A few hundred meters from the huge furnaces of the Chinese-owned Smedrevo steel mill in central Serbia, the village of Radinac is covered in thick red dust. Cancer rates have quadrupled in under a decade, and residents want the plant to clean up or shut down.
Zoran, 70, a throat cancer patient who speaks with a voice prosthesis after his larynx was removed, said residents must dry their laundry indoors and use vinegar to clean the dust from their cars.
"Water cannot wash it off," he said. "We do not go out. We do not dare."
According to data from the Smederevo public health body, which a watchdog called Tvrdjava obtained through a freedom of information request and shared with Reuters, the municipality of around 100,000 people reported 6,866 cancer cases in 2019, up from 1,738 in 2011.
The plant says it has invested 300 million euros in technology and pollution reduction since China's biggest steelmaker, Hesteel, bought it from the Serbian state for 46 million euros ($53 million) five years ago.
"We are all citizens of Smederevo.... Would we be working despite pollution, against ourselves and our children?" the plant's manager for environmental protection, Ljubica Drake, said in a statement to Reuters.
Three new production facilities will significantly reduce pollution after their completion in 2022, she said. It was "not correct" to conclude that higher cancer rates were caused by the plant's activities, she said, adding that the disease could be a result of NATO's bombing of Serbia in 1999 during a war in Kosovo.
But activists say the plant is an example of Chinese-owned industrial firms ignoring pollution standards.
Nikola Krstic, the head of Tvrdjava, an environmental group whose name means The Fort, said an analysis of the red dust in September showed high concentration of heavy metals.
"The air in the town is far below European standards for 120 days per year," he told Reuters. "Red dust is greasy, it sticks to lungs, makes breathing difficult."
China has invested billions of euros in Serbia, which is a candidate to join the EU but has an uneasy relationship with the West more than two decades after the wars that followed the breakup of Yugoslavia, and has pursued close ties with Beijing.
The authorities in Belgrade say they are prepared to challenge Chinese-owned companies over pollution.
In April, Serbia's authorities ordered China's Zijin Mining Group to temporarily halt some operations at the country's only copper mine over failure to comply with environmental standards. The mine said it would rectify all the problems swiftly, and it was permitted to reopen.
"Not only must polluters be fined, ... if they cannot reduce pollution ... they must halt operations," Zorana Mihajlovic, Serbia's mining and energy minister, told Reuters last week.