[2022 Practice guidelines for the management of arterial hypertension of the Spanish Society of Hypertension]. / Guía práctica sobre el diagnóstico y tratamiento de la hipertensión arterial en España, 2022. Sociedad Española de Hipertensión - Liga Española para la Lucha contra la Hipertensión Arterial (SEH-LELHA).

Hypertension is the most important risk factor for global disease burden. Detection and management of hypertension are considered as key issues for individual and public health, as adequate control of blood pressure levels markedly reduces morbidity and mortality associated with hypertension. Aims of these practice guidelines for the management of arterial hypertension of the Spanish Society of Hypertension include offering simplified schemes for diagnosis and treatment for daily practice, and strategies for public health promotion. The Spanish Society of Hypertension assumes the 2018 European guidelines for management of arterial hypertension developed by the European Society of Cardiology and the European Society of Hypertension, although relevant aspects of the 2017 American College of Cardiology/American Heart Association guidelines and the 2020 International Society of Hypertension guidelines are also commented. Hypertension is defined as a persistent elevation in office systolic blood pressure ≥ 140 and/or diastolic blood pressure ≥ 90 mmHg, and assessment of out-of-office blood pressure and global cardiovascular risk are considered of key importance for evaluation and management of hypertensive patients. The target for treated blood pressure should be < 130/80 for most patients. The treatment of hypertension involves lifestyle interventions and drug therapy. Most people with hypertension need more than one antihypertensive drug for adequate control, so initial therapy with two drugs, and single pill combinations are recommended for a wide majority of hypertensive patients.

Kinesiotape on quadriceps and gluteus in counter movement jump and sprint in soccer players.

BACKGROUND: Kinesiotape (KT) is a technique commonly used in sports practice. It may be beneficial in enhancing muscle function by additional cutaneous afferent stimulation. The objective of this study was to analyse the effect of KT on countermovement jump (CMJ) and 20-m sprints (sp) immediately and 24 h after its application on the quadriceps and gluteus maximus. METHODS: 37 male soccer players (19.7 ± 0.9 years old) were randomly assigned to one of 3 groups: experimental group: KT activation (KTact), placebo group: sham tape (KTst), and control group (CG). Participants performed a 30-min preliminary warm-up, after which they conducted CMJ and 20-m sp tests. These tests were repeated later (with KT application or not) and after 24 h. RESULTS: Intergroup results found no significant differences either post-test (CMJ, p = 0.115; sp, p = 0.307) or after 24 h (p = 0.053). Intragroup results showed no significant results for CMJ, although 20-m sp seemed to display significant differences in the (KTst) (p = 0.002, post-hoc: 0.015 in pre_sp vs post_sp) and the (KTact) (0.021, in post-hoc: 0.007 in pre_sp vs post_sp), with a moderate effect in pre_sp vs post_sp (0.66) in the (KTact) after KT was applied. CONCLUSION: KT application on the gluteus maximus and quadriceps in young soccer players increases the sprint execution time immediately and 24 h after application, even that the sprint execution time had not been grater that one tenth of the second (0.08 s). It also has no effect on CMJ.

Climate change impact on karstic aquifer hydrodynamics in southern Europe semi-arid region using the KAGIS model.

Nowadays, there are many urban settlements in arid and semiarid areas supplied by groundwater from adjacent small aquifers. Climate projections with expected decreases in averages precipitation values jointly with increases in the frequency of heavy rainfall events does not show a clear pattern to how water resources in karstic aquifers are going to evolve. This paper, focused in the province of Alicante (Southeast of Spain), assesses the behaviour of a small karstic aquifer, the Mela aquifer, whose resources supply urban water consumption for close municipalities. We assess the hydrogeological response of the aquifer, through the KAGIS black-box GIS-based model, for the present climate conditions and for the long period analysing the four scenarios provided by the International Panel of Climate Change. Main results prove that, if we do not diminish the greenhouse gas emissions, the climate change impact on the hydrological response of the study aquifer shows a decrease in the flow rate from its unique spring and will be non-existent during the summer months. So, it will be necessary to design supply strategies for these municipalities and to carry out them, meeting budget restrictions and avoiding potential water shortages.

Drone-based imaging to assess the microbial water quality in an irrigation pond: A pilot study.

Microbial water quality datasets are essential in irrigated agricultural practices to detect and inform measures to prevent the contamination of produce. Escherichia coli (E. coli) concentrations are commonly used to evaluate microbial water quality. Remote sensing imagery has been successfully used to retrieve several water quality parameters that can be determinants of E. coli habitats in waterbodies. This pilot study was conducted to test the possibility of using imagery from a small unmanned aerial vehicle (sUAV or drone) to improve the estimation of microbial water quality in small irrigation ponds. In situ measurements of pH, turbidity, specific conductance, and concentrations of dissolved oxygen, chlorophyll-a, phycocyanin, and fluorescent dissolved organic matter were taken at depths of 0-15 cm in 23 locations across a pond in Central Maryland, USA. The pond surface was concurrently imaged using a drone with three modified GoPro cameras, and a multispectral MicaSense RedEdge camera with five spectral bands. The GoPro imagery was decomposed into red, blue, and green components. Mean digital numbers for 1-m radius areas in the images were combined with the water quality data to provide input for a regression tree-based analysis. The accuracy of the regression-tree data description with "only imagery" inputs was the same or better than that of trees constructed with "only water-quality parameters" as inputs. From multiple cross-validation runs with "only imagery" inputs for the regression trees, the average (±SD) determination coefficient and root-mean-squared error of the decimal logarithm of E. coli concentrations were 0.793 ±â€¯0.035 and 0.131 ±â€¯0.011, respectively. The results of this study demonstrate the opportunities for using sUAV imagery for obtaining a more accurate delineation of the spatial variation of E. coli concentrations in irrigation ponds.

La interceptación de un lanzamiento de córner desde la teoría de los limitadores / The interception of a corner kick from the contraints-led perspective

El comportamiento motor surge de la continua interacción entre tres limitadores (organismo, entorno y tarea), que nunca actúan de forma aislada. Este artículo estudia su efecto en el rendimiento, comportamiento motor y comportamiento visual de porteros de fútbol durante el lanzamiento de córner. 31 participantes, divididos en tres grupos en función del nivel de juego, intentaron atrapar el balón procedente del lanzamiento de córner en dos situaciones (estática y dinámica), mientras que se registraron sus movimientos oculares. Entre los resultados se observa que los expertos tienen un rendimiento más estable, mientras que los otros grupos rinden peor en la situación más difícil; que los expertos realizan un inicio más tardío de la carrera hacia el balón y un patrón motor más rápido para atraparlo; y que la información contenida en los jugadores implicados no es relevante, ya que los porteros dedican valores cercanos al 0% del tiempo total a su fijación

Motor behavior arises from the continuous interaction between three constraints (organism, environment and task), which never act in isolation. This paper studies the effect of the constraints on the performance, motor behavior and visual search behavior of soccer goalkeepers during the corner kick. 31 participants, divided into three groups depending on the level of play, tried to catch the ball out of a corner kick in two situations (static and dynamic), while their eye movements were recorded. Among the results it is observed that the experts have a more stable performance, while the other groups perform worse in the most difficult situation; that the experts make a later start of their run up towards the ball and a faster motor pattern to catch it; and that the that the information of the players involved is not relevant, goalkeepers dedicate values ​​close to 0% of their visual total time to them

Standalone direct pumping photovoltaic system or energy storage in batteries for supplying irrigation networks. Cost analysis.

Solar photovoltaic systems have become one of the most popular topics in the water management industry. Moreover, irrigation networks are water- and energy-hungry, and utility managers are likely to adapt water consumption (and consequently energy demand) to the hours in which there is energy availability. In countries such as Spain (with high irradiance values), solar energy is an available green alternative characterised by zero electricity costs and significantly lower environmental impact. In this work, several types of irrigation scheduled programmes (according to different irrigation sectors) that minimise the number of photovoltaic solar panels to be installed are studied; moreover, the effects of the variable costs linked to energy (energy and emissions costs) are presented. Finally, the effect of incorporating batteries for storing energy to protect the system against emergencies, such as unfavourable weather, is proposed. The irrigation hours available to satisfy water demands are limited by sunlight; they are also limited by the condition that the irrigation schedule type has to be rigid (predetermined rotation) and that the pressure at any node has to be above minimum pressure required by standards. A real case study is performed, and the results obtained demonstrate that there is no universal solution; this is because the portfolio of alternatives is based on investments for purchasing equipment at present and also on future energy savings (revenues). Apart from these two values, there is an economic value (equivalent discontinuous discount rate), which also influences the final results.

Pustulosis exantemática generalizada aguda simulando necrólisis epidérmica tóxica: forma combinada / Acute Generalized Exanthematous Pustulosis Simulating Toxic Epidermal Necrolysis: Overlapping Processes

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El entrenamiento perceptivo de bloqueadoras juveniles de voleibol / Perceptive training of youth volleyball blockers

Este estudio analiza la eficacia de un programa de entrenamiento perceptivo basado en la orientación de la atención para la mejora de la toma de decisiones y el rendimiento en la acción de bloqueo de voleibol. 16 jugadoras juveniles fueron distribuidas en tres grupos: vídeo (n=6), que recibió ocho sesiones de entrenamiento en vídeo; mixto (n=5), que recibió 4 sesiones en vídeo y 4 sesiones de práctica en campo; y control (n=5), que completó las pruebas de evaluación. Los resultados muestran cómo el programa de entrenamiento mejoró la toma de decisiones de las jugadoras, ya que redujeron su tiempo de reacción (F(1,13)=9,237, p=0,009, ηp2=0,415) manteniendo el mismo porcentaje de aciertos. Sin embargo, es necesaria la práctica en campo para lograr transferir dichos aprendizajes al juego real, ya que sólo el grupo mixto mejora el porcentaje de aciertos en el test de rendimiento en campo (F(2,13)=8,608, p=0,004, ηp2=0,570; t(4) =-6,216, p=0,003) (AU)

This study examines the effectiveness of a training program based on perceptual orientation of attention for improving decision-making and performance in the blocking action of volleyball. 16 youth players were divided into three groups: video (n=6), which received eight perceptual training sessions by video; mixed (n=5), which received only half of the sessions by video, combined with practical training in the field; and control (n=5), which just completed pre-test and post-test tests. Results show how orientation of attention to relevant areas of information improved decision-making of the youth volleyball players because they reduced their reaction time (F(1,13)=9,237, p=0,009, ηp2=0,415) maintaining the same percentage of success. However, the practice on the field is necessary to achieve transfer those learning to the real game, because only mixed group improves the percentage of success in the field performance test (F(2,13)=8,608, p=0,004, ηp2=0,570; t(4)=-6,216, p=0,003) (AU)

Evaluación de las actitudes hacia la discapacidad en Educación Física: Efecto diferencial del sexo, contacto previo y la percepción de habilidad y competencia / Avaliação das atitudes em relação à deficiência na Educação Física: efeito diferencial do sexo, contato anterior e percepção de habilidade e competência / Evaluation of attitudes towards disability in Physical Education: Differential effect of sex, previous contact and skill and competence perception

El objetivo del estudio es examinar las actitudes hacia la discapacidad de alumnos de Educación Secundaria Obligatoria en Educación Física, comparando las diferencias en función del sexo, de la edad, del contacto previo con personas con discapacidad y de la habilidad deportiva y competitividad percibida. Doscientos noventa y cuatro estudiantes de Educación Secundaria Obligatoria de tres centros de Castilla - La Mancha (14.54 ± 1.31 años) formaron parte de este estudio. Para el análisis de las actitudes hacia la discapacidad se utilizaron dos instrumentos: "The Attitudes towards Inclusion of Students with Disabilities in Physical Education" (AISDPE) (Reina, Hutzler, Íñiguez Santiago, y Moreno-Murcia, 2016), y la "Escala de Actitud hacia el Alumnado con Discapacidad en Educación Física" (EAADEF) (Íñiguez-Santiago, Férriz, Martínez-Galindo, Cebrián-Sánchez, y Reina, 2017). Los resultados muestran que contactos más íntimos o frecuentes relacionados con la inclusión (como tener un amigo/a o familiar con discapacidad o realizar deporte inclusivo) se relacionarían con una actitud más positiva hacia la discapacidad, en contraposición a los contactos más superficiales o puntuales (compartir aula o clases de EF). Además, la habilidad y competitividad percibida se presentan como posibles variables mediadoras en el proceso de una potencial inclusión efectiva (AU)

The aim of the study is to examine the attitudes towards the disability of students of Compulsory Secondary Education in Physical Education, comparing the differences according to sex, age, previous contact with people with impairments and the skill and competence perception. Two hundred ninety - four students from three centers of Castilla - La Mancha (14.54 ± 1.31 years) took part of this study. In order to analyze the attitudes towards disability, two instruments were used: "The Attitudes toward Inclusion of Students with Disabilities in Physical Education" (AISDPE) (Reina, Hutzler, Íñiguez-Santiago, and Moreno-Murcia, 2016); Attitude's towards Students with Disabilities in Physical Education "(EAADEF) (Íñiguez-Santiago, Férriz, Martínez-Galindo, Cebrián-Sánchez, and Reina, 2017). The results show that more intimate or frequent contacts related to inclusion (such as having a friend or family member with disability or engaging in inclusive sport) would be related to a more positive attitude towards disability, as opposed to more superficial or specific contacts Classroom or EF classes). In addition, the perceived ability and competitiveness are presented as possible mediating variables in the process of a potential effective inclusion (AU)

O objetivo do estudo é analisar as atitudes em relação à deficiência dos alunos do Ensino Secundário em Educação Física, comparando as diferenças com base no sexo, idade, contato prévio com pessoas com deficiência e capacidade atlética percebida e competitividade. Duzentos e noventa e quatro alunos do ensino secundário três centros de Castilla - La Mancha (14,54 ± 1,31 anos) fizeram parte deste estudo. Para a análise das atitudes em relação à deficiência foram utilizados dois instrumentos: "As atitudes para a inclusão de alunos com deficiência em Educação Física" (AISDPE) (Reina, Hutzler, Íñiguez-Santiago, e Moreno-Murcia, 2016), e "Scale atitude para Estudantes com Deficiência em Educação Física (EAADEF)" (Íñiguez-Santiago, Férriz, Martínez-Galindo, Cebrián-Sánchez, e Reina, 2017). Os resultados mostram que a maioria dos contatos íntimos ou frequentes relacionadas com a inclusão (como ter um amigo / ou membro da família com deficiência ou fazer desporto inclusive) se relacionam com uma atitude mais positiva em relação à deficiência, por oposição aos contatos mais superficiais ou ponto (partilha sala de aula ou aulas de educação física). Além disso, habilidade e competitividade percebida são apresentados como possível processo de variáveis mediadoras incluindo potencial efetivo (AU)

Intercepción de un lanzamiento de córner en fútbol: análisis de la tarea / Interception of a corner kick in football: a task analysis

Debido a la inexistencia de estudios previos, la presente investigación tiene como objetivo realizar un análisis de la tarea, que es atrapar un balón procedente de un lanzamiento de córner. Para ello se analizó el rendimiento, el comportamiento motor y los movimientos oculares de jóvenes porteros cuando realizaban esta tarea. Además se compararon las variables en función de los aciertos o fallos durante el blocaje. Los resultados muestran que los fallos en el blocaje se deben a que los porteros iniciaron su carrera demasiado pronto y además utilizaron un patrón inadecuado del movimiento de sus manos y salto. El análisis de los movimientos oculares muestra que el balón es la zona informativa más importante, pero no se obtienen diferencias entre los aciertos y los fallos en el blocaje (AU)

Due to the inexistence of previous studies, the present research is aimed at performing an analysis of the task of intercepting a ball coming from a corner kick. With that objective in mind, the motor behaviour and eye movements of young goalkeepers were analysed when performing the aforementioned task. Also, variables dependent on the number of right and wrong movements during the interception were compared. Results show that errors in blocking are due to the fact that goalkeepers began their run too early and also used an inadequate pattern of hand movement and jump. The analysis of eye movements shows that the ball is the most important informational zone, but no differences were found between hits and misses in the interception (AU)

[Growth charts: Impact on the prevalence of nutritional disorders]. / Tablas de crecimiento: impacto sobre la prevalencia de los trastornos nutritivos.

INTRODUCTION: The references used to assess child growth in Spain are the graphs of the Orbegozo Foundation and the charts of the World Health Organization (WHO). The objective of this study is to analyze the differences between the two charts for weight, height and body mass index, and assess their relevance to identify growth or nutritional problems. MATERIAL AND METHODS: The values of the extreme percentiles of height, weight and body mass index for each sex from 0 to 10 years in both charts are compared. For each value Absolute differences and Z scores are calculated for each value. To evaluate the impact on the prevalence of the various nutritional or growth disorders the location of the value of the respective percentiles of in each of the charts were assessed. RESULTS: Significant differences were observed between the 3th percentile of height and weight, 97th of weight, and 85th and 97th of body mass index. Marked differences were observed for the extreme values of body mass index. During the first years, the Orbegozo charts overestimate the prevalence of malnutrition (between 2% and 19% depending on age and sex) compared to the WHO charts. In subsequent ages Orbegozo underestimates WHO between 0.7% and 2.89%. Orbegozo underestimates the prevalence of overweight (between 2.5% and 14.8%) compared to the WHO charts. The 97th percentile of Body mass index in the Orbegozo charts corresponds in most cases with WHO percentiles above 99.99%. CONCLUSION: The two charts analyzed have significant differences from a clinical and the public health point of view, in the estimation of overweight/obesity and malnutrition.

Metagenomics and development of the gut microbiota in infants.

The establishment of a balanced intestinal microbiota is essential for numerous aspects of human health, yet the microbial colonization of the gastrointestinal tract of infants is both complex and highly variable among individuals. In addition, the gastrointestinal tract microbiota is often exposed to antibiotics, and may be an important reservoir of resistant strains and of transferable resistance genes from early infancy. We are investigating by means of diverse metagenomic approaches several areas of microbiota development in infants, including the deployment of functional capabilities at the community level, the presence of antibiotic resistances and the population dynamics of the most abundant genera.

Metagenomics of human microbiome: beyond 16s rDNA.

The gut microbiota presents a symbiotic relationship with the human host playing a beneficial role in human health. Since its establishment, the bacterial community is subjected to the influence of many different factors that shape its composition within each individual. However, an important convergence is observed at functional level in the gut microbiota. A metatranscriptomic study of healthy individuals showed homogeneity in the composition of the active microbiota that increased further at functional level.

Prevención de la tendinopatía rotuliana con ejercicios excéntricos en deportistas / Patellar tendinopathy prevention in athletes with eccentric exercise

Objetivo: Conocer el efecto de dos programas de entrenamiento excéntrico sobre la morfología del tendón rotuliano. Material y método: Estudio experimental con pre y pos-test y grupo control. La muestra estuvo compuesta por 85 sujetos deportistas; 25 jugadores de baloncesto (BC) y 60 estudiantes de educación física (CAFD) que practican ejercicio físico regulado, mínimo 3 veces por semana. El entrenamiento excéntrico llevado a cabo en ambos grupos tuvo una duración de 12 semanas entre una valoración ecográfica inicial y la final. En el grupo formado por los estudiantes de CAFD se incrementó la carga de forma progresiva que no varió en el grupo de BC. Resultados: Se encontraron diferencias significativas entre la interacción del momento de la medida y el grupo. Las mediciones ecográficas aumentaron de forma significativa (p<0.001) en el grupo CAFD. El grupo experimental BC no mostró cambios, y en el grupo control obtuvo menores longitudes en el post test (p<0.05). La anchura aumentó en el grupo experimental CAFD (p<0.001) y en el grupo experimental BC (p=0.042). Conclusión: El entrenamiento excéntrico provoca una hipertrofia sobre el tendón en pacientes sin tendinopatía rotuliana. Estas mejoras deben basarse sobre una correcta progresión de la carga de trabajo y prestando atención de forma individualizada a cada sujeto (AU)

Objetive: The aim of this study is to know the effect of different eccentric exercises programs in the morphology of the patellar tendon. Methods: This is an experimental study. Eighty-five athletes were included: 25 college basketball players (GBC) and 60 college students (GCAFD) with regular sport activity (at least 3 times/week). A 12-weeks eccentric exercise program was performed. Morphology of patellar tendon was seen with ultrasound both at the beginning and at the end of the program. The difference between both groups was that in the GCAFD program, strength increased progressively, meanwhile in the GBC group it was the same during the whole 12 weeks. Results: Both tendon diameters increased with the program in the experimental GCAFD (p<0.001) versus control group. The GBC showed no changes between both experimental and control group in APLONG and APTRANS, but these parameters were lower in post-test measurement in the control group (p<0.05). LATMED increased in both experimental groups, GCAFD (p<0.001) and GBC (p=0.042). Conclusion: In athletes without patellar tendinopathy, tendon hypertrophy is seen after a program of eccentric exercises, with increase in both anteroposterior and medial lateral diameter. An individualized program must be designed to achieve these results after the exercises (AU)

A Bayesian hierarchical analysis to compare classical and atypical scrapie surveillance data; Wales 2002-2006.

We describe the application of Bayesian hierarchical models (BHM) to the analysis of risk of sheep scrapie using data from multiple surveillance sources. More specifically, we analysed data from the test results of three surveillance sources on classical and atypical scrapie in Wales for the period 2002-2006. For each form of scrapie, a BHM was fitted to assess the occurrence of spatial patterns of risk shared by the multiple surveillance sources and the association between covariates and disease. We defined a shared-component model whereby the two types of data sources: exhaustive lists (e.g. reports of clinical cases) and sample-based data sources (e.g. abattoir survey) shared a common spatial pattern of risks at parish level. This shared component was adjusted by a risk-gradient parameter that moderated the individual contribution of the datasets. For both forms of scrapie, the risk-gradient was not significantly different indicating that the sensitivity of the two types of dataset was similar for the two diseases. The spatial patterns of the combinations of data sources appeared similar within disease. However, our results suggest that classical and atypical scrapie differ in their spatial patterns and disease determinants. The joint approach permitted inference from all the available evidence and resulted in robust and less biased estimates of risk, particularly for atypical scrapie where the number of observations was very limited.

Life-stage variation in insecticide resistance of the western flower thrips (Thysanoptera: Thripidae).

The life-stage variations in insecticide resistance of western flower thrips, Frankliniella occidentalis (Pergande) (Thysanoptera: Thripidae), to selective insecticides (acrinathrin, formetanate, and methiocarb) were studied using resistant laboratory strains. In each strain, the second-instar larva was less susceptible to the insecticides tested than the adults. The lower the resistance level of the adults, the higher the difference between larva and adult susceptibility: 32-fold to methiocarb, 15.4-fold to formetanate, and 180-fold to acrinathrin in the reference strain. In laboratory-selected resistant strains, these differences were much lower: 5.8-fold to methiocarb, 4.8-fold to formetanate, and 2.0-fold to acrinathrin. In selected strains, higher resistance levels for each insecticide were found, both for larvae and adults, compared with the reference strain. These results show that after insecticide resistance selection in adults, the resistance is carried over to the larvae, but at lower levels.

Carbamates synergize the toxicity of acrinathrin in resistant western flower thrips (Thysanoptera: Thripidae).

The insecticidal efficacy of mixtures of acrinathrin (pyrethroid) with carbamate fungicides (propamocarb, carbendazim, iprovalicarb, and diethofencarb) and insecticides (carbaryl, thiodicarb, pirimicarb, and oxamyl) was studied in a field strain of Frankliniella occidentalis (Pergande). The fungicide propamocarb and the insecticides pirimicarb and oxamyl were selected for further studies of their synergism action with more detailed bioassays. The method consisted of combining increasing concentrations of acrinathrin with a constant sublethal rate of the carbamate as synergist. These three carbamates did not show synergism to acrinathrin in a laboratory insecticide-susceptible strain, but they did in two field strains, with higher acrinathrin resistance corresponding to higher synergism. Carbamates such as pirimicarb, oxamyl, and propamocarb could be practical candidates for field use as synergists, even against other pests with metabolic resistance.

Geographic density of landfill sites and risk of congenital anomalies in England.

OBJECTIVE: To investigate the risk of congenital anomalies in relation to an index of geographic density of landfill sites across 5x5 km grid squares in England. METHODS: 2 km zones were constructed in a geographical information system around 8804 landfill sites, including 607 that handled special (hazardous) wastes, and intersected with postcode coordinates of over 10 million births (136,821 with congenital anomalies), 1983-98. A landfill exposure index was calculated to represent the geographic density of landfill sites within 2 km of births for each 5x5 km grid square, calculated separately for landfill sites handling special, and non-special or unknown, waste. For each group of landfills, the index was classified into four categories of intensity, and risks for the second, third and top categories were compared to the bottom category, comprising areas with no such landfill sites within 2 km (index of zero). We used hierarchical logistic regression modelling in a Bayesian framework, with adjustment for potential confounding. RESULTS: For special waste sites, adjusted odds ratios were significant for the third category of the landfill exposure index for all anomalies combined and cardiovascular defects (OR 1.08 (95% credible interval 1.02 to 1.13) and 1.16 (1.00 to 1.33), respectively) and for hypospadias and epispadias for the third and top categories (OR 1.11 (1.02 to 1.21) and 1.12 (1.02 to 1.22), respectively). After adjustment, there were no excess risks in relation to sites handling non-special or unknown waste types. CONCLUSIONS: There was a weak spatial association between risk of certain congenital anomalies and geographic density of special (hazardous) waste sites at the level of 5x5 km grid squares. Exposure pathways and mechanisms to help interpret these findings are not well-established.