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The report calculates that the planned expansion of the Afşin Elbistan A Thermal Power Plant will cause significant public health damage and economic losses. In the first year of operation (2028), the project is estimated to cause 42 deaths and cost the economy 58.1 million USD. Over a 35-year operational period (2028-2063), the cumulative impact is projected to be 2,268 deaths and an economic cost of 2.6 billion USD, which the authors equate to the cost of building 29 hospitals with 500 beds each.

The document explores low- and zero-emissions zones (LEZs and ZEZs) as tools for cities to reduce air pollution and greenhouse gas emissions. It compares international examples from Europe and Singapore with a voluntary pilot in Santa Monica, California. A significant portion of the guide is dedicated to ensuring equity, arguing that ZEZs in California must be designed to avoid regressive financial burdens on low-income residents and people of color, who are disproportionately exposed to vehicle-related PM2.5 pollution. The authors recommend that California provide enabling legislation for cities to implement these zones and suggest targeting high-pollution sectors, such as heavy-duty freight, to maximize public health benefits in disadvantaged communities.

The report concludes that the combined operation of the proposed Thabametsi power plant with the existing Matimba and Medupi plants would cause SO2 concentrations to exceed South Africa's health-based National Ambient Air Quality Standards (NAAQS) at several receptor locations. While NOx and PM2.5 emissions from the plants alone might not exceed standards due to stack dilution, the report finds they will likely cause exceedances when added to existing baseline pollution from mobile sources and the Grootegeluk Mine. Additionally, the author argues that PM2.5 emissions from the proposed Thabametsi mine were significantly underestimated in previous reports by at least a factor of five, likely leading to significant impacts on locations to the south-west.

The report estimates that oil and gas emissions will cause over 750,000 summertime asthma attacks in children under 18 across the U.S. in 2025. It identifies volatile organic compounds (VOCs) and nitrogen oxides (NOx) as the primary precursors to this ozone smog, noting that pollution travels far downwind to affect all 48 contiguous states. The analysis highlights Texas, Oklahoma, Colorado, and Pennsylvania as states with the highest number of asthma attacks. To mitigate these effects, the report recommends implementing leak detection and repair (LDAR) programs, replacing high-emitting pneumatic equipment, and using vapor recovery units on storage tanks.

The document provides a technical comparison of air pollutant concentrations (SO2, NO2, and PM10) under two scenarios: actual emissions (Scenario 1) and requested limits (Scenario 2/2a). It highlights significant increases in predicted concentrations and exceedances of South African standards under the requested limits scenario, particularly for SO2.

The report finds that the proposed Lephalale Coal Mine (LCM) and its power plant will cause significant air quality violations and severe health and economic burdens. It argues that a previous environmental impact assessment (EIA) by GESI (2017) underestimated these impacts by neglecting mercury, existing pollution sources, and secondary PM2.5 formation. The analysis indicates that while mining alone causes 93 premature deaths, burning the coal on-site increases this to 3,120 deaths, and burning it at existing plants like Medupi or Matimba could lead to up to 41,984 premature deaths. Mercury emissions are projected to cause a loss of 3,700 IQ points and 554 lives, with significant deposition in protected ecosystems like the Waterberg Biosphere Reserve.