay here. They're so small they measure just two point five microns.

ASSOC PROFESSOR NICK HIGGINBOTHAM: The 2.5s can find their way even further into the lungs and they're even more damaging to the health because they can they can get into the bloodstream.

And a there's a large... well, there's a there's a range of diseases and illnesses that accrue from this kind of particulate penetration of the lung system.

ANDREW FOWLER: The international scientific evidence on the health effects of coal mining is mounting. A report this year on open cut coal mining in the United States found elevated rates of mortality, lung cancer and chronic heart, lung and kidney disease among people living near coal mines.

ASSOC PROFESSOR NICK HIGGINBOTHAM: Well, we know that for every ten micrograms increase in the concentration of dust, we get a half a per cent increase in the mortality rate.

Now, there's been a lot of research overseas which has looked at particulate matters and a whole range of issues such as cardiovascular disease, pulmonary disease, asthma, respiratory issues.

So there is a substantial and healthy literature which allows us to draw very strong conclusions about increasing the amount of dust in the in the atmosphere and the increase in disease and death.

(On screen: footage in Dr Tuan Au's clinic)

ANDREW FOWLER: The preliminary results of Dr Au's work with Singleton school children bear out these studies.

DR TUAN AU: When we tested the kids in Singleton here we had about one in six have a low lung function test.

ANDREW FOWLER: The national average for asthma among children is one in nine.

ALEX MATTSON: Okay, thank you.

UNIDENTIFIED NURSE: Alright, thanks Alex.

(End of footage)

(On screen: footage at swimming pool)

ANDREW FOWLER: Down at the local pool we again meet up with Alex Mattson. She's with her mother and sister. The results of the test are in. They confirm that Alex's lung function is below average.

(To Melissa Mattson): Why did you agree to your daughter being tested at Singleton School?

MELISSA MATTSON, SINGLETON RESIDENT: I felt it was a good opportunity to find out how the mining environment is affecting our children in the community.

ANDREW FOWLER: Isabella, Alex's sister, is already confirmed as an asthmatic, and she swims regularly to improve her lung capacity. Like her brother and sister she also suffers severely from allergies.

MELISSA MATTSON: Well, all three children get rashes all over their face - dermatitis and sorosis. We sent on a family holiday to Darwin in June/July last year and within three to four days every single rash had cleared up and when we came back from holidays it only took two to three days again for them all to come back.

ANDREW FOWLER: These early lung function results will hardly please the NSW Government.

Even before Dr Au's work has been completed the Health Minister told Four Corners that his study 'will not advance knowledge about the link between emissions in the Upper Hunter and asthma in children'.

ANDREW FOWLER (to Dr Tuan Au): So what happens if they don't do anything about it?

DR TUAN AU: Well, I don't know. What I'm going to do is, well, do it again until the Government will listen to it and I will let the history be the judge. If we ignore the problems and we do nothing about it's the same as murder.

ANDREW FOWLER: Dr Au's medical partner at his Singleton surgery certainly isn't ignoring the problem.

DR CRAIG BARRY, SINGLETON GP: There's a fair few reasons we've picked to move; family lifestyle reasons. In the medical profession I can work anywhere in the world in and I suppose for my children's sake is their health as well.

Long term is that there's probably better air quality elsewhere to be. I find that when we go to the coast or out of the Hunter is that their symptoms seem to reduce down, not using their medication as much; returning and using... having to get back on puffers and nasal sprays. Yeah, after returning after a couple of days.

DR TUAN AU: Well, I think well I've been here for 14 years now. I have good family and wonderful community and friend here. I can't just pack up and leave.

I hope with everybody working together we can change for the community. I think our community's not against mining company or any power station; they just want to have a change.

They would like the Government to listen to them; listen to their... what they request, and because it's their life and their family, and if we not doing anything else, the one who we lose is our family.

ANDREW FOWLER: It's a view echoed through the communities of the valley. They won't give in without a fight.

DEIDRE OLOFSSON: What we were doing it was to make the Government realise that we need a health study.

These are the things that are happening and to expose what is happening to get them actually to take notice and stop sticking their heads in the sand and actually listen to the people like they should be doing.

And not to the actual companies; it's about time they looked at the community and how they're going to help their health.

ASSOC PROFESSOR NICK HIGGINBOTHAM: This is environmental injustice. It's a very stark case where economic incentives... political incentives are disadvantaging the citizens of a region.

I mean some would say - and we would agree - that there's a sacrifice going on; that these townships, these communities are sacrificed to the greater good of economic benefit for the state of NSW, and for the companies that that make their profits.

[End of transcript]

* Editor's note: The initial figure was incorrectly given as "50 milligrams". (23 April 2010)

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