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TSMC’s expansion of its foundry in the Central Taiwan Science Park not far from Dadu Mountain is in full swing. The world’s biggest contract chip maker may be an important lifeline of Taiwan’s economy, but it has also accounted for a third of the increase in electricity demand in the country over the past five years.

On the other side of Dadu Mountain less than 20 kilometers away lies Taichung’s Longjing District. Four days after Taiwan suffered a blackout that affected most parts of the island on Aug. 15, former Premier Lin Chuan visited the coal-fired Taichung Power Plant in Longjing and was met by protesters led by opposition Kuomintang (KMT) Legislator Yen Kuan-heng, who represents the district.

“The use of nuclear power is being cut; does that mean we are jacking up the use of fossil fuels to generate power? Doesn’t pollution from particulates get worse the more coal we burn?” asks Ou Yu-mei, the head of Lishui Ward in which the plant, the world’s biggest thermal power station, is located. Another one of the protesters that day, Ou brews coffee for visitors while pointing outside as she holds court.

“The air is really not good. If you leave your car outside for two or three days, it becomes caked in black dust. I don’t want to say it’s entirely because of the Taichung Power Plant, but it’s one of the main culprits,” she says.

Taichung resident aren’t the only ones worried about air quality. “Changhua faces the dual threat of a coal-fired plant to the north and the sixth naphtha cracker plant project to the south,” says San Hsiao-ching, the deputy director-general of the Changhua County Public Health Bureau.

An eye-catching green vehicle is parked outside the community development association of Nandian Ward in the county’s Hemei Township. Some 30 to 40 people local residents have lined up to the side, waiting to undergo a lung function screening test.

Changhua County began to offer lung screenings last year, hoping in part to better understand the connection between the incidence of respiratory tract diseases and risk factors in the area.

“I did a test before, and they told me my lungs had gray spots,” says a 47-year-old woman surnamed Huang who lives in neighboring Hedong Ward. Just a few weeks earlier, she was diagnosed as having chronic obstructive pulmonary disease, and now she exercises every day, hoping to improve her lung capacity.

At the end of last year, Changhua County Commissioner Wei Ming-ku used the NT$17 million state-run utility Taiwan Power Co. (Taipower) subsidizes the county to promote electricity development to conduct lung screenings around the county and survey the prevalence of respiratory disease and key risk factors.

The county deployed the mobile screening vehicle to county townships and into elementary schools to track the health of people’s lungs from the time they are small and determine if the respiratory problems are linked to nearby power plants.

Tsai Yi-giien, the head of the Division of Pediatric Allergy and Immunology at Changhua Christian Children’s Hospital, has researched the subject. He has found that in the three Changhua townships closest to the coal-fired power plant in Longjing just across the county border, the incidence of allergic rhinitis (commonly known as hay fever) and asthma among second- and fourth-graders is clearly higher today than 10 years ago.

“Ten years is not even a generation. For allergies to steadily rise like this is a sure sign that the environment is a very important factor,” he says. But pinpointing what those environmental factors are will require further clarification, he admits.

Air quality has increasingly drawn national attention, and while there remains a lack of hard evidence of a link between health and the pollutants discharged by power plants, many public health scholars believe that the health risk from such pollution cannot be underestimated.

In fact, health has been all but ignored as a risk in Taiwan’s bumpy transition to an energy future that will rely more on renewable energy while phasing out nuclear power. Yet that risk is very real, because Taiwan’s next 10 years could be hot and dirty and face the risk of power shortages.

Lights Out vs. Black Lung

What many people don’t realize is that the Taichung Power Plant, seen by residents in both Taichung and Changhua as a major health risk, is assuming an increasingly important role in Taiwan’s power generation.

When the six generators at the natural gas-fired Tatan Power plant in northern Taiwan shut down on Aug. 15 because of human error, it caused a rolling blackout around the island. Had it not been for the Taichung Power Plant, which accounts for about 20 percent of the country’s power generation, Taiwan would have gone completely dark.

Many people are also just realizing that what helped Taiwan get through its hottest August on record was not nuclear power or alternative energy, but thermal power. At noon on a hot day in late August, coal was used to generate about 33 percent of the country’s electricity, compared to 42.5 percent from natural gas, 8.4 percent from nuclear power and 4.4 percent from renewable energy.

Taipower statistics indicate that over the past 10 years, the generation of thermal power has risen nearly 20 percent, from 151.83 billion kilowatt-hours in 2007 to 180.45 billion kWh in 2016, and its proportion of total electricity production has risen from 75 percent to 80 percent during that time.

The government’s energy transition plan has described the next 10 years as “first bitter then sweet.” It foresees coal-fired power increasing to 50 percent of Taiwan’s electricity mix by 2020 but then receding to 30 percent by 2025, when renewable energy and natural gas-fired power will account for 20 percent and 50 percent of total power generation, respectively.

The increasing use of coal in the short term flies in the face of international trends. Coal has been recognized as a hazardous toxic substance, and countries around the world are trying to reduce its use in electricity generation. In May, for example, South Korean President Moon Jae-in ordered eight domestic coal-fired power plants over 30 years old to be shut down for the month of June and 10 aging coal-fired power plants to be closed for four months next year starting in March, mainly because of pollution concerns.

Yeh Guang-perng, a gynecologist at Changhua Christian Hospital and the founder of civil group Air Clean Taiwan, cited a March 2011 report by the American Lung Association as saying that American coal-fired power plants spew 84 separate hazardous air pollutants into the air. Aside from emitting heavy metals and carbon dioxide, coal plants are big producers of PM2.5 particulates and PM2.5 precursor gases sulfur oxide and nitrogen oxide.

PM2.5 particulates, classified by the International Agency for Research on Cancer as being “carcinogenic to humans,” are of particular concern. Only 1/28th the diameter of a human hair and able to flow freely through the human body, these particulates have been linked to everything from respiratory diseases, chronic obstructive pulmonary disease, cardiovascular disease and dementia to lung, liver, and bladder cancer.

“PM2.5 pollutants can reduce the respiratory tract’s resistance to disease-carrying bacteria, and hamper the function of white blood cells,” says Vincent Su, a chest medicine specialist at Taipei Veterans General Hospital. PM2.5 particulates not only increase the incidence of these diseases but also their fatality rate, he adds.

A total of 8,600 people in Taiwan died from exposure to PM2.5 particulates in 2009, according to a study published this year by Lin Hsien-ho, an associate professor in National Taiwan University’s Institute of Epidemiology and Preventive Medicine.

Tracking down the source of PM2.5 pollutants can be tricky, however, because they come from many sources, including traffic dust, factories, overseas sources, and power generation, and the latter only accounts for 3.6 percent of all PM2.5 emissions, according to Environmental Protection Administration (EPA) figures.

But 36.4 percent of all sulfur oxides and 16.7 percent of nitrogen oxides, the precursor gases for the hazardous PM2.5 particulates, are produced by power plants, EPA data shows.

As thermal power generation grows in importance in the country’s electricity mix, the proportion of emissions from power plants is bound to rise. As Taiwan increases the share of coal-fired power in the next few years, it cannot but take the corresponding health risks and costs seriously.

Chen Yu-cheng, an assistant investigator at the National Health Research Institutes’

National Institute of Environmental Health Sciences, says PM2.5, sulfur dioxide and nitrogen dioxide values in Taiwan have improved since 2006, but annual average PM2.5 concentrations remain higher than national standards and World Health Organization guidelines.

The Culprit behind Rising Lung Adenocarcinoma

Another worry is that while the fatality rate of lung cancer in Taiwan has declined over the past five years, the incidence of pulmonary adenocarcinoma (a type of non-small cell lung cancer that begins in the glands) has grown steadily over the last 20 years.

“Of 10 lung cancer patients in Taiwan, six to seven have adenocarcinoma of the lung,” Taipei Veterans General Hospital’s Su observes.

This form of lung cancer is not highly correlated to smoking. Studies have shown that aside from other factors such as genes, occupational hazards, and exposure to cooking oil fumes, air pollution is also an important cause of the disease.

That’s why central Taiwan, home to the world’s biggest thermal power station, has garnered particular attention from doctors who study air pollution and related diseases.

Responding to the possibility of higher pollution in the near future, Wu Cheng-hung, the head of Taipower’s Department of Environmental Protection, explained that despite the short-term rise in coal’s share of the energy mix, the emissions that will be reduced by decommissioning two coal-burning generators at Hsinta Power Plant in 2024 will more than offset the additional emissions generated by new power plants.

That’s because the thermal power plants being designed for the future, including three generators at the Linkou Power Plant, three at the Dalin Power Plant and two at the Shen Ao Power Plant, will used advanced ultra-supercritical technology that is much cleaner than what is in place today.

This would be the ideal scenario, but it would mean that the two major preconditions for decommissioning aging coal- and gas-fired generators – more renewable energy and a more robust natural gas infrastructure – had been met.

At present, renewable energy contributes only about 5 percent of Taiwan’s overall power generation, and the government’s biggest hope for increasing that number substantially – offshore wind power – still faces many problems and obstacles.

At the same time, plans for a third liquefied natural gas terminal in Taiwan are being held up by environmental disputes, and a solution is unlikely in the near term.

If the development of renewable energy and natural gas facilities remains stalled, Taiwan will not be able to retire old coal-fired and oil-fired power stations, and those fuels will emerge as the biggest source of Taiwan’s electricity generation, as was the case this summer.

The most likely energy source Taiwan would call on in an electricity pinch – oil-fired power – generates serious nitrogen oxide and sulfur oxide pollution even in limited use relative to other sources.

In 2015, nitrogen oxide and sulfur oxide emissions spewed out by Taiwan’s only completely oil-fired power station, the Hsieh-ho Power Plant in Keelung, soared nearly 100 percent and 67 percent, respectively, according to EPA statistics. The huge increase occurred because the plant was forced to operate longer hours to compensate for tightening electricity supplies.

Also, because the Hsieh-ho plant is aging and scheduled to be decommissioned in the not-too-distant future, there is not enough space or time to fit them with pollution control equipment, admits EPA deputy chief Thomas Chan. The only eco-friendly option, if you can call it that, is purchasing low-sulfur oil, because the Hsieh-ho plant alone generated 12 percent of all of Taiwan’s sulfur oxide emissions in 2016.

The High Health Risk Era Has Arrived

Though oil-fired power plants are now relegated to being used only when power is tight (defined as when the operating reserve margin is below 6 percent of capacity), that threshold was attained 80 days last year and 78 days already this year with nearly four months still to go.

Aside from the two Hsieh-ho Power Plant generators, the No. 3 and 4 oil-fired generators at the Dalin Power Plant, which are to be decommissioned in September and October, respectively, and the No. 3 gas-fired generator at the Tunghsiao Power Plant will also be called on in relief in the future to keep Taiwan’s electricity flowing.

In other words, the hotter the weather, the more these old power-generating veterans will be forced back into action no matter how dirty they are.

Taipower has said it experimented with low-sulfur oil at the Hsieh-ho plant last winter and will formally use it for the first time this winter because it can cut sulfur oxide emissions by 30 percent. But its use will be restricted to winter because of its relatively high cost and the fact that air pollution and smog tend to be at their worst during the winter months. Also, beginning next year, the utility will comply with overall emission limits set by the EPA.

To keep these aging relievers from reappearing, it would mean hitting targets on both natural gas and renewable energy, quite a tall order. Not achieving them could consign Taiwan to high thermal power use and high health risks over the next 10 years.

Using Pricing to Control Demand

So how can Taiwan confront the health risks it is bound to face during its energy transition? Yu Li-hui, the deputy director-general of the Health Promotion Administration (HPA), says the EPA has joined with the ministries of Economic Affairs, Transportation and Communications, and Health and Welfare to create a task force aimed at supervising and coordinating efforts to reduce air pollution and draft clean air plans.

“Health has always been an important consideration in the interagency discussions,” Yu says, noting that the HPA believes the best way to control air pollution and improve health is by starting at the source.

Taiwan must face up to the difficulty of retiring aging, dirty power plants during the transition of the country’s energy structure and prepare to invest more in pollution control measures.

Many experts have also suggested that Taiwan consider more rational electricity pricing to keep a lid on demand and limit the chances that the dirtier power plants will be called into action.

Liang Chi-yuan, a chair professor at National Central University and an expert in energy economics, argues that the most effective approach would be to use higher prices to restrain demand.

The oil-fired Hsieh-ho Power Plant in Keelung has been used heavily in recent years because of tight power supplies, increasing Taiwan's sulfur oxide and nitrogen oxide emissions.

“Electricity prices should reflect external costs, so air pollution fees should be increased and energy and emissions taxes should be imposed,” Liang says. That means the more individuals or companies use power and generate emissions, the higher the price they will pay, creating an incentive for them to save energy and ultimately prevent an unabated rise in air pollution.

Chien Jien-wen, the director of Changhua Christian Hospital’s Department of Pediatrics, sees Taiwan’s stubbornly high power consumption as the by-product of a lack of incentives for individuals and companies to save power. Government officials, for their part, have the mentality that higher electricity demand goes hand in hand with economic growth, he contends.

The average Taiwanese uses 10,000 kWh of power per year, far higher than the 7,000 kWh per capita seen in Germany, and Chien insists that excessively low electricity prices stand out as the most important culprit.

“The best way to curb something is through pricing,” Chien argues. The key to raising prices, he says, is good communications. “Just like raising cigarette prices is the most effective way to reduce the rate of smoking, I think that if you want to lower power consumption, there has to be a reasonable increase in the cost of electricity.”

“An increase in electricity prices would have a bigger impact on businesses but only a limited effect on the average person. Though household electricity bills might go up a little, you would be cutting health care costs, so over the long run [higher prices] would be reasonable and effective,” he says.

Explaining the risks associated with different energy choices and clearly communicating them with the public is the obligation of the government. Understanding these complicated issues and being willing to shoulder the costs of their decision is the responsibility of the public. Whether renewable energy or nuclear power or electricity generated from coal or natural gas, none of them are all good or all bad.

In the end, there are in fact no free lunches. If Taiwan is unwilling to invest more time and money, demanding clean energy in a short amount of time along with lower emissions may be mission impossible.

Translated from the Chinese by Luke Sabatier