Mallorca, Spain
Mallorca, Spain

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Bousquet J.,Montpellier University | Bousquet J.,French Institute of Health and Medical Research | Anto J.,Center for Research in Environmental Epidemiology | Anto J.,Municipal Institute of Medical Research IMIM Hospital Del Mar | And 90 more authors.
Allergy: European Journal of Allergy and Clinical Immunology | Year: 2011

The origin of the epidemic of IgE-associated (allergic) diseases is unclear. MeDALL (Mechanisms of the Development of ALLergy), an FP7 European Union project (No. 264357), aims to generate novel knowledge on the mechanisms of initiation of allergy and to propose early diagnosis, prevention, and targets for therapy. A novel phenotype definition and an integrative translational approach are needed to understand how a network of molecular and environmental factors can lead to complex allergic diseases. A novel, stepwise, large-scale, and integrative approach will be led by a network of complementary experts in allergy, epidemiology, allergen biochemistry, immunology, molecular biology, epigenetics, functional genomics, bioinformatics, computational and systems biology. The following steps are proposed: (i) Identification of classical and novel phenotypes in existing birth cohorts; (ii) Building discovery of the relevant mechanisms in IgE-associated allergic diseases in existing longitudinal birth cohorts and Karelian children; (iii) Validation and redefinition of classical and novel phenotypes of IgE-associated allergic diseases; and (iv) Translational integration of systems biology outcomes into health care, including societal aspects. MeDALL will lead to: (i) A better understanding of allergic phenotypes, thus expanding current knowledge of the genomic and environmental determinants of allergic diseases in an integrative way; (ii) Novel diagnostic tools for the early diagnosis of allergy, targets for the development of novel treatment modalities, and prevention of allergic diseases; (iii) Improving the health of European citizens as well as increasing the competitiveness and boosting the innovative capacity of Europe, while addressing global health issues and ethical issues. © 2011 John Wiley & Sons A/S.


Yanez A.,Hospital Son Espases | Tejera E.,Conselleria de Salut | Torrent M.,Area de Salut de Menorca
Adicciones | Year: 2013

The socio-cultural environment is an important factor involved with the onset of smoking during adolescence. Initiation of cigarette smoking occurs almost exclusively during this stage. In this context we aimed to analyze the association of school and family factors with adolescent smoking by a cross-sectional study of 16 secondary schools randomly selected from the Balearic Islands involved 3673 students and 530 teachers. The prevalence of regular smoking (at least one cigarette per week) was 4.8% among first year students, 11.6% among second year students, 14.1% among third year students, 20.9% among fourth year students and 22% among teachers. Among first and second year students, there were independent associations between regular smoking and adolescents' perception of being allowed to smoke at home, belonging to a single parent family, poor relationship with parents, poor academic performance, lack of interest in studies and teachers' perception of smoking in the presence of pupils. Among third and fourth year students, there were independent associations between regular smoking and poor relationship with parents, adolescents' perception of being allowed to smoke at home, poor academic performance, lack of control over student misbehavior and the school attended. The school policies and practices affect student related health behavior regarding smoking, independent of individual and family factors.


Pinart M.,Center for Research in Environmental Epidemiology | Pinart M.,IMIM Hospital del Mar Research Institute | Pinart M.,CIBER ISCIII | Pinart M.,University Pompeu Fabra | And 64 more authors.
The Lancet Respiratory Medicine | Year: 2014

Background: Eczema, rhinitis, and asthma often coexist (comorbidity) in children, but the proportion of comorbidity not attributable to either chance or the role of IgE sensitisation is unknown. We assessed these factors in children aged 4-8 years. Methods: In this prospective cohort study, we assessed children from 12 ongoing European birth cohort studies participating in MeDALL (Mechanisms of the Development of ALLergy). We recorded current eczema, rhinitis, and asthma from questionnaires and serum-specific IgE to six allergens. Comorbidity of eczema, rhinitis, and asthma was defined as coexistence of two or three diseases in the same child. We estimated relative and absolute excess comorbidity by comparing observed and expected occurrence of diseases at 4 years and 8 years. We did a longitudinal analysis using log-linear models of the relation between disease at age 4 years and comorbidity at age 8 years. Findings: We assessed 16147 children aged 4 years and 11080 aged 8 years in cross-sectional analyses. The absolute excess of any comorbidity was 1·6% for children aged 4 years and 2·2% for children aged 8 years; 44% of the observed comorbidity at age 4 years and 50·0% at age 8 years was not a result of chance. Children with comorbidities at 4 years had an increased risk of having comorbidity at 8 years. The relative risk of any cormorbidity at age 8 years ranged from 36·2 (95% CI 26·8-48·8) for children with rhinitis and eczema at age 4 years to 63·5 (95% CI 51·7-78·1) for children with asthma, rhinitis, and eczema at age 4 years. We did longitudinal assessment of 10 107 children with data at both ages. Children with comorbidities at 4 years without IgE sensitisation had higher relative risks of comorbidity at 8 years than did children who were sensitised to IgE. For children without comorbidity at age 4 years, 38% of the comorbidity at age 8 years was attributable to the presence of IgE sensitisation at age 4 years. Interpretation: Coexistence of eczema, rhinitis, and asthma in the same child is more common than expected by chance alone-both in the presence and absence of IgE sensitisation-suggesting that these diseases share causal mechanisms. Although IgE sensitisation is independently associated with excess comorbidity of eczema, rhinitis, and asthma, its presence accounted only for 38% of comorbidity, suggesting that IgE sensitisation can no longer be considered the dominant causal mechanism of comorbidity for these diseases. Funding: EU Seventh Framework Programme. © 2014 Elsevier Ltd.


Gascon M.,Center for Research in Environmental Epidemiology | Gascon M.,University Pompeu Fabra | Gascon M.,CIBER ISCIII | Vrijheid M.,Center for Research in Environmental Epidemiology | And 16 more authors.
Environment International | Year: 2015

Introduction: The aims of the present study are to assess the temporal trends of organochlorine compounds (OCs) concentrations and total serum burdens from birth until adolescence and the influence of breastfeeding in these temporal trends. Methods: In 1997 two birth cohort studies were set up in Ribera d'Ebre (N=102) and the island of Menorca (N=482), Spain. Concentrations (ng/mL) of OCs [pentachlorobenzene (PeCB), four isomers of hexachlorocyclohexane (HCH), hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane (4,4'-DDT), dichlorodiphenyldichloroethylene (4,4'-DDE) and seven polychlorobiphenyl congeners (σ7PCBs)] were measured in cord blood and at the age of 4 and 14years. The total serum burdens (ng) of these compounds were estimated based on the total blood volume (mL) of children at the different ages. We compared median concentrations and total serum burdens of these OCs at the different time-points of follow-up between children of Ribera d'Ebre and Menorca and between breastfed and non-breastfed children. Results: From birth until adolescence concentrations of all OCs drastically reduced. These reductions were mainly derived from the dilution of OCs, associated to an increase in total blood volume of children at the age of 4 and 14years. Despite the reduction in OCs concentrations, the total serum burdens of 4,4'-DDE and σ7PCBs, were higher in adolescents than at birth. Increases in OCs total serum burden occurred both in breastfed and non-breastfed children, but were significantly higher in the first. Conclusions: Even after decades of banning OCs production and use, current young generations in westernized countries are still bioaccumulating these compounds. Given the potential health effects of OCs, especial attention should be paid in the control of secondary emissions in the environment and in the control of food production and contamination. In countries with endemic malaria it is important to work towards effective alternatives to the use of DDT. © 2014 Elsevier Ltd.


Gascon M.,Center for Research in Environmental Epidemiology | Gascon M.,Municipal Institute of Medical Research IMIM Hospital del Mar | Vrijheid M.,Center for Research in Environmental Epidemiology | Vrijheid M.,Municipal Institute of Medical Research IMIM Hospital del Mar | And 10 more authors.
Environment International | Year: 2011

There are at present very few studies of the effects of polybromodiphenyl ethers (PBDEs), used as flame retardants in consumer products, on neurodevelopment or thyroid hormone levels in humans. The present study aims to examine the association between pre and postnatal PBDE concentrations and neurodevelopment and thyroid hormone levels in children at age 4. years and isolate the effects of PBDEs from those of PCBs, DDT, DDE and HCB.A prospective birth cohort in Menorca (Spain) enrolled 482 pregnant mothers between 1997 and 1998. At 4. years, children were assessed for motor and cognitive function (McCarthy Scales of Children's Abilities), attention-deficit, hyperactivity and impulsivity (ADHD-DSM-IV) and social competence (California Preschool Social Competence Scale). PBDE concentrations were measured in cord blood (N = 88) and in serum of 4. years olds (N = 244). Among all congeners analyzed only PBDE 47 was quantified in a reasonable number of samples (LOQ = 0.002. ng/ml). Exposure to PBDE 47 was analyzed as a dichotomous variable: concentrations above the LOQ (exposed) and concentrations below (referents).Scores for cognitive and motor functions were always lower in children pre and postnatally exposed to PBDE47 than in referents, but none of these associations was statistically significant (β coefficient (95%CI) of the total cognition score: -2.7 (-7.0, 1.6) for postnatal exposure, and -1.4 (-9.2, 6.5) for prenatal exposure). Postnatal exposure to PBDE 47 was statistically significantly related to an increased risk of symptoms on the attention deficit subscale of ADHD symptoms (RR (95%CI) = 1.8 (1.0, 3.2)) but not to hyperactivity symptoms. A statistically significant higher risk of poor social competence symptoms was observed as a consequence of postnatal PBDE 47 exposure (RR (95%CI) = 2.6 (1.2, 5.9)). Adjustment for other organochlorine compounds did not influence the results. Levels of thyroid hormones were not associated to PBDE exposure.This study highlights the importance of assessing the effects of PBDE exposure not just prenatally but also during the early years of life. In the light of current evidence a precautionary approach towards PBDE exposure of both mothers and children seems warranted. © 2010 Elsevier Ltd.


Valvi D.,Center for Research in Environmental Epidemiology | Valvi D.,Hospital del Mar Research Institute IMIM | Valvi D.,CIBER ISCIII | Valvi D.,University Pompeu Fabra | And 15 more authors.
Environmental Health Perspectives | Year: 2012

Background: Recent experimental evidence suggests that prenatal exposure to endocrine-disrupting chemicals (EDCs) may increase postnatal obesity risk and that these effects may be sex or diet dependent. Objectives: We explored whether prenatal organochlorine compound (OC) concentrations [polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (DDE), and dichlorodiphenyltrichloroethane (DDT)] were associated with overweight at 6.5 years of age and whether child sex or fat intakes modified these associations. Methods: We studied 344 children from a Spanish birth cohort established in 1997-1998. Overweight at 6.5 years was defined as a body mass index (BMI) z-score ≥ 85th percentile of the World Health Organization reference. Cord blood OC concentrations were measured and treated as categorical variables (tertiles). Children's diet was assessed by food frequency questionnaire. Relative risks (RRs) were estimated using generalized linear models. Results: After multivariable adjustment, we found an increased RR of overweight in the third tertile of PCB exposure [RR = 1.70; 95% confidence interval (CI): 1.09, 2.64] and the second tertile of DDE exposure (RR = 1.67; 95% CI: 1.10, 2.55), but no association with DDT exposure in the population overall. Associations between overweight and PCB and DDE concentrations were strongest in girls (p-interaction between 0.01 and 0.28); DDT was associated with overweight only in boys. For DDT we observed stronger associations in children with fat intakes at or above compared with below the median, but this interaction was not significant (p-interaction > 0.05). Conclusions: This study suggests that prenatal OC exposures may be associated with overweight in children and that sex and high-fat intake may influence susceptibility.


Grimalt J.O.,CSIC - Institute of Environmental Assessment And Water Research | Carrizo D.,CSIC - Institute of Environmental Assessment And Water Research | Gari M,CSIC - Institute of Environmental Assessment And Water Research | Font-Ribera L.,CSIC - Institute of Environmental Assessment And Water Research | And 3 more authors.
Environmental Research | Year: 2010

This study of the body burden and serum concentrations of organochlorine compounds (OCs), represents a general population in a cohort from Menorca Island (birth 1997-1998) of children at birth and at 4 years of age; the study has shown that the concentrations of hexachlorobenzene (HCB), 4,4′-DDE, 4,4′-DDT, polychlorobiphenyl (PCB) congeners #153, #138 and #180 and total PCBs in sera collected at 4 years are much higher in breastfed children than in those fed with formula, e.g. HCB 0.48 vs 0.21 ng/ml, β-HCH 0.32 vs 0.24 ng/ml, total DDTs 2.2 vs 0.57 ng/ml and total PCBs 1.4 vs 0.52 ng/ml. Comparison of gender differences in 4 years old children shows higher concentrations of all examined OCs in females than in males with the exception of HCB and PeCB in breastfed children, which are higher in males than in females, e.g. β-HCH 0.34 vs 0.28 ng/ml, total DDTs 2.6 vs 1.7 ng/ml and total PCBs 1.6 vs 1.0 ng/ml for breastfed children and β-HCH 0.23 vs 0.19 ng/ml, total DDTs 0.59 vs 0.48 ng/ml and total PCBs 0.58 vs 0.45 ng/ml for formula fed children. Gender comparison of the body burden between children fed with breastmilk or formula also shows higher concentrations in females than in males, e.g. β-HCH 0.47 vs 0.35 μg, total DDTs 3.0 vs 1.8 μg and total PCBs 1.9 vs 1.2 μg for breastfed children, and β-HCH 0.39 vs 0.17 μg, total DDTs 0.48 vs 0.27 μg and total PCBs 0.66 vs 0.55 μg for formula fed children. The results may suggest a higher capacity in female children for the retention of OCs incorporated through breastfeeding. However, these results should be taken with caution because the differences of the gender averages have low statistically significance when evaluated with the Student test. © 2010 Elsevier Inc. All rights reserved.


Leiva A.,Primary Care Research Unit of Mallorca | Estela A.,Dalt Sant Joan Health Center | Torrent M.,Area de Salut de Menorca | Calafat A.,European Institute of Studies on Prevention Irefrea | And 2 more authors.
BMC Public Health | Year: 2014

Background: The likelihood of an adolescent taking up smoking may be influenced by his or her society, school and family. Thus, changes in the immediate environment may alter a young person's perception of smoking. Methods/Design. The proposed multi-center, cluster-randomized controlled trial will be stratified by the baseline prevalence of smoking in schools. Municipalities with fewer than 100,000 inhabitants will be randomly assigned to a control or intervention group. One secondary school will be randomly selected from each municipality. These schools will be randomized to two groups: the students of one will receive any existing educational course regarding smoking, while those of the other school will receive a four-year, class-based curriculum intervention (22 classroom lessons) aimed at reinforcing a smoke-free school policy and encouraging smoking cessation in parents, pupils, and teachers. The intervention will also include annual meetings with parents and efforts to empower adolescents to change the smoking-related attitudes and behaviors in their homes, classrooms and communities.We will enroll children aged 12-13 years as they enter secondary school during two consecutive school years (to obtain sufficient enrolled subjects). We will follow them for five years, until two years after they leave secondary school. All external evaluators and analysts will be blinded to school allocation.The aim of this study is to analyze the effectiveness of a complex intervention in reducing the prevalence of smoking in the third year of compulsory secondary education (ESO) and two years after secondary school, when the participants are 14-15 and 17-18 years old, respectively. Discussion. Most interventions aimed at preventing smoking among adolescents yield little to no positive long-term effects. This clinical trial will analyze the effectiveness of a complex intervention aimed at reducing the incidence and prevalence of smoking in this vulnerable age group. Trial registration. Current Controlled Trials: NCT01602796. © 2014 Leiva et al.; licensee BioMed Central Ltd.


Gari M.,CSIC - Institute of Environmental Assessment And Water Research | Grimalt J.O.,CSIC - Institute of Environmental Assessment And Water Research | Torrent M.,Area de Salut de Menorca | Sunyer J.,Center for Research in Environmental Epidemiology
Environmental Pollution | Year: 2013

Mercury levels measured in 302 hair samples of 4 year-old children from Menorca (western Mediterranean Sea) are reported. Their concentrations, arithmetic mean 1.4 μg/g, ranging between 0.040 μg/g and 10 μg/g, were higher than in other children inland populations but lower than in previously studied island cohorts, e.g. Faroe, Madeira and Seychelles. 20% of the samples were above the WHO recommended values. Higher concentrations in females than males were observed. Frequent consumption of fish and other seafood were significantly related to the observed mercury concentrations. Oily fish was the main source of this pollutant but shellfish and squid consumption were also associated with high mercury concentrations. Maternal smoking, occupational status or previous siblings were also found to significantly influence the levels of this pollutant. McCarthy Scales of Children's Abilities used to assess children's motor and cognitive abilities did not show association with mercury concentrations at 4 years of age. © 2013 Elsevier Ltd. All rights reserved.


PubMed | University Pompeu Fabra, CSIC - Institute of Environmental Assessment And Water Research and Area de Salut de Menorca
Type: | Journal: Environment international | Year: 2014

The aims of the present study are to assess the temporal trends of organochlorine compounds (OCs) concentrations and total serum burdens from birth until adolescence and the influence of breastfeeding in these temporal trends.In 1997 two birth cohort studies were set up in Ribera dEbre (N=102) and the island of Menorca (N=482), Spain. Concentrations (ng/mL) of OCs [pentachlorobenzene (PeCB), four isomers of hexachlorocyclohexane (HCH), hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane (4,4-DDT), dichlorodiphenyldichloroethylene (4,4-DDE) and seven polychlorobiphenyl congeners (7PCBs)] were measured in cord blood and at the age of 4 and 14years. The total serum burdens (ng) of these compounds were estimated based on the total blood volume (mL) of children at the different ages. We compared median concentrations and total serum burdens of these OCs at the different time-points of follow-up between children of Ribera dEbre and Menorca and between breastfed and non-breastfed children.From birth until adolescence concentrations of all OCs drastically reduced. These reductions were mainly derived from the dilution of OCs, associated to an increase in total blood volume of children at the age of 4 and 14years. Despite the reduction in OCs concentrations, the total serum burdens of 4,4-DDE and 7PCBs, were higher in adolescents than at birth. Increases in OCs total serum burden occurred both in breastfed and non-breastfed children, but were significantly higher in the first.Even after decades of banning OCs production and use, current young generations in westernized countries are still bioaccumulating these compounds. Given the potential health effects of OCs, especial attention should be paid in the control of secondary emissions in the environment and in the control of food production and contamination. In countries with endemic malaria it is important to work towards effective alternatives to the use of DDT.

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