On a clear November morning in 2025, Maria K. stands at the window of her apartment in Jänschwalde, gazing at the cooling towers of the power plant. They're still running, but not for much longer. The air quality has improved, they say. The monitoring stations confirm it. But when Maria wakes up in the morning, she still feels that tightness in her chest. The cough that never quite goes away. The shortness of breath when climbing stairs. She is 52 years old and has lived here since birth. Her lungs remember—every breath she's taken over the past decades.
Today, Lusatia is a region undergoing transformation. Air quality is measurably improving, emissions are falling, and the future is meant to be green. But in doctors' offices, lung clinics, and physiotherapists' waiting rooms, a different story is being told. The story of people whose bodies bear the invisible legacy of coal – today, now, in this very moment.
Today's air: Better, but not good enough
The figures speak for themselves: Air quality in Lusatia has improved significantly over the last ten years. Sulfur dioxide concentrations have fallen by over 80 percent, and nitrogen oxides by about 60 percent. The exceedances of limit values, which were almost commonplace in the 1990s and 2000s, are largely a thing of the past. The German Federal Environment Agency confirms: The acute burden from conventional power plant emissions is steadily decreasing.
But "better" doesn't mean "good." Even today, particulate matter levels in some parts of Lusatia are above the national average. Especially in winter, when temperature inversions trap pollutants at ground level, PM10 and PM2.5 levels rise alarmingly. The limit values are exceeded on approximately 20 to 30 days a year – not dramatically often, but often enough for people with pre-existing lung conditions.
The open-cast mines are still active. Welzow-Süd, Nochten, Jänschwalde – they continue to extract lignite, and every ton produces dust emissions. Modern irrigation systems and dust suppression measures reduce the pollution, but do not eliminate it. On windy days, the fine dust still blows over the surrounding villages.
What the measurements do not show
The official measuring stations only capture part of the reality. They are located at fixed points, measure average values, and depict trends. What they don't show: the local peaks when the wind is blowing in an unfavorable direction; the pollution directly at the edge of the open-cast mine, where there are no measuring stations; and the individual exposures of the people who work there or live in the immediate vicinity.
Residents still report days when they have to keep their windows closed, when a visible cloud of dust drifts over the area, and when their cars are gray again within hours. These experiences aren't reflected in the statistics, but they are real – and harmful to the respiratory system.
In the region's medical practices: What doctors are seeing today
Dr. Thomas Weber is a pulmonologist in Cottbus. His practice is located in the heart of Lusatia, and what he sees daily confirms the health statistics: "The prevalence of chronic respiratory diseases is significantly higher here than the national average. COPD patients who have never smoked. Asthmatics whose illness is unusually severe. Cases of pulmonary fibrosis that we would normally only expect to see in older patients."
Current data from the Robert Koch Institute shows that in the districts of Spree-Neiße, Oberspreewald-Lausitz, and Görlitz, the rate of diagnosed COPD cases among people over 50 is 15 to 20 percent higher than the German average. Asthma in children and adolescents is also more common than average – despite improved air quality.
"The paradox is," explains Dr. Weber, "that today we are treating the consequences of yesterday. The air is getting better, but people's lungs are carrying the burden of 40, 50 years of exposure. And this burden cannot simply be treated away."
The generation of the chronically ill
In the waiting rooms sit people like Maria K. – in their early to mid-50s, who have spent their entire working lives in the region. Many worked in open-pit mines, power plants, or supplier companies. Others simply lived here, breathing the same air, day after day, year after year.
Today they are patients. They come for regular lung function tests, pick up prescriptions for cortisone sprays and bronchodilators, and discuss their oxygen saturation and their capacity for daily activities. Some already need long-term oxygen therapy – in their early sixties. Their diagnoses are similar: chronic obstructive pulmonary disease (COPD), often combined with chronic bronchitis, and sometimes with pulmonary emphysema.
Health insurance data reveals a clear trend: Prescriptions for respiratory medications in Lusatia are significantly higher than the national average. The hospitalization rate due to acute exacerbations – sudden worsening of symptoms – of chronic respiratory diseases is also elevated.
Children today: Between relief and inheritance
The good news: Children born in Lusatia today breathe significantly cleaner air than their parents and grandparents. Asthma rates in newborns and toddlers have shown a slight downward trend since around 2015. Pediatricians report that severe asthma attacks are becoming less frequent and that fewer children require long-term medication.
But young people can't completely escape the legacy. Studies on lung health show that even today, the lung function of adolescents in Lusatia is, on average, slightly reduced compared to their peers from unpolluted regions. The differences aren't dramatic, but they are measurable – about 3 to 5 percent less vital capacity.
Children and adolescents between the ages of 10 and 18 are particularly affected – those who spent their early years during periods of higher pollution. Their lung development took place during a phase when air quality was improving, but not yet good. This cohort occupies a kind of "middle ground" in the legacy of coal.
Sport as a challenge
Teachers in schools in the region report a peculiarity: Students here tend to perform worse on endurance tests than in other regions. This isn't because they are less athletic, but because their lung capacity is lower. During the 800-meter run, a standard long-distance run in physical education classes, it becomes apparent that some students get out of breath more quickly and have to give up sooner.
For affected teenagers, it's more than just a bad grade. It's a constant reminder that their bodies function differently. That they can't keep up, even though they try hard. That something is wrong with them – something beyond their control.
Daily life with damaged lungs: Life in Lusatia 2025
What is life like in Lusatia today with a chronic respiratory illness? The answer depends on the severity. Mild COPD or controlled asthma can often be well managed with medication. Those affected lead a largely normal life, only needing to be careful during physical exertion and take precautions during pollen season or when they have an infection.
But there are also severe cases. People like Jürgen M., 64 years old, a former open-pit miner. He has stage 4 COPD – the most severe stage. His daily life is severely restricted. In the mornings, it takes him 20 minutes to get dressed because every movement leaves him breathless. Shopping is only possible with a walker and an oxygen concentrator. Climbing stairs has become impossible.
"The air here may be better than before," he says, "but for my lungs it's too late. They're done for. Finished."
When every breath counts
For people with severe respiratory illnesses, every day is a balancing act. Colds can become life-threatening. A flu-like infection, which is merely bothersome for healthy people, can lead to pneumonia, hospitalization, and a life-threatening exacerbation for them.
The coronavirus pandemic made this particularly clear. In Lusatia, the fear among people with lung conditions was especially high – and rightly so. The hospitalization rate for COVID-19 was above average in the region, and the mortality rate among infected individuals with pre-existing conditions was also elevated. For many, it was and remains a feeling of constant threat.
Even today, in November 2025, there are still people in the region who hardly leave their homes. Not just out of fear of Covid-19, but out of fear of anything that could put additional strain on their lungs: pollen, cold air, infections, and exertion.
What has improved – and what hasn't
The structural transformation is bringing measurable improvements. Since the gradual decommissioning of the power plant units, emissions have been steadily declining. The Jänschwalde power plant has already taken several units offline; Schwarze Pumpe will follow. With each unit that is shut down, the pollution from sulfur dioxide, nitrogen oxides, and mercury is reduced.
The renaturation of the open-cast mines is showing initial success. Green areas bind dust, young forests are beginning to grow, and windbreaks reduce the dispersion of particles. On days with good weather, air quality is now often at a level comparable to other rural regions in Germany.
The healthcare system has also adapted. There are more pulmonologists in the region than before, specialized rehabilitation facilities for respiratory diseases, self-help groups, and pulmonary exercise groups. Medical care has improved – which was urgently needed given the high number of people affected.
The invisible burden remains
What hasn't improved: people's lungs. Already damaged tissue doesn't regenerate. Scarring remains. Inflammatory processes become chronic. Lost lung function doesn't return.
The psychological burden is also enormous. Many sufferers report depression, anxiety disorders, and a feeling of powerlessness. "You feel like you're being punished for something you have no control over," says a 49-year-old asthmatic woman from Welzow. "I was born here, I lived here, and now I'm paying the price."
Recognition of an occupational illness is difficult. Only those who can prove that the exposure occurred in the workplace have a chance of receiving compensation. Residents who "only" lived there usually receive nothing. The causal link between environmental pollution and an individual's illness is legally difficult to prove.
How people today manage their lungs
In Lusatia, awareness of respiratory health is higher today than elsewhere. People pay attention to weather reports, not just for rain or sunshine, but also for air quality forecasts. Apps like "Air Quality" and regional warning systems are used extensively. On days with high levels of particulate matter, many affected individuals stay indoors and avoid physical exertion.
Air purifiers are common in homes. Many households have now purchased devices that filter fine dust and allergens. These devices run at full capacity, especially during the heating season when wood-burning stoves create additional particulate pollution.
Breathing techniques and pulmonary exercise have also become established. Physiotherapists offer special courses in which those affected learn how to optimally utilize their remaining lung capacity. Pursed-lip breathing, breathing-relieving positions, and controlled exertion – these are techniques that make everyday life easier.
Inhalation as a ritual
Inhalation therapy has become part of the daily routine for many sufferers. Morning and evening, they use a nebulizer with saline solution or medication. Some also use saline inhalers to keep the mucous membranes moist and support the self-cleaning of the bronchi.
In this context, mini-saltworks have also become established as a complementary measure – small graduation towers for home use that spray a fine salt mist. They are not medical devices and do not replace therapy, but they can offer gentle support in everyday life for people with irritated mucous membranes. Especially in the winter months, when dry air from heating systems puts additional strain on the respiratory tract, some sufferers use such devices to make the indoor climate more breathable.
The future of the lungs: What comes after coal?
Lusatia will be coal-free by 2038 – perhaps even sooner. The power plants will be decommissioned, the open-cast mines closed, and the recultivation completed. Air quality will continue to improve, and emissions will be reduced to a minimum. This is good news for future generations.
For the people living with the consequences today, little will change. Their lungs won't get healthier just because the power plants are shut down. Their COPD won't disappear, their asthma won't cure. They will still need medication, oxygen equipment, and therapies. They will still go for checkups, worry with every cold, and fear that every infection will make things worse.
Medical research is working on new therapies: biologics that specifically inhibit inflammatory processes, and regenerative approaches that could repair lung tissue. However, these therapies are expensive, often still experimental, and inaccessible to many patients.
What's realistic is stabilization. Preventing it from getting worse. Preserving the remaining lung function. And hoping that at least the next generation can breathe a sigh of relief – in the truest sense of the word.
A region learns to breathe
Today, Lusatia is a region slowly learning to breathe deeply again. The air is becoming clearer, the future greener, hope greater. But the legacy remains in the lungs of its people – an invisible archive of dust, pollutants, and decades of exposure.
The history of Lusatia is also a story about the right to clean air, about the costs of progress, about who pays when industries disappear and diseases remain. It is a story that is not yet over – because it lives on in every breath, today, tomorrow, and in the years to come.
