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Biomedical subjects

Luke Clancy

Publications and source records attributed to Luke Clancy.

6 recordsLinked to original sources

Effects of the Irish smoking ban on respiratory health of bar workers and air quality in Dublin pubs.

BACKGROUND: Environmental tobacco smoke (ETS) causes disease in nonsmokers. Workplace bans on smoking are interventions to reduce exposure to ETS to try to prevent harmful health effects. On March 29, 2004, the Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants. This study examines the impact of this legislation on air quality in pubs and on respiratory health effects in bar workers in Dublin. METHODS: Exposure study. Concentrations of particulate matter 2.5 microm or smaller (PM(2.5)) and particulate matter 10 microm or smaller (PM(10)) in 42 pubs were measured and compared before and after the ban. Benzene concentrations were also measured in 26 of the pubs. Health effects study. Eighty-one barmen volunteered to have full pulmonary function studies, exhaled breath carbon monoxide, and salivary cotinine levels performed before the ban and repeated 1 year after the ban. They also completed questionnaires on exposure to ETS and respiratory symptoms on both occasions. FINDINGS: Exposure study. There was an 83% reduction in PM(2.5) and an 80.2% reduction in benzene concentration in the bars. Health effects study. There was a 79% reduction in exhaled breath carbon monoxide and an 81% reduction in salivary cotinine. There were statistically significant improvements in measured pulmonary function tests and significant reductions in self-reported symptoms and exposure levels in nonsmoking barmen volunteers after the ban. CONCLUSIONS: A total workplace smoking ban results in a significant reduction in air pollution in pubs and an improvement in respiratory health in barmen.

Adult↗

Short-term effects of ambient particles on cardiovascular and respiratory mortality.

BACKGROUND: Particulate air pollution is associated with increased mortality. There is a need for European results from multicountry databases concerning cause-specific mortality to obtain more accurate effect estimates. METHODS: We report the estimated effects of ambient particle concentrations (black smoke and particulate matter less than 10 mum [PM10]) on cardiovascular and respiratory mortality, from 29 European cities, within the Air Pollution and Health: a European Approach (APHEA2) project. We applied a 2-stage hierarchical modeling approach assessing city-specific effects first and then overall effects. City characteristics were considered as potential effect modifiers. RESULTS: An increase in PM10 by 10 microg/m (lag 0 + 1) was associated with increases of 0.76% (95% confidence interval = 0.47 to 1.05%) in cardiovascular deaths and 0.58% (0.21 to 0.95%) in respiratory deaths. The same increase in black smoke was associated with increases of 0.62% (0.35 to 0.90%) and 0.84% (0.11 to 1.57%), respectively. CONCLUSIONS: These effect estimates are appropriate for health impact assessment and standard-setting procedures.

Air Pollutants↗

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

Air pollution exposure studies in the past decade have focused on acute (days) or long-term (years) effects. We present an analysis of medium-term (weeks to months) exposure effects of particulate pollution and temperature. We assessed the associations of particulate pollution (black smoke) and temperature with age-standardized daily mortality rates over 17 years in Dublin, Ireland, using a polynomial distributed lag model of both temperature and particulate air pollution simultaneously through 40 days after exposure. When only acute effects (3-day mean) were considered, we found total mortality increased by 0.4% for each 10-microg/m3 increase in black smoke concentration. When deaths in the 40 days after exposure were considered, we found a 1.1% increase. For respiratory mortality, the estimated effect was 0.9% for acute exposures, but 3.6% for the extended follow-up. We found each increase in current-day temperature by 1 degree C was associated with a 0.4% increase in total mortality, whereas each decrease of 1 degree C was associated with a 2.6% increase in mortality in the following 40 days. For both temperature and pollution, the largest effects on cardiovascular mortality were observed immediately, whereas respiratory mortality was delayed and distributed over several weeks. These effects were two to three times greater than the acute effects reported in other studies, and approach the effects reported in longer-term survival studies. This analysis suggests that studies on the acute effects of air pollution have underestimated the total effects of temperature and particulate air pollution on mortality.

Adolescent↗

Effect of air-pollution control on death rates in Dublin, Ireland: an intervention study.

BACKGROUND: Particulate air pollution episodes have been associated with increased daily death. However, there is little direct evidence that diminished particulate air pollution concentrations would lead to reductions in death rates. We assessed the effect of air pollution controls--ie, the ban on coal sales--on particulate air pollution and death rates in Dublin. METHODS: Concentrations of air pollution and directly-standardised non-trauma, respiratory, and cardiovascular death rates were compared for 72 months before and after the ban of coal sales in Dublin. The effect of the ban on age-standardised death rates was estimated with an interrupted time-series analysis, adjusting for weather, respiratory epidemics, and death rates in the rest of Ireland. FINDINGS: Average black smoke concentrations in Dublin declined by 35.6 mg/m(3) (70%) after the ban on coal sales. Adjusted non-trauma death rates decreased by 5.7% (95% CI 4-7, p<0.0001), respiratory deaths by 15.5% (12-19, p<0.0001), and cardiovascular deaths by 10.3% (8-13, p<0.0001). Respiratory and cardiovascular standardised death rates fell coincident with the ban on coal sales. About 116 fewer respiratory deaths and 243 fewer cardiovascular deaths were seen per year in Dublin after the ban. INTERPRETATION: Reductions in respiratory and cardiovascular death rates in Dublin suggest that control of particulate air pollution could substantially diminish daily death. The net benefit of the reduced death rate was greater than predicted from results of previous time-series studies.

Adolescent↗