China's coal industry has hidden annual costs of $250bn (£159bn) in terms of damage to health and the environment, a report by Chinese experts says.
The report said pollution affected water, land and air around mines.
It also said the burning of coal led to emissions of mercury and acid rain, and mining accidents killed nearly 3,800 people and injured many more in 2007.
The report said coal prices would have to rise by around 25% to reflect the true cost to Chinese society.
The report was prepared over three years by Chinese economists and environmentalists.
The country is the world's biggest coal producer and consumer.
"Behind China's large production and consumption of coal... lie expensive and worrying environmental and social costs," the report said.
"Currently these costs are paid by the people in China suffering from the damage," said Mao Yushi of the Unirule Institute of Economics, a co-author of the report.
The authors calculated the figure by considering the lost income from people made ill by coal pollution as well as the cost of their care.
Coal's role in climate change, including the loss of farmland through desertification and water shortages for irrigation, was also calculated.
"Recognising the true cost of coal would create incentives to developing cleaner, sustainable energy sources," said Yang Ailun, climate and energy campaign manager at Greenpeace.
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