Irish Thoracic Society Podcast Productions

Professor Luke Clancy, Director General of the Tobacco Free Research Institute Ireland and Professor at Technological University Dublin, describes how clinical observation, focused research and coalition‑building translated into major public‑health wins — the 1990 Dublin smoky‑coal ban and Ireland’s 2004 Public Health (Tobacco) Act. He reflects on the science behind excess winter mortality and air pollution, clinical innovations (bronchoscopy, COPD outreach, lung‑cancer MDTs), tobacco control advocacy, implementation lessons and leadership advice for clinicians to influence policy.   Chapters 00:00 — Introduction & guest bio 01:12 — Why clinicians should turn observation into research 01:41 — Early training, influences and clinical work 04:38 — Dublin smog: excess winter mortality & particle debate 08:01 — Publishing the evidence & getting external support 08:58 — Politics & the path to the Smoky Coal ban 11:09 — Why national rollout took decades 15:36 — Tobacco control: forming ASH & building strategy 20:04 — Coalition building, unions & the 2004 Public Health (Tobacco) Act 23:21 — International influence & lessons 24:42 — Clinical innovations: bronchoscopy, COPD, lung cancer services 27:30 — Leadership lessons for clinician‑advocates 28:46 — Wrap up & next episode preview 28:56 — End   Show notes • Kelly, I., Clancy, L. et al., 1984. Mortality in a general hospital and urban air pollution. ResearchGate. [online] (Accessed 14 December 2025) • Tobacco Free Research Institute Ireland (TFRI) https://www.tri.ie/ • Action on Smoking and Health (ASH) Ireland https://ash.ie/ • Framework Convention on Tobacco Control https://fctc.who.int/convention

In this episode, Irish respiratory fellows Barry and Sandra sit down with Professor Richard Costello to explore the rapidly evolving world of digital asthma care. From eosinophils and T2 inflammation to the future of smart inhalers and precision monitoring, this conversation dives deep into how technology is reshaping diagnosis, adherence, and long-term management. Professor Richard Costello discusses the challenges of diagnosing a highly variable disease, the limitations of symptom-based tools like the ACT, and why biomarkers and digital home spirometry are essential in modern asthma practice. They cover how digital devices can reveal patient behaviour, uncover hidden comorbidities, and distinguish difficult-to-treat asthma from true severe asthma. The episode also explores the emerging potential of closed-loop smart inhalers, real-time lung function monitoring, and how personalised dosing may soon become a reality. Along the way, the team unpacks overlooked side effects of chronic inhaled steroids, the importance of steroid stewardship, and how Ireland can move toward a more decentralised, digitally enabled model of asthma care. Chapters 00:00 – Introduction 00:31 – Episode Overview 01:15 – Rapid-Fire Round: True or False 03:45 – The Importance of Eosinophils & T2 InflammationDr. Costello explains why identifying T2 inflammation is central to diagnosing and managing asthma. 06:15 – Challenges in Diagnosing AsthmaVariability, biomarkers, bronchial responsiveness, and why asthma remains difficult to diagnose in 2025. 09:40 – The Role of Home SpirometryHow home monitoring helps differentiate asthma from mimics and guides treatment decisions. 12:10 – Differentiating Difficult-to-Treat vs Severe AsthmaUsing digital adherence data to distinguish true severity from difficult to treat asthma. 14:20 – The Future: Smart, Closed-Loop InhalersHow inhalers may soon auto-dose based on real-time airflow and physiology. 17:00 – Understanding the User, Not Just the DeviceDigital data reveals patient behaviour patterns and barriers to adherence. 20:10 – When Symptoms Aren’t AsthmaReflux, deconditioning, cardiac disease, and other asthma mimics uncovered through monitoring. 22:20 – Hidden Side Effects of High-Dose SteroidsAdrenal suppression, cataracts, diabetes, and why symptom-based escalation can lead to elevated steroid exposure. 25:00 – The Limitations of the ACT & Symptom ScoresWhy subjective questionnaires fall short in a multimorbid population. 27:10 – Ireland’s Future: Digital Home Monitoring & Decentralised CareHow integrated hubs and digital platforms could streamline diagnosis and management. 30:00 – Looking Ahead 31:29 – Closing Remarks Guest: Professor Richard Costello Professor Richard Costello is a professor of respiratory medicine at the Royal College of Surgeons in Ireland and a consultant at Beaumont Hospital, Dublin. He trained at RCSI, Beaumont, and Johns Hopkins University. A leading researcher in airways disease and digital respiratory health, he has published over 200 papers, holds several health innovation patents, and founded a company focused on inhaler adherence. He has served as Vice President of the Royal College of Physicians of Ireland and chaired the European Respiratory Society Educational Council, receiving the ERS Educational Award for his contributions to respiratory medicine.   Hosts: Dr Barry Harnedy & Dr Sandra Green Dr Barry Harnedy is a respiratory specialist trainee in Ireland. He graduated from National University of Ireland Galway. He is the current Irish Thoracic Society co Educational Officer. He is passionate about digital innovation and airways assessment.  Dr Sandra Green is a respiratory specialist trainee in Ireland. She is the current Irish Thoracic Society Sustainability Officer. As a founder of Irish Doctors for the Environment she is interested in healthcare sustainability and planetary health.

We’re back in the studio with Professor Richard Costello, exploring his vision for the future of digital health and what it takes to set up a medical device to life. He discusses how his experience in digital monitoring led him to a deeper understanding of human behaviour. 00:00 Intro and episode overview 00:41 Introduction to Professor Richard Costello 02:13 Developing an interest in digital health 04:49 Developing patents in digital health 08:37 Maintaining motivation 10:17 Challenges setting up a medical device 13:24 Vision for digital health 16:26 Restructuring healthcare to be more inclusive using digital technology 16:49 Data ownership in digital health 17:33 Portals of communication and the electronic healthcare record 19:44 GDPR in digital health 21:29 Funding structures for digital subscriptions and online platforms 23:19 Inequality and inclusion in the digital era 23:59 The carbon footprint of digital health Guest - Professor Richard Costello Professor Richard Costello is a professor of respiratory medicine at the Royal College of Surgeons in Ireland and a consultant at Beaumont Hospital, Dublin. He trained at RCSI, Beaumont, and Johns Hopkins University. A leading researcher in airways disease and digital respiratory health, he has published over 200 papers, holds several health innovation patents, and founded a company focused on inhaler adherence. He has served as Vice President of the Royal College of Physicians of Ireland and chaired the European Respiratory Society Educational Council, receiving the ERS Educational Award for his contributions to respiratory medicine. Hosts - Dr Barry Harnedy & Dr Sandra Green Dr Barry Harnedy is a respiratory specialist trainee in Ireland. He graduated from National University of Ireland Galway. He is the current Irish Thoracic Society co Educational Officer. He is passionate about digital innovation and airways assessment. Dr Sandra Green is a respiratory specialist trainee in Ireland. She is the current Irish Thoracic Society Sustainability Officer. As a founder of Irish Doctors for the Environment she is interested in healthcare sustainability and planetary health.

In this episode, Dr Marissa O’Callaghan and Dr Sandra Green host Dr. Augusta Beach and Dr. Laura Fabbri, both Early Career Representatives of the European Respiratory Society. They discuss their journeys to becoming representatives, the responsibilities of their roles, and the importance of networking and engagement within the society. This conversation also focuses on the upcoming Congress, including key sessions, tips for poster presentations, and social events, emphasizing the value of participation and proactive involvement for early career members. Keywords European Respiratory Society, Early Career Representatives, Networking, Congress, ILD, COPD, Research, Eosinophils, Asthma, Clinical Trials

In this episode, Dr Marissa O'Callaghan and Dr Sandra Green host Dr. Margaret Higgins and Dr. Barry Harnedy, the new Educational Officers of the Irish Thoracic Society, to discuss the upcoming ERS Congress in Amsterdam. They share insights on how to strategies to get the most out of your conference attendance, the importance of networking, and opportunities for pursuing fellowships. The conversation also includes a fun quiz about the ERS Congress and practical tips for first-time attendees. Keyword / Tags ERS Congress, networking, fellowship, pulmonology, education, conference tips, respiratory health, international collaboration, poster sessions, early career