Associations of black carbon with lung function and airway inflammation in schoolchildren

Background: Few studies have investigated the 24-hour respiratory health effects of personal black carbon (BC) and ultrafine particles (UFP) exposure in schoolchildren. The objective of this study was to investigate these associations with the lung function in children 10-years old with and without persistent respiratory symptoms. Methods: We conducted a cross-sectional study in 305 children (147 and 158 with and without persistent respiratory symptoms, respectively) from three European birth-cohorts: PARIS (France) and INMA Sabadell and Valencia (Spain). Personal 24-hour measurements of exposure concentrations to BC and UFP were performed by portable devices, before lung function testing. …

Short-Term Relationship between Hip Fracture and Weather Conditions in Two Spanish Health Areas with Different Climates

Objective. To evaluate differences in the short-term relationship between weather conditions and the incidence of hip fracture in people aged 65 and over among two regions of Spain.Methods. Hip fracture incidence was calculated for the years 2000–2008 for residents of Health Area 14 in Valencian Community (Mediterranean climate) and the “Mancha Centro” Health Area in Castilla-La Mancha (inland climate), Spain. The relationship between hip fracture incidence and weather was analyzed with a case-crossover design and explored in subgroups defined by sex, age, and fracture type.Results. In the inland area, a positive and significant tendency for hip fracture incidence was observed (annual incre…

Residential Exposure to Outdoor Air Pollution during Pregnancy and Anthropometric Measures at Birth in a Multicenter Cohort in Spain

Background: A growing body of research suggests that prenatal exposure to air pollution may be harmful to fetal development. We assessed the association between exposure to air pollution during pregnancy and anthropometric measures at birth in four areas within the Spanish Children’s Health and Environment (INMA) mother and child cohort study. Methods: Exposure to ambient nitrogen dioxide (NO2) and benzene was estimated for the residence of each woman (n = 2,337) for each trimester and for the entire pregnancy. Outcomes included birth weight, length, and head circumference. The association between residential outdoor air pollution exposure and birth outcomes was assessed with linear regress…

Urban environment during early-life and blood pressure in young children

Background: The urban environment is characterised by many exposures that may influence hypertension development from early life onwards, but there is no systematic evaluation of their impact on child blood pressure (BP). Methods: Systolic and diastolic blood pressure were measured in 4,279 children aged 4-5 years from a multi-centre European cohort (France, Greece, Spain, and UK). Urban environment exposures were estimated during pregnancy and childhood, including air pollution, built environment, natural spaces, traffic, noise, meteorology, and socioeconomic deprivation index. Single- and multiple-exposure linear regression models and a cluster analysis were carried out. Results: In multi…

Exposure to mercury among 9-year-old Spanish children: Associated factors and trend throughout childhood

Mercury is considered a neurotoxicant and human exposure occurs mainly from the consumption of marine species. We aimed to describe total mercury concentrations (THg) and associated factors in 9-year old children, as well as to explore the trend in THg from 4 to 9 years of age. The study population consisted of 9-year-old children participating in the INMA (Environment and Childhood) birth cohort study in Valencia, Spain (n = 405, 2013–2014). THg in hair samples was measured by atomic absorption spectrometry at the age of 4 and 9 years. Sociodemographic and dietary data was obtained through questionnaires. Multiple linear regression was used to explore the association between THg and covari…

Drinking water disinfection by-products, genetic polymorphisms, and birth outcomes in a european mother-child cohort study

Background: We examined the association between exposure during pregnancy to trihalomethanes, the most common water disinfection by-products, and birth outcomes in a European cohort study (Health Impacts of Long-Term Exposure to Disinfection By-Products in Drinking Water). We took into account exposure through different water uses, measures of water toxicity, and genetic susceptibility. Methods: We enrolled 14,005 mothers (2002-2010) and their children from France, Greece, Lithuania, Spain, and the UK. Information on lifestyle-and water-related activities was recorded. We ascertained residential concentrations of trihalomethanes through regulatory records and ad hoc sampling campaigns and e…

Comentario. Contaminación atmosférica y salud: acción estratégica en salud pública

Que la contaminacio´n atmosfe´rica causada por los humanostiene efectos negativos en la salud de los propios humanos es unhecho conocido desde hace varias de´cadas. En los u´ltimos 20 an˜os,los resultados de muchas investigaciones han demostradonumerosas caracteri´sticas de dicha relacio´n y han sentado lasbases que demuestran que, en nuestros di´as, la contaminacio´natmosfe´rica continu´a siendo un riesgo importante para la salud dela poblacio´n

Estimation of equivalent dose to the eye lens and hands in wrist surgery using OSL dosimetry

The new recommendations of the International Commission on Radiological Protection (ICRP-2012 Publication 118) proposes reducing the limit of equivalent dose to the eye lens. For this reason, it is necessary to make estimates about received equivalent dose to the eye lens of medical staff. This study provides an alternative to dosimetry of the eye lens and hands, using dosimeters nanoDots based on optically stimulated luminescence (OSL) technology in wrist surgery procedure carried out with fluoroscopy.

Additional file 1: Table S1. of Distributions and determinants of urinary biomarkers of organophosphate pesticide exposure in a prospective Spanish birth cohort study

Intake of fruit and vegetables according to the maternal sociodemographic and life style characteristics. (DOC 49 kb)

Exposure to ultrafine particles in children until 18 years of age: A systematic review.

Airborne ultrafine particles (UFP) have been related to adverse health effects, but exposure in vulnerable population groups such as children is still not well understood. We aim to review the scientific literature regarding personal exposure to UFP in different microenvironments in populations until 18 years of age. The bibliographical search was carried out in July 2019 using the online database PubMed and was completed with references in articles found in the search. We selected the studies that used continuous counters and measured UFP levels in both specific microenvironment (houses, schools, transport, etc) and personal exposure. Finally, 32 studies fulfilled the criteria: of these, 1…

A systematic review of neurodevelopmental effects of prenatal and postnatal organophosphate pesticide exposure

Agricultural and residential use of organophosphate (OP) pesticides has increased in recent decades after banning some persistent pesticides. Although there is evidence of the effects of OPs on neurodevelopment and behaviour in adults, limited information is available about their effects in children, who might be more vulnerable to neurotoxic compounds. This paper was aimed at analysing the scientific evidence published to date on potential neurodevelopmental and behavioural effects of prenatal and postnatal exposure to OPs. A systematic review was undertaken to identify original articles published up to December 2012 evaluating prenatal or postnatal exposure to OPs in children and effects …

EP-1186: Accuracy of the TG-43 dose calculation formalism for HDR skin brachytherapy

Prevalencias de exposición a riesgos laborales en trabajadoras embarazadas (proyecto INMA-Valencia)

ResumenObjetivoDescribir las prevalencias de exposición declarada a riesgos laborales en mujeres embarazas y analizar su relación con características sociodemográficas y laborales a partir de la información recogida en la cohorte INMA-Valencia.MétodosLa cohorte INMA-Valencia se inicia en 2004 con 855 mujeres embarazadas residentes en la provincia de Valencia. En la semana 32 de gestación se recogió información, mediante entrevista personal con cuestionario estructurado, sobre características sociodemográficas (edad, nivel de estudios, país de nacimiento), condiciones de empleo (actividad, ocupación, tipo de contrato, tipo de jornada) y exposición laboral autorreferida a carga física y riesg…

Concentrations and determinants of organochlorine levels among pregnant women in Eastern Spain

Persistent organic pollutants (POPs) comprise a large variety of toxic substances with ample distribution. While exposure to these toxins occurs mainly through diet, maternal POP levels may be influenced by certain sociodemographic, environmental, or lifestyle factors. This is important given that these substances may have adverse effects on fetal development. The aim of this study is to examine the sociodemographic, environmental, lifestyle, and dietary determinants of the levels of hexachlorobenzene (HCB), b-hexachlorocyclohexane (b-HCH), 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (4,4′-DDT), 1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene (4,4′-DDE), and polychlorinated biphenyls (PCB co…

Patrones de frecuentación y factores asociados al ingreso en el hospital de las urgencias hospitalarias por asma y por enfermedad pulmonar obstructiva crónica

El objetivo de este trabajo fue describir las caracteristicas epidemiologicas de las urgencias por asma y por enfermedad pulmonar obstructiva cronica atendidas en el Hospital Clinico Universitario de Valencia, asi como analizar los factores que se asocian a los ingresos hospitalarios por dichos procesos. Para ello se revisaron todas las historias clinicas de urgencias medicas de mayores de 14 anos del mencionado hospital correspondientes al periodo 1993-1995 y se identificaron las urgencias por asma y enfermedad pulmonar obstructiva cronica segun un protocolo establecido. Tras un analisis descriptivo de las variables sociodemograficas se analizaron las series temporales del numero de urgenc…

Prenatal exposure to persistent organic pollutants and rapid weight gain and overweight in infancy

Objective To examine the effects of prenatal exposure to persistent organic pollutants (POPs) on rapid growth in the first 6 months of life and overweight at 14 months of age. Design and Methods In a Spanish birth cohort study, the POPs dichlorodiphenyldichloroethylene (DDE), hexachlorobenzene (HCB), and polychlorinated biphenyls (PCBs—congeners 153, 138, 180) were measured in maternal serum collected in the first trimester of pregnancy during 2003–2008. Rapid growth was defined as a z-score weight gain >0.67 SD between 6 months of age and birth. Overweight at 14 months was defined as a BMI z-score ≥85th percentile. Generalized linear models examined the association between POPs and rapid g…

Maternal Perfluoroalkyl Substances, Thyroid Hormones, and DIO Genes: A Spanish Cross-sectional Study

Results of studies on perfluoroalkyl substances (PFASs) and thyroid hormones (THs) are heterogeneous, and the mechanisms underlying the action of PFASs to target THs have not been fully characterized. We examined the relation between first-trimester maternal PFAS and TH levels and the role played by polymorphisms in the iodothyronine deiodinase 1 (DIO1) and 2 (DIO2) genes in this association. Our sample comprised 919 pregnant Spanish women (recruitment = 2003-2008) with measurements of perfluorohexanesulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), and fr…

Water hardness and eczema at 1 and 4 y of age in the INMA birth cohort.

Abstract Background: Exposure to hard water has been suggested as a risk factor for eczema in childhood, based on limited evidence from two ecologic and two cross-sectional studies. Objectives: We evaluate this hypothesis for the first time in early infancy using prospective data from a mother–child cohort study. Methods: We used data from the INMA cohorts in Gipuzkoa, Sabadell and Valencia, Spain (N=1638). Current and ever eczema, bathing frequency and duration and covariables were collected by questionnaires at 14 months (14 m) and 4 years (4 y). Calcium carbonate (CaCO3) level in municipal water was assigned to home addresses at birth, 14 m and 4 y. We calculated Odds Ratio (OR) of eczem…

Surrounding Greenness and Pregnancy Outcomes in Four Spanish Birth Cohorts

Background: Green spaces have been associated with improved physical and mental health; however, the available evidence on the impact of green spaces on pregnancy is scarce. Objectives: We investigated the association between surrounding greenness and birth weight, head circumference, and gestational age at delivery. Methods: This study was based on 2, 393 singleton live births from four Spanish birth cohorts (Asturias, Gipuzkoa, Sabadell, and Valencia) located in two regions of the Iberian Peninsula with distinct climates and vegetation patterns (2003–2008). We defined surrounding greenness as average of satellite-based Normalized Difference Vegetation Index (NDVI) (Landsat 4–5 TM data at …

Chronic burden of near-roadway traffic pollution in 10 European cities (APHEKOM network).

AD; International audience; Recent epidemiological research suggests that near road traffic-related pollution may cause chronic disease, as well as exacerbate related pathologies, implying that the entire “chronic disease progression” should be attributed to air pollution, no matter what the proximate cause was. We estimated the burden of childhood asthma attributable to air pollution in 10 European cities by calculating the number of cases of 1) asthma caused by near road traffic-related pollution, and 2) acute asthma events related to urban air pollution levels. We then expanded our approach to include coronary heart diseases in adults.Derivation of attributable cases required combining c…

Mechanisms of the Development of Allergy (MeDALL) : Introducing novel concepts in allergy phenotypes

Asthma, rhinitis, and eczema are complex diseases with multiple genetic and environmental factors interlinked through IgE-associated and non–IgE-associated mechanisms. Mechanisms of the Development of ALLergy (MeDALL; EU FP7-CP-IP; project no: 261357; 2010-2015) studied the complex links of allergic diseases at the clinical and mechanistic levels by linking epidemiologic, clinical, and mechanistic research, including in vivo and in vitro models. MeDALL integrated 14 European birth cohorts, including 44,010 participants and 160 cohort follow-ups between pregnancy and age 20 years. Thirteen thousand children were prospectively followed after puberty by using a newly standardized MeDALL Core Q…

Factors associated with second-hand smoke exposure in non-smoking pregnant women in Spain: self-reported exposure and urinary cotinine levels.

The aim of this study was to evaluate the main sources of and sociodemographic factors associated with second-hand smoke (SHS) exposure, assessed both by questionnaire and by urinary cotinine (UC) levels, in non-smoking pregnant women. We conducted a cross-sectional study in pregnant women from 4 different regions in Spain. A total of 1783 non-smoking pregnant women completed a questionnaire about their previous smoking habit and SHS exposure in their 3rd trimester of pregnancy and provided a urine sample for measuring UC levels. We used logistic regression models to assess the relationship between several sociodemographic variables and some potential sources of SHS exposure. In addition, w…

Exposure to trihalomethanes through different water uses and birth weight, small for gestational age, and preterm delivery in Spain

Background: Evidence associating exposure to water disinfection by-products with reduced birth weight and altered duration of gestation remains inconclusive. Objective: We assessed exposure to trihalomethanes (THMs) during pregnancy through different water uses and evaluated the association with birth weight, small for gestational age (SGA), low birth weight (LBW), and preterm delivery. Methods: Mother–child cohorts set up in five Spanish areas during the years 2000–2008 contributed data on water ingestion, showering, bathing, and swimming in pools. We ascertained residential THM levels during pregnancy periods through ad hoc sampling campaigns (828 measurements) and regulatory data (264 me…

Urinary Arsenic Species and Methylation Efficiency During Pregnancy: Concentrations and Associated Factors in Spanish Pregnant Women

Background: Arsenic (As) is considered to be toxic for humans, the main routes of exposure being through drinking water and the diet. Once ingested, inorganic arsenic can be methylated sequentially to monomethyl and dimethyl arsenicals. Several factors can affect both As exposure and methylation efficiency. Objectives: To describe the urinary concentrations of the different As species and evaluate the methylation effi-ciency during pregnancy, as well as their associated factors in a birth cohort of pregnant Spanish women. Methods: Participants in this cross-sectional study were 1017 pregnant women from two areas of Spain who had taken part in the INMA (Environment and Childhood) project (20…

Outdoor, but not indoor, nitrogen dioxide exposure is associated with persistent cough during the first year of life

Background and aims: Because their lungs and immune system are not completely developed, children are more susceptible to respiratory disease and more vulnerable to ambient pollution. We assessed the relation between prenatal and postnatal nitrogen dioxide (NO2) levels and the development of lower respiratory tract infections (LRTI), wheezing and persistent cough during the first year of life. Methods: The study population consisted of 352 children from a birth cohort in Valencia, Spain. Prenatal exposure to NO2, a marker of traffic related air pollution was measured at 93 sampling sites spread over the study area during four different sampling periods of 7 days each. It was modeled for eac…

Maternal copper status and neuropsychological development in infants and preschool children.

Introduction: Copper (Cu) is an essential element involved in biological processes; however, excessive Cu could be harmful because of its reactive nature. Very few studies have evaluated its potential neurotoxic effects. We aimed to evaluate the association between maternal Cu levels and children's neuropsychological development. Methods: Study subjects were mother-child pairs from the Spanish INMA (i.e. Childhood and Environment) Project. Cu was measured by inductively coupled plasma mass spectrometry in serum samples taken at the first trimester of pregnancy (2003-2005). Neuropsychological development was assessed using the Bayley Scales of Infant Development (BSID) at 12 months (n = 651) a…

Trihalomethanes in swimming pool water in four areas of Spain participating in the INMA project

ResumenObjetivoLa natación es uno de los deportes más practicados en España, por personas de todas las edades y condiciones físicas. También es una vía de exposición a subproductos de la desinfección, compuestos potencialmente tóxicos. Su concentración en el agua de las piscinas no está legislada y es poco conocida. El objetivo de este trabajo es describir la concentración de trihalometanos en el agua de piscinas de los municipios de cuatro cohortes del estudio INMA.MétodosEn julio de 2009 se analizaron los trihalometanos en el agua de piscinas (n=27) de Asturias, Granada, Valencia y Sabadell.ResultadosLa concentración media de trihalometanos totales fue de 42,7μg/l (desviación estándar [DE…

Prevalencias de exposición a riesgos laborales en trabajadoras embarazadas (proyecto INMA-Valencia) Prevalence of exposure to occupational risks in pregnant Spanish workers (the INMA Project-Valencia)

Objetivo: Describir las prevalencias de exposición declarada a riesgos laborales en mujeres embarazas y analizar su relación con características sociodemográficas y laborales a partir de la información recogida en la cohorte INMA-Valencia. Métodos: La cohorte INMA-Valencia se inicia en 2004 con 855 mujeres embarazadas residentes en la provincia de Valencia. En la semana 32 de gestación se recogió información, mediante entrevista personal con cuestionario estructurado, sobre características sociodemográficas (edad, nivel de estudios, país de nacimiento), condiciones de empleo (actividad, ocupación, tipo de contrato, tipo de jornada) y exposición laboral autorreferida a carga física y riesgos…

Prenatal and postnatal insecticide use and infant neuropsychological development in a multicenter birth cohort study

There is little evidence about exposure to currently used insecticides during early life periods and adverse effects on child neuropsychological development. The aim of this study is to examine the association between residential insecticide use during pregnancy and infancy, and the development of children.Study subjects were participants in the INMA (Environment and Childhood) Project, a Spanish multicenter birth cohort study. Prenatal and postnatal use of indoor insecticides and other variables were obtained from personal interview during pregnancy and infancy. Mental and psychomotor development was assessed around 14 months using the Bayley Scales of Infant Development. The associations …

Vitamin D in Pregnancy and Attention Deficit Hyperactivity Disorder-like Symptoms in Childhood

Vitamin D status during prenatal brain development may influence risk of attention deficit and hyperactivity disorder (ADHD) symptoms in childhood. However, there are no prospective studies addressing this hypothesis. We aimed to examine whether maternal vitamin D status in pregnancy is associated with risk of ADHD-like symptoms in offspring.We conducted a prospective study analyzing data from 1,650 mother-child pairs from five birth cohorts embedded in the INMA Project (Spain, 1997-2008). Maternal vitamin D status in pregnancy was estimated by measuring plasma concentration of 25-hydroxyvitamin D3 [25(OH)D3] at 13 weeks of gestation. Children were assessed by teachers for ADHD-like symptom…

Radiation dose distribution around a mobile linear accelerator Mobetron using Monte Carlo simulation

The aim of this work is to analyze the scattered radiation produced by the mobile accelerator Mobetron. To do so detailed Monte Carlo simulation using two different codes, Penelope2011 and Geant4, were performed. Experimental measurements were also done to validate them. To quantify the attenuation of the internal structures present in the accelerator head on the scattered radiation produced, some of the main structural shielding in the Mobetron has been incorporated into the simulation. Results are compared with experimental measurements. Some discrepancies between the calculated and measured dose values were found. These differences can be traced back to the importance of the radiation co…

Quantifying the health impacts of outdoor air pollution: useful estimations for public health action

According to WHO,1 health impact assessment (HIA) is A combination of procedures, methods and tools used to evaluate the potential health effects of a policy, programme or project. Using qualitative, quantitative and participatory techniques, HIA aims to produce recommendations that will help decision makers and other stakeholders make choices about alternatives and improvements to prevent disease/injury, and to actively promote health. The typical procedural steps in HIA include screening, scoping, assessment of health effects, recommending alternatives and mitigations, reporting and monitoring.2 Each step helps predict or foresee potential effects of policy decisions on a population's hea…

Polymorphisms in ABC transporter genes and concentrations of mercury in newborns - Evidence from two Mediterranean birth cohorts

Background: The genetic background may influence methylmercury (MeHg) metabolism and neurotoxicity. ATP binding cassette (ABC) transporters actively transport various xenobiotics across biological membranes. Objective: To investigate the role of ABC polymorphisms as modifiers of prenatal exposure to MeHg. Methods: The study population consisted of participants (n = 1651) in two birth cohorts, one in Italy and Greece (PHIME) and the other in Spain (INMA). Women were recruited during pregnancy in Italy and Spain, and during the perinatal period in Greece. Total mercury concentrations were measured in cord blood samples by atomic absorption spectrometry. Maternal fish intake during pregnancy w…

Outdoor, indoor and personal distribution of BTEX in pregnant women from two areas in Spain - Preliminary results from the INMA project

Volatile organic compounds (VOCs), which are habitually found in both outdoor and indoor environments, may represent a significant health risk. In this context, pregnancy is a critical period since foetuses are more vulnerable than adults to exposure to toxic compounds. The objective of this study is to present the preliminary results of a series of measurements of outdoor (O), indoor (I) and personal exposure (P) to benzene, toluene, ethylbenzene, o-xylene and m,p-xylene (BTEX) in 107 pregnant women from two areas in Spain, namely Valencia and Sabadell. BTEX samplers were installed for 48 hours both inside and outside of the women’s homes, along with personal samplers. In addition, the tes…

Values for αβ and γδ T-lymphocytes and CD4+, CD8+, and CD56+ subsets in healthy adult subjects: Assessment by age and gender

Background: Normal reference values in healthy subjects for T-lymphocytes for both types of receptors, αβ and γδ, and their subsets are yet to be defined. The aim of this study was to measure peripheral blood αβ and γδ total T-lymphocytes and their subsets in a population of healthy subjects, in order to obtain valid reference values for studies in human pathology. Methods: We studied a total of 157 healthy subjects, 78 men and 79 women, establishing their levels of CD3+, CD4+, CD8+, CD56+, αβCD3+, αβCD3+CD4+, αβCD3+CD8+, αβCD3+CD56+, γδCD3+, γδCD3+CD4−CD8−, γδCD3+CD8+, and γδCD3+CD56+ T-cells by flow cytometry. The T-cell subsets were compared for different age and gender groups. Results: …

Prenatal exposure to perfluoroalkyl substances and cardiometabolic risk in children from the spanish INMA birth cohort study

BACKGROUND: Perfluoroalkyl substances (PFAS) may affect body mass index (BMI) and other components of cardiometabolic (CM) risk during childhood, hut evidence is scarce and inconsistent. OBJECTIVES: We estimated associations between prenatal PFAS exposures and outcomes relevant to cardiometabolic risk, including a composite CM risk score. METHODS: We measured perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in maternal plasma (first trimester). We assessed weight gain from birth until 6 mo. At 4 and 7 y, we calculated the age- and sex-specific z-scores for BMI, waist circumference (WC), and blood pres…

Anti-Anisakis sp. antibodies in serum of healthy subjects. Relationship with αβ and γδ T cells

Anisakiosis is nowadays one of the nematodoses more prevalent in Spain, with rates that oscillate between 0.43% in Galicia (N.W. Spain), and 15.7% and 22.1% in inland and southern regions, respectively. Likewise, it has been proved that Anisakis larvae have developed mechanisms to modulate the dichotomy of the host immune response for their own benefit. The experimental hypothesis of the present study was that Anisakis sp. larval products can be mediators of immune suppression and induce changes on the populations of αβ+ and γδ+ T cells. In the present study we determined the levels of anti-Anisakis antibodies in the serum of healthy people, and their relationship with the B and T cell subs…

EP-1613: Depth determination of skin cancers treated with superficial barchytherapy: ultrasound vs. histopathology

Prenatal exposure to mercury and neuropsychological development in young children: the role of fish consumption

Background: Vulnerability of the central nervous system to mercury exposure is increased during early development. The aim of this study is to evaluate the association between prenatal exposure to mercury and child neuropsychological development in high-fish-intake areas in Spain. Methods: Study subjects were 1362 children, participants in the INMA (Environment and Childhood) birth cohort study. Cord blood total mercury (CB-Hg) and cord polyunsaturated fatty acids (PUFA) concentrations were analysed in samples collected between 2004 and 2008. Child neuropsychological development was assessed at age 4-5 years by the McCarthy Scales of Children's Abilities (MSCA). Socio-demographic, lifestyle…

Exposure to mercury among Spanish preschool children: Trend from birth to age four

The purpose of this study is to describe the total hair mercury concentrations and their determinants in preschool Spanish children, as well as to explore the trend in mercury exposure from birth to the age four. This evolution has been scarcely studied in other birth cohort studies. The study population was 580 four year old children participating in the INMA (i.e. Childhood and Environment) birth cohort study in Valencia (2008–2009). Total mercury concentration at age four was measured in hair samples by atomic absorption spectrometry. Fish consumption and other covariates were obtained by questionnaire. Multivariate linear regression models were conducted in order to explore the associat…

La salud ambiental a través de los indicadores relacionados en la Salud para Todos en el año 2000

Jose.L.Alfonso@uv.es Ignacio.Glez-Arraez@uv.es

The spatial distribution of population exposure to outdoor air pollution in Valencia (Spain) and its association with a privation index

Objetivo: Evaluar la variación espacial de la exposición a dióxido de nitrógeno (NO2) en la ciudad de Valencia y su relación con la privación socioeconómica y la edad. Métodos: La población por sección censal (SC) procede del Instituto Nacional de Estadística. Los niveles de NO2 se midieron en 100 puntos del área de estudio, mediante captadores pasivos, en tres campañas entre 2002 y 2004. Se utilizó regresión por usos del suelo (LUR) para obtener el mapa de los niveles de NO2. Las predicciones del LUR se compararon con las proporcionadas por: a) el captador más cercano de la red de vigilancia, b) el captador pasivo más cercano, c) el conjunto de captadores en un entorno y d) kriging. Se asi…

SU-E-T-516: Limitations and Clinical Implications of the TG-43 Formalism for High-Dose-Rate Skin Brachytherapy

Purpose: In high‐dose‐rate (HDR) skin brachytherapy, sources are located outside, in contact with, or implanted at some depth below the skin surface. Nowadays, most TPS use the TG‐43 formalism that is based on sources within an infinite water medium, without accounting for the scatter defect due to surrounding air. The purpose of the present study is to evaluate the limitations of the TG‐43 formalism in HDR skin brachytherapy. Methods: This study examined two HDR sources (Ir‐192 and Co‐60) together with a hypothetical Yb‐169 source. Dose distributions were obtained using Monte Carlo methods (i.e., GEANT4). The following configurations were investigated: 1)A typical clinical case consisting …

EP-1590: Shielding design and fetal dose evaluation of a breast cancer pregnant patient undergoing HDR Ir-192 brachytherapy

The INMA INfancia y Medio Ambiente-(Environment and Childhood) project: More than 10 years contributing to environmental and neuropsychological research

Background: In 2003 the INMA—INfancia y Medio Ambiente (Environment and Childhood) project, a Spanish national network of birth cohorts including more than 3500 participants, was set up with the aim to assess the health impacts of pre- and postnatal environmental exposures on children. The project has published more than 60 papers on maternal and environmental factors related to neuropsychological development in children, one of the main research interests within the project. With the present review, we evaluate the evidence provided by the INMA project on this topic and discuss how the data can contribute to cover the challenges that children’s environmental health research will face in th…

Prenatal mercury exposure in a multicenter cohort study in Spain

Background: Mercury is a ubiquitous heavy metal that may negatively affect human health. It is desirable to investigate mercury exposure in vulnerable populations. Objective: To determine the concentrations of total mercury (T-Hg) in cord blood and to evaluate the role of maternal fish consumption in a Spanish mother and child cohort. Methods: A total of 1883 mother and child pairs from a population-based cohort were included between 2004 and 2008. T-Hg concentrations were measured in whole cord blood and maternal seafood consumption was ascertained by means of a food-frequency questionnaire. Linear regression was used in stratified analyses, while a joint model was adjusted using a mixed-e…

Prenatal Exposure to Polybrominated Flame Retardants and Fetal Growth in the INMA Cohort (Spain)

Our aim was to investigate the relation between PBDEs and fetal growth or newborn anthropometry in a Spanish cohort (2003-2008). PBDE congeners (BDE-47, -99, -153, -154, and -209) were determined in serum of 670 mothers at gestational week 12 and in 534 umbilical cord samples. Abdominal circumference (AC), estimated fetal weight (EFW), femur length (FL), and biparietal diameter (BPD) during gestation were measured by ultrasounds. At birth, weight (BW), head circumference (HC), and length (BL) were also measured. We assessed growth in the intervals between 12-20 and 20-34 weeks of gestation and size at birth by standard deviation (SD)-scores adjusted for constitutional characteristics. We co…

Prenatal exposure to fluoride and neuropsychological development in early childhood: 1-to 4 years old children

[EN]BACKGROUND: Cross-sectional and prospective studies have provided evidence of the neurotoxic effect of early exposure to fluoride (F) in pregnancy. It has been negatively associated with cognitive development during childhood, with most research conducted in areas with high F levels in community drinking water (CDW). METHOD: Data from 316 to 248 mother-child pairs from the Infancia y Medio Ambiente (Childhood and Environment, INMA) birth cohort project with maternal urinary F level adjusted for creatinine (MUFcr) measurements in the first and third trimesters of pregnancy. Children's cognitive domains and intelligence indexes were evaluated using the Bayley Scales (age of 1) and the McC…

SU-E-T-530: Comparison of Analytical and Monte Carlo Calculations for Heterogeneity Corrections in LDR Prostate Brachytherapy

Purpose: It is well‐known that tissue heterogeneities and calcifications have significant influence on low energy brachytherapy. The aim of this work is to study the application of a simplified analytic algorithm that could be compatible with commercial Treatment Planning System (TPS) based on TG‐43. The algorithm, based on the classic equivalent path length method, has been compared with Monte Carlo (MC) computations using Penelope2009. Methods: The analytical model scales the distance from the seed to the calculation point according to the electronic density of the medium relative to water. Then, the dose is calculated from TG‐43 consensus data (stored on a TPS) by scaling the radial dose…

Gender differences in the neurotoxicity of metals in children

Gender-related differences in susceptibility to chemical exposure to neurotoxicants have not received sufficient attention. Although a significant number of epidemiological studies on the neurodevelopmental effects of metal exposure has been published in the last twenty years, not many of them have considered the possible gender-specific effects of such exposure. This review is focused on studies where the gender differences in pre- and/or postnatal exposure/s to five metals (mercury, lead, manganese, cadmium, and arsenic) and neurodevelopment were evaluated. We conducted a PubMed search in December 2012 and retrieved 20 studies that met the inclusion criteria. A large body of literature on…

La biomonitorización de sustancias tóxicas en muestras biológicas de población general

ResumenLa biomonitorización de sustancias tóxicas ha sido incorporada por buena parte de los países más desarrollados, con el objetivo de conocer sus concentraciones en muestras biológicas. Estas sustancias se incorporan al organismo por medio de diferentes exposiciones ambientales. La vigilancia en muestras biológicas debe permitir conocer sus valores en grupos vulnerables y su evolución en el tiempo, comparar con los valores observados en otros países, identificar grupos que presenten valores altos o de riesgo, y promover la investigación. Su finalidad más clara es la de servir como instrumento para el diseño de políticas que permitan poner en marcha medidas de actuación en diversos secto…

Exposure to Perfluoroalkyl Substances and Metabolic Outcomes in Pregnant Women: Evidence from the Spanish INMA Birth Cohorts

BACKGROUND: Exposure to perfluoroalkyl substances (PFASs) may increase risk for metabolic diseases; however, epidemiologic evidence is lacking at the present time. Pregnancy is a period of enhanced tissue plasticity for the fetus and the mother and may be a critical window of PFAS exposure susceptibility. OBJECTIVE: We evaluated the associations between PFAS exposures and metabolic outcomes in pregnant women. METHODS: We analyzed 1,240 pregnant women from the Spanish INMA [Environment and Childhood Project (INfancia y Medio Ambiente)] birth cohort study (recruitment period: 2003-2008) with measured first pregnancy trimester plasma concentrations of four PFASs (in nanograms/milliliter). We u…

SU-F-T-63: Dosimetric Relevance of the Valencia and Leipzig HDR Applicators Plastic Cap

Purpose: Utilization of HDR brachytherapy treatment of skin lesions using collimated applicators, such as the Valencia or Leipzig is increasing. These applicators are made of cup-shaped tungsten material in order to focalize the radiation into the lesion and to protect nearby tissues. These applicators have an attachable plastic cap that removes secondary electrons generated in the applicator and flattens the treatment surface. The purpose of this study is to examine the dosimetric impact of this cap, and the effect if the cap is not placed during the HDR fraction delivery. Methods: Monte Carlo simulations have been done using the code Geant4 for the Valencia and Leipzig applicators. Dose r…

Changes in the Effect of Heat on Mortality in the Last 20 Years in Nine European Cities. Results from the PHASE Project

The European project PHASE aims to evaluate patterns of change in the temperature–mortality relationship and in the number of deaths attributable to heat in nine European cities in two periods, before and after summer 2003 (1996–2002 and 2004–2010). We performed age-specific Poisson regression models separately in the two periods, controlling for seasonality, air pollution and time trends. Distributed lag non-linear models were used to estimate the Relative Risks of daily mortality for increases in mean temperature from the 75th to 99th percentile of the summer distribution for each city. In the recent period, a reduction in the mortality risk associated to heat was observed only in Athens,…

Prenatal head growth and child neuropsychological development at age 14 months

We sought to assess the association between prenatal head growth and child neuropsychological development in the general population.We evaluated 2104 children at the age of 14 months from a population-based birth cohort in Spain. Head circumference (HC) was measured by ultrasound examinations at weeks 12, 20, and 34 of gestation and by a nurse at birth. Head growth was assessed using conditional SD scores between weeks 12-20 and 20-34. Trained psychologists assessed neuropsychological functioning using the Bayley Scales of Infant Development. Head size measurements at birth were transformed into a 3-category variable: microcephalic (10th percentile), normocephalic (≥10th and90th percentile)…

Prenatal exposure to perfluoroalkyl substances and birth outcomes in a Spanish birth cohort

BACKGROUND: Prenatal perfluorooctanoate (PFOA) exposure has been associated with reduced birth weight but maternal glomerular filtration rate (GFR) may attenuate this association. Further, this association remains unclear for other perfluoroalkyl substances (PFAS), such as perfluorooctane sulfonate (PFOS), perfluorohexane sulfonate (PFHxS), and perfluorononanoate (PFNA). We estimated associations between prenatal PFAS exposure and birth outcomes, and the influence of GFR, in a Spanish birth cohort. METHODS: We measured PFHxS, PFOS, PFOA, and PFNA in 1st-trimester maternal plasma (years: 2003-2008) in 1202 mother-child pairs. Continuous birth outcomes included standardized weight, length, he…

Drinking water disinfection by-products during pregnancy and child neuropsychological development in the INMA Spanish cohort study.

Background: Disinfection by-products (DBPs) constitute a complex mixture of prevalent chemicals in drinking water and there is evidence of neurotoxicity for some of them. Objectives: We evaluated the association between estimates of DBP exposure during pregnancy and child neuropsychological outcomes at 1 and 4–5 years of age. Methods: We conducted a population-based mother-child cohort study in Spain with recruitment at first trimester of gestation (INMA Project, 2003–2008). Neuropsychological development was measured at 1 year of age using the Bayley Scales of Infant Development and at 4–5 years with the McCarthy Scales of Children's Abilities. Modeled tap water concentrations of trihalome…

Associations of Maternal Cell-Phone Use During Pregnancy With Pregnancy Duration and Fetal Growth in 4 Birth Cohorts

Results from studies evaluating potential effects of prenatal exposure to radio-frequency electromagnetic fields from cell phones on birth outcomes have been inconsistent. Using data on 55,507 pregnant women and their children from Denmark (1996-2002), the Netherlands (2003-2004), Spain (2003-2008), and South Korea (2006-2011), we explored whether maternal cell-phone use was associated with pregnancy duration and fetal growth. On the basis of self-reported number of cell-phone calls per day, exposure was grouped as none, low (referent), intermediate, or high. We examined pregnancy duration (gestational age at birth, preterm/postterm birth), fetal growth (birth weight ratio, small/large size…

Exposure to metals and metalloids among pregnant women from Spain: Levels and associated factors

This study was funded by Grants from EU (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1); Spain: ISCIII (Red INMA G03/176, CB06/02/0041; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/00090, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI13/02187, PI14/00891, PI14/01687, PI16/1288, PI17/00663, PI18/01142 and PI19/1338; Miguel Servet FEDER MS15/00025, MS20/0006, CPII16/00051, and FIS-FSE: 17/00260); CIBERESP; Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249), AICO/2020/285, and Alicia Koplowitz Foundation 2017; Generalitat de Catalunya-CIRIT 1999SGR 00241; Department of Health…

Air Pollution Exposure During Pregnancy and Reproductive Outcomes

Air pollution is largely recognized as a risk factor for several outcomes including increased mortality, increased hospital admissions and emergency visits for both respiratory and cardiovascular diseases, and impairment of respiratory function, including reduced lung function, exacerbation of asthma and chronic obstructive pulmonary disease (Brunekreef & Holgate, 2002). Some populations have shown to be more susceptible to these effects, and among them including those people in the tails of the age distribution, i.e. the elderly and infants (Laumbach, 2010). The study of fetal growth and birth outcomes has become an important emerging field of environmental epidemiology (Sram et al., 2005)…

Temperature in summer and children's hospitalizations in two Mediterranean cities

Abstract Background and objective Children are potentially vulnerable to hot ambient temperature. However, the evidence on heat-related children's morbidity is still scarce. Our aim was to examine the association between temperatures in summer (May to September) and children's hospitalizations in two Mediterranean cities, Rome and Valencia, during the period 2001–2010. Methods Quasi-Poisson generalised additive models and distributed lag non-linear models were combined to study the relationship between daily mean temperature and hospital admissions for all natural, respiratory and gastrointestinal diseases in children under 15 years of age. Associations were summarised as the percentage of …

Methylmercury-induced developmental toxicity is associated with oxidative stress and cofilin phosphorylation. Cellular and human studies

Environmental exposure to methylmercury (MeHg) during development is of concern because it is easily incorporated in children’s body both pre- and post-natal, it acts at several levels of neural pathways (mitochondria, cytoskeleton, neurotransmission) and it causes behavioral impairment in child. We evaluated the effects of prolonged exposure to 10–600 nM MeHg on primary cultures of mouse cortical (CCN) and of cerebellar granule cells (CGC) during their differentiation period. In addition, it was studied if prenatal MeHg exposure correlated with altered antioxidant defenses and cofilin phosphorylation in human placentas (n = 12) from the INMA cohort (Spain). Exposure to MeHg for 9 days in v…

Variability of perfluoroalkyl substance concentrations in pregnant women by socio-demographic and dietary factors in a Spanish birth cohort

Background: Prenatal exposure to perfluoroalkyl substances (PFAS) might affect child health; but maternal determinants of PFAS exposure are unclear. We evaluated the socio-demographic and dietary factors of prenatal PFAS concentrations in a Spanish birth cohort. Methods: We analyzed perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in 1216 plasma samples collected during the 1ST trimester of pregnancy (2003–2008). We used multivariable linear regressions to assess the geometric mean (GM) ratios of PFAS concentrations by socio-demographic and dietary factors. We used analysis of variance (ANOVA) to asse…

Prenatal exposure to lead in Spain: Cord blood levels and associated factors

Abstract Introduction and Objective Lead is a known neurotoxic. Fetuses and infants are very vulnerable to lead exposure, since their blood-brain barrier is not completely formed. Hence, there is an importance for monitoring of blood lead levels prenatally and during early infancy. The aim of this study is to evaluate the prenatal exposure to lead and its association with maternal factors in four population based mother–child cohorts in Spain. The present research was carried out within the framework of the INMA project INfancia y Medio Ambiente (Environment and Childhood). Methods A total of 1462 pregnant women were recruited between 2004 and 2008. Lead was analyzed in a sample of cord blo…

TU-C-16A-01: Joint AAPM/SEFM/AMPR Educational Workshop On “Education of Radiotherapy Physicists”

This workshop is jointly organized by the AAPM, the Spanish (SEFM) and the Russian (AMPR) Medical Physics Societies, as part of formal educational exchange agreements signed by the AAPM with each one of these two societies.With the rapid technological advances in radiation therapy both for treatment and imaging, it is challenging how physics is taught to medical physicists practicing in radiation therapy. The main Objectives: of this workshop is to bring forth current status, challenges and issues related to education of radiation therapy physicists here in the US, Spain and Russia. Medical physicists from each one of these countries will present educational requirements of international re…

Additional file 1: Table S1. of Distributions and determinants of urinary biomarkers of organophosphate pesticide exposure in a prospective Spanish birth cohort study

Intake of fruit and vegetables according to the maternal sociodemographic and life style characteristics. (DOC 49 kb)

In utero exposure to mixtures of xenoestrogens and child neuropsychological development.

BACKGROUND: To date, no epidemiological studies have explored the impact and persistence of in utero exposure to mixtures of xenoestrogens on the developing brain. We aimed to assess whether the cumulative effect of xenoestrogens in the placenta is associated with altered infant neuropsychological functioning at two and at four years of age, and if associations differ among boys and girls. METHODS: Cumulative prenatal exposure to xenoestrogens was quantified in the placenta using the biomarker Total Effective Xenoestrogen Burden (TEXB-alpha) in 489 participants from the INMA (Childhood and the Environment) Project. TEXB-alpha was split in tertiles to test its association with the mental and…

Exposure to ambient air pollution during pregnancy and preterm birth: A Spanish multicenter birth cohort study

Background and objective: Preterm birth is a major determinant of infant mortality and morbidity. Air pollution has been suggested as a risk factor for preterm delivery; however, the scientific evidence on this impact remains inconsistent. We assessed the association between residential exposure to air pollution during pregnancy and preterm birth (gestational age at delivery <37 weeks) in Spain. Methods: This study was based on 2409 pregnant women participating in the INMA birth cohorts in Asturias, Gipuzkoa, Sabadell and Valencia. Ambient levels of nitrogen dioxide (NO2) and benzene were estimated for each woman's residence for each trimester and for the whole pregnancy, using temporally a…

Synergistic Effects of Ambient Temperature and Air Pollution on Health in Europe: Results from the PHASE Project

We studied the potential synergy between air pollution and meteorology and their impact on mortality in nine European cities with data from 2004 to 2010. We used daily series of Apparent Temperature (AT), measurements of particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) and total non-accidental, cardiovascular, and respiratory deaths. We applied Poisson regression for city-specific analysis and random effects meta-analysis to combine city-specific results, separately for the warm and cold seasons. In the warm season, the percentage increase in all deaths from natural causes per &deg

Characterizing mortality effects of particulate matter size fractions in the two capital cities of the Canary Islands

Most of the studies differentiating the effect of size-classified particulate matter (PM) exposure have been carried out in cities where the average levels of fine particles (PM2.5) were higher than those of coarse particles (PM10-2.5). These studies have suggested that PM2.5 is associated with daily mortality, but there is only limited evidence that PM10-2.5 is independently associated with mortality. The citizens of the Canary Islands are exposed to PM which is highly influenced by mineral dust because of the islands' proximity to the Western Coast of Morocco. This offers an excellent opportunity to analyze in detail the short-term association between PM size fractions and total, respirat…

Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study

10 p. Objectives: To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure.-- Design: We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The…

Prenatal exposure to organochlorine compounds and neonatal thyroid stimulating hormone levels

It has been suggested that prenatal exposure to some organochlorine compounds (OCs) may adversely affect thyroid function and may, therefore, impair neurodevelopment. The main aim of this study was to examine the relationship of cord serum levels of 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (4,4′-DDT), 1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene (4,4′-DDE), β-hexachlorocyclohexane (β-HCH), hexachlorobenzene (HCB), four individual polychlorobiphenyl (PCB) congeners (118, 138, 153, and 180), and their sum, with neonatal thyroid stimulating hormone (TSH) levels in blood samples in a mother–infant cohort in Valencia, Spain. This study included 453 infants born between 2004 and 2006. We mea…

Deficit of Interleukin-7 in Serum of Patients with Crohn's Disease

Distributions and determinants of urinary biomarkers of organophosphate pesticide exposure in a prospective Spanish birth cohort study

Background: Prenatal exposure to organophosphate pesticides (OPs) has been associated with impaired child development. Pesticide exposure determinants need to be studied in order to identify sources and pathways of pesticide exposure. The aim of this paper is to describe prenatal exposure to OPs and evaluate the associated factors in pregnant women. Methods: The study population consisted of pregnant women ( n = 573) who participated in the INMA birth cohort study in Valencia (Spain, 2003 – 2006). OP metabolites were analyzed in maternal urine at the 32nd week of gestation using a liquid chromatography-high resolution mass spectrometry method. The analysis included non-specific (diethyl pho…

WE-C-108-08: Organ Doses in a Male Phantom Undergoing High-Dose-Rate Brachytherapy Applied to the Prostate

Purpose: The aim of this study was to obtain equivalent doses to radiosensitive organs when applying high‐dose‐rate (HDR) brachytherapy to the prostate using60 Co or 192 Ir sources, and in comparison to external‐beam radiotherapy (EBRT) modalities. Methods: Monte Carlo simulations in Geant4 were performed using a voxelized adult reference man described in Publication 110 by the International Commission on Radiological Protection (ICRP). Point sources of 60Co or 192Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate. Equivalent doses per therapeutic absorbed dose to the prostate were obtained in several radiosensitive organs. …

Evolución de los riesgos ambientales en el contexto de la crisis económica. Informe SESPAS 2014

ResumenNuestro objetivo es analizar el impacto de la crisis económica-financiera en los determinantes ambientales de la salud. La Organización Mundial de la Salud estima que entre un 13% y un 27% de la carga de enfermedad de los países podría prevenirse mejorando el medio ambiente. Los efectos son de mayor magnitud en poblaciones más vulnerables, en especial entre los más pobres. En la última década, la contaminación atmosférica exterior (el riesgo ambiental más relevante, en términos de salud, para la mayoría de los países europeos) se ha reducido moderadamente, sobre todo por las políticas europeas de reducción de emisiones y por la disminución de la actividad con la crisis económica. En …

Industrial Pollution and Congenital Heart Anomalies in the Valencia Region, Spain

Background Congenital heart anomalies (CHA) are the most common type of birth defects, accounting for nearly one third of major congenital anomalies diagnosed prenatally or in infancy in Europe. In the majority of cases, the etiology is unknown, but an interaction of genetic and environmental factors such as industrial pollution may play a role in CHA development. The aim is to identify the relationship between CHA and the industrial pollution in the municipalities of …

Prenatal manganese exposure and neuropsychological development in early childhood in the INMA cohort.

Abstract Introduction Manganese (Mn) is an essential element, diet being its main source. Some epidemiological studies have found that a prenatal excess of Mn could negatively affect neuropsychological development during infancy, but the evidence is inconclusive. The aim of this study was to explore the relationship between maternal serum Mn concentrations and child neuropsychological development assessed at 1 year of age. Methods study subjects were 1179 mother–child pairs from two Spanish cohorts (Valencia and Gipuzkoa) of the INMA (Environment and Childhood) Project. Mn was measured in serum samples collected during the first trimester of pregnancy. Child neuropsychological development w…

TU-E-116-01: Clinical Implementation for Advanced Brachytherapy Dose Calculation Algorithms Beyond the TG-43 Formalism

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently‐published AAPM TG‐186 report discusses important issues for clinical implementation of these algorithms. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG‐43 and heterogeneity‐based dosimetry. A proposed commissioning flowchart will be discussed, guiding the audience through the clinical process. Further, QA tests specific to the…

Asthma Visits to Emergency Rooms and Soybean Unloading in the Harbors of Valencia and A Coruna, Spain

Soybean unloading in the harbor of Barcelona, Spain, has been associated with large increases in the numbers of asthma patients treated in emergency departments between 1981 and 1987. in this study, the association between asthma and soybean unloading in two other Spanish cities, Valencia and A Coruna, was assessed, Asthma admissions were retrospectively identified for the period 1993-1995, and harbor activities were investigated in each location. Two approaches were used to assess the association between asthma and soybean unloading: One used unusual asthma days (days with an unusually high number of emergency room asthma visits) as an effect measure, and the other estimated the relative i…

SU-E-T-176: Commissiong and Initial Clinical Experience with Dosimetry Check, a Commercial Software for in Vivo Volumetric Dosimetry

Purpose: The aim of this work is to study the differences of reference point doses between the commercial EPID based dosimetry software Dosimetry Check (DC) and TPS to establish an accuracy level of the system, to evaluate its use in clinical routine and to obtain results for the first patients. Methods: We used DC v.3.8 (Math Resolutions), two Varian Clinac iX accelerators equipped with EPID aS1000 and Eclipse v.10.0 with AAA algorithm. Several plans with and without air gap were generated over the phantoms: MP1 Water Tank and Solid Octavius 4D (PTW). 5 head and neck, 3 lung and 4 prostate cases were selected for clinical evaluation. We compared the calculated dose at the isocenter and in …

Second-hand smoke exposure in 4-year-old children in Spain: Sources, associated factors and urinary cotinine

Introduction Second-hand smoke exposure (SHS) in children remains as a major pollution problem, with important consequences for children's health. This study aimed to identify the sources of exposure to SHS among 4-year-old children, comparing self-reports to a urinary biomarker of exposure, and characterize the most important variables related to SHS exposure in this population. Methods 4-year-old children's exposure to SHS was assessed by a parental-reported questionnaire and by urinary cotinine (UC) measurements in 1757 participants from 4 different areas of the Spanish INMA (INfancia y Medio Ambiente – Environment and Childhood) Project. The questionnaire about SHS included information …

Prenatal exposure to perfluoroalkyl substances, immune-related outcomes, and lung function in children from a Spanish birth cohort study.

Background: Prenatal exposure to perfluoroalkyl substances (PFASs) has been associated with impaired immune and respiratory health during childhood but the evidence is inconsistent and limited for lung function. We studied the association between prenatal PFASs exposure and immune and respiratory health, including lung function, up to age 7 years in the Spanish INMA birth cohort study. Methods: We assessed four PFASs in maternal plasma samples collected during the 1st trimester of pregnancy (years: 2003-2008): perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorononanoate (PFNA). Mothers reported the occurrence (yes/no) of lower respir…

Severe Chronic Allergic (and Related) Diseases: A Uniform Approach – A MeDALL – GA&lt;sup&gt;2&lt;/sup&gt;LEN – ARIA Position Paper

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in …

Serum metal levels in a population of Spanish pregnant women

Objective: To describe serum levels of calcium, copper, selenium, magnesium, iron and zinc and evaluate their relationship with maternal socio-demographic characteristics and dietary variables in women in the first trimester of pregnancy. Method: Cross-sectional study with 1279 participants from the INMA cohorts. Results: The concentrations of the elements analyzed were within the normal range. Associations with higher levels of these metals were found for calcium with white meat intake (p = 0.026), for cop-per with excess body weight (p 71 g/day) (p = 0.014) and having been born in Spain (p = 0.001). Further, lower iron levels were associated with being overweight (p = 0.021) or obese (p <…

Exposure to elevated temperatures and risk of preterm birth in Valencia, Spain

Abstract Background Prematurity is the second-leading cause of death in children under the age of 5 worldwide. It is predicted that the future climate will have more intense, longer lasting and frequent extreme heat episodes, and so the temperature effect on the risk of preterm birth is generating considerable interest in the public health field. Our aim was to explore the potential short-term effects of elevated temperatures on the risk of preterm birth in Valencia (Spain). Methods All singleton natural births born in the metropolitan area of Valencia during the warm season (May–September, 2006–2010) were included ( N =20,148). We applied time-series quasi-Poisson generalized additive mode…

Transfer of perfluoroalkyl substances from mother to fetus in a Spanish birth cohort

CSIC Servicio de enlaces(opens in a new window)|Library catalogue(opens in a new window)|View at Publisher| Export | Download | Add to List | More... Environmental Research Volume 142, October 01, 2015, Pages 471-478 Transfer of perfluoroalkyl substances from mother to fetus in a Spanish birth cohort (Article) Manzano-Salgado, C.B.abc , Casas, M.abc, Lopez-Espinosa, M.-J.cd, Ballester, F.cd, Basterrechea, M.cef, Grimalt, J.O.gh, Jiménez, A.-M.ef, Kraus, T.i, Schettgen, T.i, Sunyer, J.abc, Vrijheid, M.abc a Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader, 88, Barcelona, Catalonia, Spain b Universitat Pompeu Fabra (UPF), Barcelona, Spain c CIBER Epidemiología y Salu…

Urban environment during early-life and blood pressure in children

Background. The urban environment is characterised by many exposures that may influence hypertension development, but studies evaluating multiple urban exposures from pregnancy onwards are lacking....

Spatial analysis of the relationship between mortality from cardiovascular and cerebrovascular disease and drinking water hardness

Journal Article; Research Support, Non-U.S. Gov't; Reproduced with permission from Environmental Health Perspectives. Previously published scientific papers have reported a negative correlation between drinking water hardness and cardiovascular mortality. Some ecologic and case-control studies suggest the protective effect of calcium and magnesium concentration in drinking water. In this article we present an analysis of this protective relationship in 538 municipalities of Comunidad Valenciana (Spain) from 1991-1998. We used the Spanish version of the Rapid Inquiry Facility (RIF) developed under the European Environment and Health Information System (EUROHEIS) research project. The strateg…

Infants' indoor and outdoor residential exposure to benzene and respiratory health in a Spanish cohort.

Benzene exposure represents a potential risk for children's health. Apart from being a known carcinogen for humans (group 1 according to IARC), there is scientific evidence suggesting a relationship between benzene exposure and respiratory problems in children. But results are still inconclusive and inconsistent. This study aims to assess the determinants of exposure to indoor and outdoor residential benzene levels and its relationship with respiratory health in infants. Participants were 1-year-old infants (N = 352) from the INMA cohort from Valencia (Spain). Residential benzene exposure levels were measured inside and outside dwellings by means of passive samplers in a 15-day campaign. Pe…

Genetic risk profiles for a childhood with severely overweight

Summary What is already known about this subject Genome-wide association studies have identified susceptibility loci, conferring only small effects to obesity. We selected 12 from the most accepted susceptibility genes to overweight, which have been corroborated in different populations and series of thousands of adult individuals. Single-nucleotide polymorphisms variants can have a cumulative effect on common forms of obesity, to create a genetic risk score. What this study adds We concentrated on 109 single-nucleotide polymorphisms (SNPs) located in 12 loci previously reported in association to body mass index at genome-wide significant level, for individuals of European ancestry. To iden…

Organochlorine Compounds and Ultrasound Measurements of Fetal Growth in the INMA Cohort (Spain)

This study was funded by grants from the EU (European Union): NEWGENERIS FP6-2003- Food-3-A-016320, FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1; and by grants from Spain: Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0031, and FIS-FEDER PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI04/2018, PI04/1436, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI08/1151, PI09/02647, PI09/02311, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/02429, PI14/0891, PI14/1687, and Miguel Servet CP11/00178 and CP13/00054), Conselleria de Sanitat Generalitat Valenciana, Generalitat de Catalunya (CIRIT 1999SGR 00241), Diputación Foral de Guipúzcoa (DFG/004), Departamento de Sanidad y Consumo Gobierno…

Air pollution exposure during pregnancy and reduced birth size: a prospective birth cohort study in Valencia, Spain

Abstract Background Maternal exposure to air pollution has been related to fetal growth in a number of recent scientific studies. The objective of this study was to assess the association between exposure to air pollution during pregnancy and anthropometric measures at birth in a cohort in Valencia, Spain. Methods Seven hundred and eighty-five pregnant women and their singleton newborns participated in the study. Exposure to ambient nitrogen dioxide (NO2) was estimated by means of land use regression. NO2 spatial estimations were adjusted to correspond to relevant pregnancy periods (whole pregnancy and trimesters) for each woman. Outcome variables were birth weight, length, and head circumf…

Association between exposure to organochlorine compounds and maternal thyroid status: Role of the iodothyronine deiodinase 1 gene.

Introduction: Exposure to organochlorine compounds (OCs) may interfere with thyroid hormone (TH) homeostasis. The disruption of the deiodinase (DIO) enzymes has been proposed as a mechanism of action. Aim: To evaluate the association between exposure to OCs and TH status in pregnant women, as well as to explore the role of genetic variations in the DIO1 and DIO2 genes. Methods: The study population (n = 1128) was composed of pregnant women who participated in the INMA Project (Spain, 2003–2006). Hexachlorobenzene (HCB), 1,1-dichloro-2,2-bis(4-chlorophenyl)ethylene (4,4´-DDE), b-hexachlorocyclohexane (b-HCH), polychlorobiphenyl (PCB) congeners 138, 153 and 180, thyroid stimulating hormone (T…

Exposure to mercury among 9-year-old children and neurobehavioural function

Abstract Mercury (Hg) is an environmental neurotoxicant whose main route of exposure in humans is the consumption of seafood. The aim of this study was to explore the relationship between Hg exposure at 9 years old and behaviour assessed at 9 and 11 years old. Study subjects were mother–child pairs participating in the INMA (Environment and Childhood) Project in Valencia (Spain). Total Hg (THg) was measured in hair samples from the children at 9 years old. Behaviour and emotions were assessed at 9 (n = 472) years and 11 (n = 385) years of age using the Child Behaviour Checklist test (CBCL) and the Conners Parents Rating Scale-Revised: Short Form (CPRS-R:S). Furthermore, the attention functi…

Maternal selenium status and neuropsychological development in Spanish preschool children

Background: The relationship between maternal selenium (Se) status and child neurodevelopment has been scarcely assessed. In a previous study we observed an inverse U-shaped association between maternal Se concentrations and infant neurodevelopment at 12 months of age. In this study, this non-linear association was explored at preschool age. The effect modification by breastfeeding, child's sex and cord blood mercury was also evaluated.Methods: Study subjects were 490 mother-child pairs from the Spanish Childhood and Environment Project (INMA, 2003–2012). Child neuropsychological development was assessed at around 5 years of age by theMcCarthy Scales of Children's Abilities (MSCA). Sociodem…

Pre and postnatal exposure to mercury and respiratory health in preschool children from the Spanish INMA Birth Cohort Study

Effects of mercury on maturing immune system have been reported, however the association with respiratory and allergy problems during infancy remains unclear. The aim of this study is to evaluate the association between pre and postnatal mercury exposure and respiratory and allergy problems among preschool children and to examine the role of potential modifying factors. Study subjects were children participant in Spanish Childhood and Environment Project (INMA, 2003-2008). We measured total mercury levels in cord blood (n = 1868) and hair at 4 years of age (n = 1347). Respiratory outcomes (wheezing, severe wheezing, chestiness, persistent cough, eczema and otitis) were obtained by questionn…

A genome-wide association meta-analysis of diarrhoeal disease in young children identifies FUT2 locus and provides plausible biological pathways

More than a million childhood diarrhoeal episodes occur worldwide each year, and in developed countries a considerable part of them are caused by viral infections. In this study, we aimed to search for genetic variants associated with diarrhoeal disease in young children by meta-analyzing genome-wide association studies, and to elucidate plausible biological mechanisms. The study was conducted in the context of the Early Genetics and Lifecourse Epidemiology (EAGLE) consortium. Data about diarrhoeal disease in two time windows (around 1 year of age and around 2 years of age) was obtained via parental questionnaires, doctor interviews or medical records. Standard quality control and statistic…

Prenatal arsenic exposure, arsenic methylation efficiency, and neuropsychological development among preschool children in a Spanish birth cohort.

Abstract Background Prenatal arsenic (As) exposure could negatively affect child neuropsychological development, but the current evidence is inconclusive. Objectives To explore the relationship between prenatal urinary total As (TAs) concentrations, the As species and the methylation efficiency, and child neuropsychological development in a Spanish birth cohort. We also studied the effect modification produced by sex and several nutrients and elements. Materials and methods Study subjects were 807 mother–child pairs participating in the INMA (Childhood and Environment) Project. Urinary TAs and its metabolites, monomethylarsonic acid (MMA), dimethylarsinic acid (DMA), inorganic As (iAs) and …

Response to “Comment on ‘Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brachytherapy dosimetry’ ” [Med. Phys. 42 , 4954-4964 (2015)]

SU-E-T-218: Octavius 4D: Commissioning and Clinical Implementation of a New Device for VMAT Verifications

Purpose: To commission a new device for pre‐treatment patient specific verification of VMAT plans, which is capable of reconstructing 3D dose with high resolution. Methods: Octavius 4D system (PTW) consists of an ion chamber array embedded in a cylindrical phantom which, assisted by an inclinometer, rotates synchronously with the gantry. For VMAT plans, it measures planar dose distributions as a function of gantry angle in order to compute the resulting 3D dose distribution. There are two options for the ion chamber array: Octavius 729 (general purpose) and Octavius 1000 SRS (small field size, high resolution). We have used three linacs: two Varian Clinac iX and one TrueBeam with MLC HD 120…

Study of CT/MRI mutual information based registration applied in brachytherapy

The present work aims to include magnetic resonance imaging (MRI) in a Medical Image-based Graphical platfOrm - Brachytherapy module (AMIGOBrachy) which coupled to the Monte Carlo N-Particle (MCNP6) code allows absorbed dose calculations. Computed tomography (CT) and MRI images were registered using mutual information algorithms to improve tissue segmentation potentially leading to a more accurate treatment planning system.

Influence of fetal glutathione S-transferase copy number variants on adverse reproductive outcomes

A nested case-control association study was designed to investigate the influence of maternal and fetal copy number variants (CNVs) on reproductive outcomes. Genotypes of ten CNVs encompassing GST and CYP genes were assessed. Significant associations were only found for child CNV genotypes. In particular, the child GSTM1 insertion allele was associated with prematurity protection (odds ratio, 95% CI: 0.67, 0.51-0.89; P < 0.01), whereas the child GSTT2B insertion allele was associated with an increased risk of being small for gestational age (odds ratio, 95% CI: 1.33, 1.07-1.67; P = 0.01). The study highlights the role of the fetal genome in prenatal development and also the need to analyse …

Annoyance Caused by Noise and Air Pollution during Pregnancy: Associated Factors and Correlation with Outdoor NO2 and Benzene Estimations

This study aimed to describe the degree of annoyance among pregnant women in a Spanish cohort and to examine associations with proximity to traffic, NO2 and benzene exposure. We included 2457 participants from the Spanish Childhood and Environment study. Individual exposures to outdoor NO2 and benzene were estimated, temporally adjusted for pregnancy. Interviews about sociodemographic variables, noise and air pollution were carried out. Levels of annoyance were assessed using a scale from 0 (none) to 10 (strong and unbearable)

Air Pollution During Pregnancy and Childhood Cognitive and Psychomotor Development: Six European Birth Cohorts

Background: Accumulating evidence from laboratory animal and human studies suggests that air pollution exposure during pregnancy affects cognitive and psychomotor development in childhood. Methods: We analyzed data from 6 European population-based birth cohorts-GENERATI ON R (The Netherlands), DUISBURG (Germany), EDEN (France), GASPII (Italy), RHEA (Greece), and INMA (Spain)-that recruited mother-infant pairs from 1997 to 2008. Air pollution levels-nitrogen oxides (NO2, NOx) in all regions and particulate matter (PM) with diameters of <2.5, <10, and 2.5-10 mu m (PM2.5, PM10, and PMcoarse, respectively) and PM2.5 absorbance in a subgroup-at birth addresses were estimated by land-use regressi…

Pre- and postnatal exposure to tobacco smoke and respiratory outcomes during the first year

The different role of prenatal and postnatal exposure to tobacco smoke in respiratory outcomes in infants has not yet been clearly established. Our objective is to assess the effects of these exposures on the risk of respiratory outcomes during the first year of life of infants from a Spanish multicenter cohort study. A total of 2506 women were monitored until delivery. About 2039 infants made up the final population. The outcomes were caused by the occurrence of the following: otitis, cough persisting for more than 3 weeks, lower respiratory tract symptoms (wheezing or chestiness), and lower respiratory tract infections (bronchitis, bronchiolitis, or pneumonia). The relationship between pr…

The role of parental social class, education and unemployment on child cognitive development

ABSTRACT Objective Assessing the association between socioeconomic gradient and cognitive development among children of a Spanish birth cohort aged 5-6 years from a gender perspective. Method Cognitive development was assessed on 525 children aged 5-6 years in the INMA-Valencia cohort, with the Global Cognitive Score (GCS) from McCarthy Scales of Children's Abilities. Information on social class, education level and employment was collected for both parents in addition to other sociodemographic factors, parental, family and child characteristics. The relationship between maternal and paternal socioeconomic gradient and cognitive development was assessed by linear regressions and comparing t…

Prenatal perfluoroalkyl substance exposure and neuropsychological development throughout childhood: The INMA Project.

Abstract Background Perfluoroalkyl substances (PFASs) have been related to neurodevelopmental toxicity in animals. However, human studies are inconclusive. Objectives To evaluate the association between prenatal PFAS exposure and neuropsychological development during childhood. Methods 1240 mother–child pairs from the Spanish INMA Project were analyzed. Perfluorohexanesulfonic acid (PFHxS), perfluorooctanoic acid (PFOA), perfluorooctane sulfonate (PFOS), and perfluorononanoic acid (PFNA) were measured in first-trimester maternal plasma. Neuropsychological development was assessed at 14 months, 4–5 and 7 years covering four domains: general cognitive, general motor, attention, and working me…

Statistical relationship between hardness of drinking water and cerebrovascular mortality in Valencia: a comparison of spatiotemporal models

The statistical detection of environmental risk factors in public health studies is usually difficult due to the weakness of their effects and their confounding with other covariates. Small area geographical data bring the opportunity of observing health response in a wide variety of exposure values. Temporal sequences of these geographical datasets are crucial to gaining statistical power in detecting factors. The spatiotemporal models required to perform the statistical analysis have to allow for spatial and temporal correlations, which are more easily modelled via hierarchical structures of hidden random factors. These models have produced important research activity during the last deca…

Fish and seafood consumption during pregnancy and the risk of asthma and allergic rhinitis in childhood

Background: It has been suggested that prenatal exposure to n-3 long-chain fatty acids protects against asthma and other allergy-related diseases later in childhood. The extent to which fish intake in pregnancy protects against child asthma and rhinitis symptoms remains unclear. We aimed to assess whether fish and seafood consumption in pregnancy is associated with childhood wheeze, asthma and allergic rhinitis. Methods: We pooled individual data from 60 774 mother-child pairs participating in 18 European and US birth cohort studies. Information on wheeze, asthma and allergic rhinitis prevalence was collected using validated questionnaires. The time periods of interest were: infancy (0-2 ye…

Understanding the complexity of IgE-related phenotypes from childhood to young adulthood: A Mechanisms of the Development of Allergy (MeDALL) seminar.

Mechanisms of the Development of Allergy (MeDALL), a Seventh Framework Program European Union project, aims to generate novel knowledge on the mechanisms of initiation of allergy. Precise phenotypes of IgE-mediated allergic diseases will be defined in MeDALL. As part of MeDALL, a scientific seminar was held on January 24, 2011, to review current knowledge on the IgE-related phenotypes and to explore how a multidisciplinary effort could result in a new integrative translational approach. This article provides a summary of the meeting. It develops challenges in IgE-related phenotypes and new clinical and epidemiologic approaches to the investigation of allergic phenotypes, including cluster a…

Prenatal exposure to PCB-153, p,p'-DDE and birth outcomes in 9000 mother-child pairs: exposure-response relationship and effect modifiers.

Low-level exposure to polychlorinated biphenyl-153 (PCB-153) and dichlorodiphenyldichloroethylene (p-p′-DDE) can impair fetal growth; however, the exposure–response relationship and effect modifiers of such association are not well established. This study is an extension of an earlier European meta-analysis. Our aim was to explore exposure–response relationship between PCB-153 and p-p′-DDE and birth outcomes; to evaluate whether any no exposure–effect level and susceptible subgroups exist; and to assess the role of maternal gestational weight gain (GWG). We used a pooled dataset of 9377 mother–child pairs enrolled in 14 study populations from 11 European birth cohorts. General additive mode…

Exposición ambiental a dióxido de nitrógeno y salud respiratoria a los 2 años en la Cohorte INMA-Valencia

Resumen: Objetivo: Analizar la relación entre la exposición a dióxido de nitrógeno (NO2) en las etapas prenatal y posnatal y la incidencia de problemas respiratorios en niños/as hasta los 2 años de edad. Método: La población consistió en 624 niños/as de la cohorte INMA-Valencia. Se estimó la exposición individual al NO2 en el exterior de la vivienda durante el periodo prenatal y hasta los 2 años de edad, a partir de la combinación de datos empíricos y el desarrollo de métodos geoestadísticos. Se aplicó un cuestionario para obtener la información sobre los síntomas respiratorios a los 2 años. La asociación entre la exposición al NO2 y los eventos respiratorios se realizó mediante regresión l…

Deficit of interleukin 7 in septic patients.

We recently demonstrated an overall decrease of all αβ and specially γδ T cell subsets in patients with sepsis compared with healthy subjects. IL-7 is a crucial factor for development of γδ T cells and survival in sepsis but its association with sepsis severity, evolution of organ failure and death still has not been investigated. Sera from 78 patients who met criteria for sepsis were analyzed vs control group. Septic patients showed the lowest levels of IL-7. Patients with severe sepsis reached levels of IL-7 higher than those observed in the groups of uncomplicated sepsis and septic shock. The frequency of γδ T cells at admission was lower in septic patients vs control group. At the time …

Socioeconomic status and exposure to multiple environmental pollutants during pregnancy: evidence for environmental inequity?

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 …

WE-C-141-01: Research and Relevance of Brachytherapy Dose Calculation Advancements

Research and Relevance of Brachytherapy Dose Calculation Advancements Organizer: Mark J. Rivard Moderator: Geoffrey S. Ibbott Speakers: Facundo Ballester, Asa Carlsson Tedgren, Firas Mourtada Brachytherapy dosimetry is undergoing a renaissance with the scrutiny of the AAPM TG‐43 dose calculation formalism and comparisons with alternate approaches such as the Monte Carlo method, the grid‐based Boltzmann solvers, and the collapsed‐cone technique. Treatment planning systems (TPS) using these more advanced, model‐based dose calculation algorithms (MBDCAs) are now available for clinical use. However, their accuracy and the preferred method for their use have not been established. Thus, it is imp…

Prenatal exposure to mercury and longitudinally assessed fetal growth: Relation and effect modifiers.

Background: Prenatal mercury exposure has been related to reductions in anthropometry at birth. Levels of mercury have been reported as being relatively elevated in the Spanish population. Objective: To investigate the relation between prenatal exposure to mercury and fetal growth. Methods: Study subjects were pregnant women and their newborns (n:1867) participating in a population-based birth cohort study set up in four Spanish regions from the INMA Project. Biparietal diameter (BPD), femur length (FL), abdominal circumference (AC), and estimated fetal weight (EFW) were measured by ultrasounds at 12, 20, and 34 weeks of gestation. Size at and growth between these points were assessed by st…

Estado actual sobre la exposición alimentaria al mercurio durante el embarazo y la infancia, y recomendaciones en salud pública

La exposición a dosis altas de mercurio durante periodos vulnerables (como el embarazo y la infancia) puede tener serias consecuencias para el desarrollo cognitivo, tal como se ha constatado tras los episodios de envenenamiento agudo ocurridos en Japón e Irak. El consumo de ciertos tipos de pescado es la fuente principal de exposición a mercurio de la población general. Existe una creciente preocupación por los posibles efectos neurotóxicos del mercurio, especialmente a edades tempranas en poblaciones donde el consumo de pescado es moderado-alto. La evidencia científica hasta el momento no es concluyente. En el ámbito español, el Proyecto INMA (Infancia y Medio Ambiente) ha proporcionado in…

Prenatal Se concentrations and anthropometry at birth in the INMA study (Spain).

Abstract We assessed whether prenatal selenium (Se) exposure is associated with anthropometry at birth, placental weight and gestational age. Study subjects were 1249 mother-child pairs from the Valencia and Gipuzkoa cohorts of the Spanish Childhood and Environment Project (INMA, 2003–2008). Se was determined in serum samples taken at the first trimester of pregnancy. Socio-demographic and dietary characteristics were also collected by questionnaires. Mean (SD) serum Se concentration was 79.57 (9.64) μg/L. Se showed weak associations with both head circumference and gestational age. The association between serum Se concentration and birth weight and length was negative, and direct for place…

Vitamin D Status in Pregnancy and Determinants in a Southern European Cohort Study

Background Population-based data on vitamin D status in pregnancy in southern European countries are scarce. We assessed the prevalence and determinants of vitamin D insufficiency and deficiency in pregnancy in Spain. Methods Plasma 25-hydroxyvitamin D3 (25(OH)D3) concentration was measured at the first trimester of gestation in 2,036 pregnant women from several geographical areas of Spain (latitude 39–42°N). Uni- and multivariable regression models were conducted to identify predictors of circulating 25(OH)D3 concentration and vitamin D insufficiency (20–30 ng/mL) and deficiency (<20 ng/mL). Results Thirty-one per cent and 18% of women were vitamin D insufficient and deficient, respectivel…

Occurrence of DBPs in Drinking Water of European Regions for Epidemiology Studies

International audience; A three-year study was conducted on the occurrence of disinfection by-products (DBPs) - trihalomethanes (THMs), haloacetic acids (HAAs), and haloacetonitriles - in drinking water of regions of Europe where epidemiology studies were being carried out. Thirteen systems in six countries (i.e., Italy, France, Greece, Lithuania, Spain, United Kingdom) were sampled. Typically chlorinated DBPs dominated. However, in most of Catalonia (Spain) and in Heraklion (Greece), brominated DBPs dominated. The degree of bromine incorporation into the DBP classes was in general similar among them. This is important, as brominated DBPs are a greater health concern. In parts of Catalonia,…

Preterm birth and exposure to air pollutants during pregnancy.

Background Research has shown that prenatal exposure to air pollutants may have a detrimental effect on fetal development with the strength of the relationship depending on the effect being studied The evidence to date however is insufficient to establish a direct causal link between such exposure and preterm delivery This study evaluates the specific effect of prenatal exposure to NO2 and benzene on preterm births Methods The population under study comprised 785 pregnant women who formed part of the INMA cohort in Valencia Spain (2003-2005) Multiple regression models were used for mapping outdoor nitrogen dioxide (NO2) and benzene levels throughout the area Individual exposure was assigned…

Prenatal exposure to organochlorine compounds and neuropsychological development up to two years of life

Polychlorinated biphenyls (PCB), hexachlorobenzene (HCB), and dichlorodiphenyl dichloroethylene (pp′DDE) are persistent, bioaccumulative, and toxic environmental pollutants with potential neurotoxic effects. Despite a growing body of studies investigating the health effects associated with these compounds, their specific effects on early neuropsychological development remain unclear. We investigated such neuropsychological effects in a population-based birth cohort based in three regions in Spain (Sabadell, Gipuzkoa, and Valencia) derived from the INMA [Environment and Childhood] Project. The main analyses in this report were based on 1391 mother–child pairs with complete information on mat…

Maternal Consumption of Seafood in Pregnancy and Child Neuropsychological Development: A Longitudinal Study Based on a Population With High Consumption Levels

Seafood consumption during pregnancy is thought to be beneficial for child neuropsychological development, but to our knowledge no large cohort studies with high fatty fish consumption have analyzed the association by seafood subtype. We evaluated 1,892 and 1,589 mother-child pairs at the ages of 14 months and 5 years, respectively, in a population-based Spanish birth cohort established during 2004-2008. Bayley and McCarthy scales and the Childhood Asperger Syndrome Test were used to assess neuropsychological development. Results from multivariate linear regression models were adjusted for sociodemographic characteristics and further adjusted for umbilical cord blood mercury or long-chain p…

Influence of prenatal exposure to environmental pollutants on human cord blood levels of glutamate

El pdf del artículo es la versión post-print.

Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis

Background Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. Methods and findings We conducted an individual participant data meta-analysis of data from 162,129 mothers and their children from 37 pregnancy and birth cohort studies from Europe, No…

SU-E-T-509: DICOM Test Case Plans for Model-Based Dose Calculations Methods in Brachytherapy

Purpose: The TG‐186 report provides guidance to early adopters of model‐based dose calculation algorithms (MBDCAs) for brachytherapy. A charge of the AAPM‐ESTRO Working Group on MBDCA is to develop well‐defined test case plans, available as references for the software commissioning process to be performed by end‐users. The aim of this work is to develop test case plans for a generic HDR 192 Ir source alone and in combination with a vaginal cylinder applicator with 180° tungsten‐alloy shielding in a DICOM‐based water phantom. Methods: A DICOM CT dataset was created with a 30 cm diameter water sphere surrounded by air. The voxel size was 1.33×1.33×1.33 mm3 for evaluating absorbed dose rate (c…

Social factors associated with nitrogen dioxide (NO2) exposure during pregnancy: The INMA-Valencia project in Spain

Numerous studies have focused on the effects of exposure to air pollution on health: however, certain subsets of the population tend to be more exposed to such pollutants depending on their social or demographic characteristics. In addition, exposure to toxicants during pregnancy may play a deleterious role in fetal development as fetuses are especially vulnerable to external insults. The present study was carried out within the framework of the INMA (Infancia y Medio Ambiente or Childhood and the Environment) multicenter cohort study with the objective of identifying the social, demographic, and lifestyle factors associated with nitrogen dioxide (NO2) exposure in the subjects in the cohort…

Selenium status during pregnancy: Influential factors and effects on neuropsychological development among Spanish infants

Selenium(Se) has been positively associated with neurodevelopment in early life. However, its margin of safety is rather narrow, and few prospective studies have evaluated its potential neurotoxic effects at intermediate levels. We aimed to explore the association between maternal Se concentrations and child neuropsychological development, including the genetic effect modification of the Se metabolizing gene INMT. Study subjects were 650 mother-child pairs from the Spanish Childhood and Environment Project (INMA, 2003-2005). Infant neuropsychological development was assessed around 12 months of age by the Bayley Scales of Infant Development. Sociodemographic and dietary characteristics were…

Prenatal exposure to perfluoroalkyl substances and immune and respiratory outcomes

Prenatal exposure to perfluoroalkyl substances (PFAS) may be associated with impaired immune and respiratory health during childhood but the evidence is scarce and inconsistent. We studied the association between prenatal PFAS exposure and immune and respiratory health up to age 7 years in the Spanish INMA birth cohort (n=1188). We assessed perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), and perfluorononanoate (PFNA) in maternal plasma samples. Mothers reported the occurrence (yes/no) of chest infections, lower respiratory tract infections, wheezing, asthma, and eczema in the previous 12 months at 1.5 and 4 years of the child and at 7 years. A…

Paving the way of systems biology and precision medicine in allergic diseases: the Me DALL success story

MeDALL (Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015) has proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy. MeDALL has linked epidemiological, clinical and basic research using a stepwise, large-scale and integrative approach: MeDALL data of precisely phenotyped children followed in 14 birth cohorts spread across Europe were combined with systems biology (omics, IgE measurement using microarrays) and environmental data. Multimorbidity in the same child is more common than expected by chance alone, suggesting that these diseases share causal mechanisms irrespective of IgE sen…

Microsporidia and Its Relation to Crohn's Disease. A Retrospective Study

Background: The cause of Crohn's Disease (CD) remains unknown. Recently a decrease in the global lymphocyte population in the peripheral blood of CD patients has been reported. This decrease was more evident in gamma delta T lymphocytes, especially gamma delta CD8+T subsets. Furthermore, a decrease of IL-7 was also observed in these patients. We propose the hypothesis that microsporidia, an obligate intracellular opportunistic parasite recently related to fungi, in CD patients can take advantage of the lymphocytes and IL-7 deficits to proliferate and to contribute to the pathophysiology of this disease. Methods and Findings: In this case-control study, serum samples were collected from 36 C…

Influence of the Urban Exposome on Birth Weight

Background: The exposome is defined as the totality of environmental exposures from conception onwards. It calls for providing a holistic view of environmental exposures and their effects on human health by evaluating multiple environmental exposures simultaneously during critical periods of life. Objective: We evaluated the association of the urban exposome with birth weight. Methods: We estimated exposure to the urban exposome, including the built environment, air pollution, road traffic noise, meteorology, natural space, and road traffic (corresponding to 24 environmental indicators and 60 exposures) for nearly 32,000 pregnant women from six European birth cohorts. To evaluate associatio…

Personal Exposure to Ultrafine Particles According to Different Environments and Modes of Transport in Schoolchildren: Results from a Spanish Cohort in Valencia

Background Combustion, especially in diesel engines, emits a complex mixture of gases and particles that could be harmful for the respiratory and cardiovascular systems. Daily personal exposure to the smallest particulate matter (less than 0.1 µm and usually called nanoparticles or ultrafine particles – UFP) has been studied to a lesser extent compared to coarser particles. In this study we aim to assess personal exposure to UFP in different environments and transport modes among schoolchildren from a Spanish birth-cohort in the province of Valencia. Methods The study population consisted of 114 children aged 10-11 years. For each of them, personal exposure to UFP was measured continuously …

Dietary and Household Sources of Prenatal Exposure to Polybrominated Diphenyl Ethers (PBDEs) in the INMA Birth Cohort (Spain)

This study looked at predictors of exposure to polybrominated diphenyl ethers (PBDEs) with a focus on dietary and household-level factors. Concentrations of BDE-47, -99, -153, and -209 and their sum (∑PBDEs) were measured in cord serum. Spanish women (n = 541) completed two semiquantitative food frequency questionnaires during the first and third trimesters of pregnancy. The daily mean intake (grams) of eggs, dairy products, meat, cereals and pasta, vegetables and pulses, fruits, shellfish and cephalopods, and fish, and the weekly mean intake (servings) of lean, large oily, other oily, and other fish from both questionnaires were averaged. Information on house size, curtains and carpets at …

PO-1047: Late G3 toxicity in prostate cancer patients treated with escalated dose (ED) technique: technical dependence

Prenatal Exposure to Organochlorine Compounds and Birth Size

Objective: To investigate the possible association between birth size and cord concentrations of some organochlorine compounds (OCs), including 4,4′-dichlorodiphenyltrichloroethane (DDT), 4,4′-1,1-dichloro-2,2-bis(p-dichlorodiphenyl)ethylene (DDE), hexachlorobenzene (HCB), β-hexachlorocyclohexane (β-HCH), 4 polychlorinated biphenyl (PCB) congeners (118, 138, 153, and 180), and their sum (ΣPCBs) in a birth cohort in Valencia, Spain. Study Design: A total of 494 mothers and their newborns (born 2003–2006) participated in the study. Multivariate linear regression analyses were performed between birth weight, length, or head circumference and OC concentrations. Results: Median concentrations of…

Evaluating the neurotoxic effects of lactational exposure to persistent organic pollutants (POPs) in Spanish children.

Although the brain continues developing in the postnatal period, epidemiological studies on the effects of postnatal exposure to neurotoxic POPs through breast-feeding remain mostly inconclusive. Failure to detect associations between postnatal exposure and health outcomes may stem from the limitations of commonly employed approaches to assess lactational exposure. The aim of the present study was to assess whether lactational exposure to polychlorinated biphenyl-153 (PCB-153), dichlorodiphenyldichloroethylene (DDE), or hexachlorobenzene (HCB) as estimated with a physiologically based pharmacokinetic (PBPK) model, is associated with decrements in mental and psychomotor development scores of…

Outdoor NO2 and benzene exposure in the INMA (Environment and Childhood) Asturias cohort (Spain)

Air pollution exposure during pregnancy has been linked to a wide range of negative health effects. NO2, a traffic pollution marker, and benzene, an industrial pollution indicator, stand out among the types of air pollution linked to these effects. The aim of this work is to show the methodology used to assign exposure levels for both pollutants and preliminary reports in the INMA (Environment and Childhood) Asturias cohort in Spain. This cohort consists of 494 pregnant women and their children, who have been recruited and followed since 2004. Air pollution levels were measured at 67 points by means of passive samplers. The mean NO2 measured value was 21.2 mu g m(-3) (range 3.5 mu g m(-3) t…

Reproducibility and validity of a food frequency questionnaire among pregnant women in a Mediterranean area

Background: Studies exploring the role of diet during pregnancy are still scarce, in part due to the complexity of measuring diet and to the lack of valid instruments. The aim of this study was to examine the reproducibility and validity (against biochemical biomarkers) of a semi-quantitative food frequency questionnaire (FFQ) in pregnant women. Methods: Participants were 740 pregnant women from a population-based birth cohort study in Valencia (INMA Study). We compared nutrient and food intakes from FFQs estimated for two periods of pregnancy (reproducibility), and compared energy-adjusted intake of several carotenoids, folate, vitamin B12, vitamin C and a-tocopherol of the FFQ in the firs…

SU-F-T-13: Transit Dose Comparisons for Co-60 and Ir-192 HDR Sources

Purpose: The purpose of this study is to compare the transit dose due to the movement of high dose rate (HDR) Ir-192 and Co-60 sources along the transfer tube. This is performed by evaluating air-kerma differences in the vicinity of the transfer tube when both sources are moved with the same velocity from a HDR brachytherapy afterloader into a patient. Methods: Monte Carlo simulations have been performed using PENELOPE2014. mHDR-v2 and Flexisource sources have been considered. Collisional kerma has been scored. The sources were simulated within a plastic catheter located in an infinite air phantom. The movement of the seed was included by displacing their positions along the connecting cath…

Eye lens equivalent dose in interventional neuroradiology based on OSL dosimetry

Over the past years there has been an increase in the assessment of eye lens doses in interventional radiology procedures. This is due to the new recommendations of the International Commission on Radiological Protection (ICRP-2012 Publication 118) that proposes to reduce equivalent dose limit for the eye lens. The aim of this study is to make estimates of equivalent dose received by eye lens of the medical staff in interventional neuroradiology procedures. Consequently, this study presents an alternative for eye lens dosimetry. For this purpose nanoDot dosimeters based on optically stimulated luminescence (OSL) technology from Landauer Inc. product were used. The measurements obtained for …

Prenatal and postnatal residential usage of insecticides in a multicenter birth cohort in Spain

Abstract: This study aimed to describe the residential use of insecticides in a birth cohort in Spain. Study subjects were 2 456 women enrolled into the INMA (Environment and Childhood) birth cohort followed prospectively during pregnancy and in the early postnatal period. The women were recruited at the beginning of their pregnancy between 2003 and 2008 in four regions of Spain. Socio-demographic, environmental and lifestyle information was obtained at two interviews during pregnancy, one at the first (mean:13.8 +/- 2.6 weeks of gestation) and the other at the third trimester (mean: 33.3 +/- 23 weeks of gestation). Information about prenatal use of indoor and outdoor insecticides (type, ti…

The Urban Exposome during Pregnancy and Its Socioeconomic Determinants

Background: The urban exposome is the set of environmental factors that are experienced in the outdoor urban environment and that may influence child development. Objective: The authors’ goal was to describe the urban exposome among European pregnant women and understand its socioeconomic determinants. Methods: Using geographic information systems, remote sensing and spatio-temporal modeling we estimated exposure during pregnancy to 28 environmental indicators in almost 30,000 women from six population-based birth cohorts, in nine urban areas from across Europe. Exposures included meteorological factors, air pollutants, traffic noise, traffic indicators, natural space, the built environment…

Prenatal exposure to mixtures of xenoestrogens and genome-wide DNA methylation in human placenta

BACKGROUND: In utero exposure to xenostrogens may modify the epigenome. We explored the association of prenatal exposure to mixtures of xenoestrogens and genome-wide placental DNA methylation. MATERIALS & METHODS: Sex-specific associations between methylation changes in placental DNA by doubling the concentration of TEXB-alpha exposure were evaluated by robust multiple linear regression. Two CpG sites were selected for validation and replication in additional male born placentas. RESULTS: No significant associations were found, although the top significant CpGs in boys were located in the LRPAP1, HAGH, PPARGC1B, KCNQ1 and KCNQ1DN genes, previously associated to birth weight, Type 2 diabetes…

Prenatal exposure to mixtures of xenoestrogens and repetitive element DNA methylation changes in human placenta

BACKGROUND: Prenatal exposure to endocrine disrupting compounds (EDCs) has previously shown to alter epigenetic marks. OBJECTIVES: In this work we explore whether prenatal exposure to mixtures of xenoestrogens has the potential to alter the placenta epigenome, by studying DNA methylation in retrotransposons as a surrogate of global DNA methylation. METHODS: The biomarker total effective xenoestrogen burden (TEXB) was measured in 192 placentas from participants in the longitudinal INMA Project. DNA methylation was quantitatively assessed by bisulfite pyrosequencing on 10 different retrotransposons including 3 different long interspersed nuclear elements (LINEs), 4 short interspersed nuclear …

Estudio de la evolución de la exposición a plomo en la población infantil española en los últimos 20 años: ¿un ejemplo no reconocido de «salud en todas las políticas»?

ResumenObjetivoDescribir la evolución temporal de las concentraciones de plomo en el aire en España, desde antes de su prohibición como aditivo de la gasolina hasta la actualidad, así como estudiar la evolución de la carga corporal de plomo en la población infantil española.MétodosSe obtuvieron las concentraciones medias anuales de plomo en el aire en diversas ciudades españolas, desde la década de 1980 hasta la actualidad. Se realizó una búsqueda bibliográfica con el fin de identificar estudios publicados sobre concentraciones de plomo en la población infantil española.ResultadosEn general se observó una disminución de las concentraciones de plomo, de mayor magnitud entre 1991 y 1999. Esta…

Maternal seafood consumption during pregnancy and child attention outcomes: a cohort study with gene effect modification by PUFA-related genes

Abstract Background There is a need to test the fetal programming theoretical framework in nutritional epidemiology. We evaluated whether maternal seafood intake during pregnancy was associated with 8-year-old attention outcomes after adjusting for previous child seafood intake and cognitive function. We also explored effect modification by several single nucleotide polymorphisms (SNPs) related with polyunsaturated fatty acid (PUFA) metabolism. Methods Our final analyses included 1644 mother-child pairs from the prospective INMA (INfancia y Medio Ambiente) cohort study (Spain, recruitment between 2003 and 2008). We used food frequency questionnaires to assess prenatal and postnatal seafood …

EP-1131: Octavius 4D 1000 SRS, a new instrument for SBRT VMAT IMRT verification. Commissioning and clinical implementation

El rol de la clase social, la educación y el desempleo parentales en el desarrollo cognitivo infantil

Objective: Assessing the association between socioeconomic gradient and cognitive development among children of a Spanish birth cohort aged 5-6 years from a gender perspective. Method: Cognitive development was assessed on 525 children aged 5-6 years in the INMA-Valencia cohort, with the Global Cognitive Score (GCS) from McCarthy Scales of Children's Abilities. Information on social class, education level and employment was collected for both parents in addition to other sociodemographic factors, parental, family and child characteristics. The relationship between maternal and paternal socioeconomic gradient and cognitive development was assessed by linear regressions and comparing the vari…

Nicolás Olea. Libérate de tóxicos. Guía para evitar los disruptores endocrinos. Barcelona: RBA Libros; 2019. 416 p. ISBN: 978-84-9187-402-7. Depósito legal: B. 16.795-2019

Prenatal exposure to traffic-related air pollution and fetal growth in a cohort of pregnant women

Objectives Scant evidence is available on effects of air pollution on longitudinally measured fetal biometry, and thus it remains unclear as to whether there are critical windows of exposure or specificity of effects. Our objective was to examine the association between exposure to nitrogen dioxide (NO2) during pregnancy and fetal and neonatal anthropometry in a cohort of Spanish women. Methods Temporally adjusted land-use regression was used to estimate exposure to NO2 at home addresses. Biparietal diameter (BPD), abdominal circumference (AC), femur length (FL) and estimated fetal weight (EFW) were evaluated in each trimester by ultrasound. As neonatal outcomes, weight, length and head cir…

Prenatal mercury exposure and birth outcomes

Background: Results regarding the association between mercury exposure and anthropometry at birth, gestational length and placental weight are inconsistent, as is the role of seafood intake in these asso- ciations. Objective: We assessed whether prenatal mercury exposure is associated with anthropometry at birth, placental weight and gestational length in a population with a relatively high exposure to mercury from seafood consumption. Methods: Total mercury (T – Hg) was determined in cord blood from 1869 newborns with birth outcome measures, within the Spanish multicenter INMA cohort from 2004 to 2008. We adjusted cohort speci fi c linear and Cox regression models to evaluate the associati…

SU-E-T-691: Shielding Evaluation of a Treatment Room with An Electronic Brachytherapy System

Purpose: Esteya™ (Elekta) is a brachytherapy electronic system used for treating skin cancer lesions. This unit is based on a 69.5 kV X-ray source and a surface applicator which produces a circular beam of a specific diameter, which varies from 1 to 3 cm. This study aims to establish the radiation protection measures for the system. Methods: A characterization of the scattered and leakage radiation of the system was implemented by means of experimental measurements. The scattered radiation measurements were performed with a Berthold LB133 ionization chamber, evaluating the dose rate for different distances from the applicator surface. The patient was simulated through water equivalent solid…

Postnatal weight growth and trihalomethane exposure during pregnancy.

Abstract Background Impaired postnatal growth after chloroform exposure in utero has been observed in rodents without an effect on birth weight. We aimed to study the relationship between exposure to trihalomethanes (THMs) during pregnancy and postnatal weight growth during infancy. Methods We analysed 2216 mother–child pairs recruited in Gipuzkoa, Sabadell, Valencia (Spain, INMA Project, enrolment: 2003–2008) and Crete (Greece, RHEA Study, enrolment: 2007–2008). Drinking water habits and water-related activities ascertained through personal interviews were combined with THM measurements in drinking water to estimate THM exposure through different exposure routes during pregnancy. Weight me…

Association of γδ T Cells with Disease Severity and Mortality in Septic Patients

ABSTRACTGamma-delta T cells are the most abundant of all epithelial-resident lymphocytes and are considered a first line of defense against pathogens in the mucosa. Our objective was to confirm the reduction in γδ T cell subsets and its relationship with mortality in patients with sepsis. We studied 135 patients with sepsis attended in the emergency department and intensive care unit of two hospitals and compared them with a similar control group of healthy subjects. The αβ and γδ T cell subsets were determined via flow cytometry according to the stage of the sepsis and its relationship with mortality. All the lymphocyte subsets were reduced with respect to the corresponding subsets in the …

Prenatal exposure to cooking gas and respiratory health in infants is modified by tobacco smoke exposure and diet in the INMA birth cohort study

Background: Studies that have evaluated the association between exposure to gas appliances emissions at home with respiratory health in children obtained heterogeneous and limited results. The aim of this study is to analyze the association between the use of gas cooking at home during pregnancy and respiratory problems in children during their first year of life. Methods: In the years 2003 through 2008 pregnant women were enrolled in 4 Spanish areas and visited in different age-points following a common protocol. Outcomes studied (from a questionnaire) were any episode of lower respiratory tract infection (LRTI), wheezing, persistent cough, chestiness and otitis. The association between ex…

Variación espacial de la exposición a contaminación atmosférica en la ciudad de Valencia y su relación con un índice de privación The spatial distribution of population exposure to outdoor air pollution in Valencia (Spain) and its association with a privation index

Objetivo: Evaluar la variación espacial de la exposición a dióxido de nitrógeno (NO2) en la ciudad de Valencia y su relación con la privación socioeconómica y la edad. Métodos: La población por sección censal (SC) procede del Instituto Nacional de Estadística. Los niveles de NO2 se midieron en 100 puntos del área de estudio, mediante captadores pasivos, en tres campañas entre 2002 y 2004. Se utilizó regresión por usos del suelo (LUR) para obtener el mapa de los niveles de NO2. Las predicciones del LUR se compararon con las proporcionadas por: a) el captador más cercano de la red de vigilancia, b) el captador pasivo más cercano, c) el conjunto de captadores en un entorno y d) kriging. Se asi…

The independent role of prenatal and postnatal exposure to active and passive smoking on the development of early wheeze in children

Maternal smoking during pregnancy increases childhood asthma risk, but health effects in children of nonsmoking mothers passively exposed to tobacco smoke during pregnancy are unclear. We examined the association of maternal passive smoking during pregnancy and wheeze in children aged ≤2 years.Individual data of 27 993 mother–child pairs from 15 European birth cohorts were combined in pooled analyses taking into consideration potential confounders.Children with maternal exposure to passive smoking during pregnancy and no other smoking exposure were more likely to develop wheeze up to the age of 2 years (OR 1.11, 95% CI 1.03–1.20) compared with unexposed children. Risk of wheeze was further …

First-trimester maternal concentrations of polyfluoroalkyl substances and fetal growth throughout pregnancy

Background: Several studies have investigated the possible association between prenatal exposure to perfluoroalkyl substances (PFASs) and birth anthropometry. However, none has assessed fetal size longitudinally. We studied the possible association between PFASs and fetal biometry. Methods: In 1230 mother-child pairs of three cohorts from the Spanish INMA-Project, we analyzed perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in first-trimester maternal plasma (collection: 2003-2008). We measured abdominal circumference (AC), femur length (FL), biparietal diameter (BPD), and estimated fetal weight (EFW)…

Exposure to perfluoroalkyl substances and thyroid function in pregnant women and children: A systematic review of epidemiologic studies

Introduction: Thyroid hormones (THs) are especially important for brain maturation and development during the fetal period and childhood. Several epidemiological studies have assessed the possible association between exposure to perfluoroalkyl substances (PFAS) and thyroid outcomes during the early stages of life. We aimed to review this evidence. Methods: We conducted a systematic review in compliance with the PRISMA Statement (search conducted in PubMed and Embase, as well as in the citations of the selected articles). We chose studies if they dealt with thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxin (T4), or thyroid dysfunctions, and perfluorohexane sulfonate (PFHxS),…

Association between breastfeeding duration and cognitive development, autistic traits and ADHD symptoms: a multicenter study in Spain

BACKGROUND: Several studies have related longer breastfeeding duration to better intellectual performance in children. By contrast, few studies have investigated the potential protective effects of breastfeeding against behavioral problems such as attention deficit hyperactivity disorder (ADHD) symptoms, and even fewer on autism spectrum disorders (ASD) traits. METHODS: We examined the association between breastfeeding duration and cognitive development, attention, ADHD symptoms, and autistic traits using data from the INMA Project, a Spanish multicenter birth-cohort study, and taking into account the intensity of breastfeeding. Duration of any, predominant, and exclusive breastfeeding was …

Exposure to nitrogen dioxide and respiratory health at 2 years in the INMA-Valencia cohort

Resumen Objetivo Analizar la relación entre la exposición a dióxido de nitrógeno (NO2) en las etapas prenatal y posnatal y la incidencia de problemas respiratorios en niños/as hasta los 2 años de edad. Método La población consistió en 624 niños/as de la cohorte INMA-Valencia. Se estimó la exposición individual al NO2 en el exterior de la vivienda durante el periodo prenatal y hasta los 2 años de edad, a partir de la combinación de datos empíricos y el desarrollo de métodos geoestadísticos. Se aplicó un cuestionario para obtener la información sobre los síntomas respiratorios a los 2 años. La asociación entre la exposición al NO2 y los eventos respiratorios se realizó mediante regresión logí…

Lifelong Residential Exposure to Green Space and Attention: A Population-based Prospective Study

C.T. is a recipient of a European Respiratory Society Fellowship (RESPIRE2–2015–7251) P.D. is funded by a Ramón y Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and Competitiveness. S.L. is funded by a Miguel Servet-FEDER fellowship (MS15/0025) awarded by the Spanish Ministry of Economy and Competitiveness. M.G. is funded by a Miguel Servet-FEDER fellowship (MS13/00054) awarded by the Spanish Ministry of Economy and Competitiveness

Early-Life Exposure to Outdoor Air Pollution and Respiratory Health, Ear Infections, and Eczema in Infants from the INMA Study

Background: Prenatal and early-life periods may be critical windows for harmful effects of air pollution on infant health. Objectives: We studied the association of air pollution exposure during pregnancy and the first year of life with respiratory illnesses, ear infections, and eczema during the first 12–18 months of age in a Spanish birth cohort of 2,199 infants. Methods: We obtained parentally reported information on doctor-diagnosed lower respiratory tract infections (LRTI) and parental reports of wheezing, eczema, and ear infections. We estimated individual exposures to nitrogen dioxide (NO2) and benzene with temporally adjusted land use regression models. We used log-binomial regressi…

DNA methylation changes associated with prenatal mercury exposure:A meta-analysis of prospective cohort studies from PACE consortium

Mercury (Hg) is a ubiquitous heavy metal that originates from both natural and anthropogenic sources and is transformed in the environment to its most toxicant form, methylmercury (MeHg). Recent studies suggest that MeHg exposure can alter epigenetic modifications during embryogenesis. In this study, we examined associations between prenatal MeHg exposure and levels of cord blood DNA methylation (DNAm) by meta-analysis in up to seven independent studies (n = 1462) as well as persistence of those relationships in blood from 7 to 8 year-old children (n = 794). In cord blood, we found limited evidence of differential DNAm at cg24184221 in MED31 (β = 2.28 × 10-4, p-value = 5.87 × 10-5) in relat…

Synergism between exposure to mercury and use of iodine supplements on thyroid hormones in pregnant women

Objective: To evaluate the association between mercury exposure and thyroid-stimulating hormone (TSH), total triiodothyronine (TT3) and free thyroxine (FT4) levels during pregnancy as well as to explore if there is any synergic action between mercury and intake of iodine from different sources. Methods: The study population was 1407 pregnant women participating in the Spanish INMA birth cohort study. Total mercury concentrations were analyzed in cord blood. Thyroid hormones (THs) were measured in serum samples collected at 13.2 +/- 1.5 weeks of gestation. The association between mercury and TH levels was evaluated with multivariate linear regression models. Effect modification caused by iod…

Birth Weight and Prenatal Exposure to Polychlorinated Biphenyls (PCBs) and Dichlorodiphenyldichloroethylene (DDE): A Meta-analysis within 12 European Birth Cohorts

Abstract: Objectives: Exposure to high concentrations of persistent organochlorines may cause fetal toxicity, but the evidence at low exposure levels is limited. Large studies with substantial exposure contrasts and appropriate exposure assessment are warranted. Within the framework of the EU (European Union) ENRIECO (ENvironmental Health RIsks in European Birth Cohorts) and EU OBELIX (OBesogenic Endocrine disrupting chemicals: LInking prenatal eXposure to the development of obesity later in life) projects, we examined the hypothesis that the combination of polychlorinated biphenyls (PCBs) and dichlorodiphenyldichloroethylene (DDE) adversely affects birth weight. Methods: We used maternal a…