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The report finds that 14 industrial facilities in South Africa's Mpumalanga Highveld Priority Area (HPA) caused between 305 and 650 early deaths in 2016 due to PM2.5 pollution. The most significant contributors were the Lethabo, Kendal, and Kriel power stations. Modeling indicates that compliance with the 2020 Minimum Emission Standards (MES) would reduce these annual early deaths by 60%, preventing between 182 and 388 deaths. The report also highlights severe exceedances of World Health Organization (WHO) guidelines for SO2 and NO2, particularly at sensitive sites like schools and hospitals. In 2016, these 14 facilities accounted for up to 92% of the daily ambient SO2 limit, suggesting that national air quality standards cannot be met without reducing emissions from these specific sources.

Professor Peter Orris reviews Dr. Andrew Gray's modeling of emissions from 12 coal-fired power plants, a Synfuels facility, and a NatRef refinery in South Africa. Orris concludes that these facilities create a significant public health hazard, contributing to hundreds of premature deaths annually via PM2.5 exposure. He notes that while implementing the 2020 Minimum Emission Standards (MES) would significantly reduce PM2.5-related deaths, it would not eliminate all WHO guideline exceedances for SO2 and NO2. The review emphasizes the vulnerability of children and the elderly at sensitive sites like schools and hospitals.