An influential South African government agency recommended the country phase out coal-fired power stations on Thursday as it published a ten-year study which found that people living near them were 6% more likely to die than their peers elsewhere.

South African officials and citizens are debating whether and how fast the country should embark on a partly donor-funded programme to switch to sun and wind energy from coal. The fossil fuel provides three quarters of national power and employs 90 000 people in jobs unions are fighting hard to protect.

The report by the South African Medical Research Council (SAMRC) and Britain's Department for International Development (DFID) collected nearly three-million death certificates from 1997 to 2018 and compared them with air quality data nationwide.

It found higher birth defects and higher death rates among all ages in communities adjacent to the power stations -- especially from cardiovascular and lung disease.

"Some recommendations are ... that power stations could be decommissioned," co-author Caradee Wright said, presenting the report's findings in the capital Pretoria.

"We realize ... that's not going to happen immediately," she said. "But ... (coal-fired power) does have such a negative impact on human health."

Wright also called for more stringent enforcement of harmful emissions limits in South Africa's coal belt, home to some 3.6-million people.

The African National Congress-led government, which is divided over the future of the country's coal-fired power plants, often grants waivers from the limits to state power company Eskom and coal-to-liquid fuel producer Sasol.