Lung cancer deaths much higher in Dublin - health board report

Heart disease, cancer and accidents are the main causes of illness and death among the 1

Heart disease, cancer and accidents are the main causes of illness and death among the 1.3 million people living in counties Dublin, Wicklow and Kildare, according to a major Eastern Health Board report launched today. The health status report, the first profile of the public health status of people in the EHB region, discloses that cancer accounts for about one in four deaths in the region.

Mortality from lung cancer is considerably higher in Co Dublin, in both men and women, than the national average.

Key recommendations of the report, which will be used in planning future health services for the region, include a national coronary heart disease (CHD) strategy, the abolition of tobacco advertising in the media, a further reduction in the legal alcohol limit for drivers and lifestyle changes.

The EHB chief executive officer, Mr P.J. Fitzpatrick, says the report blames smoking as the single greatest preventable cause of illness and death.

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Smoking is estimated to account for 87 per cent of deaths from lung cancer, 82 per cent of deaths from chronic obstructive pulmonary disease, 21 per cent of deaths from CHD and 18 per cent of deaths from strokes.

The report advocates the progressive exclusion of smoking on health board property and on all forms of public transport and indoor places where the public gathers.

It also recommends the rigorous enforcement of laws preventing the sale of tobacco to young children.

The EHB director of public health, Dr Brian O'Herlihy, says the high incidence of deaths from lung cancer in Co Dublin is likely to be due to the higher smoking rates in the county in the past. He said 90 per cent of lung cancer is attributable to smoking and therefore preventable.

Ireland should lead the demand for the earliest possible ban on tobacco advertising in all forms of media communication, he said.

The report recommends that a well-organised mammography screening programme could cut breast cancer deaths in the at-risk groups by up to 24 per cent. Breast cancer is the leading cause of cancer deaths in women under 65.

An effective cervical screening programme in the at-risk groups could reduce deaths from cervical cancer by up to 60 per cent, the report states.

It recommends sheltering from excess sunlight to avoid skin cancer, the most common of all cancers.

One hundred deaths and some 5,000 injuries caused by road traffic accidents in the EHB region each year could be reduced by a number of measures, according to the report.

It recommends the reduction of the legal alcohol limit for drivers, the strict enforcement of speed limits and the wearing of safety belts and, for all cyclists, the wearing of bicycle helmets. Just one in six children wear helmets at present, the report reveals.

Major lifestyle changes could improve Irishwomen's life expectancy, which is among the lowest in the EU, according to the report. Initiatives to improve the health of the disabled, homeless and travellers are also set out.

With poisonings from medications or housing agents accounting for about 200 admissions of young children to hospitals in the EHB region each year, the report recommends the universal use of child-resistant containers to reduce this figure.

The report also recommends an increase in peri-conceptional folic acid intake which, it says, could cut by half the number of children born with neural defects in the EHB region each year.

With increasing numbers of refugees/asylum-seekers bringing a different pattern of infectious disease to that found in Ireland the report says health screening for communicable diseases, as a requirement for the processing of applications for refugee/asylum status, should be considered.

Other recommendations include the development of a national standardised injury surveillance system in hospital accident and emergency departments, so that priority issues can be identified locally and interventions monitored.

The report deplores the "complacency" among parents regarding vaccination of their children and urges parents to present their baby to their family doctor at two months to commence the primary vaccination programme.

The 108-page report - Public Health in the Eastern Health Board Region - was compiled by the board's department of public health, which was set up in 1995.

Mary Carolan

Mary Carolan

Mary Carolan is the Legal Affairs Correspondent of the Irish Times