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

9/1/2006 4

London 1952

6

9/1/2006 7

Daytime in Dublin Jan. 1982

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).

Oct 1985

“THE SITUATION HAS BEEN

EXAGGERATED”

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

1st SEPT 1990 Sale

Distribution

Marketing

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

Acknowledgements Pre-Ban

Micheal Bailey (Foras Forbartha)

John Gormley

Karen Dubsky (Irish Clean Air Group)

The People of Templeogue in Dublin, the people of Mahon in Cork

Frank McDonald (IT),David Hanley (Morning Ireland),Marian Finucane (Liveline)

Post-Ban

Doug Dockery and Pat Goodman