Effect of Air Pollution Control on Mortality in County Cork, Ireland

Abstract

ISEE-0562 Background and Objective: Previously, we reported reductions in black smoke concentration (−36 μg/m3) and 6–16% reductions in total non-trauma, cardiovascular, and respiratory mortality rates following a 1990 ban on the marketing, sale, and distribution of coal in Dublin, Ireland. We have now evaluated changes in mortality rates in County Cork following a similar coal ban in 1995, where a similar 16.5 μg/m3 reduction in black smoke concentration was observed. Methods: Using Poisson regression, we regressed weekly age/gender standardized mortality rates against an indicator of the post- versus pre-ban period (before and after October 1, 1995) adjusting for influenza epidemics, weekly mean temperature, and the Irish standardized mortality rates in the areas not affected by the 1990, 1995, 1998, or 2000 local bans on coal sales. Results: Compared to the pre-ban period, we found a significant reduction in the total, non-trauma mortality rate (−6% 95% CI = −9%, −5%) with larger reductions in the younger (<75 yrs) subjects (−14%; 95% CI = −16%, −11%), compared to those 75+ yrs (−5%; 95% CI = −7%, −3%). In analyses of broad ICD9 categories, we found significant reductions in the cardiovascular (−13%), respiratory (−8%), and ‘other cause’ (−7%) mortality rates. We also found significant 7–25% reductions in specific cardio-respiratory mortality rates including ischemic heart disease, ischemic stroke, pneumonia, COPD, and lung cancer. Conclusion: These reductions in cardio-respiratory mortality rates were similar in size to those seen in Dublin following the 1990 ban.