How many deaths are we talking about here? According to the Society of Cardiovascular & Interventional Radiology, in the US, 10 million people, 5% or one in twenty adults over the age of 50, suffers from PAD (also known as Peripheral Vascular Disease or PVD) though the rate is higher for men and smokers. The Society says "In extreme cases, untreated PVD can lead to gangrene, a serious condition that may require amputation of a leg, foot or toes. If you have PVD, you are also at higher risk for heart disease and stroke."

The Australian Heart Foundation says 19,000 Australians die from smoking every year. An Australian Institute of Health and Welfare (AIHW) report says heart attack and stroke accounted for 50,294 deaths in 2002 which is 37.6% of all deaths. Peripheral Vascular Disease claimed 2,581 lives in 2002 - 1.9 % of all deaths from all causes in all ages. In the period 1991 - 2002, death rates from PVD fell by 40.2% among males and 37.1% among females while the rate of smoking fell 21% for males and 16% for females over the decade 1991 - 2001.

"As more people quit smoking the death rate from PVD should fall further but perhaps PVD is killing fewer people now because of the reduction of lead in petrol too, and greater awareness of the need to undertake renovations in a lead-safe manner. Unleaded petrol was introduced in Australia in 1985 and Elizabeth O'Brien's lead poisoning prevention campaign helped bring about the increased tax on leaded petrol, and thus a more rapid phase out of leaded petrol since 1993.

"The ban on leaded petrol as of January 2002 will result in greater longevity for all Australians in years to come," says O'Brien, "and more Council bans on smoking in parks, beaches and outside large buildings could similarly benefit the health of all Australians. I fully support Clean Up Australia's call for cigarette companies to take responsibility for the 7 billion butts that smokers are tossing into our waterways, parks and beaches each year. We really don't want all that lead and cadmium in the cigarette filters going down to the ocean and giving sea-life a pain in the butt (if fish have butts)! It would be better still if the number of cigarettes smoked were decreased drastically."

"The majority of the world's lead is used in the lead acid batteries that keep our cars starting and more waste and other emissions are created during the mining and smelting of auto materials and making and recycling of cars than even during the use of the vehicle. Thus the greatest single act of environmental protection generally that any individual can make is to decide not to buy a car," says O'Brien. "And when it comes to ensuring one's own immediate environment is healthy, the most important single decision a child can make is the decision not to smoke. My vision is for environmental health policy in Australia to shift its major focus to preventing car-buying (by provision of fabulous and cheap public transport and walking and cycling paths) and preventing children taking up smoking." "It has been wonderful to celebrate my United Nations Award this week but I celebrate every day the fact that my three sons have decided not to smoke or buy cars," says O'Brien.

[REFERENCES:

* The LEAD Group - www.lead.org.au/mr/20040605.html;

* The LEAD Group - www.lead.org.au/mr/20030106.html;

* United Nations Association of Australia - www.unaavictoria.com.au/events/world_awards_media.php;

* Lead, Cadmium, Smoking, and Increased Risk of Peripheral Arterial Disease by Ana Navas-Acien, MD, MPH; Elizabeth Selvin, MPH; A. Richey Sharrett, MD, DrPH; Emma Calderon-Aranda, PhD, MD; Ellen Silbergeld, PhD; Eliseo Guallar, MD, DrPH in Circulation Issue 109, published by the American Heart Association (AHA) Inc, 7th June 2004; The full text of the research article is available from Circulation Online at http://circ.ahajournals.org/cgi/reprint/01.CIR.0000130848.18636.B2v1

* Professor Eliseo Guallar (personal communication with co-author of study) - eguallar@jhsph.edu

* 'Safe' levels of lead, cadmium news release by the American Heart Association - www.eurekalert.org/pub_releases/2004-06/aha-lo060304.php

* Heart, Stroke and Vascular Diseases - Australian Facts 2004 by Australian Institute of Health and Welfare - www.aihw.gov.au/publications/cvd/hsvd04/hsvd04.pdf;