Coal combustion generates almost 40% of world's electricity. However, it also produces 1.1 billion tons of coal combustion residues (CCR) annually, half of which end up in landfills. Although current regulations require proper lining and monitoring programs, the ubiquitous old, abandoned landfills are often not lined nor included in these programs. In addition, the total number of coal ash disposal sites and their status in the world is unknown. Therefore, this article reviews the environmental damage caused by CCR and three commonly used risk assessment methodologies: leaching assessment, groundwater assessment, and toxicity testing.

Leaching methods are usually the first step in coal ash risk assessment, however, a large number of methods with different parameters make a comparison of data difficult. Groundwater pollution is commonly detected near coal ash disposal sites, but other anthropogenic activities may also exist nearby. Therefore, multivariate statistical methods and isotope traces should be used to differentiate between different sources of pollution. So far, both stable (δ¹⁸O, δD, δ¹¹B, δ³⁴S, δ⁷Li) and radiogenic (⁸⁷Sr/⁸⁶Sr, ²⁰⁶Pb/²⁰⁷Pb) isotopes have been successfully used as coal ash pollution tracers. Coal ash also negatively affects biota, reduces the diversity of organisms, affects children's health, and increases the risk for developing various diseases. Toxicity studies are great for early screening of coal ash safety; however, they provide no insights into mechanisms causing the adverse effects.

Future directions are also proposed, such as the development of new ‘low-level’ detection methods for coal ash pollution and sustainable and selective method for recovery of critical elements.