Effect of Air Pollution Control on Mortality and Hospital Admissions in Ireland

152 Pages·2013·6.48 MB·English

by  Health Effects Institute

R e s e a R c h R e p o R t
H E A L T H H E A L T H Effect of Air Pollution Control
EF F ECTS EF F ECTS on Mortality and Hospital
INSTITUTE INSTITUTE
Admissions in Ireland
101 Federal Street, Suite 500
Number 176
Boston, MA 02110, USA Douglas W. Dockery, David Q. Rich,
July 2013
[phone] Patrick G. Goodman, Luke Clancy,
www.healtheffects.org Pamela Ohman-Strickland, Prethibha George,
and Tania Kotlov
R e s e a R c h
R e p o R t
Number 176
July 2013
Includes a Commentary by the Institute’s Health Review Committee

Effect of Air Pollution Control on
Mortality and Hospital Admissions in Ireland
Douglas W. Dockery, David Q. Rich, Patrick G. Goodman, Luke Clancy,
Pamela Ohman-Strickland, Prethibha George, and Tania Kotlov
with a Commentary by the HEI Health Review Committee
Research Report 176
Health Effects Institute
Boston, Massachusetts
· ·
Trusted Science Cleaner Air Better Health
Publishing history: The Web version of this document was posted at www.healtheffects.org in July 2013.
Citation for document:
Dockery DW, Rich DQ, Goodman PG, Clancy L, Ohman-Strickland P, George P, Kotlov T. 2013.
Effect of Air Pollution Control on Mortality and Hospital Admissions in Ireland. Research Report
176. Health Effects Institute, Boston, MA.
© 2013 Health Effects Institute, Boston, Mass., U.S.A. Cameographics, Belfast, Me., Compositor. Printed by
Recycled Paper Printing, Boston, Mass. Library of Congress Number for the HEI Report Series: WA 754 R432.
Cover paper: made with at least 55% recycled content, of which at least 30% is post-consumer waste; free
of acid and elemental chlorine. Text paper: made with 100% post-consumer waste recycled content; acid free;
no chlorine used in processing. The book is printed with soy-based inks and is of permanent archival quality.
C O N T E N T S

About HEI vii
About This Report ix
Preface xi
HEI STATEMENT 1
INVESTIGATORS’ REPORT by Dockery et al. 3
ABSTRACT 3
INTRODUCTION 4
SPECIFIC AIMS 4
METHODS AND STUDY DESIGN 5
Study Area 5
Air Pollution Monitoring 8
Mortality Rates 8
Hospital Admissions 12
Period Definitions 16
Influenza Epidemics 16
Weather 16
STATISTICAL METHODS AND DATA ANALYSIS 16
Air Pollution 16
Mortality Analyses 16
Hospital Admissions 17
RESULTS 17
Air Pollution 17
Mortality 26
Hospital Admissions 42
DISCUSSION AND CONCLUSIONS 49
Air Pollution 49
Mortality 50
Hospital Admissions 54
Comparison with Other Studies 56
Conclusions 56
IMPLICATIONS OF FINDINGS 56
ACKNOWLEDGMENTS 56
REFERENCES 57
APPENDIX A. Population 59
APPENDIX B. Air Pollution 65
APPENDIX C. Deaths 66
APPENDIX D. Hospital Admissions 72
APPENDIX E. Influenza Outbreaks 76
Research Report 176

APPENDIX F. Weather 77
APPENDIX G. Simulation Analysis: Control of
Long-Term Trends 78
APPENDIX H. Effects of the 1995 Coal Ban on Mortality
Rates in County Cork 82
APPENDIX I. Effects of the 1998 Coal Ban on Mortality
Rates in Affected Counties 86
APPENDIX J. Effects of the 1990 Coal Ban on Mortality
Rates in Dublin 97
APPENDIX K. Effects of the 1995 Coal Ban on Hospital
Admissions in Cork County Borough 101
APPENDIX L. Effects of the 1998 Coal Ban on Hospital
Admissions in Affected Counties 103
ABOUT THE AUTHORS 109
OTHER PUBLICATIONS RESULTING FROM
THIS RESEARCH 109
ABBREVIATIONS AND OTHER TERMS 109
COMMENTARY by the Health Review Committee 111
INTRODUCTION 111
STUDY SUMMARY 112
Study Objectives 112
Methods 112
Study Populations 112
Air Pollution Data 113
Health Data 114
Other Variables 115
Statistical Analyses 115
Air Pollution 115
Mortality 115
Hospital Admissions 116
Additional Sensitivity and Simulation Analyses 116
Comparison of Current and Previous Approaches to
Investigating the Dublin Ban 116
Main Results 116
Air Pollution 116
Mortality 118
Hospital Admissions 118
Comparison of Current and Previous Results
for the 1990 Dublin Ban 119
HEALTH REVIEW COMMITTEE EVALUATION 119
Air Pollution Evaluation 120
Pollutant Measurements 120
Air Quality Monitoring 120
Pollutant Analyses and Implications for
Health Outcomes Analyses 120
Research Report 176

Health Outcomes Evaluation 121
Quality of Mortality Data and Standardization 121
Choice of Populations Affected by the Bans 121
Choice of Populations Not Affected by the Bans 122
Sensitivity of Results to the Statistical Approach
to the Background Trends 123
Adjustment for Influenza Epidemics 124
Major Mortality Findings 124
Evaluation of Hospital Admissions 124
Confounding by Other Factors 124
Conclusions 125
ACKNOWLEDGMENTS 125
REFERENCES 125
Related HEI Publications 127
HEI Board, Committees, and Staff 129

A B O U T H E I
The Health Effects Institute is a nonprofit corporation chartered in 1980 as an independent
research organization to provide high-quality, impartial, and relevant science on the effects of air
pollution on health. To accomplish its mission, the institute
• Identifies the highest-priority areas for health effects research;
(cid:129) Competitively funds and oversees research projects;
(cid:129) Provides intensive independent review of HEI-supported studies and related
research;
(cid:129) Integrates HEI’s research results with those of other institutions into broader
evaluations; and
(cid:129) Communicates the results of HEI’s research and analyses to public and private
decision makers.
HEI typically receives half of its core funds from the U.S. Environmental Protection Agency and
half from the worldwide motor vehicle industry. Frequently, other public and private
organizations in the United States and around the world also support major projects or research
programs. HEI has funded more than 280 research projects in North America, Europe, Asia, and
Latin America, the results of which have informed decisions regarding carbon monoxide, air
toxics, nitrogen oxides, diesel exhaust, ozone, particulate matter, and other pollutants. These
results have appeared in the peer-reviewed literature and in more than 200 comprehensive
reports published by HEI.
HEI’s independent Board of Directors consists of leaders in science and policy who are
committed to fostering the public–private partnership that is central to the organization. The
Health Research Committee solicits input from HEI sponsors and other stakeholders and works
with scientific staff to develop a Five-Year Strategic Plan, select research projects for funding, and
oversee their conduct. The Health Review Committee, which has no role in selecting or
overseeing studies, works with staff to evaluate and interpret the results of funded studies and
related research.
All project results and accompanying comments by the Health Review Committee are widely
disseminated through HEI’s Web site (www.healtheffects.org), printed reports, newsletters and
other publications, annual conferences, and presentations to legislative bodies and public agencies.
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