David V Bates

Abstract

Respiratory physiologist and leading epidemiologist who studied health effects of air pollution. Born in West Malling, UK, on May 20, 1922, he died of metastatic colorectal cancer on Nov 21, 2006, in Vancouver, British Columbia, Canada, aged 84 years. David Bates was a young doctor working in the UK at St Bartholomew's Hospital in 1952 when a cold fog descended on London for 4 days in December, followed by a thick sulphurous smoky fog. Unbeknown to him at the time, a coroner noted that the morgues were full. But in a city that had been subject to deadly bombings and attendant smoke, and was used to fogs, no one bothered to connect the cold fog—and resultant increase in the burning of coal—with the full morgues. “When I arrived at Bart's Hospital on 10 December 1952, everything was normal for that time of year. Our wards at that time of year always had a number of cases of advanced chronic obstructive pulmonary disease, many in outright heart failure”, Bates would later write in Environmental Health Perspectives. London was, however, also full of cigarette smokers breathing air polluted by low-quality, high-sulphur coal. During the next 2 months 12 000 people died as a result of this fog. The incident led to new laws on clean air, and it sparked Bates' interest in respiratory physiology. In 1956, he moved to McGill University, Montreal, Canada, where he studied the effects of ozone on the lung. He and his colleagues published seminal papers on ventilation and lung physiology, and on what happened in the lung when it was damaged by environmental pollutants. Jon Samet, professor of epidemiology at Johns Hopkins University, Baltimore, MD, USA, met him in the late 1970s. By then, Bates had shifted his focus to the epidemiology linking pollution and lung disease. “David was a key figure in beginning to understand how the lung was damaged by environmental agents like tobacco and air pollution and what the physiological effects are”, Samet said. “Then what made him intrigued was how populations are affected, so he moved onto epidemiology.” Bates joined the University of British Columbia in Vancouver as dean in 1972. He held that post until 1977. In the 1980s, he and Ronnie Sizto published two highly cited papers on air pollution and hospital admissions in southern Ontario, which they called “the acid summer haze effect”. A 1992 paper in Environmental Research on health indices of the adverse effects of air pollution and the question of coherence was also quite popular, Samet said, and influenced the US Environmental Protection Agency's standards. In 1991, Bates helped plan the University of Southern California Children's Health Study, a study of air pollution in southern California that he advised for 15 years. “He knew more about more aspects of the health effects of air pollution than anyone I knew”, said John Peters, who worked with him at the University of Southern California and is director of the university's division of environmental health. Bates was also a well-respected mentor. “He could tell you that you were wrong without making you feel bad”, Peters said. Bates was a “forceful advocate for environmental protection”, said Frank Speizer, professor of environmental science at Harvard School of Public Health, Boston, MA. He would urge others to go beyond the pure scientific papers and synthesise so that they could campaign for change. In 2003, he and Peters, along with colleagues, published one such paper in the American Journal of Public Health titled “Breathless in Los Angeles”. It concluded: “Our children deserve a visionary public health regulatory policy that addresses these challenges and protects them from sources of air pollution.” In the past few years, Bates co-edited a newsletter for the California Air Resources Board meant for the general public. Bates was known for the poetry he wrote and as a raconteur, including one anecdote, recalled Spezier, about how, when penicillin was being tested, Bates had the job of administering the shot, then collecting the participants' urine and carrying it back to the laboratory on his bicycle for analysis. He “kept an open and inquisitive mind both in science and in non-science”, Peters said. Bates is survived by his children, Andrew, Elizabeth, and Joanna, a senior associate dean in medical education at the University of British Columbia. His wife, Margaret Sutton, predeceased him.