Association between GIS-based exposure to urban air pollution during pregnancy and birth weight in the INMA Sabadell Cohort.

BACKGROUND: There is growing evidence that traffic-related air pollution reduces birth weight. Improving exposure assessment is a key issue to advance in this research area. OBJECTIVE: We investigated the effect of prenatal exposure to traffic-related air pollution via geographic information system (GIS) models on birth weight in 570 newborns from the INMA (Environment and Childhood) Sabadell cohort. METHODS: We estimated pregnancy and trimester-specific exposures to nitrogen dioxide and aromatic hydrocarbons [benzene, toluene, ethylbenzene, m/p-xylene, and o-xylene (BTEX)] by using temporally adjusted land-use regression (LUR) models. We built models for NO(2) and BTEX using four and three 1-week measurement campaigns, respectively, at 57 locations. We assessed the relationship between prenatal air pollution exposure and birth weight with linear regression models. We performed sensitivity analyses considering time spent at home and time spent in nonresidential outdoor environments during pregnancy. RESULTS: In the overall cohort, neither NO(2) nor BTEX exposure was significantly associated with birth weight in any of the exposure periods. When considering only women who spent < 2 hr/day in nonresidential outdoor environments, the estimated reductions in birth weight associated with an interquartile range increase in BTEX exposure levels were 77 g [95% confidence interval (CI), 7-146 g] and 102 g (95% CI, 28-176 g) for exposures during the whole pregnancy and the second trimester, respectively. The effects of NO(2) exposure were less clear in this subset. CONCLUSIONS: The association of BTEX with reduced birth weight underscores the negative role of vehicle exhaust pollutants in reproductive health. Time-activity patterns during pregnancy complement GIS-based models in exposure assessment.

Prevalence of major depression in preschool children.

The prevalence of preschool major depressive disorder (MDD) was studied in the community. The whole population of children between 3 and 6 years attending preschool nurseries in three areas (one urban, one rural and one suburban) in Spain (n = 1,427) were contacted. Selection was by a two-stage procedure. At stage I, the ESDM 3-6, a screening measure for preschool depression, was used to identify a sample for more intensive interviewing. Sensitivity and specificity of the cut-off point of the ESDM 3-6 had been previously tested in a pilot study (n = 229). During the first stage, 222 preschool children (15.6%) were found to be probable depressives, because they scored 27 or more, the cut-off used. At stage II, the children were interviewed and diagnosed by the consensus of two clinicians, blind to the ESDM 3-6 results. DSM-IV diagnostic criteria were used to define caseness. A total of 16 children (1.12%) met the MDD criteria. The prevalence by areas was urban 0.87%, rural 0.88%, suburban 1.43%. Sex distribution prevalence was 1:1. This study is a contribution to the scarce epidemiology of preschool depression in the community.

Teacher reports of peer aggression in preschool: its relationship to DSM-IV externalizing symptoms.

OBJECTIVE: to establish the prevalence and associations of peer aggression as manifested in preschool children, in community-based populations and to study links with DSM-IV externalizing diagnoses. METHOD: Subjects were 1104 children, 3-to-5-year-olds attending rural and urban pre-schools classes. Teachers completed the Peer Conflict Scale (PCS) to inform about direct physical and verbal aggression, object aggression and symbolic aggression and the questionnaire on psychopathology ECI-4. RESULTS: 6.6% (n=73) had at least one positive item on the PCS. This percentage dropped to 2.6% (n=29) if we take into account a minimum of three positive items. Physical direct aggression was the more prevalent type of aggressive behavior, followed by verbal aggression, object aggression and symbolic aggression. Significant differences by gender and age were found. Peer aggression was associated with male gender from three years of age. Physical, object and verbal aggressive behavior was linked with externalizing disorders. This association was very strong with oppositional disorder. CONCLUSIONS: The present research with a Spanish population confirms the existence of peer aggression in preschoolers and the gender differences. Our chief contribution is about the age of emergence of sex differences and gender differences in different types of peer aggression.

[Evaluation of a worksite smoking cessation program]. / Evaluación de un programa de deshabituación tabáquica en el medio laboral.

AIMS: To evaluate the effects of a worksite smoking cessation program conducted to reduce the prevalence of smokers among staff of the town council of Sabadell (Spain). POPULATION AND METHODS: A pre-post intervention study was conducted. A survey was performed to determine the prevalence and characteristics of smokers and to invite them to participate in a smoking cessation program. The intervention involved an individual visit with medical history, measurement of carbon monoxide in expired air and prescription of nicotine replacement therapy followed by 12 sessions of group therapy over 1 year to reinforce abstinence. Follow-up to evaluate abstinence took place at 6, 12 and 24 months. A post-intervention survey was carried out to evaluate the program's effectiveness. RESULTS: A total of 1,203 questionnaires were sent with a response rate of 51%. Thirty-three percent of the subjects (n = 204) were smokers and 101 smokers enrolled in the program. Abstinence rates at 12 and 24 months were 45% and 33% respectively with no differences between sexes. Low and moderate nicotine dependence was associated with a greater probability of abstinence at 6 (OR = 6.7; p = 0.01) and 12 months (OR = 5.4: p = 0.05), adjusted by sex, age, and compliance with nicotine replacement therapy. The prevalence of smokers in the post-intervention questionnaire was 19%. In addition, 26% (n = 10) of subjects who quit smoking in the 12-month study period without participating in the program reported quitting because of the program. CONCLUSIONS: The results indicate that worksite smoking cessation programs can substantially contribute to reducing the prevalence of smoking.

Evaluación de un programa de deshabituación tabáquica en el medio laboral / Evaluation of a worksite smoking cessation program

Objetivos: Se evalúa una intervención realizada en el lugar del trabajo para facilitar el abandono del hábito tabáquico y reducir la prevalencia de fumadores entre el personal del Ayuntamiento de Sabadell. Población y métodos: Estudio preintervención y postintervención. Se realizó una encuesta para conocer la prevalencia y las características de los fumadores e invitarles a participar en un programa de deshabituación. El programa constaba de una visita individual con historia clínica, medida de monóxido de carbono en aire espirado y prescripción de terapia con sustitutos de nicotina y 12 sesiones de terapia grupal para reforzar la abstinencia a lo largo de 1 año. A los 6, 12 y 24 meses se realizaron controles para conocer la abstinencia. Con una encuesta postintervención se valoró el impacto del programa. Resultados: Se enviaron 1.203 cuestionarios con una tasa de respuesta del 51%. Un 33% (n = 204) era fumador y 101 personas iniciaron el programa. La abstinencia a los 12 meses fue del 45% y a los 24 meses del 33%, sin que se observaran diferencias según el sexo. La dependencia moderada o baja a la nicotina se asoció con una mayor probabilidad de estar abstinente a los 6 meses (odds ratio [OR] = 6,7; p = 0,01) y a los 12 meses (OR = 5,4; p = 0,05) ajustando por sexo, edad y seguimiento del tratamiento con sustitutos de nicotina. La prevalencia de fumadores en el cuestionario postintervención fue del 19%. Un 26% (n = 10) de los que habían dejado de fumar en el último año sin participar en el programa declaró haberlo dejado gracias a él. Conclusiones: Los resultados indican que este tipo de programa en un entorno laboral puede contribuir de forma notable a reducir el tabaquismo

Aims: To evaluate the effects of a worksite smoking cessation program conducted to reduce the prevalence of smokers among staff of the town council of Sabadell (Spain). Population and methods: A pre-post intervention study was conducted. A survey was performed to determine the prevalence and characteristics of smokers and to invite them to participate in a smoking cessation program. The intervention involved an individual visit with medical history, measurement of carbon monoxide in expired air and prescription of nicotine replacement therapy followed by 12 sessions of group therapy over 1 year to reinforce abstinence. Follow-up to evaluate abstinence took place at 6, 12 and 24 months. A post-intervention survey was carried out to evaluate the program's effectiveness. Results: A total of 1,203 questionnaires were sent with a response rate of 51%. Thirty-three percent of the subjects (n = 204) were smokers and 101 smokers enrolled in the program. Abstinence rates at 12 and 24 months were 45% and 33% respectively with no differences between sexes. Low and moderate nicotine dependence was associated with a greater probability of abstinence at 6 (OR = 6.7; p = 0.01) and 12 months (OR = 5.4: p = 0.05), adjusted by sex, age, and compliance with nicotine replacement therapy. The prevalence of smokers in the post-intervention questionnaire was 19%. In addition, 26% (n = 10) of subjects who quit smoking in the 12-month study period without participating in the program reported quitting because of the program. Conclusions: The results indicate that worksite smoking cessation programs can substantially contribute to reducing the prevalence of smoking