Serum PCB levels in a representative sample of the Spanish adult population: the BIOAMBIENT.ES project

This manuscript presents the levels of six indicator polychlorinated biphenyl (PCB) congeners (IUPAC nos. 28, 52, 101, 138, 153 and 180) in the serum of 1880 individuals from a representative sample of the Spanish working population recruited between March 2009 and July 2010. Three out of the six PCBs studied (180, 153 and 138) were quantified in more than 99% of participants. PCB 180 was the highest contributor, followed by PCBs 153 and 138, with relative abundances of 42.6%, 33.2% and 24.2%, respectively. In contrast, PCBs 28 and 52 were detected in only 1% of samples, whereas PCB 101 was detectable in 6% of samples. The geometric mean (GM) for ΣPCBs138/153/180 was 135.4 ng/g lipid (95% CI: 121.3-151.2 ng/g lipid) and the 95th percentile was 482.2 ng/g lipid. Men had higher PCB blood concentrations than women (GMs 138.9 and 129.9 ng/g lipid respectively). As expected, serum PCB levels increased with age and frequency of fish consumption, particularly in those participants younger than 30 years of age. The highest levels we found were for participants from the Basque Country, whereas the lowest concentrations were found for those from the Canary Islands. The Spanish population studied herein had similar levels to those found previously in Greece and southern Italy, lower levels than those in France and central Europe, and higher PCB levels than those in the USA, Canada and New Zealand. This paper provides the first baseline information regarding PCB exposure in the Spanish adult population on a national scale. The results will allow us to establish reference levels, follow temporal trends and identify high-exposure groups, as well as monitor implementation of the Stockholm Convention in Spain.This work was funded as part of a research agreement between the Spanish Ministry of Agriculture, Food and the Environment n° EG042007 and the Institute of Health Carlos III (project nos. SEG 1251/07 and 1210/10). The authors would like to thank S. González for the technical assistance, F. Cutanda for the helpful advice, and Silvia Gómez; the volunteers of BIOAMBIENT.ES and healthcare staff from the Societies for Prevention of IBERMUTUAMUR, MUTUALIA, MCPREVENCIÓN, MUGATRA, UNIMAT PREVENCIÓN, and PREVIMAC

Blood lead levels in a representative sample of the Spanish adult population: the BIOAMBIENT.ES project

This paper provides the first baseline information on a national scale regarding lead exposure in the Spanish adult population. Blood lead levels were measured in a representative sample of the Spanish working population (1880 subjects aged 18-65 years) in order to help establish reference levels, follow temporal trends, identify high-exposure groups and to enable comparisons with other countries. All participants completed an epidemiological questionnaire including gender, age, occupational sector, geographic area, and dietary and lifestyle information. We found that the geometric mean of blood lead levels in the study population was 24.0μg/L (95% CI: 23.0-25.1μg/L), with women having significantly lower levels than men, 19.5μg/L (18.5-20.5μg/L) compared to 28.3μg/L (26.7-30.0μg/L), respectively. Mean blood lead levels were higher in elder groups in both genders. Women of a childbearing age had blood levels of 18.0μg/L (GM). Reference values (95%) for lead in blood in the studied population was 56.80μg/L, with -64.00μg/L, 44.80μg/L and 36.00μg/L for man, women and women of childbearing age, respectively. Workers from the service sector had lower blood lead levels than those from the construction, agricultural and industry sectors. Small, although significant, geographical differences had been found. In an European comparison, the Spanish population studied herein had lead levels similar to populations in countries such as France and Belgium, and slightly lower levels than Italian, Czech, German or UK populations.This work was funded by the Spanish Ministry of Agriculture, Food and Environment (MAGRAMA) and The Institute of Health Carlos III (ISCIII) agreement, SEG 1251/07. The authors would like to thank nurses and doctors from Corporacion Mutua, BIOAMBIENT.ES volunteers and M. Rodríguez, S. González, M. Rosado and S. Gómez for their collaboration.S

The end of the decline in cervical cancer mortality in Spain: trends across the period 1981–2012

BACKGROUND: In Spain, cervical cancer prevention is based on opportunistic screening, due to the disease's traditionally low incidence and mortality rates. Changes in sexual behaviour, tourism and migration have, however, modified the probability of exposure to human papilloma virus among Spaniards. This study thus sought to evaluate recent cervical cancer mortality trends in Spain. METHODS: We used annual female population figures and individual records of deaths certified as cancer of cervix, reclassifying deaths recorded as unspecified uterine cancer to correct coding quality problems. Joinpoint models were fitted to estimate change points in trends, as well as the annual (APC) and average annual percentage change. Log-linear Poisson models were also used to study age-period-cohort effects on mortality trends and their change points. RESULTS: 1981 marked the beginning of a decline in cervical cancer mortality (APC(1981-2003): -3.2; 95% CI:-3.4;-3.0) that ended in 2003, with rates reaching a plateau in the last decade (APC2003-2012: 0.1; 95% CI:-0.9; 1.2). This trend, which was observable among women aged 45-46 years (APC(2003-2012): 1.4; 95% CI:-0.1;2.9) and over 65 years (APC(2003-2012): -0.1; 95% CI:-1.9;1.7), was clearest in Spain's Mediterranean and Southern regions. CONCLUSIONS: The positive influence of opportunistic screening is not strong enough to further reduce cervical cancer mortality rates in the country. Our results suggest that the Spanish Health Authorities should reform current prevention programmes and surveillance strategies in order to confront the challenges posed by cervical cancer.This study was supported by a research grant from the Spanish Health Research Fund [FIS PI11/00871]. Mortality data were furnished by the Spanish National Statistics Institute under the terms of a specific confidentially protocolS

Concentraciones de PCBs en suero de la población adulta española

Este proyecto ha sido financiado por el Ministerio de Medio Ambiente y Medio Rural y Marino, y por el Instituto de Salud Carlos III, mediante los proyectos EG042007 y SEG 1251/07

Trends in oral cavity, pharyngeal, oesophageal and gastric cancer mortality rates in Spain, 1952-2006: an age-period-cohort analysis

BACKGROUND: Although oral cavity, pharyngeal, oesophageal and gastric cancers share some risk factors, no comparative analysis of mortality rate trends in these illnesses has been undertaken in Spain. This study aimed to evaluate the independent effects of age, death period and birth cohort on the mortality rates of these tumours. METHODS: Specific and age-adjusted mortality rates by tumour and sex were analysed. Age-period-cohort log-linear models were fitted separately for each tumour and sex, and segmented regression models were used to detect changes in period- and cohort-effect curvatures. RESULTS: Among men, the period-effect curvatures for oral cavity/pharyngeal and oesophageal cancers displayed a mortality trend that rose until 1995 and then declined. Among women, oral cavity/pharyngeal cancer mortality increased throughout the study period whereas oesophageal cancer mortality decreased after 1970. Stomach cancer mortality decreased in both sexes from 1965 onwards. Lastly, the cohort-effect curvature showed a certain degree of similarity for all three tumours in both sexes, which was greater among oral cavity, pharyngeal and oesophageal cancers, with a change point in evidence, after which risk of death increased in cohorts born from the 1910-1920s onwards and decreased among the 1950-1960 cohorts and successive generations. This latter feature was likewise observed for stomach cancer. CONCLUSIONS: While the similarities of the cohort effects in oral cavity/pharyngeal, oesophageal and gastric tumours support the implication of shared risk factors, the more marked changes in cohort-effect curvature for oral cavity/pharyngeal and oesophageal cancer could be due to the greater influence of some risk factors in their aetiology, such as smoking and alcohol consumption. The increase in oral cavity/pharyngeal cancer mortality in women deserves further study.The study was funded by a research grant from the Spanish Health Research Fund (FIS PI11/00871). DSM was funded by the Galician Health Service; NA, EF, JGP, PFN, RPB and GLA were funded by the Carlos III Institute of Health, Madrid, Spain; and MCA was funded by the CIBER in Epidemiology and Public Health, Spain (CIBERESP). The study design and research findings are the responsibility of the authors.S

Dietary inflammatory index and all-cause mortality in large cohorts: The SUN and PREDIMED studies

[Background]: Inflammation is known to be related to the leading causes of death including cardiovascular disease, several types of cancer, obesity, type 2 diabetes, depression-suicide and other chronic diseases. In the context of whole dietary patterns, the Dietary Inflammatory Index (DII®) was developed to appraise the inflammatory potential of the diet. [Objective]: We prospectively assessed the association between DII scores and all-cause mortality in two large Spanish cohorts and valuated the consistency of findings across these two cohorts and results published based on other cohorts.[Design]: We assessed 18,566 participants in the “Seguimiento Universidad de Navarra” (SUN) cohort followed-up during 188,891 person-years and 6790 participants in the “PREvencion con DIeta MEDiterránea” (PREDIMED) randomized trial representing 30,233 person-years of follow-up. DII scores were calculated in both cohorts from validated FFQs. Higher DII scores corresponded to more proinflammatory diets. A total of 230 and 302 deaths occurred in SUN and PREDIMED, respectively. In a random-effect meta-analysis we included 12 prospective studies (SUN, PREDIMED and 10 additional studies) that assessed the association between DII scores and all-cause mortality.[Results]: After adjusting for a wide array of potential confounders, the comparison between extreme quartiles of the DII showed a positive and significant association with all-cause mortality in both the SUN (hazard ratio [HR] = 1.85; 95% CI: 1.15, 2.98; P-trend = 0.004) and the PREDIMED cohort (HR = 1.42; 95% CI: 1.00, 2.02; P-trend = 0.009). In the meta-analysis of 12 cohorts, the DII was significantly associated with an increase of 23% in all-cause mortality (95% CI: 16%–32%, for the highest vs lowest category of DII).[Conclusion]: Our results provide strong and consistent support for the hypothesis that a pro-inflammatory diet is associated with increased all-cause mortality. The SUN cohort and PREDIMED trial were registered at clinicaltrials.gov as NCT02669602 and at isrctn.com as ISRCTN35739639, respectively.Supported by the official funding agency for biomedical research of the Spanish Government, Instituto de Salud Carlos III (ISCIII), through grants provided to research networks specifically developed for the trial (RTIC G03/140, to R.E.; RTIC RD 06/0045, to Miguel A. Martínez-González) and through Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERobn), and by grants from Centro Nacional de Investigaciones Cardiovasculares (CNIC 06/2007), Fondo de Investigación Sanitaria–Fondo Europeo de Desarrollo Regional (Proyecto de Investigación (PI) 04-2239, PI 05/2584, CP06/00100, PI07/0240, PI07/1138, PI07/0954, PI 07/0473, PI10/01407, PI10/02658, PI11/01647, P11/02505, PI13/00462, PI13/00615, PI13/01090, PI14/01668, PI14/01798, PI14/01764), Ministerio de Ciencia e Innovación (Recursos y teconologia agroalimentarias(AGL)-2009-13906-C02 and AGL2010-22319-C03 and AGL2013-49083-C3-1- R), Fundación Mapfre 2010, the Consejería de Salud de la Junta de Andalucía (PI0105/2007), the Public Health Division of the Department of Health of the Autonomous Government of Catalonia, Generalitat Valenciana (Generalitat Valenciana Ayuda Complementaria (GVACOMP) 06109, GVACOMP2010-181, GVACOMP2011-151), Conselleria de Sanitat y, PI14/01764 AP; Atención Primaria (CS) 2010-AP-111, and CS2011-AP-042), and Regional Government of Navarra (P27/2011).). Drs. Shivappa and Hébert were supported by grant number R44DK103377 from the United States National Institute of Diabetes and Digestive and Kidney Diseases

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

International audienceInterindividual clinical variability in the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is vast. We report that at least 101 of 987 patients with life-threatening coronavirus disease 2019 (COVID-19) pneumonia had neutralizing immunoglobulin G (IgG) autoantibodies (auto-Abs) against interferon-ω (IFN-ω) (13 patients), against the 13 types of IFN-α (36), or against both (52) at the onset of critical disease; a few also had auto-Abs against the other three type I IFNs. The auto-Abs neutralize the ability of the corresponding type I IFNs to block SARS-CoV-2 infection in vitro. These auto-Abs were not found in 663 individuals with asymptomatic or mild SARS-CoV-2 infection and were present in only 4 of 1227 healthy individuals. Patients with auto-Abs were aged 25 to 87 years and 95 of the 101 were men. A B cell autoimmune phenocopy of inborn errors of type I IFN immunity accounts for life-threatening COVID-19 pneumonia in at least 2.6% of women and 12.5% of men