Laboratorio Normativo Of Salud Publica

Bilbao, Spain

Laboratorio Normativo Of Salud Publica

Bilbao, Spain
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Arrizabalaga J.J.,Hospital Universitario Of Alava Arabako Unibertsitate Ospitalea Hospital Santiago Ospitalea | Larranaga N.,Subdireccion de Salud Publica de Gipuzkoa | Larranaga N.,CIBER ISCIII | Espada M.,Laboratorio Normativo Of Salud Publica | And 3 more authors.
Endocrinologia y Nutricion | Year: 2012

Background: An epidemiologic survey showed in 1992 iodine deficiency and endemic goiter in schoolchildren from the Basque Country. Objectives: 1) To determine the percentage of homes of schoolchildren where iodized salt (IS) is used; 2) to assess iodine nutrition status in schoolchildren and to compare the data collected to those available from previous epidemiological studies. Design and Methods: A cross-sectional study in 720 randomly selected schoolchildren. Urinary iodine concentration (UIC) was measured using high-performance liquid chromatography(HPLC) with electrochemical detection. Results: IS was used at 53.0% of the homes (95% confidence interval [CI], 49.2-56.7%). Median UIC has increased by 226%, from 65μg/L in 1992 to 147μg/L (percentile [P], P25, 99μg/L; P75, 233μg/L) today. Both schoolchildren consuming IS and those using unfortified salt at their homes had UICs corresponding to adequate iodine intakes (165 and 132μg/L respectively). UICs experienced great seasonal fluctuations, being 55% higher during the November-February period than in June-September period (191μg/L vs 123μg/L; p<0.001). Conclusions: Schoolchildren from the Basque Country have normalized their iodine nutrition status. The strong seasonal pattern of UICs suggests that consumption of milk and iodine-rich dairy products coming from cows feed iodized fodder is one of the most significant factors involved in the increase in iodine intake since 1992. © 2012 SEEN.


Leon G.,CEU Cardenal Herrera University | Murcia M.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region | Murcia M.,CIBER ISCIII | Rebagliato M.,Foundation for the Promotion of Health and Biomedical Research in the Valencian Region | And 15 more authors.
Paediatric and Perinatal Epidemiology | Year: 2015

Background Maternal clinical thyroid disorders can cause reproductive complications. However, the effects of mild thyroid dysfunctions are not yet well established. The aim was to evaluate the association of maternal thyroid function during the first half of pregnancy with birthweight and preterm delivery. Methods We analysed data on 2170 pregnant women and their children from a prospective population-based cohort study in four Spanish areas. Mid-gestation maternal serum and urine samples were gathered to determine thyroid-stimulating hormone (TSH), free thyroxine (fT4), and urinary iodine concentration (UIC). Thyroid status was defined according to percentile distribution as: euthyroid (TSH and fT4 >5th and <95th percentiles); hypothyroxinaemia (fT4<5th percentile and TSH normal), hypothyroidism (TSH > 95th percentile and fT4 normal or <5th percentile), hyperthyroxinaemia (fT4>95th percentile and TSH normal), and hyperthyroidism (TSH<5th percentile and fT4 normal or >95th percentile). Response variables were birthweight, small and large for gestational age (SGA/LGA), and preterm delivery. Results An inverse association of fT4 and TSH with birthweight was found, the former remaining when restricted to euthyroid women. High fT4 levels were also associated with an increased risk of SGA [odds ratio, 95% confidence interval (CI) 1.28 (95% CI 1.08, 1.51)]. Mean birthweight was higher in the hypothyroxinaemic group (β=109, P<0.01). Iodine intake and UIC were not associated with birth outcomes. Conclusions High maternal fT4 levels during the first half of pregnancy were related to lower birthweight and increased risk of SGA newborns, suggesting that maternal thyroid function may affect fetal growth, even within the normal range. © 2015 John Wiley & Sons Ltd.


Ibarluzea J.,CIBER ISCIII | Alvarez-Pedrerol M.,CIBER ISCIII | Alvarez-Pedrerol M.,Center for Research in Environmental Epidemiology | Alvarez-Pedrerol M.,Municipal Institute of Medical Research IMIM Hospital del Mar | And 17 more authors.
Chemosphere | Year: 2011

Organochlorine pesticides and polychlorinated biphenyls (PCBs) are consistently found in human tissues. Serum levels of organochlorine compounds (OC) in pregnant women in particular have raised concern about possible harm to humans in the early phases of physical and behavioural development. The objective of the present study was to evaluate the association between concentration of OCs in serum of two cohorts of pregnant women from Gipuzkoa and Sabadell in Spain and socioeconomic, reproductive and dietary variables. Concentration of polychlorinated biphenyls (PCBs: 28, 52, 101, 118, 138, 153 and 180), hexachlorobenzene (HCB), beta and gamma-hexachlorocyclohexane (β-HCH and γ-HCH), heptachlor epoxide, dichlorodiphenyl dichloroethylene (p,p′-DDE) and dichlorodiphenyl trichloroethane (p,p′-DDT) were measured in the serum of 1259 pregnant women. Associations between OCs and potential predictor variables were assessed using linear regression models adjusted for potential confounders.The compounds most commonly found in the serum were p,p′-DDE (99% of the samples) and PCB-153 (95% of the samples). Geometric means of serum concentrations (ngg-1 lipid) of organochlorine pesticides were 110.0, 19.1, and 33.5 for p,p′-DDE, β-HCH, and HCB respectively, while the geometric means of PCBs were 21.8, 38.9 and 26.9 for PCB 138, 153, and 180 respectively.The levels of all OCs increased with age. BMI was positively associated with the concentration of organochlorine pesticides but inversely related to PCB concentrations. The serum levels of OCs fell only after a cumulative period of breastfeeding of over a year. Levels of PCBs were related to fish intake, but in general dietary factors did not improve the explained variability of the concentrations of OCs. Overall, the levels of OCs found in the study are at the lower end of the range reported in Spain and other countries. © 2010 Elsevier Ltd.


Arrizabalaga J.J.,Hospital Universitario Araba Araba Unibertsitate Ospitalea | Jalon M.,Evaluacion de Riesgos Alimentarios | Espada M.,Laboratorio Normativo Of Salud Publica | Canas M.,Evaluacion de Riesgos Alimentarios
Medicina Clinica | Year: 2015

Background and objective Changes to dairy cow feeding have made milk a very important food source of iodine in several European countries and in USA. We aimed to measure the iodine content in ultra-high temperature (UHT) milk, the most widely consumed milk in Spain and in the south-west of Europe. Material and methods Every month, throughout 2008, UHT milk samples of commercial brands available in Vitoria-Gasteiz (Basque Country, Spain) were collected and their iodine content was determined using high-performance liquid chromatography, according to official method 992.22 of the Association of Official Analytical Chemists International. Results The average (SD) iodide content and median (P25-P75) of standard UHT milk samples (n = 489) were 197.6 (58.1) and 190 (159-235) μg/L, respectively. There were no significant differences between the iodide content in whole, semi-skimmed and skimmed milk (P =.219). The average iodide concentration and median in organic UHT milk (n = 12) were 56.4 (8.6) and 55 (50.5-61.5) μg/L, figures that are much lower than those found in standard milk (P <.0001). Conclusions Standard UHT milk available in our food-retailing outlets constitutes a very important source of iodine. One glass of standard UHT milk (200-250 mL) provides an average amount of 50 μg of iodine. This amount represents around 50% of the iodine intake recommended during childhood or 20% of the iodine intake recommended for pregnant and lactating women. © 2013 Elsevier Espana, S.L.U. Todos los derechos reservados.


Sunyer J.,Center for Research in Environmental Epidemiology | Sunyer J.,Municipal Institute of Medical Research | Sunyer J.,University Pompeu Fabra | Sunyer J.,CIBER ISCIII | And 16 more authors.
European Respiratory Journal | Year: 2012

Tobacco consumption and exposure to second-hand smoke (SHS) are associated with reduced birth weight. One issue that has not been clarified previously is that of the potential higher risk of this outcome in mothers with asthma. We assessed the role of prenatal maternal tobacco use and SHS on reproductive outcomes and assessed the interaction with maternal history of asthma. Data was collected from the INMA study, a maternal birth cohort selected from the general population established in Spain in 2002. We measured cotinine at the 32nd week of pregnancy in 2,219 females. Diagnosed maternal asthma was self-reported during pregnancy. 35% of mothers reported not being exposed to smoking or SHS during pregnancy. Active smoking (i.e. self-reported or cotinine >50 ng·mL-1) was related to a 134 g decrease in birth weight and a relative risk of 1.8 for small for gestational age and fetal growth restriction. These results were not modified by maternal asthma. Maternal asthma had a similar frequency in all exposure groups. Non SHS-exposed females had the lowest prevalence of asthma. SHS (i.e. cotinine 20-50 ng·mL-1) decreased birth weight by 32 g among those without maternal asthma, but these differences were not statistically significant (95% CI -88.76-24.76). Maternal asthma did not promote these effects. Maternal history of asthma did not modify the effects of smoking on reproductive outcomes in a cohort sampled from the general population. Copyright©ERS 2012.


PubMed | Laboratorio Normativo Of Salud Publica, Hospital Universitario Araba Araba Unibertsitate Ospitalea and Evaluacion de Riesgos Alimentarios
Type: Journal Article | Journal: Medicina clinica | Year: 2015

Changes to dairy cow feeding have made milk a very important food source of iodine in several European countries and in USA. We aimed to measure the iodine content in ultra-high temperature (UHT) milk, the most widely consumed milk in Spain and in the south-west of Europe.Every month, throughout 2008, UHT milk samples of commercial brands available in Vitoria-Gasteiz (Basque Country, Spain) were collected and their iodine content was determined using high-performance liquid chromatography, according to official method 992.22 of the Association of Official Analytical Chemists International.The average (SD) iodide content and median (P25-P75) of standard UHT milk samples (n=489) were 197.6 (58.1) and 190 (159-235) g/L, respectively. There were no significant differences between the iodide content in whole, semi-skimmed and skimmed milk (P=.219). The average iodide concentration and median in organic UHT milk (n=12) were 56.4 (8.6) and 55 (50.5-61.5) g/L, figures that are much lower than those found in standard milk (P<.0001).Standard UHT milk available in our food-retailing outlets constitutes a very important source of iodine. One glass of standard UHT milk (200-250mL) provides an average amount of 50g of iodine. This amount represents around 50% of the iodine intake recommended during childhood or 20% of the iodine intake recommended for pregnant and lactating women.


Rebagliato M.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Rebagliato M.,University Miguel Hernández | Murcia M.,Research Center Biomedica En Red Of Epidemiologia lud Publica | Murcia M.,Valencian Center for Research on Public Health | And 20 more authors.
Epidemiology | Year: 2010

Background: An adequate iodine intake during pregnancy is essential for the synthesis of maternal thyroid hormones and normal brain development in the fetus. Scant evidence is available on the effects and safety of iodine supplementation during pregnancy in areas with adequate or mildly deficient iodine intake. We examined the association of maternal iodine intake and supplementation with thyroid function before 24 weeks of gestation in population-based samples from 3 different areas in Spain. Methods: A cross-sectional study of 1844 pregnant women (gestational age range 8-23 weeks) was carried out in 3 areas in Spain (Guipúzcoa, Sabadell, Valencia), during the period 2004-2008. We measured levels of free thyroxine and thyroid-stimulating hormone (TSH) in serum, iodine in a spot urine sample, and questionnaire estimates of iodine intake from diet, iodized salt and supplements. Adjusted associations were assessed by multiple linear regression and logistic regression analyses. Results: There was an increased risk of TSH above 3 μU/mL in women who consumed 200 μg or more of iodine supplements daily compared with those who consumed less than 100 μg/day (adjusted odds ratio = 2.5 [95% confidence interval = 1.2 to 5.4]). We observed no association between urinary iodine and TSH levels. Pregnant women from the area with the highest median urinary iodine (168 μg/L) and highest supplement coverage (93%) showed the lowest values of serum free thyroxine. (geometric mean = 10.09 pmol/L [9.98 to 10.19]). Conclusions: Iodine supplement intake in the first half of pregnancy may lead to maternal thyroid dysfunction in iodine-sufficient or mildly iodine-deficient populations. © 2009 by Lippincott Williams & Wilkins.


Sunyer J.,Center for Research in Environmental Epidemiology | Sunyer J.,Municipal Institute of Medical Research IMIM Hospital Del Mar | Sunyer J.,CIBER ISCIII | Sunyer J.,University Pompeu Fabra | And 21 more authors.
Epidemiology | Year: 2010

Background: Dichlorodiphenyldichloroethylene (DDE) and other organochlorines suppress immunity biomarkers in animals and humans. Our aim was to study the association between prenatal levels of DDE and lower respiratory tract infection in infants independently from polychlorinated biphenyls (PCBs) and other organochlorines. Methods: Maternal levels of p′p′-DDE, dichlorodiphenyltrichloroethane (p′p-DDT), PCB congeners 28, 118, 138, 153, and 180, hexachlorobenzene, and β-hexachlorocyclohexane were measured in first trimester serum of 584 pregnant women from a general population-based cohort in Sabadell (Catalonia, Spain). Mothers reported lower respiratory tract infection in interviewer-led questionnaires administered at infant age 6 and 14 months. Results: Thirteen percent of babies had recurrent lower respiratory tract infection during the first 14 months of life. Among the organochlorines, DDE showed the highest levels (median = 112 ng/g lipid); dichlorodiphenyltrichloroethane was not detectable. The median total PCB level was 85 ng/g. DDE was the only organochlorine that showed an association with recurrent lower respiratory tract infection (at levels >83 ng/g, the first tertile, relative risk = 2.40 [95% confidence interval = 1.19-4.83]), lower respiratory tract infection at 6 months (1.68 [1.06-2.66]), and lower respiratory tract infection at 14 months (1.52 [1.05-2.21]). Adjusting for PCBs, hexachlorobenzene or β-hexachlorocyclohexane did not confound the association. Conclusions: Immunologic suppression by DDE as observed in experimental studies could explain the relation between DDE and lower respiratory tract infection, independently of PCBs. Exposure to DDE during prenatal life could be critical for the development of the immune and respiratory systems. © 2010 by Lippincott Williams & Wilkins.


Julvez J.,Center for Research in Environmental Epidemiology | Julvez J.,Hospital Del Mar Research Institute | Julvez J.,CIBER ISCIII | Julvez J.,Harvard University | And 23 more authors.
Epidemiology | Year: 2013

Background: The fetus depends on maternal thyroid hormones during pregnancy for normal brain development. Little is known about the effects of subclinical hypothyroidism and mild hypothyroxinemia during pregnancy on neurodevelopment of the child. Methods: We evaluated a population-based birth cohort in Spain. A total of 1761 children and their mothers were included in the main analyses. Serum levels of free thyroxine and thyrotropin were measured in pregnant women. Mental and psychomotor development of their children was assessed using the Bayley Scales of Infant Development during the second year of life. Results: Low free thyroxine levels (<5th percentile) and self-reported prepregnancy thyroid disorder without medical treatment were associated with a decrease of mental scores (Beta =-3.4 [95% confidence interval=-6.7 to-0.2]) and-5.5 [-8.9 to-2.0], respectively). No association between thyrotropin levels and mental scores or psychomotor scores was observed. Conclusions: Low free thyroxine levels in healthy pregnant women are related to a moderate delay in child neurodevelopment. The impairment is similar in magnitude to that observed in mothers with untreated prepregnancy thyroid disorder. The value of screening pregnant women for thyroid function requires further assessment, particularly in mildly iodine-deficient areas. © 2012 by Lippincott William & Wilkins.

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