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The bad news about coal-burning plants doesn’t stop at air pollution and greenhouse gas emissions. This week, a new study found that 91 percent of coal plants surveyed across the United States were contributing unsafe levels of pollutants to groundwater as well.

The pollutants—which include arsenic and lithium—seep into the ground from piles of toxic waste scrubbed from the stacks, called coal ash. This tainted groundwater poses a health risk for any drinking water wells nearby.

It’s an example of how producing and burning fossil fuels is more than just a seemingly distant, incremental concern posed by a warming climate. With that in mind, here are five other hazards posed by oil, natural gas, and coal.

Particulate matter

Even though we’ve made a lot of progress with our vehicles, air pollution is implicated in four to seven million deaths each year. Particulate matter, comprised of soot and other particles less than 10 micrometers in diameter, are some of the worst pollutants. The smaller, the scarier: the tiniest particles lodge in the lungs, and continued exposure can reduce lung function and cause asthma and cancer. Diesel-powered vehicles, such as semi-trucks, are some of biggest emissions culprits. Living within 200 meters of a highway elevates your risk of health impacts from the finest of the fine particles, less than 2.5 micrometers across, known as PM 2.5.

Airborne metals

Coal-burning power plants are the largest single source of airborne mercury, an acutely toxic heavy metal that can cause neurological damage, especially in children and unborn babies. Based on the EPA’s most recent data, 22.9 tons of the total 55 emitted in 2014 came from coal plants.

Earthquakes

From 1973 to 2008, an average of 24 earthquakes annually, of magnitude 3 or greater, rumbled across the central U.S. That average jumped to 193 from 2009 to 2014. In 2014, the same region had 688 of these earthquakes. The uptick coincides with a boom in hydraulic fracturing or “fracking,” a natural gas mining process. Geologists have found that some of these earthquakes coincide with the timing and location of underground fracking waste disposal, which is thought to change the stresses on nearby faults. In a 2018 study, scientists concluded that fracking-caused earthquakes were “pervasive” in Oklahoma.

Other polluted waters

It’s not just burning coal—extracting it pollutes water, too. Fracking uses a mix of 750 chemicals, including some known to be toxic, to pry open underground cracks in order to extract natural gas. If not carefully discarded, this wastewater can be hazardous. In Appalachia, mining companies literally blow apart mountaintops to reach coal deposits. It’s as destructive as it sounds, and the exposed rock leaches chemicals like selenium and sulfate into nearby waters. Though it didn’t find a causal link between these practices and health impacts, a 2015 review concluded that “people who live near coal mining in Appalachia experience a wide range of health problems,” including “forms of cancer, cardiovascular and respiratory disease, kidney disease, developmental problems, depression, poorer health-related quality of life, and a wide variety of illness symptoms.”

Explosions

Natural gas is the cleanest-burning fossil fuel. But it’s also very flammable. The pipelines and reservoirs that move and store gas pose a risk if they’re leaky. In February, a natural gas explosion killed a girl at her home in Texas, and another explosion burned five buildings in San Francisco. The largest gas leak in history happened at the Aliso Canyon, near Los Angeles. Residents nearby reported feeling ill and 97,100 tons of methane—a greenhouse gas that warms the planet even more than CO2—spewed into the atmosphere before the Southern California Gas Company was able to close the leak.

A happier story: acid rain

Acid rain forms when sulfur dioxide and nitrogen oxides react in the atmosphere to form sulfuric acid and nitric acid. Then, the acids mix with rain, snow, fog, and even dust before traveling to the ground, where they can erode structures and harm plants and wildlife.

But this is one of the rare success stories on this list.

You may feel like you haven’t heard about acid rain in a while, and that’s because we’ve actually done a great job at stopping it. In the 90s, the U.S. launched a sulfur cap and trade program, which put a “cap” on the total permitted emissions and gave out a certain amount of “allowances,” which polluting coal plants could either use and sell off. The program cut emissions by more than 4 million tons annually.