Mortality in small geographical areas and proximity to air polluting industries in the Basque Country (Spain).

OBJECTIVES: To study the association between proximity to air polluting industrial facilities and mortality in the Basque Country (Spain) in the 1996-2003 period. METHODS: A cross-sectional ecological study with 1465 census sections (CS) as units of analysis with a mean population of 1257 inhabitants. Association of CS mortality with proximity of industries of the European Pollutant Emission Register was studied by type of industrial activity and adjusted for social deprivation. Two distance thresholds (1 km and 2 km) were used as proxies for exposure in a 'near versus far' analysis. Causes of mortality studied were: all causes; tracheal, bronchial, and lung cancer; haematological tumours; ischaemic heart disease; cerebrovascular diseases; chronic diseases of the lower respiratory tract; and breast cancer (in women). Poisson's generalised linear mixed models (GLMM) with two random effects (heterogeneity and structured spatial variability) were used in a fully Bayesian environment. RESULTS: Men living in sections within 1 km from energy production industries had greater mortality from tracheal, bronchial, and lung cancer [CI(90%) 6% to 53%] as compared with people living further. Women had greater mortality from ischaemic heart disease [CI(90%) 1% to 17%] and respiratory illness [CI(90%) 1% to 24%] within 2 km from metal-processing industries. On the contrary, within the 1 km buffer from mineral industries, mortality was lower for all causes [CI(90%) -20% to -6%] and for ischaemic heart disease [CI(90%) -40% to -10%] in women, and from respiratory diseases in men [CI(90%) -39% to -4%], while it was greater for breast cancer in women [CI(90%) 2% to 28%] within the 2 km buffer. CONCLUSIONS: Analysis of mortality by census sections is a helpful exploratory tool for investigating environmental risk factors and directing actions to sites and risk factors with a greater impact on health. Further epidemiological and environmental investigations around metal-processing and energy-producing plants are required.

Air pollution and cardiovascular admissions association in Spain: results within the EMECAS project.

OBJECTIVE: To evaluate the short term effect of air pollution on cardiovascular admissions in 14 Spanish cities METHODS: The period under study was from 1995 to 1999. Daily emergency admissions for all cardiovascular diseases (CVD) and heart diseases (HD) were obtained from hospital records, and the corresponding daily levels of particulates, SO2, NO2, CO, and ozone were recorded. The magnitude of association was estimated using Poisson generalised additive models controlling for confounding and overdispersion. For each cause, lagged effects, up to three days, of each pollutant were examined and combined estimates were obtained. For ozone the analyses were restricted to the warm period. One and two pollutant models were performed. RESULTS: Associations were more consistent in lag 0 (concurrent day) and 1 (lag 0-1), except in the case of ozone where there was a more delayed relation (lag 2-3). For combined estimates an increase of 10 microg/m3 in the PM10 levels in lag 0-1 was associated with an increase of 0.9% (95% CI: 0.4 to 1.5%) in the number of hospital admissions for CVD, and 1.6% (0.8 to 2.3%) for HD. For ozone the corresponding estimates for lag 2-3 were 0.7% (0.3 to 1.0) for CVD, and 0.7% (0.1 to 1.2) for HD. An increase of 1 mg/m3 in CO levels was associated with an increase of 2.1% (0.7 to 3.5%) in CVD admissions, and 4.2% (1.3 to 7.1%) in HD admissions. SO2 and NO2 estimates were more sensitive in two pollutant models CONCLUSIONS: A short term association between increases in daily levels of air pollutants and the number of daily admissions for cardiovascular diseases, with specificity for heart diseases, has been described in Spanish cities.

Trends in the prevalences of congenital anomalies and age at motherhood in a Southern European region: a population-based study.

OBJECTIVES: To estimate the prevalences of the main groups of congenital anomalies and to assess their trend over time. DESIGN: Population-based study of prevalences. SETTING: The Basque Country, Spain. PARTICIPANTS: All births and all congenital anomalies diagnosed prenatally, at birth or during the first year of age, in all hospitals of the country, from 1999 to 2008. MAIN OUTCOMES MEASURES: Total diagnosed prevalences and prevalences at birth of all chromosomal and non-chromosomal anomalies, Down's syndrome, anomalies of the nervous system, urinary, limbs, digestive system and congenital heart defects. RESULTS: Mean age (SD) of women at childbirth and the proportion of them over 35 years of age shifted from 32.1 (4.5) years, with 18.3% in 1999-2001, to 32.3 (4.7) years, with 23.9% in 2006-2008. Between 1999 and 2008, 991 cases of chromosomal anomalies and 3090 of non-chromosomal anomalies were diagnosed, which yields, respectively, total prevalences of 5.2‰ and of 16.2‰. Among chromosomal anomalies, Down's syndrome is the most frequent (2.9‰). With marginal statistical significance, the results point at an increasing trend in total diagnosed chromosomal anomalies, but a decreasing one in prevalences at birth. Among non-chromosomal congenital anomalies, congenital heart defects are the most frequent (5.2‰) one. Rates of all non-chromosomal, urinary and limb anomalies grew during the study period, whereas those of congenital heart defects and anomalies of the digestive system did not change significantly. CONCLUSIONS: In the Basque Country, rates of chromosomal anomalies are higher than the overall estimated prevalence in European countries, and continue to increase slightly, which may be related to the rise in maternal age. Rates of non-chromosomal anomalies are within the European frequent range of values, and the increases observed need to be checked in the following years.

Lead in drinking water in the Greater Bilbao Area (Basque Country, Spain).

The concentration of lead in drinking water prior to distribution in the Greater Bilbao Area (905,000 inhabitants) does not exceed 10 micrograms/l, however, the distribution network, service lines and domestic plumbing, can affect this concentration. This study determined what proportion of homes built in this Area before 1950 and between 1951 and 1975 exceeded specified lead levels in water and estimated the level of exposure to lead through drinking first draw water. A random stratified sampling was carried out based on the home's construction year. It was concluded that 84% (CI = 75.5-91.4) of the homes built before 1950 and 99% (CI = 93.3-100) of the homes built between 1951 and 1975 received first draw water containing lead levels below 10 micrograms/l, the geometric mean being 2.74 micrograms/l. Based on the geometric mean found in our study the calculated lead intake from drinking water of the infant population of 5 kg weight consuming 0.75 l/day, would be 2.9 micrograms/kg/week, i.e. 12% of the Provisional Tolerable Weekly Intake.