After losing four relatives to respiratory illnesses, Zeina Matar fled her hometown north of the Lebanese capital, where she says a decaying power plant produces little electricity but very deadly pollution.

Thick black smoke sometimes rises from its red-and-white chimneys, leaving a gray haze in the air over the Zouk Mikael industrial estate, where toxins from a nearby mountain range remain trapped.

Zeina, 40, says she lost her younger sister and a cousin to pulmonary fibrosis and two of her uncles died of lung cancer years earlier.

They all lived near the plant, where experts and local residents say air pollution means people are more likely to get cancer and respiratory diseases than anywhere else in the crisis-hit country.

“We could die tomorrow,” said Zeina, who has relocated to southern Lebanon to escape the plant’s emissions.

A Greenpeace study found that the surrounding Jounieh area ranks fifth in the Arab world and 23rd globally among cities most polluted with nitrogen dioxide, a dangerous pollutant released when fuel is burned.

The environmental group’s 2018 study cited the Zouk plant, built in the 1940s, as well as cars on a busy highway and private power generators as the top contributors to pollution.

The walls of Zeina’s balconies at her old home in Zouk Mikael are blackened by smoke, and the laundry she used to hang outside is being damaged by toxic chemicals emanating from the plant, she said.

“Whenever they refilled the station with heating oil, we closed the windows,” Zeina said. “The smell is unbearable.”

The Lebanese economy has been in freefall since a financial crisis in late 2019, and the authorities can now barely afford more than an hour of grid electricity a day.

Zouk Mikael’s plant, one of the country’s largest, is now running at minimal capacity, if it is operational at all, but its emissions are still causing high rates of lung disease, experts warn.

Among them is Paul Makhlouf, a pulmonologist at Notre Dame du Liban hospital in Jounieh, who said he left his local home after noticing a rise in respiratory illness among patients.

In 2014, he found that lung disease among patients living near the plant had increased by three percent from the previous year, an annual increase he now estimates has doubled.

“When I saw the results, I moved from there,” he said. “I escaped.”

Makhlouf largely blames the type of fuel burned at the Zouk Mikael plant, which he says is high in sulfide and nitrous oxide – cancer-causing chemicals that attack the respiratory tract and skin.

To make matters worse, the seaside facility is at a low elevation and heavy smoke is trapped in the densely populated area of ??nearby mountains overlooking the Mediterranean Sea.

Pictures leaked online last month showing thick black smoke billowing again from the Zouk plant as it burned low-grade fuel oil to produce just one hour of electricity that day.

The Department of Energy said the plant had been forced to use heavy fuel oil to “continue to power the airport, hospitals and other vital facilities.”

Since then, the system has been running mostly at night.

“Sometimes we wake up in the middle of the night to a loud noise”when the station comes on line and burns fuel oil, said Zeina’s 80-year-old aunt Samia, who still lives near the plant.