Adaptación de los servicios de una organización de salud pública a la disminución de los recursos / Adapting the service portfolio of a public health organisation to shrinking resources

Este trabajo describe el proceso de revisión del catálogo de servicios de salud pública de la ciudad de Barcelona para responder a la reducción presupuestaria producida a partir de 2010 en las administraciones públicas en España. Se basó en un grupo de trabajo que revisó las diferentes líneas de actividad, teniendo en cuenta los gastos y los ingresos asociados y su razón de ser, valorando factores como la obligación legal de desempeño, la financiación finalista, la petición explícita por las administraciones fundadoras y la existencia o no de otros actores capaces de asumirla. Se describen los cambios y sus consecuencias. Se valora que el nuevo catálogo está consolidado y se considera ratificado por los órganos de gobierno, que se han renovado tras los relevos políticos. Creemos que esto es fruto de haberlo basado en el consenso profesional y los criterios de gestión, claves para el buen funcionamiento de un organismo autónomo ejecutivo de carácter público (AU)

This paper describes the review process of the Agency of Public Health of Barcelona's service portfolio in response to the budget cuts introduced since 2010 in the public administrations in Spain. A working group reviewed the different business activities, taking into account their costs and generated revenue and their justification, assessing factors such as the existence of legal constraints, tied funding, explicit demands from the founding administrations and other actors that may be capable of undertaking particular activities. The changes and their consequences are described. The new service portfolio has been consolidated and is considered ratified by the Agency board, which was renewed after political changes. We conclude that this is because it was based on professional consensus and management criteria, which are key for the smooth operation of a public autonomous executive organization (AU)

[Adapting the service portfolio of a public health organisation to shrinking resources]. / Adaptación de los servicios de una organización de salud pública a la disminución de los recursos.

This paper describes the review process of the Agency of Public Health of Barcelona's service portfolio in response to the budget cuts introduced since 2010 in the public administrations in Spain. A working group reviewed the different business activities, taking into account their costs and generated revenue and their justification, assessing factors such as the existence of legal constraints, tied funding, explicit demands from the founding administrations and other actors that may be capable of undertaking particular activities. The changes and their consequences are described. The new service portfolio has been consolidated and is considered ratified by the Agency board, which was renewed after political changes. We conclude that this is because it was based on professional consensus and management criteria, which are key for the smooth operation of a public autonomous executive organisation.

Enforcing regulations on alcohol sales and use as universal environmental prevention.

The informal social control over alcohol consumption that was traditional in Southern European countries has weakened. At the same time there is an increase in binge drinking and drunkenness among young people in Spain. To mitigate this problem, regulations on alcohol and driving and restrictions on the sale and consumption of alcohol have been adopted. This paper documents the current regulations in the city of Barcelona and describes efforts to enforce them and their outcomes. Data from the municipal information systems on infringements reported for the period 2008-13 are provided. There is an increasing pressure of municipal services to enforce the rules in two areas: a) alcohol sales at night (retailers); and b) consumption in the public space (citizens). An increase in the controls of drink-driving has also taken place, and the proportion above legal limits has decreased. The largest relative increase occurred in the control of retailers. In Barcelona interventions are made to limit the supply and consumption of alcohol at low cost and during the night, and of driving under the influence of alcohol. There have been no documented episodes of massive drinking in public spaces (known as 'botellón') in the city. These actions, which complement other preventive efforts based on health education, can change the social perceptions of alcohol by minors in a direction less favorable to consumption, promoting environmental prevention.

El control social informal sobre el consumo de alcohol, tradicional en los países del Sur de Europa, se ha debilitado. Este cambio ha ido acompañado de un incremento de los episodios de consumo intensivo y borracheras en jóvenes en España. Para mitigar este problema, se han adoptado regulaciones sobre alcohol y conducción, y otras que restringen la venta y el consumo de alcohol. Este trabajo documenta las regulaciones vigentes y describe los esfuerzos realizados en la ciudad de Barcelona en este campo y sus resultados. Asimismo, se recopilan datos de infracciones denunciadas en los sistemas de información municipal para el período 2008-13.Se observa un incremento de la presión de los servicios municipales para hacer cumplir las normas en dos aspectos: a) la venta en horario nocturno (establecimientos); y b) el consumo en la vía pública (ciudadanía). Por otra parte, también se aprecia un aumento en la actividad de control de la alcoholemia de los conductores, mientras que la proporción que superan los límites legales descendió. El mayor incremento relativo se ha producido en las acciones sobre establecimientos.En Barcelona se realizan intervenciones para limitar la oferta y consumo de alcohol a bajo coste y en horario nocturno, así como la conducción bajo la influencia del alcohol. En la ciudad no se han documentado episodios de botellón masivo en espacios públicos. Estas acciones, que complementan otros esfuerzos preventivos basados en la educación para la salud, pueden modificar la percepción social del alcohol por los menores en un sentido menos favorable al consumo, contribuyendo a crear un entorno de prevención ambiental.

Hacer cumplir las regulaciones sobre venta y consumo del alcohol como prevención ambiental universal / Enforcing regulations on alcohol sales and use as universal environmental prevention

El control social informal sobre el consumo de alcohol, tradicional en los países del Sur de Europa, se ha debilitado. Este cambio ha ido acompañado de un incremento de los episodios de consumo intensivo y borracheras en jóvenes en España. Para mitigar este problema, se han adoptado regulaciones sobre alcohol y conducción, y otras que restringen la venta y el consumo de alcohol. Este trabajo documenta las regulaciones vigentes y describe los esfuerzos realizados en la ciudad de Barcelona en este campo y sus resultados. Asimismo, se recopilan datos de infracciones denunciadas en los sistemas de información municipal para el período 2008-13. Se observa un incremento de la presión de los servicios municipales para hacer cumplir las normas en dos aspectos: a) la venta en horario nocturno (establecimientos); y b) el consumo en la vía pública (ciudadanía). Por otra parte, también se aprecia un aumento en la actividad de control de la alcoholemia de los conductores, mientras que la proporción que superan los límites legales descendió. El mayor incremento relativo se ha producido en las acciones sobre establecimientos. En Barcelona se realizan intervenciones para limitar la oferta y consumo de alcohol a bajo coste y en horario nocturno, así como la conducción bajo la influencia del alcohol. En la ciudad no se han documentado episodios de botellón masivo en espacios públicos. Estas acciones, que complementan otros esfuerzos preventivos basados en la educación para la salud, pueden modificar la percepción social del alcohol por los menores en un sentido menos favorable al consumo, contribuyendo a crear un entorno de prevención ambiental

The informal social control over alcohol consumption that was traditional in Southern European countries has weakened. At the same time there is an increase in binge drinking and drunkenness among young people in Spain. To mitigate this problem, regulations on alcohol and driving and restrictions on the sale and consumption of alcohol have been adopted. This paper documents the current regulations in the city of Barcelona and describes efforts to enforce them and their outcomes. Data from the municipal information systems on infringements reported for the period 2008-13 are provided. There is an increasing pressure of municipal services to enforce the rules in two areas: a) alcohol sales at night (retailers); and b) consumption in the public space (citizens). An increase in the controls of drink-driving has also taken place, and the proportion above legal limits has decreased. The largest relative increase occurred in the control of retailers. In Barcelona interventions are made to limit the supply and consumption of alcohol at low cost and during the night, and of driving under the influence of alcohol. There have been no documented episodes of massive drinking in public spaces (known as ‘botellón’) in the city. These actions, which complement other preventive efforts based on health education, can change the social perceptions of alcohol by minors in a direction less favorable to consumption, promoting environmental prevention

Indicadores para la gestión de los servicios de salud pública

Se pretende definir indicadores apropiados para la gestión de los distintos servicios de una organización que presta servicios integrales de salud pública a una población y territorio definidos. Métodos: Análisis de la actividad y discusión con los responsables de los diversos servicios para buscar indicadores de obtención viable que recojan de la mejor forma tres aspectos: su actividad, su cobertura, calidad o efectividad, y su coste.

Gestión de calidad en una organización de salud pública / Quality management in a public health agency

Se presenta la experiencia de introducción de acciones de mejora de la calidad en una organización de salud pública. Tras la acreditación ISO 17025 del laboratorio de control oficial obtenida por requisito legal, la dirección acordó en 2003 extender la política de calidad, poniendo en marcha un repertorio de acciones mediante el análisis de procesos y la formulación de acciones de mejora, la mayor formalización de procedimientos, el conocimiento de la opinión de los clientes, la creación de grupos de mejora, y la auditoría o certificación externa. La organización respondió de forma diversa a estas iniciativas. Someter los servicios a auditoría o certificación externa parece el motor más poderoso para el cambio. El estudio de costes de la actividad permite valorar que, en 2010, el 75% del gasto total se realiza en servicios de salud pública sujetos a auditoría/certificación externa (AU)

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users’ opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification (AU)

[Quality management in a public health agency]. / Gestión de calidad en una organización de salud pública.

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification.

Indicadores para la gestión de los servicios de salud pública / Indicators for the management of public health services

Objetivos Se pretende definir indicadores apropiados para la gestión de los distintos servicios de una organización que presta servicios integrales de salud pública a una población y territorio definidos.Métodos Análisis de la actividad y discusión con los responsables de los diversos servicios para buscar indicadores de obtención viable que recojan de la mejor forma tres aspectos: su actividad, su cobertura, calidad o efectividad, y su coste.Resultados Se obtienen indicadores cuantitativos para todos los servicios productivos de salud pública relacionados en el catálogo de servicios, pero en algunas líneas de trabajo no parece factible cubrir los tres ámbitos. Además, para las actividades de coordinación y enlace los indicadores son a menudo menos cuantitativos y poco sensibles a cambios. Se ha podido cuantificar el coste para las grandes líneas de trabajo productivo y los 47 servicios o productos, y los costes indirectos se han estimado en un 14%.Conclusiones Es factible desarrollar un sistema de información de gestión para los servicios de salud pública que permita comparaciones a lo largo del tiempo o entre territorios, con indicadores de actividad para todas las líneas de trabajo productivo. Los indicadores que reflejan la cobertura, calidad o impacto de los servicios plantean las mayores dificultades. Para algunas líneas de trabajo se pueden obtener indicadores de coste por unidad de producto con sentido, y para otras es más difícil. En todos los casos, el coste por habitante y año es un buen indicador sintético del coste de los servicios de salud pública (AU)

Objectives To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. Methods We analyzed the agency’s activity and held discussions with those responsible for the distinct services to define indicators whose estimation is viable and which optimally describe three aspects: the services’ activity, coverage, quality or effectiveness, and cost. Results Quantitative indicators were defined for all the productive public health services inventoried in the agency’s services portfolio, but not all three aspects could be covered in all areas. In addition, for coordination and liaison services, the indicators were often less quantitative and less sensitive to change. Costs were estimated for the main areas of productive activity and for the 47 services or products, with indirect costs being estimated as 14% of expenditure.Conclusions We defined a system of indicators for management control, allowing comparisons over time and with other geographical areas, and with activity indicators covering all production areas. Defining indicators reflecting coverage, quality or impact for all services is more difficult. Cost can be estimated by unit of production for some services, but less successfully for others. The yearly cost by population is always a good synthetic indicator of the cost of public health services (AU)

Decline in hospitalisations due to dog bite injuries in Catalonia, 1997-2008. An effect of government regulation?

OBJECTIVE: To analyse population-based data on hospitalisation caused by dog bite injuries after changes in legal regulations on dog ownership, including breed-specific regulations. DESIGN: Descriptive study. SETTING: Hospitals in Catalonia (Spain), 1997-2008. SUBJECTS: Persons hospitalised with injuries caused by dog bites. RESULTS: There has been a significant decline in hospitalisation caused by injuries from dog bites from 1.80/100,000 in 1997-9 to 1.11/100,000 in 2006-8, after the enactment of stricter regulations on dog ownership in 1999 and 2002. The magnitude of this change is significant (-38%), and has been greatest in less urban settings. CONCLUSIONS: Government regulations were associated with a sizable decrease in injuries caused by dog bites in Catalonia. More evaluative studies in this field may provide criteria to focus future regulations and other preventive interventions.

[Indicators for the management of public health services]. / Indicadores para la gestión de los servicios de salud pública.

OBJECTIVES: To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. METHODS: We analyzed the agency's activity and held discussions with those responsible for the distinct services to define indicators whose estimation is viable and which optimally describe three aspects: the services' activity, coverage, quality or effectiveness, and cost. RESULTS: Quantitative indicators were defined for all the productive public health services inventoried in the agency's services portfolio, but not all three aspects could be covered in all areas. In addition, for coordination and liaison services, the indicators were often less quantitative and less sensitive to change. Costs were estimated for the main areas of productive activity and for the 47 services or products, with indirect costs being estimated as 14% of expenditure. CONCLUSIONS: We defined a system of indicators for management control, allowing comparisons over time and with other geographical areas, and with activity indicators covering all production areas. Defining indicators reflecting coverage, quality or impact for all services is more difficult. Cost can be estimated by unit of production for some services, but less successfully for others. The yearly cost by population is always a good synthetic indicator of the cost of public health services.

[The Balanced Scorecard as a management tool in a public health organization]. / El Cuadro de Mando Integral como instrumento de dirección en una organización de salud pública.

OBJECTIVE: The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. METHODS: Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. CONCLUSION: The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.

El Cuadro de Mando Integral como instrumento de dirección en una organización de salud pública / The Balanced Scorecard as a management tool in a public health organization

Objetivos: El Cuadro de Mando Integral (CMI, o Balanced Scorecard) es un instrumento para la planificación estratégica de las empresas. Adoptamos su uso en una organización de salud pública para alinear la práctica cotidiana de la dirección con los objetivos más estratégicos. Métodos: Nuestro equipo directivo requirió de discusiones con apoyo externo para clarificar los conceptos subyacentes en el CMI, adaptarlos a una organización sanitaria pública distinta del medio empresarial para el que se diseñó inicialmente y adoptarlo como instrumento de dirección. Esto llevó a la construcción de un CMI por el Comité de Dirección en el año 2002, a la posterior evaluación y a su reformulación periódica. Además, se han formulado CMI de segundo nivel para diversas direcciones y servicios de la organización. La adopción del CMI por el equipo directivo comportó un esfuerzo previo de clarificación sobre quiénes son los accionistas y los clientes de una organización pública como la nuestra. También llevó a realizar un análisis de la actividad realizada y de su producción, así como un modelo de procesos. Aunque es difícil atribuir determinados cambios a una causa concreta, creemos que diversas mejoras de gestión introducidas se pueden relacionar, al menos parcialmente, con su uso. Conclusión: El uso sistemático del CMI ha permitido cohesionar mejor el equipo de dirección y el conjunto de la organización, e impregnar la gestión cotidiana con los objetivos más estratégicos. La organización ha integrado mejor los elementos relacionados con sus clientes, ha iniciado acciones para mejorar los procesos internos transversales más complejos, y ha desarrollado de manera más sistemática y general los elementos orientados al crecimiento y desarrollo de sus cuadros y de todo el personal. Al mismo tiempo, los directivos han pasado a tener más presentes las necesidades de las administraciones titulares de la agencia que conforman sus órganos de gobierno

Objective: The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Methods: Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. Conclusion: The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board

[Pesticides in the diet: adding pieces to the puzzle]. / Plaguicidas en la dieta: aportando piezas al rompecabezas.

OBJECTIVES: To improve information on exposure to pesticides through diet in Spain by reporting the results on 88 pesticide parameters in 1,109 food samples obtained between 1998 and 2003 as part of the Barcelona program for research on the health quality of foods. MATERIAL AND METHOD: The results are presented by food groups. For fruits and vegetables, the results were compared with those for the previous period. Statistical comparisons were performed using the chi2 test. RESULTS: Of the 1,109 samples, 116 were positive for pesticides (10.5%). Persistent chlorinated compounds were detected in 1.5% and other compounds were found in 14.4%. Positive results were concentrated in fruits, vegetables, spices, cereals and their derivatives. There were no positive results among vegetable oils, eggs or fish products, and almost none in dairy products and meats. Fruits contained the greatest number of pesticides but none were persistent. Vegetables contained fewer pesticides, but some of these were persistent chlorinated compounds. Comparison of the results for fruits and vegetables with those of the 1989-97 period revealed no significant trends. CONCLUSIONS: Although a considerable number of samples contained pesticides, most of these were not persistent chlorinated compounds. The number of pesticides in fruits was notable.

Plaguicidas en la dieta: aportando piezas al rompecabezas / Pesticides in the diet: adding pieces to the puzzle

Objetivos: Mejorar la informacion sobre la exposicion a plaguicidas mediante la dieta en nuestro pais con la presentación de los resultados de deteccion de 88 parametros de (..) (AU)

Objectives: To improve information on exposure to pesticides through diet in Spain by reporting the results on 88 pesticide parameters in 1,109 (AU)

Polycyclic aromatic hydrocarbons in foods: human exposure through the diet in Catalonia, Spain.

The dietary intake of 16 polycyclic aromatic hydrocarbons (PAHs) (naphthalene, acenaphthylene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene, pyrene, benz[a]anthracene, chrysene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[a]pyrene, dibenz[a,h]anthracene, benzo[g,h,i]perylene, and indeno[1,2,3-c,d]pyrene) by the general population of Catalonia, Spain, was calculated. Concentrations of PAHs in food samples randomly acquired in seven cities of Catalonia from June to August 2000 were measured. Eleven food groups were included in the study. High-performance liquid chromatography was used to analyze PAHs. The dietary intakes of total and carcinogenic PAHs was calculated for five population groups: children, adolescents, male adults, female adults, and seniors. Among the analyzed PAHs, there was a predominance of phenanthrene (16.7 microg/kg) and pyrene (10.7 microg/kg). By food group, the highest levels of total PAHs were detected in cereals (14.5 microg/kg) and in meat and meat products (13.4 microg/kg). The mean estimated dietary intake of the sum of the 16 PAHs was as follows: male adults, 8.4 microg/day; adolescents, 8.2 microg/day; children, 7.4 microg/day; seniors, 6.3 microg/day; female adults, 6.3 microg/day. The calculated daily intake of PAHs would be associated with a 5/106 increase in the risk for the development of cancer in a male adult with a body weight of 70 kg.

Medio ambiente saludable e higiene de los alimentos. Evaluación de los objetivos del Plan de Salud de Cataluña para el año 2000 / Environment and food hygiene. Evaluation of the objectives of the Health Plan for Catalonia for the year 2000

Fundamento y objetivo: El medio ambiente constituye uno de los cuatro grandes determinantes de la salud poblacional. Por ello a partir de la intensa relación entre salud, medio ambiente e higiene alimentaria se formularon objetivos de salud y de disminución de riesgo, explicitados en el Documento marco para la elaboración del Plan de Salud de Cataluña, con un horizonte de cumplimiento en el año 2000. La finalidad de este trabajo fue evaluar adecuadamente los objetivos que se propusieron en 1991 sobre este ámbito. Población y método: Se ha evaluado la evolución de los 14 objetivos formulados mediante el seguimiento de los correspondientes indicadores a partir de diversas fuentes de información, entre las que se han de destacar el Registro de Enfermedades de Declaración Obligatoria, la Red de Vigilancia Epidemiológica de Cataluña, así como los datos de actividad de las inspecciones y análisis de aguas de consumo público y residuales, asentamientos, mataderos y establecimientos de distribución de alimentos. Resultados: La morbilidad declarada por fiebre tifoidea y por brucelosis se ha reducido de forma clara, mientras que la disminución de casos de enteritis y diarreas, de brotes de toxiinfección alimentaria y de triquinosis ha resultado insuficiente para alcanzar los objetivos previstos. En cuanto a los indicadores relacionados con las aguas de consumo público, los establecimientos alimentarios y los asentamientos no permanentes se observa una tendencia positiva en su control. Respecto a las muestras de carne con residuos de componentes ilegales, se ha conseguido el valor propuesto (0%). Conclusiones: El balance global de los objetivos del área de salud alimentaria y medio ambiente formulados para el año 2000 puede considerarse positivo. De los 14 objetivos, 9 se han conseguido plenamente, 4 no se han alcanzado y uno se ha conseguido parcialmente. La creciente importancia de las condiciones ambientales y de la seguridad de los alimentos y bebidas en la reducción de riesgos para la salud de las personas fundamentan la elaboración y aplicación de objetivos rigurosos en los sucesivos períodos de planificación sanitaria (AU)

Background and objectives: Environment constitutes one of the four health determinants. Therefore, health and risk-reduction objectives were formulated in the Framework Document for the development of the Health Plan for Catalonia for the year 2000. The main purpose of this paper is to evaluate the degree of achievement of these targets. Subjects and method: We have assessed the evolution of 14 objectives by means of monitorizing appropriate indicators. We have scrutized several health information sources such as the Catalan Notifiable Diseases Surveillance System. In addition, activity data from inspections and analyses of public water system, food distribution establishments and slaughterhouses were analized. Results: Brucellosis and typhoid Fever reported morbidity decreased dramatically, whereas the reduction of enteritis, food poisoning and trichinosis cases have been insufficient to achieve the predicted objective. There is a positive upward trend in the control of public water system and food establishments. Furthermore, meat containing illegal components has been eradicated. Conclusions: The assessment of the objectives is definetly positive. In other words, there are 9 of 14 fully achieved, 1 partially accomplished and 4 that have not been fulfilled. There is a growing importance of environmental conditions and drink and food safety in order to reduce health risks. Therefore, good definitions of strict objectives are required for the next health planning periods (AU)

Polychlorinated naphthalenes in foods: estimated dietary intake by the population of Catalonia, Spain.

Concentrations of polychlorinated naphthalenes (PCNs) were measured in foodstuffs randomly acquired in seven cities of Catalonia, Spain. A total of 108 samples, belonging to 11 food groups (vegetables, tubers, fruits, cereals, pulses, fish and shellfish, meat and meat products, eggs, milk, dairy products, and oils and fats), were analyzed by high-resolution gas chromatography/high-resolution mass spectrometry (HRGC/HRMS). The levels of tetra-, penta-, hexa-, and hepta-CNs, those of octachloronaphthalene, and the mean sum concentration of tetra-octa-CN were determined. The highest concentration of total PCNs was found in oils and fats (447 pg/g), followed by cereals (71 pg/g), fish and shellfish (39 pg/g), and dairy products (36 pg/g). In general, tetra-CN was the predominant homologue in all food groups except for fruits and pulses, which had greater proportions of hexa-CNs. The dietary intake of total PCNs was subsequently determined. For calculations, recent data on consumption of the selected food items were used. Intake of PCNs was estimated for five population groups of Catalonia: children, adolescents, male and female adults, and seniors. When the dietary intake of total PCNs was expressed in nanogram per kilogram of body weight per day, it was age-dependent, with the highest and lowest values corresponding to children (1.65) and seniors (0.54), respectively. The largest contribution to the daily PCNs intake came from oils and fats and from cereals. The result of the current study is the first published report concerning human exposure to PCNs through the diet.

Levels of polychlorinated biphenyls in foods from Catalonia, Spain: estimated dietary intake.

From June to August 2000, food samples were randomly acquired in seven cities in Catalonia, Spain. Polychlorinated biphenyl (PCB) concentrations were determined for 108 samples of vegetables, fruits, pulses, cereals, fish and shellfish, meats and meat products, eggs, milk and dairy products, and oils and fats. Levels of 11 PCB congeners (IUPAC 28, 52, 77, 101, 105, 118, 126, 138, 153, 169, and 180) were determined by high-resolution gas chromatography-high-resolution mass spectrometry. For toxic equivalent (TEQ) calculations, World Health Organization (WHO) toxicity equivalent factors (WHO-TEFs) were used. The highest levels of most congeners were found in fish and shellfish (11,864.18 ng/kg [wet weight]), and the next highest levels, which were substantially lower, were found in milk and dairy products (674.50 ng/kg [wet weight]). For the general population of Catalonia, the total dietary intake of PCBs was found to be 150.13 pg WHO-TEQ/day. The largest contribution to this intake came from fish and shellfish (82.87 pg WHO-TEQ/day) and dairy products (29.38 pg WHO-TEQ per day). A relatively large contribution was also noted for cereals (11.36 pg WHO-TEQ/day). Among the PCB congeners determined in this study, PCB 126 showed the largest contribution to total TEQ intake (50.56%). The data obtained in this study should be useful in risk assessment with regard to human PCB exposure through food in Catalonia.

Human exposure to dioxins through the diet in Catalonia, Spain: carcinogenic and non-carcinogenic risk.

The main objectives of this study were to estimate the dietary intake of dioxins by the population of Catalonia, Spain, to determine which food groups showed the greatest contribution to this intake, and to assess the health risks potentially associated with the dietary dioxin intake. From June to August 2000, food samples were randomly acquired in seven cities of Catalonia. Dioxin concentrations were determined in 108 samples belonging to the following groups: vegetables, fruits, pulses, cereals, fish and shellfish, meats and meat products, eggs, milk and dairy products, and oils and fats. Estimates of average daily food consumption were obtained from recent studies. Total dietary intake of dioxins for the general population of Catalonia was estimated to be 95.4 pg WHO-TEQ/day (78.4 pg I-TEQ/day), with fish and shellfish (31%), diary products (25%), cereals (14%) and meat (13%) showing the greatest percentages of contribution to dioxin intake. The contribution of all the rest of food groups to the total dietary intake was under 20%. The non-carcinogenic risk index of dioxin intake through the diet was in the range 0.34-1.36, while the carcinogenic risk level was 1,360 excess cancer over a lifetime of 70 years. Our results corroborate the decreasing tendency in dietary intake of dioxins found in recent studies (2000-2001) from various countries.