Salamanca, Spain


Salamanca, Spain
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Esteban M.,Institute Salud Carlos III | Ruiz-Moraga M.,Ibermutuamur | Perez-Gomez B.,Institute Salud Carlos III | Perez-Gomez B.,CIBER ISCIII | Castano A.,Institute Salud Carlos III
Gaceta Sanitaria | Year: 2013

The fieldwork of BIOAMBIENT.ES was developed from March 2009 to July 2010. BIOAMBIENT.ES is a human biomonitoring study of environmental pollutants performed in Spain at the national level. This article aims to show the tasks performed before starting the fieldwork to ensure the quality of the samples and consequently the quality of the results. A total of 1,936 whole blood, serum and first-morning urine samples and 604 hair samples were collected from workers who attended the annual occupational health examination in 38 centers in the Peninsula, Ceuta and the Canary Islands. Before the fieldwork was started, the optimal sampling material and sample shipment was identified and fieldworkers were trained in their tasks. Due to the planning and organization of the pre-analytical phase, only 1% of the collected samples had to be rejected due to problem with spills, conservation, etc. In addition, the analyses conducted showed no pre-analytical interferences. © 2012 SESPAS.

Julia M.,University Pompeu Fabra | Catalina-Romero C.,Ibermutuamur | Calvo-Bonacho E.,Ibermutuamur | Benavides F.G.,University Pompeu Fabra | Benavides F.G.,CIBER ISCIII
Occupational and Environmental Medicine | Year: 2013

Objectives The aim of this study was to analyse the association between job stress and occupational injuries. Methods A prospective cohort study in a sample of 10 667 workers belonging to the insured population of the Mutual Insurance Company in Spain. Job stress was assessed with the Spanish version of the Job Stress Survey. A 1-year follow-up of the workers' clinical records was conducted to determine the incidence of occupational injuries, and the incidence rate per 1000 workers-year was calculated. The associations between the incidence of occupational injuries, job stress and job stress components ( job pressure ( JP) and lack of organisational support (LOS)) were assessed calculating the rate ratio (RR) and its CI of 95% using Poisson regression models. Results After adjusting for confounders, a significant association between LOS and increased incidence of occupational injuries was found. Such an association was observed for the LOS index (RRa=3.11, 95% CI 1.53 to 6.31), LOS severity (RRa=2.64, 95% CI 1.31 to 5.33) and LOS frequency (RRa=2.67, 95% CI 1.32 to 5.38) scales in women. There was no significant association between job stress or its components and the incidence of occupational injuries among men. Conclusions This prospective study found evidence of an association between the LOS and the incidence of occupational injuries in women, with potential implications for the prevention of accidents at work.

Canas A.I.,Institute Salud Carlos III | Cervantes-Amat M.,Institute Salud Carlos III | Cervantes-Amat M.,CIBER ISCIII | Esteban M.,Institute Salud Carlos III | And 5 more authors.
International Journal of Hygiene and Environmental Health | Year: 2014

This paper provides the first baseline information on a national scale regarding lead exposure in the Spanish adult population. Blood lead levels were measured in a representative sample of the Spanish working population (1880 subjects aged 18-65 years) in order to help establish reference levels, follow temporal trends, identify high-exposure groups and to enable comparisons with other countries. All participants completed an epidemiological questionnaire including gender, age, occupational sector, geographic area, and dietary and lifestyle information. We found that the geometric mean of blood lead levels in the study population was 24.0. μg/L (95% CI: 23.0-25.1. μg/L), with women having significantly lower levels than men, 19.5. μg/L (18.5-20.5. μg/L) compared to 28.3. μg/L (26.7-30.0. μg/L), respectively. Mean blood lead levels were higher in elder groups in both genders. Women of a childbearing age had blood levels of 18.0. μg/L (GM). Reference values (95%) for lead in blood in the studied population was 56.80. μg/L, with -64.00. μg/L, 44.80. μg/L and 36.00. μg/L for man, women and women of childbearing age, respectively. Workers from the service sector had lower blood lead levels than those from the construction, agricultural and industry sectors. Small, although significant, geographical differences had been found.In an European comparison, the Spanish population studied herein had lead levels similar to populations in countries such as France and Belgium, and slightly lower levels than Italian, Czech, German or UK populations. © 2013 Elsevier GmbH.

Catalina-Romero C.,Ibermutuamur | Calvo E.,University of Malaga | Sanchez-Chaparro M.A.,University of Malaga | Valdivielso P.,University of Malaga | And 4 more authors.
Scandinavian Journal of Public Health | Year: 2013

Aims: To investigate whether there is an association between job stress, lipid profile and dyslipidemia diagnosis. Methods: This study used a questionnaire to evaluate job stress and lifestyle variables in 91,593 workers undergoing periodic checkups. Serum lipid levels were measured in all cases. Results: The prevalence of job stress was 8.7% (95% CI, 8.5-8.8%). In bivariate analyses, job stress was significantly associated with previous dyslipidemia diagnosis (p < 0.001), lipid-lowering therapy (p < 0.001), and altered total-cholesterol (p = 0.001), HDL-cholesterol (p < 0.001) and LDL-cholesterol levels (p = 0.025). After adjusting for potential confounding variables, job stress was still associated with current dyslipidemia diagnosis (OR = 1.10; 95% CI, 1.04-1.17), high LDL-cholesterol (OR = 1.14; 95% CI, 1.05-1.23), low HDL-cholesterol (OR 1.08; 95% CI, 1.01-1.15), high total cholesterol/HDL-cholesterol ratio (OR 1.13; 95% CI, 1.05-1.23) and high LDL-cholesterol/HDL-cholesterol ratio (OR 1.11; 95% CI, 1.04-1.19). Conclusion: These results support the hypothesis of an association between job stress and lipid disturbances. © 2013 the Nordic Societies of Public Health.

Fenger R.V.,Glostrup University Hospital | Gonzalez-Quintela A.,Complejo Hospitalario Universitario | Linneberg A.,Glostrup University Hospital | Husemoen L.L.N.,Glostrup University Hospital | And 6 more authors.
Respiratory Medicine | Year: 2013

Background: Asthma has been linked to obesity and the presence of the metabolic syndrome. Objective: To explore which components of the metabolic syndrome that were associated with wheezing, a main symptom of asthma. Further, to explore whether these associations were different in individuals with and without rhinitis symptoms. Methods: We used data from the Ibermutuamur Cardiovascular Risk Assessment Plan (ICARIA) including 85,555 Spanish workers (median age = 34, range = 16-75 years) with assessments of self reported wheezing and rhinitis symptoms. Fasting blood samples were analysed for serum triglyceride (s-TG), HDL (s-HDL) and glucose; blood pressure, waist circumference (WC) and body mass index (BMI) were measured. Results: In mutually adjusted analyses including all components of the metabolic syndrome and possible confounders, elevated WC (or BMI), elevated s-TG and low s-HDL were significantly associated with wheezing. Odds ratio (OR) with confidence interval (CI) were: elevated WC = 1.54 (1.46-1.62), elevated s-TG = 1.24 (1.18-1.30), low s-HDL = 1.17 (1.12-1.22). These associations were stronger in individuals without than in those with rhinitis symptoms, OR's (CI's) were WC = without rhinitis 1.70 (1.57-1.85) vs. with rhinitis 1.47 (1.37-1.58). Elevated s-TG = without rhinitis 1.36 (1.26-1.46) vs. with rhinitis 1.21 (1.13-1.29). Low s-HDL = without rhinitis 1.24 (1.15-1.34) vs. with rhinitis 1.11 (1.04-1.18). Conclusions: High s-TG and low s-HDL were associated with wheezing after adjustment for adiposity. This may substantiate elevated s-TG and lowered s-HDL as markers or inducers of inflammation associated disease. The study supports the notion that these biochemical markers have differential effects on different types of wheezing. © 2013 Elsevier Ltd. All rights reserved.

Lopez-Sendin N.,Ibermutuamur | Alburquerque-Sendin F.,University of Salamanca | Cleland J.A.,Franklin Pierce University | Cleland J.A.,Concord Hospital | And 2 more authors.
Journal of Alternative and Complementary Medicine | Year: 2012

Objectives: The objective of this study was to determine the effects of physical therapy, including massage and exercise, on pain and mood in patients with advanced terminal cancer. Design: The design was a randomized controlled pilot study. Subjects: Twenty-four (24) patients with terminal cancer were randomly assigned to one of two treatment groups. Interventions: Group A received a physiotherapy intervention consisting of several massage techniques, mobilizations, and local and global exercises. Group B received a simple hand contact/touch to areas of pain (cervical area, shoulder, interscapular area, heels, and gastrocnemius), which was maintained for the same period of time as the intervention group. All patients received six sessions of 30-35 minutes in duration over a 2-week period. Outcomes: Outcomes were collected at baseline, at 1 week, and at a 2-week follow-up (after treatment completion) by an assessor blinded to the treatment allocation of the participants. Outcomes included the Brief Pain Inventory (BPI, 0-10 scale), Memorial Pain Assessment Card (0-10 scale), and Memorial Symptom Assessment Scale (MSAS Physical, Psychological, 0-4 scale). Baseline between-group differences were assessed with an independent t-test. A two-way repeated-measures analysis of variance was used to examine the effects of the intervention. Results: There were no significant between-group baseline differences (p>0.2). A significant group×time interaction with greater improvements in group A was found for BPI worst pain (F=3.5, p=0.036), BPI pain right now (F=3.94, p=0.027), and BPI index (F=13.2, p<0.001), for MSAS Psychological (F=8.480, p=0.001). Conclusions: The combination of massage and exercises can reduce pain and improve mood in patients with terminal cancer. A sustained effect on pain and psychologic distress existed; however, parameters such as physical distress and the least pain were no greater in the intervention group as compared to the sham. © Copyright 2012, Mary Ann Liebert, Inc. 2012.

To determine the prevalence of non-alcoholic fatty liver disease (NAFLD) and associated risk factors in a group of managers from the Community of Madrid. Retrospective cross-sectional study of 1838 workers (78.5% male) who underwent medical examination between January 1, 2010 and December 31, 2010 as part of a worker health surveillance program. Data were collected from medical records, laboratory results, anthropometric measurements and hepatic ultrasound. The prevalence of NAFLD was 44.0%: 54.0% in men and 7.3% in women (p<0.001). In both sexes, NAFLD was associated with increasing age, higher weight, shorter stature, higher body mass index, waist circumference and metabolic syndrome, as well as higher levels of uric acid and blood glucose. In the multivariate logistic regression analysis, the risk of NAFLD risk was associated with an abdominal circumference ≥ 102cm for men and ≥ 88cm in women (OR=5.2; 95%CI 3.8-7.1 ), age ≥ 40 years (OR : 3.0; 95%CI 2.3-4.0), triglycerides ≥ 150mg/dl (OR=2.1; 95%CI 1.5-2.8), HDL cholesterol <45mg/dl in women and <40mg/dl in men (OR=1.6; 95%CI 1.1-2.2), and total cholesterol >200/dl mg (OR=1.4; 95%CI 1.0-1.9). NAFLD prevalence is notably different among sexes and is associated with hypertriglyceridemia, hypercholesterolemia, low HDL cholesterol, abdominal obesity and metabolic syndrome. Screening programs for NAFLD in worker medical surveillance programs could be of interest in occupational medicine. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

Catalina-Romero C.,Ibermutuamur | Martinez-Munoz P.,Ibermutuamur | Quevedo-Aguado L.,Ibermutuamur | Ruiz-Moraga M.,Ibermutuamur | And 2 more authors.
Gaceta Sanitaria | Year: 2013

Objectives: To analyze the duration of non-work-related sick leave due to anxiety disorders and to identify demographic, occupational and clinical variables that may contribute to its prediction. Methods: We performed a prospective cohort study of 1,161 workers with an episode of non-work-related sick leave due to an anxiety disorder, belonging to the insured population of a mutual insurance company. We assessed the duration of non-work-related sick leave episodes and the main potentially related demographic, occupational and clinical variables. All non-work-related sick leave processes were followed-up until discharge. Cox regression analyses were conducted to establish the predictors of non-work-related sick leave duration. Results: The median duration of non-work-related sick leave due to anxiety disorders was 83 days. In a multivariate analysis, the following factors were identified as being significantly associated with increases in the duration of sick leave (p <0.05): age of over 35 years, lower educational level (primary school studies, secondary school studies or high-school diploma vs. university degree), and the existence of comorbidity and unemployment occurring during the sick leave. In contrast, being separated or divorced was associated with an earlier return to work (p <0.05). Conclusions: Anxiety disorders are associated with long periods of non-work-related sick leave compared with other disorders and standard time duration. Demographic, occupational and clinical variables collected at the initial assessment of the sick leave episode would help to identify groups with an increased risk of prolonged sick leave, requiring strategies to facilitate return to work. © 2011 SESPAS.

PubMed | Ibermutuamur and Institute Salud Carlos III
Type: Journal Article | Journal: Journal of exposure science & environmental epidemiology | Year: 2016

Urinary cadmium levels (U-Cd) were measured in 1770 adults (aged 18-65 years) as a representative sample of the Spanish workforce. The geometric mean (GM) was 0.28g/l with 95% CI: 0.27-0.32g/l (GM: 0.20g/g 95% CI: 0.18-022g/g creatinine). The 95% percentile was 1.03g/l. U-Cd increased with age, with women showing higher U-Cd than men (p<0.001; 0.24g/g vs 0.17g/g). A multivariate analysis confirmed that sex, age and smoking habit significantly influence U-Cd. Smoking habit increases U-Cd by 90% per 10 years of age, almost twice the increase observed for non-smoking. Female smokers had 85% higher U-Cd than non-smokers, whereas the corresponding value for male smokers and non-smokers was 45%. No regional differences were observed with respect to the national reference level. The Spanish population studied here exhibits similar urinary cadmium levels to its European counterparts in Germany and slightly lower levels than in France, the Czech Republic, Italy and the United Kingdom. This paper provides the first baseline information concerning cadmium exposure in the Spanish adult population on a national scale. As such, these findings will help us to establish reference levels, follow temporal trends and identify high-exposure groups, thereby enabling comparisons with other countries and contributing to the improvement of public health and environmental quality.

PubMed | Ibermutuamur, Hospital Universitario Doce Of Octubre, Biomedical Research Institute Sant Pau and Sociedad de Prevencion de Ibermutuamur
Type: Journal Article | Journal: European journal of preventive cardiology | Year: 2016

Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain.National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests.Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK.Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk.Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.

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