Heavy Drinking by Occupation in Spain: Differences Between Weekdays and the Weekend.

Estimating occupational disparity in heavy drinking jointly for weekdays and the weekend may be misleading for prevention purposes, because reasons for disparity in both periods may differ. The main objective was to assess occupational disparity in heavy average drinking (HAD) by week period and sex. 42,108 employees aged 16-64 were recruited from national surveys in Spain between 2011 and 2020. The outcome was HAD, defined as daily alcohol intake over 20 g (men) or 10 g (women). Occupation was classified in 15 categories. HAD adjusted prevalence ratios (HAD-aPRs) taking all occupations as reference, and relative adjusted excess prevalences (HAD-aEPs) comparing the weekend to weekdays in each occupation, were estimated using Poisson regression models with robust variance adjusted for sociodemographic and health covariates. The HAD-aPRs comparing each occupation with all occupations ranged 0.63-1.92 on weekdays and 0.65-1.45 on the weekend, with the highest aPRs on weekdays in construction, hospitality and primary-sector workers (1.92-1.62). The weekend-weekdays HAD-aEPs by occupation ranged 2.60-8.33, with the highest values in technicians/administrators, other professionals, teachers and health professionals (8.33-6.44). The global aEP was higher in women (6.04) than in men (3.92), especially in occupations just mentioned (8.70-11.73 in women vs. 3.64-6.32 in men). There was a considerable relative disparity in HAD risk between occupations on weekdays, with the highest risks in certain low-skilled occupations. Such disparity decreased on the weekend. The relative weekend increase in HAD risk was greater in women and in certain high-skilled occupations. This should be considered when designing prevention interventions on harmful drinking.

Abrupt peaks in perceived risk of occasional drug use after changing the question order in a repeated self-administered survey.

Background: Question-order changes in repeated surveys can distort comparisons. We want to describe the evolution of drug risk perceptions among Spanish adolescents and assessing whether the 2006 peaks in perceived risk of occasional drug use can be explained by question-order changes. Methods: The subjects were secondary students from a biennial national survey during 2000-2012. A one-off intervention was applied in 2006, replacing the two-adjacent items on perceived risk of occasional and regular use of each drug by non-adjacent items. Annual prevalence of high-risk perception were obtained for occasional and regular use of cannabis, heroin, cocaine and ecstasy. Subsequently, the 2006 percent level change (PC) in such were estimated prevalence using segmented Poisson regression, adjusting for various student and parent covariates. Results: The 2006 PC in prevalence of high-risk perception of occasional drug use ranged from +63% (heroin) to +83% (ecstasy). These PCs were very high in all considered subgroups. However, the 2006 PC in prevalence of high-risk perception of regular drug use ranged from 1% (heroin) to 12% (cannabis). The evolution of preventive interventions does not suggest alternative causal hypotheses for 2006 peaks other than question-order changes. Conclusion: Within the cognitive heuristics framework, the 2006 spikes in perceived risk of occasional drug use were most likely due to a release of the anchor exerted by perceived risk of regular drug use over that of occasional use triggered by 2006 question-order changes. In repeated surveys it is inexcusable to pre-test the effect of any change in questionnaire format.

Excessive Drinking Among Men Who Have Sex With Men Recruited From Web-Based Resources: Cross-sectional Questionnaire Study.

BACKGROUND: US and Northern European studies have found a higher prevalence of alcohol-related problems among men who have sex with men (MSM) than among the general population of men (GPM). However, most of them relied on traditional sampling methods, not profiting from MSM dating apps and websites for recruitment. Besides, analogous comparisons in Southern Europe are lacking. OBJECTIVE: This study aimed to compare several indicators of excessive drinking between MSM and GPM in Spain. METHODS: Overall, 5862 MSM were recruited through dating apps or websites for the Méthysos Project, and 10,349 GPM were recruited using probability sampling via the Household Survey on Alcohol and Drugs in Spain from 2018 to 2020. The outcomes were the prevalence of hazardous or harmful drinking (Alcohol Use Disorders Identification Test [AUDIT] ≥8), hazardous drinking (AUDIT-Consumption ≥4), harmful drinking (AUDIT-Problem ≥4), regular hazardous drinking (>14 standard drinks per week), and monthly binge drinking. The prevalence of excessive drinking indicators was calculated for MSM and GPM and compared using the adjusted prevalence ratio (aPR). Two different aPRs and their 95% CIs were estimated using Poisson regression models with robust variance. The first was adjusted for sociodemographic characteristics, and the second was adjusted for the aforementioned covariates plus other drug use. RESULTS: The prevalence of hazardous or harmful drinking was 15.6% (913/5862) among MSM versus 7.7% (902/10,349) among GPM. After adjusting for sociodemographic covariates, the risk was higher in MSM than in GPM for harmful or hazardous drinking (aPR 1.8, 95% CI 1.6-2.0), harmful drinking (aPR 2.3, 95% CI 2.0-2.7), and binge drinking (aPR 1.7, 95% CI 1.5-1.9); the same in both populations for hazardous drinking (aPR 0.9, 95% CI 0.9-1.0); and higher in GPM than in MSM for regular hazardous drinking (aPR 0.7, 95% CI 0.6-0.9). The relative excess risk of harmful drinking and binge drinking among MSM tended to increase with increasing education level and size of the place of residence, and the opposite was true for the deficit risk in regular hazardous drinking. Additional adjustment for other drug use greatly buffered the relative excess risk in harmful drinking and binge drinking in MSM, while it deepened its deficit risk in regular hazardous drinking. CONCLUSIONS: The use of web-based resources allowed recruiting a large sample of MSM. The risk of hazardous or harmful drinking was 80% greater in MSM than in GPM, which was mainly because of the higher risk of harmful drinking and binge drinking among MSM. Nearly 1 in 6 MSM would benefit from early brief alcohol intervention procedures. The subgroup with harmful or binge drinking combined with other drug use is an important contributor to excess MSM risk in hazardous or harmful drinking and must be a priority target for harm reduction interventions.

[Characteristics of COVID-19 cases and contacts reported in an area of Madrid during beginning of de-escalation.] / Características de los casos y contactos de COVID-19 identificados en un área de Madrid durante el inicio de la desescalada.

OBJECTIVE: Deescalation began in May 2020 increases social interaction, which has an influence on COVID-19 epidemiological surveillance. The aim of this study was the characterization of COVID-19 cases detected during this period. METHODS: We analyzed certain variables of interest coming from the epidemiological surveys carried out in an area of Madrid during May 2020, and stratified the results depending on its temporal relation with the deescalation. Prevalence for each category of response and average duration in minutes of the telephonic call were calculated. Confidence intervals were estimated at 95%. RESULTS: We included 167 cases, being 30.5% of them incident and 49.1% prevalent. The main source of infection was home (38.0%; CI 95% 31.4-46.2). Regarding healthcare and social care workers, the main source of infection was workplace (93.0%; 85.4-100). Average number of close contacts per case was 2.0 (1.8-2.2), being 1.5 (1.0-2.0) among pre-deescalation incident cases and 2.4 (1.8-3.0) among those post-deescalation. Average duration of each survey was 35.9 minutes (32.2-38.9), being 32.1 (24.4-39.8) among pre-deescalation incident cases and 37.0 (29.6-44.4) among those post-deescalation. Most of the contacts were household, both before and after beginning of deescalation. CONCLUSIONS: Home is the most prevalent place for the acquisition of the infection among general population, while workplace is the most prevalent among healthcare and social care workers. The initial phase of deescalation do not represents a change regarding sources of infection, but it may increase the number of close contacts.

OBJETIVO: La desescalada iniciada en mayo de 2020 aumenta las interacciones sociales, lo que influye en la vigilancia epidemiológica de la COVID-19. Este estudio tuvo como objetivo caracterizar los casos identificados durante este periodo. METODOS: Se analizaron parámetros de interés de las encuestas epidemiológicas realizadas en un área de Madrid durante mayo de 2020, estratificando los resultados según su relación temporal con la desescalada. Para las distintas opciones de respuesta, se calculó la prevalencia, y para la duración de la encuesta, la media en minutos. Los intervalos de confianza se estimaron al 95%. RESULTADOS: Se incluyeron 167 casos, siendo un 30,5% incidentes y un 49,1% prevalentes. El principal lugar de contagio fue el domicilio (38,8%; IC 95% 31,4-46,2). En el caso de los trabajadores sanitarios y sociosanitarios fue el centro de trabajo (93,0%; 85,4-100). El número medio de contactos por caso fue 2,0 (1,8-2,2), siendo 1,5 (1,0-2,0) en los casos incidentes predesescalada y 2,4 (1,8-3,0) en los postdesescalada. El tiempo medio por encuesta fue de 35,9 minutos (32,2-38,9), siendo 32,1 (24,4-39,8) en los incidentes predesescalada y 37,0 (29,6-44,4) en los postdesescalada. El principal ámbito de contacto fue el domicilio, tanto antes como después del inicio de la desescalada. CONCLUSIONES: Los contagios se producen principalmente en el domicilio en el caso de la población general y en el centro de trabajo en cuanto a los profesionales sanitarios y sociosanitarios. La fase inicial de la desescalada no supone un cambio en las fuentes de exposición, pero sí podría haber aumentado el número de contactos a investigar.

A mirror in fiction: drawing parallelisms between Camus's La Peste and COVID-19.

COVID-19 represents one of the most challenging global health issues in modern times. However, as epidemics have affected humans since our origins, many before us have described how significantly they compromise human lives. Leaving apart the aspects more linked to medicine and health sciences, we focus here on analysing how epidemics force people to change their habits, what type of emotions and behaviours they promote, and which roles are played by different social actors. For such a purpose, especially if we wish to draw some parallels between past epidemics and COVID-19, historical records seemed to be more suitable than literary works. Nonetheless, we have taken this approach relying on La Peste (Albert Camus, 1947), a novel based on a fictional epidemic of plague in the Algerian town of Oran. Far from creating a barrier separating fiction from reality, this reading allowed us to establish several links with our current situation. Recognising that context and solutions vary widely between the two scenarios, core matters concerning epidemics seemed to remain invariable. The important role of data and statistics, the leadership acquired by health authorities, the separations of relatives or the negative effects on trade and business are some issues which took place in Oran as well as nowadays. Besides that, epidemics also affect humans at an individual level, and certain thoughts and feelings in La Peste's main characters may make us identify with our own fears and desires.