The public health risk of ionising radiation released from the coal-fired energy chain, 20 deaths (GW a)(-1), is about 18 times that of the nuclear energy chain, 1.1 deaths (GW a)(-1), in China. The main contributors to the fatality risk for the former are the public dose caused by the use of coal ash and the occupational exposure caused by radon and its progeny in coal mines. The total health risk (but excluding low probability/high consequence accidents) of the coal-fired energy chain, 57.1 deaths (GW a)(-1), is about 12 times of that of the nuclear energy chain, 4.6 deaths (GW a)(-1). The health risk of coal-fired energy chain could be significantly reduced if technique and management were improved. Even then the risk of the coal-fired energy chain is about 4.4 times that of the nuclear energy chain.