Subdireccion de Salud Publica de Gipuzkoa

Donostia / San Sebastián, Spain

Subdireccion de Salud Publica de Gipuzkoa

Donostia / San Sebastián, 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.


Peters T.,Addenbrookes Hospital | Brage S.,Addenbrookes Hospital | Westgate K.,Addenbrookes Hospital | Franks P.W.,Umeå University | And 42 more authors.
European Journal of Epidemiology | Year: 2012

To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigorous physical activity (MVPA) was measured in 1,941 healthy individuals from 10 European countries using individually-calibrated combined heart-rate and movement sensing. Participants also completed the short EPIC-PAQ, which refers to past year's activity. Pearson (r) and Spearman (σ) correlation coefficients were calculated for each country, and random effects meta-analysis was used to calculate the combined correlation across countries to estimate the validity of two previously- and one newly-derived ordered, categorical PA indices ("Cambridge index", "total PA index", and "recreational index") that categorized individuals as inactive, moderately inactive, moderately active, or active. The strongest associations with PAEE and MVPA were observed for the Cambridge index (r = 0.33 and r = 0.25, respectively). No significant heterogeneity by country was observed for this index (I2 = 36.3%, P = 0.12; I2 = 0.0%, P = 0.85), whereas heterogeneity was suggested for other indices (I2 > 48%, P < 0.05, I2 > 47%, P < 0.05). PAEE increased linearly across self-reported PA categories (P for trend <0.001), with an average difference of approximately 460 kJ/d for men and 365 kJ/d for women, between categories of the Cambridge index. The EPIC-PAQ is suitable for categorizing European men and women into four distinct categories of overall physical activity. The difference in PAEE between categories may be useful when estimating effect sizes from observational research. © 2011 The Author(s).


Zabala A.J.,Subdireccion de Salud Publica de Gipuzkoa | Font M.O.,Subdireccion de Salud Publica de Gipuzkoa | Gallastegi P.M.,Subdireccion de Salud Publica de Gipuzkoa | Ibarbia E.E.,Subdireccion de Salud Publica de Gipuzkoa | Rodriguez L.S.M.,Subdireccion de Salud Publica de Gipuzkoa
Revista Espanola de Salud Publica | Year: 2011

Background: Directive 98/8/EC harmonizes and regulates in the European market authorization and registration of biocides and establishes a period of 14 years for review of active substances. This study analyzes the most significant changes produced in the registry of biocides used as disinfectants registered since the publication of the Directive. Method: Information was obtained from the registry of biocides published in the website of the Ministry of Health, Social Policy and Equa lity in May 2010. We used an Excel data base for the dump and data pro cessing. Results: There are 1575 biocides with intended use as environmental and food area disinfectants registered in Spain (1137 formulas and 438 active ingredients). Formulas are composed of 56 active sustances which are being assessed for their inclusion in the Community list of authorized substances. 54% of the formulas are registered as both bactericide and fun gicide, 79% are contact disinfectants, 42% of the formulas correspond to those composed of quaternary ammonium compounds and 67.9% are made with a single active substance. Regarding hazardous properties 45.3% are corrosive, 25.7% irritant, 9.8% harmful, 1.1% toxic, and 33.1% are dangerous to the environment. Conclusions: The Spanish registry of biocides has complied with the provisions of the Directive cancelling the registrations of the formulas containing substances not included in the list. Of all the substances which are under review in Europe, 58% of environmental disinfectants and 76.4% of food area disinfectants are authorized in Spain.


Lertxundi A.,CIBER ISCIII | Lertxundi A.,University of the Basque Country | Ayerdi M.,Subdireccion de Salud Publica de Gipuzkoa | Alvarez J.,Laboratorio Of Salud Publica Del Gobierno Vasco | Ibarluzea J.M.,CIBER ISCIII
Gaceta Sanitaria | Year: 2010

Objectives: To evaluate the air quality to which a population of 90,000 inhabitants in the province of Gipuzkoa (Basque Country, Spain) is exposed. The population resides in a periurban environment, where industrial activity (11 iron and steel foundries) is scattered among residential areas. Methods: Throughout 2006 and 2007, levels of particulate matter less than 2.5mm in diameter (PM2.5) were quantified and levels of trace elements in PM2.5 fraction [cadmium (Cd), arsenic (As), manganese (Mn), copper (Cu), chromium (Cr), nickel (Ni), iron (Fe), lead (Pb), mercury (Hg) and zinc (Zn)] were analyzed. The samples were gathered in seven sampling sites using three high-volume Digitel DAH 80 samplers. Annual and seasonal variability were evaluated for the various contaminants in each valley and PM10 and PM2.5 samples were also gathered at the same site for a month, with the goal of analyzing the composition of trace elements in each particle size. Finally, the results were compared with those obtained from the same study area by the Basque Government Air Quality Network equipment. Results: The observed PM2.5 concentrations (12.2-28.9γg/m3) were similar to those described in urban environments in large European cities, while mean trace element concentrations were significantly higher. The Mn levels observed in all three valleys indicated the influence of the steel and metal industries on air quality. Conclusion: The finding that levels of particulate matter and trace elements in the study area were similar to or higher than those found in metropolitan areas has implications for the evaluation of health risks in populations far from large population centers. © 2009 SESPAS.


Golubic R.,University of Cambridge | May A.M.,University Utrecht | Benjaminsen Borch K.,University of Tromsø | Overvad K.,University of Aarhus | And 14 more authors.
PLoS ONE | Year: 2014

Objective: To examine the validity of the Recent Physical Activity Questionnaire (RPAQ) which assesses physical activity (PA) in 4 domains (leisure, work, commuting, home) during past month. Methods: 580 men and 1343 women from 10 European countries attended 2 visits at which PA energy expenditure (PAEE), time at moderate-to-vigorous PA (MVPA) and sedentary time were measured using individually-calibrated combined heart-rate and movement sensing. At the second visit, RPAQ was administered electronically. Validity was assessed using agreement analysis. Results: RPAQ significantly underestimated PAEE in women [median(IQR) 34.1 (22.1, 52.2) vs. 40.6 (32.4, 50.9) kJ/kg/day, 95%LoA: -44.4, 63.4 kJ/kg/day) and in men (43.7 (29.0, 69.0) vs. 45.5 (34.1, 57.6) kJ/kg/day, 95%LoA: -47.2, 101.3 kJ/kg/day]. Using individualised definition of 1MET, RPAQ significantly underestimated MVPA in women [median(IQR): 62.1 (29.4, 124.3) vs. 73.6 (47.8, 107.2) min/day, 95%LoA: -130.5, 305.3 min/day] and men [82.7 (38.8, 185.6) vs. 83.3 (55.1, 125.0) min/day, 95%LoA: -136.4, 400.1 min/day]. Correlations (95%CI) between subjective and objective estimates were statistically significant [PAEE: women, rho = 0.20 (0.15-0.26); men, rho = 0.37 (0.30-0.44); MVPA: women, rho = 0.18 (0.13-0.23); men, rho = 0.31 (0.24-0.39)]. When using non-individualised definition of 1MET (3.5 mlO2/kg/min), MVPA was substantially overestimated (∼30 min/day). Revisiting occupational intensity assumptions in questionnaire estimation algorithms with occupational group-level empirical distributions reduced median PAEE-bias in manual (25.1 kJ/kg/day vs. -9.0 kJ/kg/day, p<0.001) and heavy manual workers (64.1 vs. -4.6 kJ/kg/day, p<0.001) in an independent hold-out sample. Conclusion: Relative validity of RPAQ-derived PAEE and MVPA is comparable to previous studies but underestimation of PAEE is smaller. Electronic RPAQ may be used in large-scale epidemiological studies including surveys, providing information on all domains of PA. © 2014 Golubic et al.


Artieda J.,Subdireccion de Salud Publica de Gipuzkoa | Manterola J.M.,Hospital Mendaro | Tolosa E.,Salud Publica de Comarca Bajo Deba | Moreno B.,Laboratorio Of Salud Publica Of Gipuzkoa | And 2 more authors.
Enfermedades Infecciosas y Microbiologia Clinica | Year: 2015

In October 2012, an outbreak of acute gastroenteritis caused by Shigella sonnei was detected in a nursery and primary school in the north of Spain affecting 112 people: 63.7% were pupils and teachers and 35.7% their co-habitants. The source was a sick child who had travelled to an endemic country, and the key trigger factor was inadequate hygiene in one of the toilets of the school. The enforcement of strict hygiene measures was essential for controlling the outbreak. © 2015 Elsevier España, S.L.U.


PubMed | Salud Publica de Comarca Bajo Deba, Laboratorio Of Salud Publica Of Gipuzkoa, Subdireccion de Salud Publica de Gipuzkoa and Hospital Mendaro
Type: Journal Article | Journal: Enfermedades infecciosas y microbiologia clinica | Year: 2015

In October 2012, an outbreak of acute gastroenteritis caused by Shigella sonnei was detected in a nursery and primary school in the north of Spain affecting 112 people: 63.7% were pupils and teachers and 35.7% their co-habitants. The source was a sick child who had travelled to an endemic country, and the key trigger factor was inadequate hygiene in one of the toilets of the school. The enforcement of strict hygiene measures was essential for controlling the outbreak.


Vrijheid M.,Center for Research in Environmental Epidemiology | Vrijheid M.,Municipal Institute of Medical Research IMIM Hospital del Mar | Vrijheid M.,CIBER ISCIII | Martinez D.,Center for Research in Environmental Epidemiology | And 32 more authors.
Journal of Epidemiology and Community Health | Year: 2012

Background: Inequities in the distribution of environmental exposures may add an extra burden to socially disadvantaged populations, especially when acting during vulnerable periods such as pregnancy and early life, but such inequities may be more complex and uncertain than is generally assumed. We therefore examine whether socioeconomic inequities exist in pregnancy exposures to multiple common environmental contaminants in air, water and food. Methods: A Spanish population-based birth cohort study enrolled over 2000 pregnant women between 2004 and 2008. Questionnaires assessed parental education, occupation, country of birth, diet and many other factors. Environmental pollutant assessments included nitrogen dioxide as a marker of traffic-related air pollution, trihalomethanes as a marker of tap water disinfection by-products, organochlorine biomarkers measured in maternal serum during pregnancy (polychlorinated biphenyls (PCB), dichlorodiphenyl dichloroethylene (p,p′-DDE), hexachlorobenzene and b-hexachlorocyclohexane) and mercury concentrations measured in cord blood. Results: Associations between socioeconomic status indicators and nitrogen dioxide and trihalomethanes were generally weak and inconsistent in direction. Concentrations of PCB, hexachlorobenzene and mercury were higher in higher social classes than lower social classes. p,p′-DDE and b-hexachlorocyclohexane were not related to social class. Social class explained between 1% and 5% of the variability in pollutant concentrations, much less than other variables such as region of residence, country of birth and maternal age. Discussion: This study demonstrates that the general assumption that more disadvantaged populations have higher levels of exposure to environmental pollution does not always hold and requires further elucidation in different international settings.


Sobrado M.M.,Institute Investigacion Sanitaria Biodonostia | Carollo I.M.,Subdireccion de Salud Publica de Gipuzkoa | Carollo I.M.,CIBER ISCIII | Gomez M.-C.T.,Subdireccion de Salud Publica de Alava | And 5 more authors.
Revista Espanola de Salud Publica | Year: 2012

Background: geographic differences described in the prognosis of cancer patients in the Basque Country have been attributed to a different incidence in tumours with different lethality. Therefore, cancer relative survival adjusted by case-mix was included to estimate cancer survival by provinces and health regions, using data from 1995 to 2004. Methods: a total of 93 585 cases of malignant tumours were identified from a population-based cancer registry. The five-year relative survival (RS) was calculated using Ederer s method. The five-year relative excess risk (RER) of death was estimated with a generalised linear model, standardized by age and adjusted for sex, date of diagnosis and case-mix. Results: the five-year RS increased fromperiod 1995-1999 to 2000-2004, this latter, with values ranging by health regions between 46-58% and 57-65% in men and women, respectively. There was an excess risk of death in Bizkaia (RER=1.06, CI95%: 1.03-1.09), this same effect being identified in almost all the health regions in the province. In contrast, in Gipuzkoa province, differences were only statistically significant in the Gipuzkoa and Tolosa health regions (RER=1.07; CI95%: 1.02-1.13 and RER=0.91; CI95%: 0.84-0.98, respectively), and even these disappeared after adjusting for potential confounders. Conclusions: cancer patients of Bizkaia, except for the Uribe health region, presented a worse prognosis.

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