Doctor Refines Heart Attack Study

By Margie Wood, The Pueblo Chieftain, Colo.

Jan. 26–Dr. Carl Bartecchi told the city-county health board Wednesday that his heart attack study is under review by a health journal and he has refined it somewhat to respond to critiques.

In November, Bartecchi reported that his study showed hospital admissions for heart attacks in Pueblo declined by 27 percent in the 18 months after the city’s indoor smoking ban went into effect on July 1, 2003, compared to the 18 months before the ban. There were 399 heart attacks from January 2003 to July 2003, and 291 in the following 18 months.

During the same period, the heart attack rate in Colorado Springs and the national rate both declined by approximately 3 percent.

Bartecchi addressed some of the criticisms raised since his initial report:

– Seasonality, the fact that heart attacks peak in the winter. Bartecchi said he has adjusted his figures for that.

– The study didn’t identify whether the heart attack patients were smokers or nonsmokers, because privacy laws didn’t allow that much scrutiny of the files. But, Bartecchi maintains that smoking bans benefit both smokers and nonsmokers, and said a central concern of the ban is preventing nonsmokers from being harmed by secondhand smoker or “sidestream smoke” n the emission from a cigarette burning in an ashtray.

– The statistics were checked to account for people who died of a heart attack without being hospitalized, and there wasn’t a significant difference.

– General air pollution statistics have been added and show that Colorado Springs has more pollution than Pueblo but lower heart attack rates.

– Were there other major preventive efforts under way at the same time as the smoking ban? No, Bartecchi said. The local population grew slightly during the time heart attacks were declining.

– Did the ordinance cause people to stop smoking?

As a relentless foe of smoking, Bartecchi would hope so, but the statistics don’t tell that information.

In fact, he said, “We’re not saying that the ordinance caused the decline in heart attacks, just that it was associated with the decline. We call it an observation study. It does tell us that smoke makes a difference (in health) and people ought to be wary.”

Bartecchi added that his study team is getting requests to present information in other cities and states, in support of other smoking ban efforts.

A statewide ban may be considered by the Colorado Legislature this session.

“Personally, I’m not so sure the Legislature is the way to go,” Bartecchi said. “I’d rather see a statewide ballot issue n let the people vote on it.”

He added that local ordinances are probably easier to pass than a statewide measure, because “the tobacco industry can’t fight it in every city, but they can rally their troops against a state issue.”

In other action, health department staffers reviewed plans they are making for a mass flu shot clinic. The idea is to vaccinate 10,000 people in one day, and a secondary purpose would be to gear up for an even larger vaccination effort if an avian flu epidemic strikes in the United States. If that happens, the health department would be expected to vaccinate everyone in the county within 48 hours.

A budget for the mass clinic is still being developed for presentation to a joint meeting of City Council and Pueblo County commissioners on Feb. 7.

At that session, the two boards also are expected to talk about a new building for the health department and repairs to the existing building.

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Copyright (c) 2006, The Pueblo Chieftain, Colo.

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