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1.
Gac Sanit ; 30 Suppl 1: 45-54, 2016 Nov.
Article in Spanish | MEDLINE | ID: mdl-27132480

ABSTRACT

Many of the world's most developed countries have adopted biomonitoring of toxic substances in order to ascertain their levels in biological samples. These substances get into the body through different environmental exposures. Monitoring toxic substances in biological samples should allow us to ascertain their levels in vulnerable groups, assess their evolution over time, make comparisons with levels observed in other countries, identify groups at risk or with high toxic levels and promote research. The main objective of biomonitoring is to act as a policy design tool to facilitate the implementation of particular measures in various sectors: health, environmental, agricultural and livestock or food industry sectors. In Spain, information on levels of toxic substances of environmental origin is provided by specific studies on health effects from environmental sources, such as the INMA project (INfancia y Medio Ambiente [childhood and environment]). In addition, biomonitoring projects have been implemented in Catalonia and the Canary Islands, together with a national biomonitoring programme in the adult working population. However, further progress is needed to develop a system that covers the general population as well as subgroups at risk, which relies on the collaboration of the involved authorities and the participation of professionals from different sectors and citizen organisations interested in the relationship between health and the environment.


Subject(s)
Environmental Exposure/analysis , Environmental Monitoring/methods , Hazardous Substances/analysis , Adult , Humans , Population Surveillance , Spain
2.
Environ Res ; 145: 116-125, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26656512

ABSTRACT

INTRODUCTION: Second-hand smoke exposure (SHS) in children remains as a major pollution problem, with important consequences for children's health. This study aimed to identify the sources of exposure to SHS among 4-year-old children, comparing self-reports to a urinary biomarker of exposure, and characterize the most important variables related to SHS exposure in this population. METHODS: 4-year-old children's exposure to SHS was assessed by a parental-reported questionnaire and by urinary cotinine (UC) measurements in 1757 participants from 4 different areas of the Spanish INMA (INfancia y Medio Ambiente - Environment and Childhood) Project. The questionnaire about SHS included information about smoking habits at home by household members, and about exposure to SHS in other places including other homes, bars, restaurants or transportation. The association between quantified UC levels (>4ng/ml) and sociodemographic variables and the different sources of SHS exposure was examined using logistic regression. RESULTS: Based on parental reports, 21.6% of the children were exposed to SHS at home and 47.1% elsewhere; making a total 55.9% of the children exposed to SHS. In addition, 28.2% of the children whose parents reported being not regularly exposed to SHS had quantified UC values. Children from younger mothers (<34 vs. ≥39.4 y) had a higher odds of exposure to SHS [OR (95% CI): 2.28 (1.70-3.05) per year], as well as from families with a lower educational level [OR secondary: 2.12 (1.69-2.65); primary or less: 2.91 (2.19-3.88)]. The odds of quantifiable UC in children dropped after the smoking ban in public places [OR=0.59 (0.42-0.83)]. Regarding the sources of SHS exposure we observed that quantifiable UC odds was increased in children whose parents smoked at home in their presence [OR mother occasionally: 13.39 (7.03-25.50); mother often: 18.48 (8.40-40.66); father occasionally: 10.98 (6.52-18.49); father often: 11.50 (5.96-22.20)] or in children attending other confined places, mainly other houses where people smoked [OR: 2.23 (1.78-2.80)]. CONCLUSIONS: Children's SHS exposure is nowadays an unresolved major public health problem in Spain. After the ban of smoking in public places health care professionals should put more emphasis to the parents on the importance of controlling the exposure of their children in private spaces.


Subject(s)
Cotinine/urine , Environmental Monitoring/methods , Inhalation Exposure/analysis , Tobacco Smoke Pollution/analysis , Child, Preschool , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Sociological Factors , Spain , Surveys and Questionnaires
3.
J Occup Environ Med ; 55(8): 924-31, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23887697

ABSTRACT

OBJECTIVE: To evaluate the potential association between occupational exposure to chlorinated and petroleum solvents and mycosis fungoides (MF). METHODS: A questionnaire on lifetime job history was administered to 100 patients diagnosed with MF and 2846 controls. Odds ratios (ORs) were calculated as the measure of the association between exposure to each specific solvent and MF. RESULTS: In the total sample and in men, cases and controls did not differ in relation to exposure to any of the solvents studied. In women, an association with MF was seen for the highest level of estimated exposure to perchloroethylene (OR = 11.38; 95% confidence interval: 1.04 to 124.85) and for exposure less than the median to kerosene/fuel/gasoil (OR = 8.53; 95% confidence interval: 1.11 to 65.62). CONCLUSIONS: These results do not provide conclusive evidence that exposure to solvents may increase risk of MF because they were not found in men.


Subject(s)
Hydrocarbons, Chlorinated/adverse effects , Mycosis Fungoides/chemically induced , Occupational Exposure/adverse effects , Petroleum/adverse effects , Skin Neoplasms/chemically induced , Adult , Aged , Case-Control Studies , Female , Fuel Oils/adverse effects , Humans , Kerosene/adverse effects , Male , Middle Aged , Odds Ratio , Sex Factors , Solvents/adverse effects , Surveys and Questionnaires , Tetrachloroethylene/adverse effects
4.
Eur Respir J ; 40(2): 371-6, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22323568

ABSTRACT

Tobacco consumption and exposure to second-hand smoke (SHS) are associated with reduced birth weight. One issue that has not been clarified previously is that of the potential higher risk of this outcome in mothers with asthma. We assessed the role of prenatal maternal tobacco use and SHS on reproductive outcomes and assessed the interaction with maternal history of asthma. Data was collected from the INMA study, a maternal birth cohort selected from the general population established in Spain in 2002. We measured cotinine at the 32nd week of pregnancy in 2,219 females. Diagnosed maternal asthma was self-reported during pregnancy. 35% of mothers reported not being exposed to smoking or SHS during pregnancy. Active smoking (i.e. self-reported or cotinine >50 ng·mL(-1)) was related to a 134 g decrease in birth weight and a relative risk of 1.8 for small for gestational age and fetal growth restriction. These results were not modified by maternal asthma. Maternal asthma had a similar frequency in all exposure groups. Non SHS-exposed females had the lowest prevalence of asthma. SHS (i.e. cotinine 20-50 ng·mL(-1)) decreased birth weight by 32 g among those without maternal asthma, but these differences were not statistically significant (95% CI -88.76-24.76). Maternal asthma did not promote these effects. Maternal history of asthma did not modify the effects of smoking on reproductive outcomes in a cohort sampled from the general population.


Subject(s)
Asthma/complications , Asthma/etiology , Tobacco Smoke Pollution , Adolescent , Adult , Anthropometry , Asthma/epidemiology , Birth Weight , Cohort Studies , Cotinine/urine , Female , Gestational Age , Humans , Infant, Newborn , Male , Maternal Exposure , Pregnancy , Pregnancy Complications , Pregnancy Outcome , Smoking/adverse effects , Treatment Outcome
5.
Gac. sanit. (Barc., Ed. impr.) ; 24(4): 274-281, jul.-ago. 2010. tab
Article in Spanish | IBECS | ID: ibc-85686

ABSTRACT

ObjetivoDeterminar y analizar las concentraciones de siete plaguicidas organoclorados; hexaclorobenceno (HCB), beta-hexaclorociclohexano (β-HCH), gamma-hexaclorociclohexano (γ-HCH), heptacloro epóxido, beta-endosulfán, diclorodifenildicloroetileno (p,p′-DDE) y diclorodifeniltricloroetano (p,p′-DDT) en suero de adultos de cuatro zonas de Bizkaia no expuestos a fuentes conocidas de plaguicidas.MétodoSe analizaron 283 muestras individuales de voluntarios captados a partir del censo. Se les entrevistó utilizando un cuestionario con variables sociodemográficas y de consumo. Se analizaron los datos utilizando la ji al cuadrado para variables discretas, y el análisis de varianza y un modelo de regresión lineal múltiple para las variables continuas.ResultadosEl p,p′-DDE fue detectado en el 100% de los individuos (media: 191,43ng/g lípido), mientras que el 31% mostró valores detectables de p,p′-DDT (media: 18,9ng/g lípido). Un 96,5% de los individuos presentaban valores detectables de HCB (media: 78,56ng/g lípido); el 90,4% β-HCH (media: 42,78ng/g lípido) y un 3,5% γ-HCH. No se detectó heptacloro epóxido ni beta-endosulfán. En el modelo de regresión, el incremento de la edad aumentaba los valores de todos los plaguicidas (p<0,05). No se observaron diferencias significativas por zona de residencia, excepto para el HCB y el p,p′-DDE. Las mujeres presentaron valores significativamente más altos de HCB y de β-HCH (p<0,001). El índice de masa corporal mostró un gradiente positivo significativo con el HCB y el β-HCH (p<0,05). No se observó asociación entre los plaguicidas y otras variables, lactancia, ocupación o clase social.ConclusionesLos resultados indican que la población general adulta de Bizkaia ha estado y está expuesta a plaguicidas organoclorados. Sin embargo, sus valores se encuentran dentro del intervalo observado por otros autores (AU)


ObjectiveTo identify and analyze levels of seven organochlorine pesticides [hexachlorobenzene (HCB), beta-hexachlorocyclohexane (β-HCH), gamma-hexachlorocyclohexane (γ-HCH), heptachlor epoxide, beta-endosulfan, dichlorodiphenyldichloroethylene (p,p′-DDE) and dichlorodiphenyltrichloroethane (p,p′-DDT)] in the serum of adults of four areas of Biscay (Spain) not exposed to known sources of pesticides.MethodWe analyzed 283 individual samples from volunteers recruited from the census. The volunteers were interviewed using a questionnaire with items on demographic variables and consumption. Data were analyzed using the chi-square test for discrete variables and analysis of variance and multiple linear regression models for continuous variables.ResultsWe detected p,p′-DDE in 100% of the volunteers (mean: 191.43ng/g lipid), while 31% had detectable levels of p,p′-DDT (mean: 18.9ng/g lipid). Detectable levels of HCB were found in 96.5% of the volunteers (mean: 78.56ng/g lipid), β-HCH in 90.4% (mean: 42.78ng/g lipid) and γ-HCH in 3.5%. Heptachlor epoxide and beta-endosulfan were not detected. In the regression model higher levels of all pesticides were found with increasing age (p<0.05). There were no significant differences by area of residence, except for HCB and p,p′-DDE. Women had significantly higher levels of HCB and β-HCH (p<0.001). Body mass index showed a significant positive gradient in HCB and β-HCH (p<0.05). There was no association between pesticides and other variables, breast feeding, occupation or social class.ConclusionsThese results indicate that the general adult population of Biscay has been and is exposed to organochlorine pesticides. However, their levels are within the range observed by other authors (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pesticides/blood
6.
Sci Total Environ ; 408(20): 4468-74, 2010 Sep 15.
Article in English | MEDLINE | ID: mdl-20659760

ABSTRACT

In 2005 an urban solid waste incinerator (SWI) was commissioned in Bilbao (Basque Country, Spain). Serum and urine samples were collected from 95 and 107 volunteers in 2006 and 2008 respectively, of which 62 were repeats from the same individuals. Blood lead levels (BPb) were determined, as were the concentrations of cadmium (Cd), chromium (Cr) and mercury (Hg) in urine (UCd, UCr and UHg). The town of Alonsotegi and a borough of Bilbao (Altamira, Rekalde) were considered to be close, less than 2 km from the plant, and correspond to an urban environment with high traffic density. The areas of reference were a borough of Bilbao (Santutxu-Zurbaran), 5 km from the plant, also in an urban area with high traffic density, and a small town with little industrial activity and low traffic density (Balmaseda) 20 km from the plant; neither of these is downwind from the site with respect to prevailing winds. There was a significant correlation for BPb, r=0.63 (p<0.001), between the two surveys. However, there was no linear correlation for the other three metals (UCd, UCr and UHg), between the two sampling periods (p>0.05). Multiple linear regression models did not show increases over time of the levels of BPb, UCd, UCr and UHg in the areas close to the SWI compared to those of areas located further away, after adjusting for confounding variables. These results reinforce the hypothesis that populations near modern plants for solid waste incineration do not manifest increased levels of heavy metals.


Subject(s)
Air Pollutants/blood , Cadmium/blood , Chromium/blood , Incineration , Lead/blood , Mercury/blood , Adult , Aged , Air Pollutants/urine , Cadmium/urine , Chromium/urine , Cities , Environmental Exposure/analysis , Female , Humans , Lead/urine , Male , Mercury/urine , Middle Aged , Urban Population , Young Adult
7.
Gac Sanit ; 24(4): 274-81, 2010.
Article in Spanish | MEDLINE | ID: mdl-20541847

ABSTRACT

OBJECTIVE: To identify and analyze levels of seven organochlorine pesticides [hexachlorobenzene (HCB), beta-hexachlorocyclohexane (ß-HCH), gamma-hexachlorocyclohexane (γ-HCH), heptachlor epoxide, beta-endosulfan, dichlorodiphenyldichloroethylene (p,p'-DDE) and dichlorodiphenyltrichloroethane (p,p'-DDT)] in the serum of adults of four areas of Biscay (Spain) not exposed to known sources of pesticides. METHOD: We analyzed 283 individual samples from volunteers recruited from the census. The volunteers were interviewed using a questionnaire with items on demographic variables and consumption. Data were analyzed using the chi-square test for discrete variables and analysis of variance and multiple linear regression models for continuous variables. RESULTS: We detected p,p'-DDE in 100% of the volunteers (mean: 191.43ng/g lipid), while 31% had detectable levels of p,p'-DDT (mean: 18.9ng/g lipid). Detectable levels of HCB were found in 96.5% of the volunteers (mean: 78.56ng/g lipid), ß-HCH in 90.4% (mean: 42.78ng/g lipid) and γ-HCH in 3.5%. Heptachlor epoxide and beta-endosulfan were not detected. In the regression model higher levels of all pesticides were found with increasing age (p<0.05). There were no significant differences by area of residence, except for HCB and p,p'-DDE. Women had significantly higher levels of HCB and ß-HCH (p<0.001). Body mass index showed a significant positive gradient in HCB and ß-HCH (p<0.05). There was no association between pesticides and other variables, breast feeding, occupation or social class. CONCLUSIONS: These results indicate that the general adult population of Biscay has been and is exposed to organochlorine pesticides. However, their levels are within the range observed by other authors.


Subject(s)
Hydrocarbons, Chlorinated/blood , Pesticides/blood , Adult , Aged , Female , Humans , Male , Middle Aged , Spain , Young Adult
8.
Health Policy ; 76(1): 38-48, 2006 Mar.
Article in English | MEDLINE | ID: mdl-15946763

ABSTRACT

BACKGROUND: Previous studies have shown the validity of Adjusted Clinical Groups (ACGs) in the primary care setting, but the absence of administrative databases is a problem for the implementation of this system. OBJECTIVES: To assess the validity of physicians' notes in computerized clinical records for the implementation of ACGs, and to determine the ability of the ACGs system to explain the use of primary care resources in real conditions of the daily practice. RESEARCH DESIGN: Cross-sectional study. SUBJECTS: All patients who were continuously assigned to 56 physicians from public primary health care centers in the Bizkaia Basque Country (Spain) over at least a 6-month period were included. MEASURES: Patients were classified by means of the ACGs system using the ICD-9-CM diagnostic codes according to three scenarios: (1) those annotated by the physicians in the computerized medical record, (2) codification of computerized medical records diagnoses by the research team, and (3) computerized medical records diagnoses complemented by hospital discharge codes. RESULTS: The ACGs system explained more than 50% of the variance in visits made to primary care physicians, 25-40% of prescriptions, 25-30% of referrals and requests of laboratory tests, and 14-16% of radiographs. The coefficients of determination remained almost invariable after the addition of hospital diagnoses or correction of coding errors. Fifty-two physicians (93%) registered their patients' diagnosis quite acceptably, whereas only 29 (52%) included this datum in the prescriptions. CONCLUSIONS: The ACGs system is a useful tool to explain the use of primary care services in a national health care system within the European Union. The implementation of ACGs from the physician's annotations in the computerized medical records is feasible.


Subject(s)
Medical Records , Primary Health Care/statistics & numerical data , Risk Adjustment , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Medical Audit , Middle Aged , Spain
9.
Cancer Causes Control ; 16(10): 1253-9, 2005 Dec.
Article in English | MEDLINE | ID: mdl-16215876

ABSTRACT

OBJECTIVES: Mycosis Fungoides (MF) is a rare disease with an occurrence indicating that occupational exposures may play a role. To estimate the association between MF and occupational exposures as measured by means of an job-exposure matrix (JEM). METHODS: A European multicenter case-control study was conducted from 1995 to 1997 and included seven rare cancers, one of which was MF. Patients between 35 and 69 years of age, diagnosed with MF (n=140), were recruited and the diagnoses were checked by a reference pathologist who classified 83 cases as definite, 35 cases as possible and 22 cases as not accepted. Among the 118 accepted cases, 104 cases were interviewed, of which 76 were definite cases. We selected population controls and colon cancer controls to serve all seven case groups. Altogether 833 colon cancer controls and 2071 population controls were interviewed. Based on the reported occupational experiences, a team of industrial hygiene specialists identified five potential exposures and developed an JEM. This JEM was used to estimate the odds ratios (OR) for MF as a function of these exposures. The JEM included aromatic and/or halogenated hydrocarbons (AAHs), chrome (VI) and its salts, electromagnetic radiations, silica and pesticides. RESULTS: Exposures to AHHs (OR 6.3, C.I 2.4-16.7 for male) were associated with a high MF risk. CONCLUSIONS: The study supports the hypothesis that some MFs have an occupational etiology but only a small fraction of exposed workers are apparently susceptible since the disease is so rare.


Subject(s)
Mycosis Fungoides/epidemiology , Occupational Diseases/epidemiology , Occupational Exposure/adverse effects , Skin Neoplasms/epidemiology , Adult , Aged , Case-Control Studies , Chromium Alloys/adverse effects , Europe/epidemiology , Female , Humans , Hydrocarbons, Aromatic/adverse effects , Hydrocarbons, Halogenated/adverse effects , Logistic Models , Male , Middle Aged , Pesticides/adverse effects , Radiation , Silicon Dioxide/adverse effects
10.
J Occup Environ Med ; 46(3): 205-11, 2004 Mar.
Article in English | MEDLINE | ID: mdl-15091282

ABSTRACT

Mycosis fungoides (MF) is a rare disease with an unknown etiology. Its distribution suggests that occupational exposures may play a role. In the present study, we searched for occupational factors associated with MF. A European multicenter case-control study on seven rare cancers, including MF, was conducted from 1995 to 1997. Patients between 35 and 69 years of age diagnosed with MF (n = 134) were identified and their diagnoses were checked by a reference pathologist who classified 83 cases as definitive, 35 cases as possible, and 16 cases as not histologically verified. Of the 118 histologically verified cases, 104 were interviewed, of which 76 were definitive cases. As controls, we selected population controls and colon cancer controls to serve all seven case groups. Altogether, 833 colon cancer controls and 2071 population controls were interviewed. The response rate was 91.5% for cases (76 of the 83 definitive cases), and 66.6% for controls. A high risk of MF for men was observed in the industries of other non-metallic mineral products (Odds Ratio [OR] 5.3, 95% confidence interval [CI] = 1.7-16.2) and of wholesale trade (OR 3.6, 95% CI = 1.3-10.5). A high risk was found for female employees in the sector of pulp paper manufacture (OR 14.4, 95% CI = 2.2-95.1). The male occupations with the highest risks were glass formers, potters, and ceramics workers (OR 17.9, 95% CI = 5.4-59.4) and technical salesmen (OR 8.6, 95% CI = 2.4-30.8). For women, the occupations associated with the highest risks were government executives (OR 4.8, 95% CI = 1.0-22.6) and railway and road vehicles loaders (OR 3.9, 95% CI = 1.0-14.0). The results suggest that some occupational factors are associated with MF. Working as glass formers, pottery, and ceramics workers carried the highest risk, and these findings deserve further attention and replication. Females working in the paper and pulp industries may also be exposed to carcinogens of relevance to MF.


Subject(s)
Mycosis Fungoides/etiology , Occupational Diseases/epidemiology , Skin Neoplasms/etiology , Adult , Aged , Case-Control Studies , Europe/epidemiology , Female , Humans , Logistic Models , Male , Middle Aged , Mycosis Fungoides/epidemiology , Occupational Diseases/etiology , Occupations , Rare Diseases , Risk Factors , Skin Neoplasms/epidemiology
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