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US Six Cities and Relevance
for Clean Air Policy in Ireland
Clean Air Conference 2015
September 28, 2015
Wood Quay Venue, ...
Dublin Coal Ban
 On September 1, 1990, the
marketing, sale, and distribution of
bituminous coals was banned
within the ci...
0
20
40
60
80
100
120
140
µg/m3
Dublin Black Smoke
Ban on Coal Sales
14.6 µg/m3
50.2 µg/m3
Bans on
Coal Sales
September 1, 1990
-Dublin
October 1, 1995
-Cork
October 1, 1998
-Limerick
-Dundalk
-Drogheda
-Wexford
-...
98th percentiles of Daily Black Smoke
Concentrations in Major Urban Areas
Air Quality in Ireland 2010; Key Indicators of A...
What are the effects of
repeated, long term
exposures to Fine Particles?
Satellite-Derived PM2.5:
2001–2006 Average
Von Donkelaar et al Envir Hlth Pers 2010;118:847
Six Cities Adult Mortality Study
 Random sample of
8411 adults in six
cities
 Dirty: Steubenville,
OH & St. Louis, MI
 ...
Follow-up
Six Cities Adult Mortality Study
 Random sample of
8411 adults in six
cities
 Dirty: Steubenville,
OH & St. Louis, MI
 ...
Six Cities Adult Mortality
0.7
0.8
0.9
1.0
1.1
1.2
1.3
1.4
0 10 20 30 40
PM2.5 (µg/m3
)
MortalityRiskRatio
Steubenville
To...
Six Cities Mortality Follow-up
 1974 to 1989 follow-up
 Annual returned
postcards and
National Death Index
 1,364 death...
Six Cities Cohort Follow-up
Laden et al, AJRCCM 2006;54:709
0.7
0.8
0.9
1.0
1.1
1.2
1.3
1.4
0 5 10 15 20 25 30 35
PM2.5 (µ...
Can we see effect of air
pollution controls in US?
Age-adjusted death rates: United States, 1960-2005
600
800
1,000
1,200
1,400
Rateper100,000population
1970 1980 1990
Age-a...
County life expectancies at birth for white males
and females;1997–2001
CJL Murray et al, Eight Americas: Investigating Mo...
Trends in the Levels of the Six Criteria Pollutants
Relative to U.S. National Standards: 1980 - 2006
51 Metropolitan areas (dots); Study Counties (shaded gray)
Life Expectancy vs PM2.5
1978-82
71
72
73
74
75
76
77
78
79
80
81
5 10 15 20 25 30 35
PM2.5 (µg/m3
)
LifeExpectancy
Steube...
Life Expectancy vs PM2.5
1997-2001
71
72
73
74
75
76
77
78
79
80
81
5 10 15 20 25 30 35
PM2.5 (µg/m
3
)
LifeExpectancy
Top...
Life Expectancy vs PM2.5
1980-2000
71
72
73
74
75
76
77
78
79
80
81
5 10 15 20 25 30
PM2.5 (µg/m3
)
LifeExpectancy
Topeka
...
Life Expectancy vs PM2.5
1980-2000
71
72
73
74
75
76
77
78
79
80
81
5 10 15 20 25 30
PM2.5 (µg/m
3
)
LifeExpectancy
Pope, ...
71
72
73
74
75
76
77
78
79
80
81
5 10 15 20 25 30
LifeExpectancy
PM2.5 (µg/m3)
Coleraine St
PM2.5 9.7 µg/m3
↓
2012 Life Ex...
Black Smoke Before and After Bans
Goodman et al, JAWMA 2009
71
72
73
74
75
76
77
78
79
80
81
5 10 15 20 25 30 35
LifeExpectancy
PM2.5 (µg/m3)
CORK
Black Smoke
Pre-Ban
32.4 µg/m3
↓
↑
...
65
67
69
71
73
75
77
79
81
0 10 20 30 40 50
LifeExpectancy
PM2.5 (µg/m3)
1984-90
50.2 µg/m3
↑
1990-96
14.6 µg/m39.0 yr
Imp...
0 2 4 6 8 10
Galway
Celbridge
Leixlip
Naas
Waterford
Limerick
Dundalk
Drogheda
Arklow
Cork
Dublin
2000Ban1998Ban
1995
Ban
...
How big is 3.5 year increase in life
expectancy?
 68 year old nonsmoking male
 Additional life expectancy
15.5 years
 A...
How big is 3.5 year increase in life
expectancy in population of Ireland?
 Tobacco Smoking
 6.8 years reduced life expec...
Conclusions
 PM2.5 associated significant life
shortening (mortality)
 Improved air quality leads to
measurably improved...
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US Six Cities and Relevance for Clean Air Policy in Ireland

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Presentation given by Prof. Doug Dockery at the 2015 Clean Air Conference, 28/09/15, Dublin

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US Six Cities and Relevance for Clean Air Policy in Ireland

  1. 1. US Six Cities and Relevance for Clean Air Policy in Ireland Clean Air Conference 2015 September 28, 2015 Wood Quay Venue, Dublin Douglas W. Dockery Professor of Environmental Epidemiology Harvard School of Public Health
  2. 2. Dublin Coal Ban  On September 1, 1990, the marketing, sale, and distribution of bituminous coals was banned within the city of Dublin (Air Pollution Act, 1987).
  3. 3. 0 20 40 60 80 100 120 140 µg/m3 Dublin Black Smoke Ban on Coal Sales 14.6 µg/m3 50.2 µg/m3
  4. 4. Bans on Coal Sales September 1, 1990 -Dublin October 1, 1995 -Cork October 1, 1998 -Limerick -Dundalk -Drogheda -Wexford -Arklow
  5. 5. 98th percentiles of Daily Black Smoke Concentrations in Major Urban Areas Air Quality in Ireland 2010; Key Indicators of Ambient Air Quality DUBLIN CORK 1990 Ban 1995 Ban 1998 Ban
  6. 6. What are the effects of repeated, long term exposures to Fine Particles?
  7. 7. Satellite-Derived PM2.5: 2001–2006 Average Von Donkelaar et al Envir Hlth Pers 2010;118:847
  8. 8. Six Cities Adult Mortality Study  Random sample of 8411 adults in six cities  Dirty: Steubenville, OH & St. Louis, MI  Moderate: Watertown, MA & Harriman, TN  Clean: Topeka, KS & Portage, WI  Enrolled 1974-77  14-16 years of mortality follow-up Dockery et al, NEJM 1993;329:1753
  9. 9. Follow-up
  10. 10. Six Cities Adult Mortality Study  Random sample of 8411 adults in six cities  Dirty: Steubenville, OH & St. Louis, MI  Moderate: Watertown, MA & Harriman, TN  Clean: Topeka, KS & Portage, WI  Enrolled 1974-77  14-16 years of mortality follow-up Dockery et al, NEJM 1993;329:1753
  11. 11. Six Cities Adult Mortality 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 0 10 20 30 40 PM2.5 (µg/m3 ) MortalityRiskRatio Steubenville Topeka Watertown Kingston St. Louis Portage EPA NAAQS
  12. 12. Six Cities Mortality Follow-up  1974 to 1989 follow-up  Annual returned postcards and National Death Index  1,364 deaths  104,243 person years  PM2.5 measurements 1979-1986  1990 to 1998 follow-up  National Death Index search  1,368 deaths  54,735 person years  PM2.5 estimated from PM10 1990-1998 Laden et al, AJRCCM 2006;54:709
  13. 13. Six Cities Cohort Follow-up Laden et al, AJRCCM 2006;54:709 0.7 0.8 0.9 1.0 1.1 1.2 1.3 1.4 0 5 10 15 20 25 30 35 PM2.5 (µg/m 3 ) MortalityRiskRatio Steubenville Topeka Watertown Kingston St. Louis Portage Improved air quality leads to reduced mortality
  14. 14. Can we see effect of air pollution controls in US?
  15. 15. Age-adjusted death rates: United States, 1960-2005 600 800 1,000 1,200 1,400 Rateper100,000population 1970 1980 1990 Age-adjusted 1960 0 2000 2005
  16. 16. County life expectancies at birth for white males and females;1997–2001 CJL Murray et al, Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States. PLoS Med. 2006 Sep;3(9):e260
  17. 17. Trends in the Levels of the Six Criteria Pollutants Relative to U.S. National Standards: 1980 - 2006
  18. 18. 51 Metropolitan areas (dots); Study Counties (shaded gray)
  19. 19. Life Expectancy vs PM2.5 1978-82 71 72 73 74 75 76 77 78 79 80 81 5 10 15 20 25 30 35 PM2.5 (µg/m3 ) LifeExpectancy Steubenville Topeka Boston EPA NAAQS Pope, Ezzati, Dockery. NEJM 2009; 360:376
  20. 20. Life Expectancy vs PM2.5 1997-2001 71 72 73 74 75 76 77 78 79 80 81 5 10 15 20 25 30 35 PM2.5 (µg/m 3 ) LifeExpectancy Topeka Boston Steubenville EPA NAAQS Pope, Ezzati, Dockery. NEJM 2009; 360:376
  21. 21. Life Expectancy vs PM2.5 1980-2000 71 72 73 74 75 76 77 78 79 80 81 5 10 15 20 25 30 PM2.5 (µg/m3 ) LifeExpectancy Topeka Pope, Ezzati, Dockery. NEJM 2009; 360:376
  22. 22. Life Expectancy vs PM2.5 1980-2000 71 72 73 74 75 76 77 78 79 80 81 5 10 15 20 25 30 PM2.5 (µg/m 3 ) LifeExpectancy Pope, Ezzati, Dockery (NEJM 2009) EPA NAAQS Health benefits below current NAAQS CAFE Stage I Limit Value CAFE Stage II Limit Value
  23. 23. 71 72 73 74 75 76 77 78 79 80 81 5 10 15 20 25 30 LifeExpectancy PM2.5 (µg/m3) Coleraine St PM2.5 9.7 µg/m3 ↓ 2012 Life Expectancy 80.9 year 1990 Life Expectancy 74.8 year What would these results say about air pollution in Ireland? PM2.5 in 1990?
  24. 24. Black Smoke Before and After Bans Goodman et al, JAWMA 2009
  25. 25. 71 72 73 74 75 76 77 78 79 80 81 5 10 15 20 25 30 35 LifeExpectancy PM2.5 (µg/m3) CORK Black Smoke Pre-Ban 32.4 µg/m3 ↓ ↑ Post-Ban 17.2 µg/m3 3.8 yr Implications of US data for Cork?
  26. 26. 65 67 69 71 73 75 77 79 81 0 10 20 30 40 50 LifeExpectancy PM2.5 (µg/m3) 1984-90 50.2 µg/m3 ↑ 1990-96 14.6 µg/m39.0 yr Implications of US data for Dublin?
  27. 27. 0 2 4 6 8 10 Galway Celbridge Leixlip Naas Waterford Limerick Dundalk Drogheda Arklow Cork Dublin 2000Ban1998Ban 1995 Ban 1990 Ban Estimated Extra Years Life Expectancy Implications of US data? Median 3.5 yrs
  28. 28. How big is 3.5 year increase in life expectancy?  68 year old nonsmoking male  Additional life expectancy 15.5 years  Additional 3.5 years life expectancy  19.0 years +
  29. 29. How big is 3.5 year increase in life expectancy in population of Ireland?  Tobacco Smoking  6.8 years reduced life expectancy for average smoker (Streppel et al, Tob Cont 2007)  31% Current Smoking in Ireland(2009) (Special Eurobarometer 332)  6.8 yr among 31% of population  2.1 yr longer life expectancy in population  Diabetes  7.8 years for men, 8.4 years for women (Fromer et al, Arch Int Med 2007)  4.7% Diabetes Mielitus in Ireland (2005) (Institute of Public Health in Ireland, 2006.)  8 yr among 4.7% of population  0.4 yr longer life expectancy in population  Fine particle air pollution  Median 3.5 years for reduction in Black Smoke due to ban  100% of population affected  3.5 yr longer life expectancy in population
  30. 30. Conclusions  PM2.5 associated significant life shortening (mortality)  Improved air quality leads to measurably improved public health  Benefits at all levels of air pollution  Even in clean communities  Ireland likely has substantially longer life expectancy due to ban on coal sales

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