Environmental health officer Maurice Mulcahy has won the first Tom Power medal for his research into the effects of second hand smoke in Ireland. He spoke to Hélène Hofmanabout fighting for smoking bans and why the battle isn't won yet
Eight years ago Maurice Mulcahy completed a study into air quality levels in Galway pubs. He discovered that not only was the smokiest pub in the world in Galway but that bar workers were exposed to 41 hours of smoke a week and, unless a smoking ban was introduced, 150 bar workers would die every year as a result of passive smoking.
It is this research that became instrumental to the introduction of the smoking ban into Irish workplaces in March 2004.
At the end of this month, Maurice Mulcahy, now the principal environmental health officer for HSE West, will be presented with the inaugural Tom Power medal which recognises commitment to tackling the issue of smoking in Ireland.
Tom Power, the late chief executive officer of the Office of Tobacco Control (OTC), was dedicated to reducing the burden of disease and death caused by tobacco both here and abroad.
"I get the figures, that's what I'm good at," says Maurice Mulcahy. "It was always said that smoking is bad, but no one puts figures behind it to convert it into what it actually means for your health.
"People need to know exactly what they're exposed to. You get tired of being told what to do, you want to know 'why shouldn't I do this?' and 'what are the consequences if I do it?'. We showed that just half an hour's exposure to smoke can put you at risk. You have to give people the information and let them make up their own minds," he says.
Included in the research that Mulcahy has completed since is a study into the effects of passive smoking on children and another on the relationship between heart attacks. He is currently examining the impact of passive smoking in the home.
Mulcahy has shared his findings with a number of conferences around the world. He made a presentation to the House of Commons, and collaborated with Harvard Medical School, Berkeley University and the EU on a number of other research projects.
"When the Government here started looking around for Irish research to back a smoking ban, mine was really the only one available and it became a critical part of the evidence base. I come from a background of occupational safety," he says.
"Some risks are worse than others and I can't understand why smoking isn't treated the way asbestos might be. More people die from tobacco-related illnesses than road accidents, and 75 per cent of the country doesn't even smoke. I tried to show those risks in a way that people would understand and once Tom Power and Micheál Martin were on board, I quickly realised we were pushing an open door," he says.
For several research projects he has collaborated with Jim Repace, a leading biophysicist and international second hand smoke consultant from the United States, whom he met through a conference organised by Tom Power. Together they conducted the first comparison into second hand smoke exposure once the ban was introduced.
"We did the first two air quality tests before and after the ban. We wanted to confirm that the ban was worthwhile and show there had been a reduction in risk. When you make a change you have to make sure it works and show people the improvements or else it crumbles," he explains.
By measuring air nicotine concentrations in 20 Galway pubs just before the smoking ban came in, and six weeks after, Mulcahy recorded a reduction of about 80 per cent. However, although the risk levels had been significantly reduced they had not been eliminated completely.
"I wanted to know why it [the risk] hadn't gone away completely. Why was at least 10 per cent always there? We attached sensitive nicotine filters to the optics behind the bar where the barman would be to see what they were being exposed to. Smoke went down but it didn't disappear, we always got a reduction in the 70s and 80s," he says.
"The problem is that before the ban, pubs never had outdoor areas to smoke and we found that the pubs that now had smoking areas had higher levels.
"That happens because legislation doesn't have a distance requirement or impose a time delay on a smoker. The smoker can stand next to the door, finish their cigarette, come in and exhale smoke. Levels in pubs where that happens were still above the risk levels," he says.
"After a smoking ban, some people's exposure to smoke actually goes up. For example, you can still smoke in hotel bedrooms here. You can also take the example of security guards standing outside a pub.
"Now they're beside where people are smoking and the risk for them has gone up," he says. "Now you can still smoke in psychiatric hospitals. Maybe it's time we revised that and looked at the effect of smoking areas too and see if they're working.
"Bringing in the smoking ban was the right decision to make. There is something in cigarette smoke that has an impact on the heart, it strangles the heart.
"I plan on continuing to push myself to provide the information to find where the risk is and work to eliminate it," he says.
Maurice Mulcahy will be presented with the Tom Power medal by Éamonn Rossi, chief executive of the OTC, at a special dinner tomorrow Wednesday, May 30th.