The Public Health Benefits of Smokey Coal Ban – and today’s challenges – Prof Luke Clancy
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Transcript of The Public Health Benefits of Smokey Coal Ban – and today’s challenges – Prof Luke Clancy
The Public Health Benefits of Smokey
Coal Ban -and todays challenges
Prof Luke Clancy
Director General
TobaccoFree Research Institute Ireland
Clean Air Conference 2015 Sept 28th
Wood Quay Venue Dublin City Council 1
Improving Air Quality
Ambient Outdoor
Dublin Smog- 1990
Ban on sale ,marketing and distribution of bituminous coal-
SI 1st September 1990
Indoors Public Places
Smoke filled Pubs- 29th March 2004
Public Health (Tobacco) (Amendment) Act 2004
(Commencement) Order 2004.
Smogfree Ireland 1990-2015
Prof Luke Clancy, Director General
TobaccoFree Research Institute Ireland
8
Dublin 1982 Case Fatality Rates
Kelly I. and Clancy Luke, Irish Medical Journal; 77:10: 322-324.
1984
CFR
2
3
4
5
6
7
8
9
10
Jan '80 Jan '81 Jan '82 Jan '83
Date
Dublin Borough
0
200
400
600
800
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31
January 1982
Bla
ck S
mo
ke (
ug
/m3)
15
20
25
30
35
40
Death
sDeaths
Black
Smoke
10
DUBLIN 1982
The SMOG event was associated with a cold spell of
weather with a temperature inversion.
This event was 30 years after the infamous London
1952 episode.
Mortality in a general hospital and
urban air pollution.
Kelly I, Clancy L Ir Med J. 1984 Oct; 77(10):322-4.
Data Points
Individual stations recorded BS levels up to
1400 micrograms/m3 during the SMOG
Mortality average of 16 deaths/day for Jan
22 deaths/day in SMOG episode
Max 38 deaths on 14th Jan
Discussion
Half of the Cardiovascular excess mortality occurred during the week of the
SMOG
Two thirds of the excess Respiratory Mortality occurred after the SMOG had
subsided.
The Dublin SMOG event gave rise to about 33 excess deaths per 100,000 of
population (London 1952 approx. 47).
Conclusions Air quality in Dublin is not the problem some
commentators would have us believe.
The cost of the introduction of a smokeless zone policy could involve the expenditure of £180,000,000.
The scientific evidence about the effects of smokeless zones on Dublin’s air quality is most uncertain as the basic research has yet to be carried out - no Urban Air Pollution Dispersion Model exists for Dublin.
ACKNOWLEDGEMENTS
Geoffrey J. Bourke, M.D., F.R.C.P.I., Professor of Community Medicine andEpidemiology, University College, Dublin.
Frank J. Convery, Heritage Trust Professor of Environmental Studies,University College, Dublin.
W.J.R. Couchman F.R.S.H., F.I.D.H.E., Couchman & Associates,Consulting Engineers, Foxrock, Dublin 18.
John Kelly, B.E., Ph.D., Dean of Faculty of Engineering &Architecture, University College, Dublin.
Hugh Munro, B.E. C.Eng., F.I.E.I., F.C.I.B.S., Consulting Engineer,56 Tritonville Road, Dublin 4.
Peter Skrabanek, Ph.D., Lecturer in Community Medicine, TrinityCollege, Dublin.
National Coal Board, London and Glasgow.
In compiling this casebook we wish to gratefully acknowledge the
contributions made by the following people and organisations
Dublin Black Smoke levels before and after
the intervention
Black Smoke
0
20
40
60
80
100
120
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
m g/m
3
Excess mortality (1982 SMOG event against average 1980-1996)
Respiratory Cardiovascular Total (Weekly data)
33 (122%) 34 (65%) 83 (73%)
(Monthly data)
91 (77%) 71 (30%) 172 (34%)
Effect of air-pollution control on death rates
in Dublin, Ireland: an intervention study.
Clancy L, Goodman P, Sinclair H, Dockery DW.
Lancet. 2002 Oct 19;360(9341):1210-4.
Cause-specific mortality and the extended effects of particulate
pollution and temperature exposure.
84-90
90-96
84-90
90-96
84-90
90-96
84-90
90-96
Dublin
7.0
8.0
9.0
10.0
11.0
De
ath
s p
er
10
00
PY
r
Dublin Death Rate Before and After Ban
Summer
Autumn
Winter
Spring
Improving Air Quality
• Dublin Smog- 1990
Ban on sale ,marketing and distribution of bituminous coal-
SI 1st September 1990
• Smoke filled Pubs- 29th March 2004
Public Health (Tobacco) (Amendment) Act 2004
(Commencement) Order 2004.
Smokefree Ireland 2004-2014 A global leader in Tobacco Control
Prof Luke Clancy, Director General
TobaccoFree Research Institute Ireland
Smokefree Outcome Measurements
SHS Exposure Particles PM2.5, PM10
Benzene
Nicotine
Health Effects
Respiratory Symptoms
Sensory irritation Symptoms
PFT measurements, (FEV1, FVC, P.F)
Carbon Monoxide, Cotinine
Result: Average PM2.5 Levels
Pre Ban Range: 3.2 to 315.1 (mgm-3) Post Ban Range: 21.4 to 0.6 (mgm-3)
Benzene 18.8(14) 3.72(1.6) -80.2% P<0.01
0.0
10.0
20.0
30.0
40.0
Pre Ban Post Ban
35.5
5.8
Mic
rog
ram
s/m
3
Time of Monitoring
Average PM2.5 Levels (42 pubs)
Outcome measures-Mortality
Reduction in
• IHD
•COPD and
•STROKE
3,726 fewer smoking-related deaths over a 4 yr. period
It has reduced Health Inequalities in Ireland
Understanding Advocacy Roles
Governments/Institutions adopt policies in a climate of public readiness
Public health advocates need to shift public opinion in the right direction
Political action becomes compelling
Political inaction becomes a liability
CONCLUSIONS
The ban on smoky coal in Dublin was an immediate success.
It has helped to safeguard health by reducing exposure to the harmful effects of outdoor air
pollution
It has reduced Cardiovascular, Cerebrovascular
and Respiratory Mortality in the general population