The TV news reports looked very bad for officially “embattled” state Environment Minister Ian Hunter last week.

A concerned local, wearing a face mask, was berating him by a dusty roadside: “Do you want somebody to die?”

The sad reality – and irony – is that locals have most likely died as a result of the coal-fired power stations that have chugged pollution over the iron triangle town for nearly 60 years until the industry was shut down last year.

At their height, the two stations – one commissioned in 1963 and the other in 1985 – reportedly consumed 40,000 tonnes of coal per week, with some doctors arguing their operation made Port Augusta a hotspot for respiratory disease.

Local research is thin, but studies in NSW and overseas have established a clear link between coal-fired power stations and health problems, including respiratory problems, lung cancer, heart disease and low birth weight in babies.

While the dust which has enveloped Port Augusta since the state’s post-Christmas storms may well be damaging people’s health, decades of pollution has rained upon the people of Port Augusta with little or no political sympathy.

It remains a relevant issue because, despite the closure of the Northern Power Station last year, the cumulative effects of pollution on some people’s health might not be seen in full for years to come.

This may explain why successive South Australian governments – like their interstate counterparts – have long downplayed the potential health impacts of the coal-fired power stations, arguing that the blame lies with other factors, such as smoking, and environmental dust in the hot, dry region.

To briefly recap, the dust that has sparked so much recent attention comes from the enormous 220-hectare ash dam connected to the now-defunct power stations. Ash from the stations was stored there, covered in seawater to prevent it polluting the air.

The owner of the power stations, Flinders Power, which has largely escaped public scrutiny during the media feeding frenzy on the hapless Hunter, has actually been attempting to control the ash dam’s contents for months. The seawater fix no longer worked after the station’s decommissioning, so the company had a contractor use a cropdusting plane to coat the site with a gel surface. That surface was blown away by the storms, exposing the dust and sending it swirling over the town.

The Government regulator, the Environment Protection Authority (EPA), has a dust management agreement with Flinders Power, and has been conducting analysis of the dust which, while not particularly toxic in its make-up, does pose a threat to human health due to the small size of the particulate matter.

And this is the key point.

Particulate matter of 10 micrometers and lower in diameter (known as PM10) can enter the human respiratory system, being drawn deeply into the lungs.

According to the National Pollutant Inventory, exactly this sort of pollution was produced for many years by the Northern Power Station in Port Augusta, with the level falling as the station has wound down its operations.

In 1998/99, the survey estimated he power station emitted 1.4 million kilograms of PM10.

In 2013/14, this had fallen to 510,000kg, although it also emitted an estimated 250,000kg of the smaller, and more dangerous, PM2.5.

According to local renewable energy lobby group Repower Port Augusta, the 2013/14 figure made the Northern Power Station the 11th highest emitter of PM10 of all Australia’s power stations and the 9th highest emitter of PM2.5.

When contacted by InDaily about historical levels of particulate matter in Port Augusta, the EPA pointed to previous government statements which asserted that the average level of particulate matter in Port Augusta was comparable to that in Adelaide.

Even a cursory examination of the National Pollutant Inventory raises questions about how this could be so.

Data from 2014-15 – when the coal-powered station was still operating – estimates that emissions of PM10 in the Port Augusta local government area were nearly 10 times the level emitted in Adelaide, more than 500 times the level of PM2.5. Even local government districts in metropolitan Adelaide with heavy industry – such as Port Adelaide Enfield – didn’t come close to the level of particulates estimated to be emitted in Port Augusta.

While data is relatively scarce, some reports and studies over the years have documented the toll of these emissions on the local community. The state’s health authorities claimed in 2010 that the local lung cancer rate, which it conceded was 1.45 times greater than what would normally be expected, was due to higher smoking rates. That claim was strongly challenged by the lobby group Doctors for the Environment Australia, and the local council, which pointed out that while the smoking rates were higher than average, they still didn’t account for the massive rate of cancer.

The lung cancer concerns followed a major study of South Australian children in 1993, which found Port Augusta had the highest prevalence of asthma in the state.

SA Health tells InDaily that when the EPA detects high levels of emissions, it will ask SA Health to provide advice on potential health effects. When asked when this has happened in relation to Port Augusta, an SA Health spokesperson said: “In the early 1990s SA Health worked with the EPA to reduce levels of coal dust in Port Augusta. Since then, the EPA regulated emissions through licensing within agreed levels.”

A 2011 article co-authored by David Shearman, an emeritus professor at the University of Adelaide, outlined the mechanisms by which coal-fired power station emissions damage health, and also highlighted the lack of political will by Australian governments to address the problems caused by this cheap, and therefore politically popular, source of power.

In September 2016, the World Health Organisation described air pollution – much of which comes from burning fossil fuels – as a public health “emergency”.

Other research indicates that long-term exposure to particulate air pollution boosts the risk of lung cancer, even at concentrations below the legal maximum.

Dino Pisaniello, Professor of Public Health at the University of Adelaide, told InDaily that while the health impacts of coal-fired power stations were well established, there hadn’t been specific studies done in Port Augusta to establish the extent of the damage to the local community’s health.

However, he said he had no doubt that pollution from the stations would have caused cases of lung cancer and other problems over the years.

He said that for every 10 micro-grams of PM10 in the air there would be a 1.3 per cent reduction in a person’s lung parameters, which is of particular concern for people with already compromised respiratory systems.

“I have no doubt there would have been some cases of lung cancer, people dying of heart disease… more in Port Augusta because of the nature of the environment and the industry,” Pisaniello said.

However, he said there had been little research – and little public interest – in the problem in South Australia and Australia more broadly, partly due to the heavy focus of the debate on greenhouse gas emissions.

“I think part of the problem is that unless you’re willing to put in the time and effort to do that kind of research, it’s just too hard,” he said.

“The data on exposure is very patchy. There needs to be more robust sampling studies to really understand the source (of the problems).”

One person who was always certain about the root cause of health problems in Port Augusta was the fierce long-time mayor of the town, the late Joy Baluch.

Baluch lost her husband – a non-smoker – to lung cancer, and had a child with severe asthma.

In her many trips to Adelaide hospitals to seek treatment, she found many children from her town, all suffering similar problems.

She was contemptuous of government attempts to blame smoking and other factors for the town’s burden of disease.

In an oral history project recorded in 2008, she said pollution from the power stations was the spur for her entering local government.

“I had a barrow to push, and it was the health of this city, and my beloved son was born asthmatic all as a result of the fallout of the fly-ash, six hundred tonnes a year over this city and this region,” she said. “Respiratory problems in all age groups increased, went like that (clicks fingers).  I’ve still got the letter to the editor that I responded to that was the forerunner to me getting into Council, and there was indication that the Government were going to put in another boiler and The Transcontinental wrote an editorial and said how good it would be, economic benefits, ra-di-ra-di-ra-di, and I took umbrage.”

Baluch, who died of breast cancer in 2013, became a campaigner for solar power to replace the coal-fired station.

So the irony here is inherent: many of the players, including the State Liberals, who have been blaming the Government (not, curiously, the company responsible) for failing to control the dust and threatening the lives of locals are the same voices who have wanted the coal power stations to remain open.

The Government, which many argue hastened the demise of the coal-fired stations with its heavy focus on renewables, is under fire for damaging the health of a community due to the uncontrolled release of coal’s nasty side products.

But it was this Government that once dismissed local concerns about air quality.

It’s certainly fair to ask for quick action by Flinders Power, and a firm hand from the EPA, to quickly contain the cloud of fly ash.

But the reality is that coal-powered electricity power stations located downwind only a few kilometres from the town centre have rained fly ash upon the community for decades.

The other bizarre twist is the attitude towards the private owners of the site and the taxpayers’ responsibility for the cost of the site’s rehabilitation.

The State Liberals, who sold off the government-owned power stations, want the State Government and your taxes to pay for health checks for Port Augusta’s population and, by implication, step up to help rehabilitate the site.

Labor, who opposed the privatisation, has played down the health problems caused by the polluting stations, despite wanting renewable energy to replace dirty fossil-fuel-burning power stations and, in the case of Port Augusta, actually succeeding in this policy objective.

The Government has now agreed to pay for health checks, on the understanding that Flinders Power will pay it back.

In that case, why doesn’t it also provide support to people whose health has likely been compromised over the past decades?

It seems fair to conclude that the local community has indeed been failed by South Australian governments and regulators, at the very least by a lack of will to fund detailed examinations of any links between air quality and health. It’s a failure that started many years ago.

Political heads – on all sides – remain firmly planted in the fine, polluted, lung-choking sand.