Hiriko gune berdeek osasunean duten eragina aztertzen: hiru ikerketa epidemiologiko.

229 p.Doktorego-tesi honek gune berdeek osasun adierazle ezberdinetan, zehazki ugalketa osasunean eta atentzioan, duten eragina aztertu da. Horretarako, hiru ikerketa epidemiologiko egin dira. Lehenengo lanean, etxebizitza inguruko gune berdeek ugalketa osasunean duten eragina aztertzen da, bitartekari ezberdinak kontuan edukiz eta emakume haurdunak izanik parte hartzaileak. Bigarren lana eskoletako haurrekin egin da, gune berde edo gune girs batera joateak partaideen atentzioan eduki dezakeen eragina aztertuz. Hirugarren lanean, INMA proiektuko partaideak erabili dira, gune berdeek hauen atentzioan epe luzeera izan dezakeen eragina aztertuz. Ondoren, hiru lanetan lortutako emaitzen laburpen bat eta eztabaida nagusi bat egin dira. Gainera, dibulgaziorako bideo eta artikulu bana egin dira informazioa gizarteratze aldera. Azkenik, tesiaren ondorio nagusiak idatzi dira

Geovisualización y predicción de los valores de NO2 como contaminantes ambientales con posibles efectos en el crecimiento y desarrollo infantil: el caso de estudio en Gipuzkoa en el marco del proyecto INMA (Infancia y Medioambiente)

El siguiente trabajo, forma parte del proyecto INMA, cuyo objetivo es el de estudiar el papel de los contaminantes ambientales más importantes en el aire, agua y en la dieta durante el embarazo e inicio de la vida y sus efectos en el crecimiento y desarrollo infantil. En concreto, este Trabajo Fin de Máster surge de la necesidad de crear un modelo de Land Use Regression (LUR) para la creación de un patrón territorial de predicción de NO2 del área de estudio de INMA Gipuzkoa. La geoespacialización de algunas de las variables ya contempladas en el proyecto, junto a la modelización mediante SIG de otras variables territoriales: (usos del suelo, incidencia de tráfico, cercanía a centros escolares…), permiten ampliar la información sobre la realidad territorial analizada. En análisis espacial realizado complementa y mejora el análisis estadístico sanitario. Además, la visualización de la información permite identificar diferentes patrones y posibilita el establecer “áreas críticas” de emisión de NO2, estableciendo de este modo, lugar de priorización para la intervención en cuestiones de Ordenación Territorial (mejora las condiciones ambientales y planificación de la actuación sanitaria)

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

Effects of residential greenness on attention in a longitudinal study at 8 and 11-13 years

In an urbanizing world, with 55% of the population living in cities, it is essential to design friendly and healthy ones. An emerging body of evidence has associated greenspace exposure with improved cognitive development, including attentional function; however, the longitudinal studies looking at the association with attentional function are still scarce. Therefore, the objective of this study was to analyze the association of the exposure to greenspace and attention in school children. This study was based on 751 participants at 8 years and 598 at 11-13 years of two sub-cohorts of the INMA cohort study in Gipuzkoa and Asturias, Spain. Greenspace exposure at home was characterized using four indicators: (i) average of Normalized Difference Vegetation Index (NDVI) and (ii) Vegetation Continuous Field (VCF) in buffers of 100 m, 300 m, and 500 m around the residential address, (ii) availability of a green space within 300 m from the residential address, and (iv) residential distance to green spaces. Participants' attention was characterized twice at ages of 8 and 11 years, using the computerized Attentional Network Test (ANT). General linear models were used for the cross-sectional analyses and linear mixed effects model for the longitudinal analyses. Our cross-sectional analyses showed a statistical significant protective association between average NDVI at 300 m and inattentiveness (-7.20, CI 95%: 13.74; -0.67). In our longitudinal analyses, although we generally observed beneficial associations between greenspace exposure and attention, none attained statistical significance. No statistically significant indirect effect were seen for NO2. Our findings add to the emerging body of evidence on the role of green spaces in neurodevelopment, which can provide the evidence base for implementing intervention aimed at promoting neurodevelopment in urban children

Ingesta de flúor a través del consumo de agua de abastecimiento público en la cohorte INMA-Gipuzkoa

Objetivo Estimar la ingesta de flúor en mujeres embarazadas y sus hijos/as de la cohorte INMA-Gipuzkoa a través del consumo de agua de la red municipal y comparar estas ingestas con los valores recomendados. En Euskadi, la fluoración del agua de consumo es obligatoria en abastecimientos de más de 30.000 habitantes. Método Se han incluido 575 mujeres embarazadas (reclutamiento en 2006-2008) y 424 niños/as de 4 años (seguimiento en 2010-2012). Las concentraciones de fluoruros en el agua se obtuvieron del sistema de información de aguas de consumo de Euskadi (EKUIS). Los hábitos de consumo de agua y las variables socioeconómicas se obtuvieron mediante cuestionario. Resultados El 74,9% de las mujeres y el 87,7% de los/las niños/as consumían agua de red municipal. En agua fluorada, el valor medio de fluoruro fue de 0,805 mg/l (desviación estándar [DE]: 0,194) durante el periodo de reclutamiento, y de 0,843 mg/l (DE: 0,080) durante el seguimiento de los/las niños/as. La ingesta media de flúor y el percentil 95 en las zonas fluoradas fueron de 0,015 y 0,026 mg/kg al día en las mujeres y de 0,033 y 0,059 mg/kg al día en los/las niños/as. Considerando solo el flúor aportado por el agua, el 8,71% de los/las niños/as residentes en zonas con fluoración superaban la ingesta de 0,05 mg/kg al día recomendada por la European Food Safety Authority. Conclusión Los resultados obtenidos muestran que las ingestas de flúor a través del agua de consumo pueden superar lo recomendado en población infantil, y propician futuros estudios que aporten evidencias que puedan ayudar en las políticas de fluoración de las aguas de consumo público.Objective To estimate fluoride intake through consumption of water from the municipal network in pregnant women and their children from the INMA-Gipuzkoa cohort and to compare these intakes with recommended levels. In Euskadi (Spain), fluoridation of drinking water is compulsory in water supplies for more than 30,000 inhabitants. Method 575 pregnant women (recruitment, 2006-2008) and 424 4-year-old children (follow-up, 2010-2012) have been included. Fluoride levels in drinking water were obtained from the water consumption information system of the Basque Country (EKUIS). Water consumption habits and socioeconomic variables were obtained by questionnaire. Results 74.9% and 87.7% of women and children consumed water from the municipal network. Average fluoride levels in fluoridated water were 0.805 (SD: 0.194) mg/L during baseline recruitment and 0.843 (SD: 0.080) mg/L during follow up, at 4 years old of the children. Average and 95th percentile of fluoride intake were 0.015 and 0.026 mg/kg per day in women and 0.033 and 0.059 mg/kg per day in children. Considering only fluoride provided by drinking water, 8.71% of children living in fluoridated areas exceeded intake level recommended by the European Food Safety Authority, consisting in 0.05 mg/kg per day. Conclusion The results show that ingested levels of fluoride through consumption of municipal water can exceed the recommended levels in children and encourages further studies that will help in fluoridation policies of drinking water in the future

Association between prenatal exposure to air pollutants and newborn thyroxine (T4) levels

Background: Thyroid hormones play a key role in fetal and child development. Recent studies have linked prenatal exposure to atmospheric contaminants with changes in thyroid hormone levels in newborns, but the data from the few studies that have explored this issue are inconclusive. The present study aims to assess the association of total thyroxine (TT4) levels in newborns with weekly prenatal exposure to PM2.5 and NO2 and to identify sensitivity windows to exposure to air pollution in different developmental stages. Methods: This prospective cohort study included mother-child pairs from the INMA-Gipuzkoa project. Specifically, 463 mother-child pairs with data on PM2.5 and NO2 exposure during pregnancy and TT4 levels at birth were included. PM2.5 and NO2 levels were measured by high-volume aerosol samplers and passive samplers respectively during the women's pregnancies. TT4 levels were measured in heel-prick blood samples from infants. Data on maternal and infant covariates were gathered through questionnaires administered in the first and third trimesters of pregnancy and review of clinical records. Potential associations of PM2.5 and NO2 with TT4 levels over the entire pregnancy was assessed by linear regression models and DLMs were used to identify susceptibility windows. Results: The exposure of pregnant women to PM2.5 during pregnancy was positively associated with infant TT4 level at birth (β [95% CI] = 0.198 [0.091, 0.305]. DLMs identified three different sensitivity windows, one in the periconceptional period with a negative association between PM2.5 exposure and TT4 levels at birth, and a second (weeks 12–17) and a third one (weeks 31–37) with a positive association. In addition, the later the exposure, the stronger the association. In contrast, no association was observed between NO2 exposure and TT4 levels. Conclusions: The results indicate that prenatal exposure to PM2.5 could lead to a thyroid function impairment in newborns.This work is part of the INMA Project (INfancia y Medio Ambiente), which has received funding from the following organizations: Carlos III Health Institute (PI06/0867), Department of Health of the Government of the Basque Country (2005111093), Gipuzkoa Regional Government (DFG06/002) and the local councils of the study areas (Zumarraga, Urretxu, Legazpi, Azkoitia, Azpeitia and Beasain)

On pathways and agreement: Objective and perceived accounts of neighbourhood attributes and their associations with mental health during pregnancy

There is growing interest in understanding the links between neighbourhood environmental attributes (i.e. greenness, walkability and air pollution) and human health. Recent research has analysed the mediating role of a diverse set of potential factors and studied the agreement between objective and perceived modalities of those attributes. In this study, we explored the connections between objective neighbourhood attributes, their perceived accounts and mental health during pregnancy, using a measure of social cohesion as potential mediator with data from two samples of pregnant women recruited during the 12th week of pregnancy in two Spanish cities (Donostialdea, n = 440; Barcelona n = 364). Besides, we ran analyses on the agreement between objective and perceived measures. We fitted four separate Structural Equation Models and detected associations between objective neighbourhood attributes and mental health occurred only through their perceived counterparts and the strengthening of social cohesion. We also found poor to fair agreement between greenness measures in both cities, walkability measures only in Donostialdea, and were unable to detect any meaningful agreement between air pollution variables. Using rescaled versions of neighbourhood attribute variables and in some instances, we saw that the higher the objective value of a given attribute, the larger the differences between objective and perceived accounts of such attributes.This research was funded by Diputación Foral de Gipuzkoa (the Gipuzkoan Provincial Council), Grant No 105/19 within their call “Programa Red Guipuzcoana de Ciencia, Tecnología e Innovación 2019” (Network Gipuzkoan Program for Science, Technology and Innovation 2019)

Environmental Noise Exposure and Sleep Habits among Children in a Cohort from Northern Spain

Environmental noise is considered the second most serious environmental risk factor in Europe. However, little evidence exists regarding its impact on health and sleep in children, and the results are inconclusive. In this study, we aim to analyse the effect of environmental noise exposure on 11-year-old children’s sleep habits. Data were collected from 377 participants in the INMA-Gipuzkoa (INfancia y Medio Ambiente) cohort project using both parent-reported and actigraphic sleep measures. The results revealed that 60% of children have a day-evening-night environmental noise exposure (Lden) of above 55 dB, which is defined as a “high noise level”. No differences in noise exposure were observed between different socioeconomic groups. However, no effect of environmental noise was found on sleep variables. The paper highlights the importance of studying how environmental noise may affect children’s sleep.This study was funded by grants from the Instituto de Salud Carlos III (FIS-PI06/0867, FIS-PI09/00090, FIS-PI13/02187, FIS-PI17/01340, FIS-PI18/01142, FIS-PI18/01237 incl FEDER funds), the French Agency for Food, Environmental and Occupational Health & Safety (EST-2016 RF-21), CIBERESP, the Basque Government Department of Health (2005111093, 2009111069, 2013111089, 2015111065 and 2018111086), the Gipuzkoa Provincial Council (DFG06/002, DFG08/001, DFG15/221 and DFG 89/17) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia, Azpeitia and Beasain)

Residential surrounding greenspace and mental health in three spanish areas

Exposure to greenspace has been related to improved mental health, but the available evidence is limited and findings are heterogeneous across different areas. We aimed to evaluate the associations between residential exposure to greenspace and specific psychopathological and psychosomatic symptoms related to mental health among mothers from a Spanish birth cohort. Our study was based on data from 1171 women participating in two follow-ups of a population-based cohort in Valencia, Sabadell, and Gipuzkoa (2004-2012). For each participant, residential surrounding greenspace was estimated as the average of the satellite-based Normalized Difference Vegetation Index (NDVI) across different buffers around the residential address at the time of delivery and at the 4-year follow-up. The Symptom Checklist 90 Revised (SCL-90-R) was applied to characterize mental health at the 4-year follow-up. We developed mixed-effects logistic regression models controlled for relevant covariates to evaluate the associations. Higher residential surrounding greenspace was associated with a lower risk of somatization and anxiety symptoms. For General Severity Index (GSI), obsessive-compulsive, interpersonal sensitivity, depression, hostility, phobic anxiety, paranoid ideation, and psychoticism symptoms, we generally observed protective associations, but none attained statistical significance. Findings from this study suggested a potential positive impactof greenspace on mental health