This document summarizes the public health impacts of policies banning smoky coal and smoke in indoor public places in Ireland. It discusses a 1990 ban on smoky coal in Dublin that reduced air pollution and associated excess mortality. A 2004 ban on smoking in pubs and other public places reduced secondhand smoke exposure by over 80% and led to 3,726 fewer smoking-related deaths over 4 years. The bans have helped protect public health by reducing exposure to outdoor air pollution and secondhand smoke.

1. 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

2. 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.

3. Smogfree Ireland 1990-2015
Prof Luke Clancy, Director General
TobaccoFree Research Institute Ireland

4. 9/1/2006 4
London 1952

6. 6

7. 9/1/2006 7
Daytime in Dublin Jan. 1982

8. 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

9. 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
BlackSmoke(ug/m3)
15
20
25
30
35
40
Deaths
Deaths
Black
Smoke

10. 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.

11. Mortality in a general hospital and
urban air pollution.
Kelly I, Clancy L
Ir Med J. 1984 Oct; 77(10):322-4.

12. 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

13. 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).

14. Oct 1985

15. “THE SITUATION HAS
BEEN
EXAGGERATED”

16. 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.

18. ACKNOWLEDGEMENTS
Geoffrey J. Bourke, M.D., F.R.C.P.I., Professor of Community Medicine and
Epidemiology, 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, Trinity
College, 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

19. 1st SEPT 1990
Sale
Distribution
Marketing

20. Dublin Black Smoke levels before and after
the intervention
Black Smoke
0
20
40
60
80
100
120
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
mg/m3

21. 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%)

22. 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.

23. Cause-specific mortality and the extended effects of particulate
pollution and temperature exposure.

24. 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
Deathsper1000PYr
Dublin Death Rate Before and After Ban
Summer
Autumn
Winter
Spring

25. 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.

27. Smokefree Ireland 2004-2014
A global leader in Tobacco Control
Prof Luke Clancy, Director General
TobaccoFree Research Institute Ireland

28. 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

29. 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
Micrograms/m3
Time of Monitoring
Average PM2.5 Levels (42 pubs)

30. 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

31. 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

32. 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

33. 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