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According to the World Bank, 16 of the world's 20 most polluted cities are in China. The industrial revolution that's transforming the world's most populous country is also destroying its environment. China is now the world's second-largest emitter of carbon dioxide, the main gas that's linked to global warming.

NPR's Louisa Lim visited the city that topped China's pollution charts for the last three years.

LOUISA LIM: It's half past seven in the morning on the street of one of China's most polluted city, Linfen. But, frankly, it feels more like the middle of the night, and that's because the sky is still dark and cars still have their headlights switch on in order to navigate their way through the heavy haze of pollutants, which darkens the air here. People are getting to work now, and I can see them cycling pass me, many wearing facemasks in a desperate attempt to protect themselves against the very air they breathe.

(Soundbite of crowd)

LIM: The people's hospital is one of the busiest places in town, and the respiratory diseases department is the busiest of all.

Dr. XU(ph)(Resident, Linfen, China): (Chinese spoken)

LIM: I can't speak, I'm too busy says Dr. Xu, surveying the crowd thronging his consultation room.

Ms. SUN HAIXIA (Textile Worker, China): (Chinese spoken)

LIM: Every day, there are too many patients to count here, says textile worker Sun Haixia. She brought in her grandma with a chronic cough. The air pollution is affecting everybody, she says. We've pushed our environment to its limits.

(Soundbite of woman shouting)

LIM: The reasons for this environmental degradation are clear in Beilu village on the city's outskirts. Coal heats the brick bungalows here. It's also the mainstay of the local economy. The air is acrid and sulfurous. It makes your eyes sting and your throat dry and scratchy. Piles of snow still on the ground are black from coal dust.

Ms. WANG DONGLI (Resident, Beilu Village): (Chinese spoken)

LIM: It's more than 20 years since we've seen blue sky, says Wang Dongli, a cheerful 36-year-old, in a pink windbreaker who's trying to sell toothpaste to the other villages. After economic reform started in 1979, there were more and more factories, she says. And then, we couldn't see blue sky anymore. We've ruined Mother Nature.

Unidentified Woman #1: (Chinese spoken)

LIM: Lung cancer got this one, leukemia that one, the old lady say.

Unidentified Woman #2: (Chinese spoken)

LIM: Gathering in the alley, hands deep in their pockets against the icy cold. They talk in hushed tones, wheeling off a long list of recent deaths. The local doctor, Zhang Keguan, says Beilu is known locally as the cancer village.

Dr. ZHANG KEGUAN (Physician, Beilu Village): (Through Translator) Around 1,000 people live here, at least 20 have died from cancer recently, while three or four are still suffering. They won't live long. Most who died in recent years were young, just 30 or 40 years old.

(Soundbite of children playing)

LIM: Children play in the alleyways, unaware that just being outside could harm their health. The anecdotal evidence of a high death rate is backed up by a government research project done by a scientist, Wang Dintao(ph), who didn't want to be interviewed. Figures show the normal death rate in China is six per 1,000 each year. In the most polluted parts of Linfen, for those ages over 55, that has risen to 61 per 1,000 each year.

(Soundbite of child crying)

Ms. QIAO XIAOLING (Resident, Linfen): (Chinese spoken).

LIM: For Qiao Xiaoling, such bold statistics disguise the terrible pain of loss. Her husband died four years ago from leukemia. Then lung cancer claimed her 34-year-old son. As she minds her three-year-old grandson, she admits she doesn't know what caused their illnesses.

Ms. XIAOLING: (Through Translator) I don't know if it's because of the water or the air. I'm scared in my heart and worry about this little boy. I think about moving, but I don't have the money.

(Soundbite of moving vehicle)

LIM: Trucks transporting coal thunder past her house 24 hours a day. Within a kilometer of Beilu village, there is a coal-processing plant, a power station, a pharmaceutical factory, and a Coke oven, where a coal is bake at extreme temperatures to produce fuel for blast furnaces.

The village is located in a natural basin, which traps pollutants. And the shallow village wells are polluted, too. The nearby Fin River(ph) is drying up, in some places to a dirty trickle. The whole place feels like it's been hit by a post-industrial apocalypse. But even officials like Wang Jinglong from the Shanxi Environmental Protection Agency admit polluting factories play a vital role in China's development.

Mr. WANG JINGLONG (Shanxi Environmental Protection Agency): (Through Translator) If we closed all Linfen's polluting factories, the environment would clear up. The water would still be polluted, but the air would be better. But then a new problem would emerge, how would people afford to eat?

LIM: He says the government closed 40 Coke ovens in Linfen in the last year alone and is determined to do more. But on the ground, there is still a real feeling of discontent.

Dr. KEGUAN (Resident, China): (Chinese spoken)

LIM: No one cares about us, the village doctor Zhang Keguan says. The people here feel abandoned and bitter. They think cleaning up environmental pollution should be a priority, but 91 percent of city mayors in the province fear environmental measures would harm economic progress. It is a sign of the gulf dividing China's citizens from those who govern them.

Some, however, argued their problem isn't just China's, but a consequence of globalization and the outsourcing of pollution. Environmental expert, Jeff Woo(ph) cites the example of Coke plants, which produce carcinogens like benzopyrine as well as carbon dioxide emissions.

Mr. JEFF WOO (Environmental Expert, Linfen, China): (Through translator) The U.S. has shut down a lot of Coke factories. Now Coke production using large ovens has been transferred to developing countries. The U.S. imports much of its Coke from China, so part of China's pollution traces back to the U.S.

LIM: Back on the ground in China, these polluting industries are making some people rich. That much is clear in a grimy car showroom on the outskirts of Linfen. Manager Wang Hongsheng says sales are growing here at some of the fastest rates in China, around 20 percent a year.

Mr. WANG HONGSHENG (Car Showroom Manager, Linfen, China): (Through translator) Linfen's development is pretty fast because of it's natural reserves, it's coal, and iron mines, so ordinary people's lives are improving very fast, and ordinary farmers are buying cars.

(Soundbite of car honking)

LIM: And more cars will emit more pollutants. And as the average standard of living rises, China's thirst for energy grows. So it's opening a new coal-fired power plant a week, leading again to more polluting emissions.

One scene outside Linfen encapsulates the challenges China faces. A team of orange-coated street sweepers are hard at work, armed with brooms made from tree branches.

They sweep energetically, corralling the coal dust into black heaps by the side of the road. But even as they work, factories around them belch out pollution and yet more coal trucks hurtle past, leaving-yet more coal dust in their wake. It's a scene that illustrates the magnitude and impossibility of the task ahead.

Louisa Lim, NPR News, Linfen, Shanxi.

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