Cassel has been working on protecting communities from coal ash pollution for 15 years and said rain and hurricanes amplified by climate change have exacerbated these threats. And those who live near coal ash dumps, she said, continue to discover cancer at a rate that makes them think, “This cannot be normal.”

“EPA, you know the record,” Cassel said. “You made the record.”

Kristina Zierold, a professor at the University of Mississippi, said she has found that children exposed to coal ash are more likely to suffer from depression and have poorer school performance than children who aren’t exposed.

Zierold said she has been researching the health impacts of coal ash on children since 2011 and was awarded a National Institutes of Health grant in 2015 to investigate coal ash and neurobiological health in children 6 to 14 years old.

She and her research team utilized air pollution and dust sampling in the homes of children to collect coal ash and tested children for neurobehavioral and mental health conditions in multiple ways.

If a child performs poorly in school, that can have cascading effects through adulthood, Zierold said. Depression in children can lead to poor social interaction, lack of learning, and in some cases suicide, she said.

“Do you want your children playing on coal ash in parks and playgrounds?” Zierold asked. “Do you want them breathing it in and ingesting it? I don’t.”

Brianna Knisley, the director of public power campaigns at Appalachian Voices, said the 2008 Kingston Fossil Plant coal ash spill was one of the worst industrial disasters in US history. It’s an example of what happens when the EPA leaves coal ash management up to state regulators and utilities, she said.

The 900 workers who cleaned up the spill were denied protective gear and told the coal ash they were working to remove was clean enough to eat. Hundreds of workers became sick and dozens are dead, Knisley said.

Angie Mummaw, an organizer with Appalachian Voices who lives near the Cumberland Fossil Plant in Tennessee, said she’s tired of communities like hers being treated as sacrifice zones while the coal industry asks for permanent loopholes instead of cleaning up the messes they’ve created.

Knisley has worked with communities where coal ash was used to fill children’s ball fields and seen Tennessee Valley Authority waste piles of the toxic ash piled up behind a public playground, open to the wind. The Tennessee Valley Authority did not immediately respond to questions from Inside Climate News.

“This is coal ash management without strong federal regulation and enforcement,” Knisley said. “States and utilities are not going to keep communities safe.”

This article originally appeared on Inside Climate News, a nonprofit, non-partisan news organization that covers climate, energy, and the environment. Sign up for their newsletter here.