Purpose: To investigate the impact of a planned coal-fired power plant (CFPPT) in Shenao on air quality and health at subnational levels in Taiwan. Methods: We applied the Gaussian trajectory transfer-coefficient (GTx) model to estimate annual average PM2.5 (particulate matter with aerodynamic diameter less than 2.5 μm) increments in 19 Taiwanese cities and counties caused by CFPPT operation. A population health risk assessment was performed by incorporating evidence of the health effects of PM2.5 provided by prospective studies and estimating long-term PM2.5 exposure. Additionally, we considered ischemic heart disease, stroke, lung cancer, and chronic obstruct pulmonary disease as the primary outcomes. The population-attributable fraction was used to estimate the county-level mortality burden attributable to CFPPT-generated PM2.5 in 2025. Results: The estimated annual PM2.5 increments ranged from 0.004 μg/m3 (Taitung County) to 0.28 μg/m3 (Hsinchu County) due to the Shenao CFPPT. The total and premature deaths attributable to PM2.5 from Shenao CFPPT operation in Taiwan during 2025–2040 would be 576 (95% confidence interval [CI]: 537–619) and 145 (95% CI: 136–155), respectively. Notably, we estimated 198 (95% CI: 169–234) deaths and 58 (95% CI: 51–66) premature deaths, respectively, in New Taipei City, which accounted for over a quarter of the total deaths. Overall, the mortality rate attributable to the Shenao CFPPT in Taiwan was 6 per 10,000. Conclusion: A scientific approach should be adopted for assessing the impacts of CFPPT operation on population health, which can serve as a valuable policymaking reference for the government.
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