Many power plants built prior to 1970 in the Ohio River Valley were grandfathered under the Clean Air Act and have never been upgraded to meet today's environmental standards. And because in part they don't have to meet tighter air quality standards in the East, utilities continue to site plants here.

Coal-fired power plants are the largest known contributor to hazardous air pollutants. At least 67 air toxins are released; most are known or suspected carcinogens and neurotoxins. Not coincidentally, West Virginia has the highest rate of death from power plant pollution in the U.S. That pollution doesn't stay put: tall smokestacks assure its delivery to the East Coast and Canada.