The development of thermal power engineering significantly affects the environmental parameters of the environment, primarily the state of atmospheric air. The active operation of thermal power plants operating on solid fuels leads in terms of pollutant emissions and the impact on public health. Almaty is a metropolis, which is characterized by a very high level of environmental pollution. The purpose of the work is to study and analyse the factors of atmospheric air pollution from heat and power enterprises using coal fuel and the consequences for public health. The research was carried out using general scientific methods of cognition, in particular, system analysis, synthesis, abstraction, deduction, generalization, and concretization. In the course of the study, the ecological state of the atmospheric air of the city of Almaty was analysed, the algorithm and results of analytical control of the state of atmospheric air were presented, the dynamics of the air pollution index in this region was presented over time, and optimal and realistic measures for implementation were developed to reduce the impact of thermal power engineering on the state of air and public health, improve the overall environmental situation. The possibilities of applying modern management and technological measures to minimize pollutant emissions based on the synergy of environmental safety and energy efficiency, with the introduction of modern innovative systems for controlling and monitoring environmental pollution, were also studied. The results of the study are of significant practical importance for the development and modernization of heat and power enterprises in Kazakhstan using coal as fuel, and can also be used as an effective tool for further analysis of the risks of diseases associated with emissions from coal combustion.