Childhood dental caries experience in northern Spain: a cross-sectional study

Purpose This study aimed to describe the caries experience in primary and permanent dentition of schoolchildren from a sample taken in public schools in Bilbao, to identify the most vulnerable child population, and compare them with the findings obtained by the Children's Dental Care Programme in the region of the Basque Country (Spain). Methods A cross-sectional study was conducted using a representative sample (n = 1682) of children from 5-year-old early childhood education classes and the first- and second-year elementary classes in public schools in Bilbao. The dependent variable was the caries experience determined through oral examinations carried out by a single dentist. On the other hand, independent variables were measured through questionnaires completed by families, with help from teachers as appropriate. In the statistical analysis, Mann-Whitney and Kruskal-Wallis nonparametric tests, as well as two logistic regressions, were performed, and the significance level was set at alpha = 0.05 for decision making. Results The mean (SD) values of dft, DMFT, DMFS and DMFT of first permanent molars scores were 1.25 +/- 2.20, 0.16 +/- 0.61, 0.20 +/- 0.90 and 0.15 +/- 0.57, respectively. Compared to the findings in the most recent PADI report, the schoolchildren in our sample had slightly greater experience of dental caries in primary dentition and much greater experience in permanent dentition. Conclusion The dft index of the primary dentition for the current sample is 1.25, while the DMFT index for the permanent dentition is 0.16. Among pupils in early childhood and elementary education in public schools in Bilbao, children from families with low socioeconomic status and educational attainment are most vulnerable to developing caries.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. JF-B received a grant from Bilbao City Council to carry out this study (2015-061533)

Hortzetako txantxarra: etiopatogeniaren garapena eta osasun publikoaren erronka

Knowledge about the etiopathogenesis of dental caries has advanced a great deal in recent decades. Nevertheless, the disease remains a great challenge for public health. It is necessary to continue the research and implement new preventive strategies, especially in the most vulnerable communities, taking into account the sociodemographic factors that influence the onset of the disease. Currently, the individual preventive strategy is not effective to deal with caries inequalities. Dental caries experience has decreased in recent decades with the implementation of the PADI program and the fluoridation of waters in the region of the Basque Country, being among the best in Europe. However, lower social classes still have much higher caries experience than the rest. That is why it is very important that, if the Basque Government finally stops the fluoridation of water, methodologically rigorous studies are carried out to evaluate the impact of this measure, especially on vulnerable groups.; Hortzetako txantxarraren etiopatogeniari buruzko ezagutzak asko aurreratu dira azken hamarkadetan, baina gaixotasunak osasun publikoarentzat erronka handia izaten jarraitzen du. Beharrezkoa da ikerketarekin jarraitzea eta prebentzio-estrategia berriak ezartzea, batez ere komunitate ahulenetan, gaixotasuna sorrarazten duten faktore soziodemografikoak kontuan hartuta. Gaur egun jarraitzen den estrategia prebentibo indibiduala ez da eragikorra txantxarrak sortzen dituen desberdintasunei aurre egiteko. Azken hamarkadetan aho-hortzetako txantxarren indizeak jaitsi egin dira Euskal Autonomia Erkidegoan, PADI programari eta uren fluorizazioari esker; gaur egun Europako onenen artean daude. Hala ere, klase sozial baxuenek besteek baino indize askoz handiagoak dituzte. Hori dela eta, oso garrantzitsua da Eusko Jaurlaritzak, azkenean uraren fluorizazioa bertan behera uzten badu, azterketa metodologiko zorrotzak egitea erabaki horren eragina neurtzeko, bereziki talde ahuletan

Ingurumen-zarata eta osasuna

Lan honek zaratak pertsonen osasunean duen eraginaren inguruko ebidentzia zientifikoa biltzea du helburu. Bertan aztergai izan dira zaratak sistema kardiobaskularrean eta, zehazki, hipertentsioan eta bihotzeko gaixotasunetan duen eragina, gaixotasun metabolikoekin duen erlazioa, loaren kalitate subjektibo zein objektiboa eta baita minbizia garatzeko arriskua. Gainera, zarataren ondorio psikologiko eta kognitiboak ere ikertu dira. Haurtzaroari arreta berezia eskaini zaio, talde zaurgarria denez gero. Zarataren mekanismoari dagokionez, badirudi zaratak sortzen duen kalteak HPA ardatzaren eta sistema sinpatikoaren aktibazioa dakarrela, eta horrekin batera estresaren hormonen eta estres oxidatiboaren areagotzea eta hantura. Egungo ebidentzietan oinarrituta, beharrezkotzat jotzen da osasun publikoaren alde epe luzeko estrategiak eta araudiak garatzea.; This work aims to gather scientific evidence about the impact of noise on public health. The effect of noise on the cardiovascular system and specifically on hypertension and heart disease, its relation to metabolic diseases, the subjective or objective quality of sleep, and the risk of developing cancer, have been examined. The psychological and cognitive effects of noise have also been investigated. Special attention has been paid to childhood as a vulnerable group. As for the noise mechanism, the noise damage appears to be due to the HPA axis and ac-tivation of the sympathetic system due to stress hormones, oxidative stress and inflammation. Based on current evidence, the development of long-term strategies and directive policies for public health is considered necessary

Does exposure to greenness improve children's neuropsychological development and mental health? A Navigation Guide systematic review of observational evidence for associations

[EN] Background: Contact with nature may have a key role in child brain development. Recent observational studies have reported improvements in children's neuropsychological development and mental health associated with greenness exposure. In a rapidly urbanizing word, researchers, policymakers, healthcare workers and urban planners need to work together to elaborate evidence-based policies and interventions to increase the availability of quality green space with the potential to enhance childhood development. Objective: To review the observational evidence assessing the effect of exposure to greenness on children's neuropsychological development and mental health. Methods: The protocol for the review was preregistered at PROSPERO (CRD42020213838). The Navigation Guide systematic review methodology was followed. Search strategies were formulated and adapted to each database. Searches were performed in PubMed, Scopus, Web of Science and EBSCO's GreenFILE on October 5, 2021. Additional articles were further identified by hand-searching reference lists of included papers. Results: A systematic search of 4 databases identified 621 studies, of which 34 were included in the review. The studies included investigated diverse domains within neuropsychological development and mental health, such as attention, working memory, intelligence, cognitive development, academic performance, well-being, attention-deficit/hyperactivity disorder symptoms, and behavior. Most of the studies were rated as having high or probably high risk of bias in the assessment. Discussion: Although nearly all studies showed a positive association between greenness exposure and the outcomes studied, the heterogeneity in the methods used to assess exposure and the diversity of domains within each main outcome has made it difficult to draw clear conclusions. Future studies should adopt a longitudinal design to confirm the causality of the associations and include measures to determine which characteristics of greenness have the greatest influence on each domain. Researchers should also try to explore pathways linking exposure to greenness with the neuropsychological development and mental health, by implementing mechanistic studies.This study was funded by a grant from Instituto de Salud Carlos III (FIS-PI18/01237 include FEDER funds)

Is Brief Exposure to Green Space in School the Best Option to Improve Attention in Children?

The positive effects of Green Spaces on health are thought to be achieved through the mechanisms of mitigation, instoration and restoration. One of the benefits of Green Spaces may be the restoration of attention and so the objective of this research is testing empirically whether exposure to a green environment improves attention in school children. For so doing, we first used a split-unit statistical design in each of four schools, then combined the primary results via meta-analysis. The Attention Network Test (ANT) was used to measure attention before and after exposure and a total of 167 seven-year-old students participated in the experiments. Overall, our experimental results do not support the hypothesis that students’ exposure to activities in green vs. grey spaces affected their performance in ANT. This was so despite the fact that neither age nor gender biases have been detected and despite that our experiments have been proved to be sufficiently statistically powerful. It would be advisable to consider air pollution and noise. We also recommend that participants attend the experiment with mental exhaustion to maximize the ability to detect significant changes.This research was funded by KUTXA FUNDAZIOA, grant number KUTXA18/001

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 (2003 & ndash;2008). Total As (organic and inorganic compounds) and its main metabolites (monomethylarsonic acid, [MMA], dimethylarsinic acid, [DMA], inorganic As [iAs]) and arsenobetaine [AB]) were measured in urine samples collected during the first trimester. Socio-demographic and dietary information was collected through questionnaires. Multivariate linear regression models were used to explore the association between As species concentrations and covariates. Arsenic methylation efficiency was determined through the percentages of the metabolites and using As methylation phenotypes, obtained from principal component analysis. Results: Median urine concentrations were 33.0, 21.6, 6.5, 0.35 and 0.33 lig/g creatinine for total As, AB, DMA, MMA and iAs, respectively. Daily consumption of rice and seafood during the first trimester of pregnancy were positively associated with the concentration of As species (i.e., beta [CI95%] = 0.36 [0.09, 0.64] for rice and iAs, and 1.06 [0.68, 1.44] for seafood and AB). TAs, AB and iAs concentrations, and DMA and MMA concentrations were associated with legume and vegetable consumption, respectively. The medians of the percentage of As metabolites were 89.7 for %DMA, 5.1 for %MMA and 4.7 for %iAs. Non-smoker women and those with higher body mass index presented a higher methylation efficiency (denoted by a higher %DMA and lower %MMA). Discussion: Certain dietary, lifestyle, and environmental factors were observed to have an influence on both As species concentrations and methylation efficiency in our population. Further birth cohort studies in low exposure areas are necessary to improve knowledge about arsenic exposure, especially to inorganic forms, and its potential health impact during childhood.This study was supported by grants from Instituto de Salud Carlos III, Spain [FIS-FEDER: 07/0314; FIS 11/01007, 13/1944, 16/1288, 19/1338; Miguel Servet-FEDER: CP15/0025, CPII20/00006; FIS-FSE: 17/00260; Miguel Servet-FSE: MS15/0025, MS20/0006; PI06/0867 and FIS-PI18/01142 incl. FEDER funds] , Generalitat Valenciana, Spain BEST/2020/059, Department of Health of the Basque Government, Spain (2005111093) , Provincial Government of Gipuzkoa (DFG06/002) , and annual agreements with the municipalities in the study area (Zumarraga, Urretxu, Legazpi, Azkoitia, Azpeitia and Beasain)

Gestational phthalate exposure and lung function during childhood: A prospective population-based study

The potential effect of gestational exposure to phthalates on the lung function levels during childhood is unclear. Therefore, we examined this association at different ages (from 4 to 11 years) and over the whole childhood. Specifically, we measured 9 phthalate metabolites (MEP, MiBP, MnBP, MCMHP, MBzP, MEHHP, MEOHP, MECPP, MEHP) in the urine of 641 gestating women from the INMA study (Spain) and the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC in their offspring at ages 4, 7, 9 and 11. We used linear regression and mixed linear regression with a random intercept for subject to assess the association between phthalates and lung function at each study visit and for the overall childhood, respectively. We also assessed the phthalate metabolites mixture effect on lung function using a Weighted Quantile Sum (WQS) regression. We observed that the phthalate metabolites gestational levels were consistently associated with lower FVC and FEV1 at all ages, both when assessed individually and jointly as a mixture, although most associations were not statistically significant. Of note, a 10% increase in MiBP was related to lower FVC (-0.02 (-0.04, 0)) and FEV1 z-scores (-0.02 (-0.04,-0.01) at age 4. Similar significant reductions in FVC were observed at ages 4 and 7 associated with an increase in MEP and MnBP, respectively, and for FEV1 at age 4 associated with an increase in MBzP. WQS regression consistently identified MBzP as an important contributor to the phthalate mixture effect. We can conclude that the gestational exposure to phthalates was associated with children's lower FVC and FEV1, especially in early childhood, and in a statistically significant manner for MEP, MiBP, MBzP and MnBP. Given the ubiquity of phthalate exposure and its established endocrine disrupting effects in children, our findings support current regulations that limit phthalate exposure.The INMA study was funded by grants from the European Union (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1) , and from Spain: Instituto de Salud Carlos III and Ministry of Health (Red INMA G03/176; CB06/02/0041; PI041436, PI081151, PI06/0867, PS09/00090, PI13/02187; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI12/01890, PI13/1944, PI13/2032, PI14/00891, PI14/1687, PI17/01194, and PI17/00663; MV16/00015; predoctoral grant PFIS - FI14/00099, pre-doctoral grant PFIS FIS-FSE: 17/00260, FIS19/1338, MV16/00015, Miguel Servet-FEDER: CP11/0178, and Miguel Servet-FSE: MS13/00054, MSII16/00051, and MS16/00128) , CIBERESP; Department of Health of the Basque Government (2005111093 and 2009111069) ; the Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001) ; and the Generalitat de Catalunya-CIRIT (1999SGR 00241) . ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya. We acknowledge support from the Spanish Ministry of Science and Innovation through the "Centro de Excelencia Severo Ochoa 2019-2023" Program (CEX 2018-000806-S) , and support from the Generalitat de Catalunya through the CERCA Program

Associations of residential greenspace exposure and fetal growth across four areas in Spain

An accumulating body of evidence has associated exposure to greenspace with improved birth outcomes, including higher birth weight and lower risk of low birth weight; however, evidence on such association with in-utero fetal growth is scarce. We explored the influence of maternal exposure to residential greenspace and fetal growth in four INMA (Infancia y Medio Ambiente) Spanish birth cohorts (2003-2008), with 2,465 participants. Residential greenspace was characterised by the Normalised Difference Vegetation Index (NDVI) average across 100 m, 300 m, and 500 m buffers around the residence. Repeated ultrasound measurements of the abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW) were used. We created customised-generalised least squares models to evaluate associations of residential greenspace exposure on each fetal growth parameter, controlled for the relevant confounders. There were associations be-tween the 500 m buffer and BPD, FL, and AC. We also found associations in the 300 m buffer and FL and AC. The associations in the 100 m buffer were null. Estimates were higher among participants with lower socioeconomic status. Mediation analyses found that air pollution might explain 15-37% of our associations. Mediation by physical activity was not observed. Greenspace exposure may be beneficial for fetal growth.We are grateful to all the participants for their generous collaboration. A full roster of the INMA Project founders can be found at: https://www.proyectoinma.org/proyecto-inma/financiadores/. Maria Torres Toda is funded by a PFIS (Contrato Predoctoral de Formación en Investigación en Salud) fellowship (FI17/00128) awarded by Instituto de Salud Carlos III. Maria Foraster is beneficiary of an AXA Research Fund grant. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation and State Research Agency through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program

Susceptible windows of exposure to fine particulate matter and fetal growth trajectories in the Spanish INMA (INfancia y Medio Ambiente) birth cohort

While prior studies report associations between fine particulate matter (PM2.5) exposure and fetal growth, few have explored temporally refined susceptible windows of exposure.We included 2328 women from the Spanish INMA Project from 2003 to 2008. Longitudinal growth curves were constructed for each fetus using ultrasounds from 12, 20, and 34 gestational weeks. Z-scores representing growth trajectories of biparietal diameter, femur length, abdominal circumference (AC), and estimated fetal weight (EFW) during early (0-12 weeks), mid-(12-20 weeks), and late (20-34 weeks) pregnancy were calcu-lated. A spatio-temporal random forest model with back-extrapolation provided weekly PM2.5 exposure estimates for each woman during her pregnancy. Distributed lag non-linear models were implemented within the Bayesian hierarchical framework to identify susceptible windows of exposure for each outcome and cumulative effects [13cum, 95% credible interval (CrI)] were aggregated across adjacent weeks. For comparison, general linear models evaluated associations between PM2.5 averaged across multi-week periods (i.e., weeks 1-11, 12-19, and 20-33) and fetal growth, mutually adjusted for exposure during each period. Results are presented as %change in z-scores per 5 mu g/m3 in PM2.5, adjusted for covariates.Weeks 1-6 [13cum =-0.77%, 95%CrI (-1.07%,-0.47%)] were identified as a susceptible window of exposure for reduced late pregnancy EFW while weeks 29-33 were positively associated with this outcome [13cum = 0.42%, 95%CrI (0.20%, 0.64%)]. A similar pattern was observed for AC in late pregnancy. In linear regression models, PM2.5 exposure averaged across weeks 1-11 was associated with reduced late pregnancy EFW and AC; but, positive associations between PM2.5 and EFW or AC trajectories in late pregnancy were not observed.PM2.5 exposures during specific weeks may affect fetal growth differentially across pregnancy and such as-sociations may be missed by averaging exposure across multi-week periods, highlighting the importance of temporally refined exposure estimates when studying the associations of air pollution with fetal growth