While filters catch most of the pollution at the plants – AGL's Liddell and Bayswater, Delta's Vales Point, EnergyAustralia's Mt Piper and Origin's Eraring – they emit secondary particles that most other nations ban.

“Australian power stations are operating without the modern pollution control technologies and they’ve been allowed to get away with it for years and years," Dr Eward said. "That wouldn’t be the case anywhere in Europe or North America, or even in most of Asia.”

The Environment Protection Authority is now reviewing the licences of three: Vales Point, Mt Piper and Eraring. By the time the last of the five is due to shut in 2042, the number of expected low-weight births would be 3029, with new onset diabetes put at 4412, the study found.

Guy Marks, principal investigator at the Centre for Air Pollution, Energy and Health Research and a professor at UNSW, said Dr Ewald's research was "certainly at the cutting edge of this work".

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"He's made a series of assumptions that are plausible," Professor Marks said. "It's a useful way to try to bring to the government's attention to the price there is to pay from high-emissions intensity [generation]."

The impact tally is likely to be conservative because it only focused on three health outcomes caused by long-term fine particle air pollution. It did not include health damage from short-term pollution spikes such as asthma and exacerbated lung disease, nor the effects of ozone, mercury and other toxin exposures, the report said.

'Further scrutiny'

A NSW Health spokeswoman said the agency had conducted similar research but identified lower premature deaths. "The discrepancy in the number of power station-related loss of life appears to be largely due to the assessment of the amount of power station-related PM2.5 that people are exposed to."

Dr Ewald's approach, particularly estimates of the proportion of sulphur-dioxide and nitrous oxides in Sydney from power stations, "requires further scrutiny before firm conclusions can be drawn about its validity", she said.

Major energy firms rejected the report, with EnergyAustralia calling it "inaccurate" and yet to be formally peer-reviewed.

"[W]e strongly reject the implication that our operations pose unacceptable risks to human health," a spokesman said, adding the paper was "needlessly upsetting for the community", a spokesman said.

An AGL spokesman said the company was committed to improving its plants performance, and said both complied "with environmental laws and environment protection licence conditions set by the [EPA]."

'Raining down'

But community groups said tougher controls were well overdue.

"It's weak legislation" that had allowed high pollution levels to continue, Julie Favell who convenes the Lithgow Environment Group, said. "It's shocking to think that it's gone on for so long."

Sue Winn, whose family lives within a few kilometres of Vales Point and includes several asthma sufferers, said they had long had pollution "raining down" on them.

"There's got to be poor health outcomes by being exposed to this day in, day out and night in, night out," Ms Winn, secretary of the Mannering Park Progress Association, said.

Greens' bill

Greens environment spokeswoman Cate Faehrmann has introduced a bill into the NSW parliament to limit the amount of toxic air pollution from coal-fired power stations in the state.

Dr Ewald's report "should send shockwaves through the government", she said.

“It is unacceptable that toxic emissions from Australia’s power stations are multiple times higher than what is allowed in the EU, the US and China,” Ms Faehrmann said. “We hope the government and Labor will put people’s health ahead of the profits of AGL and Origin Energy and support the bill when it is debated on Thursday.”