The call for NSW Health to immediately undertake an epidemiological assessment of the health of residents near coal ash dams was among 16 recommendations contained in the recently released report Costs for remediation of sites containing coal ash repositories.

About 200 million tonnes of coal ash waste is currently dumped in unlined sites across NSW, with more than half of the material stored in the Hunter and Central Coast.

Existing studies show the material, which is growing at at rate of 3.8 million tonnes a year, contains heavy metals - including mercury, lead, arsenic, selenium and chromium.

In addition to being a significant contributor to water, soil and air pollution, there are also concerns it may impact on human health.

Charlestown-based GP Kathleen Wild said research from the United States pointed to an increase in illnesses such as asthma and lung disease and possibly ADHD due to exposure to coal ash.

"Often when we are talking about the safety of being exposed to this kind of stuff we just don't have the information in the Australian context to say that this stuff (illness) doesn't happen," Dr Wild, a member of Doctors for the Environment, said.

"We have a lot of data about what is in the air but a lot of the time we don't have a lot of information about what happens to the people.

"I think a health study is the next logical step from tracking the fact that this pollution is happening to what is happening to real people."

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The parliamentary committee has recommended that the health study be published by December 31, 2022.

The tight turnaround means it would not be possible to conduct a real time study such as the one being done to determine the health impacts of exposure to PFAS in the Red Zone near Williamtown.

However, Dr Wild said there were other study options that would allow health data to be examined retrospectively.

"We know that exposure to pollution is more than the sum of its parts," she said.

"You need to stand back and look at those populations around Lake Macquarie and ask what is their burden of lung disease or ADHD and see if it can be explained by some of these exposures."

Coal ash community alliance member Gary Blaschke said the health of communities in regions surrounding all ash dams had been swept under the carpet for decades.

"The committee's report notes that there has been little research on the impacts and long-term health consequences on surrounding communities, despite previous independent reports into high rates of childhood asthma over three decades and cancer clusters being officially 6 per cent above the NSW average," he said.

"We can only hope that whoever conducts the epidemiological assessment is independent from the authorities who have let us down for decades."

NSW Health is yet to indicate whether it will support the committee's recommendation.

The committee's final report notes there are divergent views about the potential health impacts of coal ash.

"Community members, environmental groups and health professionals argued coal ash should be treated as hazardous waste material given the significant environmental and health risks it poses and has caused," Committee chairman Daniel Mookhey MLC wrote.

"In contrast, industry representatives and power station operators commented that there were technical processes that could be carried out, but are not currently, to make coal ash non-toxic and inert."

Environmental Justice Australia lawyer and author of Unearthing Australia's toxic coal ash legacy Bronya Lipski said communities across Australia had been put at risk by the poor regulation of coal ash.

"Its comments acknowledge the risks posed by these enormous toxic sites and the need to protect human and environmental health, but they are merely a starting point," she said.

"We welcome the recommendation for NSW Health to immediately undertake an epidemiological assessment of the health of residents near coal ash dams to establish the health impacts of coal ash and publish by 31 December 2022.

"Yet the committee falls short of making robust recommendations to rectify the problems it identifies. It missed an opportunity to detail best practice laws and has disappointed community expectations on what this inquiry would deliver.

Hunter Community Environment Centre estimates about 100 tonnes of metal pollutants from coal-ash leach into waterways in the region each year. This includes 40 tonnes from AGL's Bayswater and Liddell power stations.

As part of last year's inquiry, the NSW EPA gave an undertaking to investigate the potential environmental impacts of coal-ash waste dumps in Lake Macquarie.

The site-specific environmental and operational circumstances of each power station will be considered as part of the review.

It follows a recent review of air emissions monitoring data and licensing requirements for all coal fired power stations in NSW, tightening emission limits and strengthening monitoring and reporting requirements.

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