The northeastern industrial town of Tuzla is among the ten most polluted cities of Europe in 2018, according to the World Health Organisation (WHO).

Along with Macedonia’s northwestern town of Tetovo, Tuzla found itself on WHO’s list of the places with the largest concentration of toxic particles in the air. The population of these towns heavily relies on coal for heating purposes, but older vehicles are also a strong contributor to the pollution, Reuters reported.

According to WHO, the high pollution claims 1,350 people annually in Macedonia.