Coal will be a dominant energy source in both developed and developing countries for at least the first half of the 21 st century. Environmental problems associated with coal, before mining, during mining, in storage, during combustion, and postcombustion waste products are well known and are being addressed by ongoing research. The connection between potential environmental problems with human health is a fairly new field and requires the cooperation of both the geoscience and medical disciplines. Three research programs that illustrate this collaboration are described and used to present a range of human health problems that are potentially caused by coal. Domestic combustion of coal in China has, in some cases, severely affected human health. Both on a local and regional scale, human health has been adversely affected by coals containing arsenic, fluorine, selenium, and possibly, mercury. Balkan endemic nephropathy (BEN), an irreversible kidney disease of unknown origin, has been related to the proximity of Pliocene lignite deposits. The working hypothesis is that groundwater is leaching toxic organic compounds as it passes through the lignites and that these organics are then ingested by the local population contributing to this health problem. Human disease associated with coal mining mainly results from inhalation of particulate matter during the mining process. The disease is Coal Worker's Pneumoconiosis characterized by coal dust-induced lesions in the gas exchange regions of the lung; the coal worker's "black lung disease". (C) 2002 Elsevier Science B.V. All rights reserved.