Asbestos exposure and small cell lung cancer: Systematic review and meta-analysis.

Asbestos is a mineral that is carcinogenic to humans. Its use has been banned in many occidental countries yet it is still produced in the United States, and materials that contain asbestos remain in many occupational settings and indoor environments. Even though asbestos carcinogenicity is well known, there is scant literature on its specific effects regarding small cell lung cancer (SCLC). We therefore conducted a systematic review and meta-analysis to determine SCLC risk among workers exposed to asbestos. A systematic search of the literature was conducted to identify studies which reported occupational exposure to asbestos and SCLC-related deaths and/or incidence. We identified seven case-control studies that included 3,231 SCLC cases; four studies reported smoking-adjusted risks. A significantly increased risk of SCLC (pooled OR 1.89; 95% CI, 1.25-2.86) was observed on pooling studies on men (six studies) that displayed moderate heterogeneity (I2 = 46.0%). Overall, our synthesis suggests that occupational exposure to asbestos significantly increases the risk of SCLC on men.

Percepción del consumo de alcohol propio y de allegados en universitarios de primer curso como predictor del consumo a 10 años. / Percepción del consumo de alcohol propio y de allegados en universitarios de primer curso como predictor del consumo a 10 años.

The alcohol use perceptions young people have of those close to them can affect their expectations regarding alcohol and, thus, their own drinking. We aim to identify the predictive ability of own and significant others' perceived drinking at age 18-19 in the alcohol use patterns at 27-28. A cohort study was carried out among university students in Spain (n=1,382). Binge Drinking (BD) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). College students perceive their family's alcohol consumption as very low or nothing, while the perception of their own alcohol use or that of their friends is higher. Perceiving higher alcohol use among their siblings and friends increases the risk of BD for both sexes and RC for women. Living away from the parental home increases the risk of RC and BD. In conclusion, the perception of their friend's alcohol use at age 18-19 is the most influential variable in BD among both sexes and in RC among men throughout 10 years of follow-up. Parental alcohol consumption does not affect college student drinking patterns when friends and siblings are considered. Living with one's family acts as a protective factor. Preventive measures focused on young people should take a contextual approach and include those closest to them.

El consumo percibido por los jóvenes de sus allegados puede afectar a las expectativas respecto al consumo de alcohol y de este modo, a su propio consumo. El objetivo del estudio ha sido identificar la capacidad predictiva de la percepción de consumo de alcohol propio y de los allegados al inicio del periodo universitario, en los patrones de consumo observados a lo largo de 10 años de seguimiento. Se ha llevado a cabo un estudio de cohortes en universitarios en España (n=1.382). Consumo Intensivo de Alcohol (CIA) y Consumo de Riesgo de alcohol (CRA) se midieron con el Test de Identificación de los Trastornos debidos al Uso de Alcohol (AUDIT) a los 18, 20, 22, 24 y 27 años. Se calcularon las Odds Ratios (ORs) con regresión logística multinivel para medidas repetidas. Los universitarios percibían bajo o nulo consumo de alcohol de sus familiares y mayor de sus amigos. Percibir mayor consumo de sus hermanos y amigos aumentó el riesgo de CIA en ambos géneros y de CRA en mujeres. Vivir fuera del domicilio familiar aumentó el riesgo de ambos patrones. En conclusión, la percepción del consumo de alcohol de amigos a los 18-19 años resultó la variable más influyente para el CIA en ambos géneros y el CRA en mujeres a lo largo de 10 años de seguimiento. El consumo de alcohol de los padres al inicio del periodo universitario parece no afectar a los patrones de consumo practicados durante la juventud, una vez se ajusta por el consumo de amigos y hermanos. Vivir en el domicilio familiar actúa como factor protector. Las medidas preventivas en los jóvenes deben tener un enfoque contextual incluyendo a sus allegados.

Nomophobia and Alcohol, Tobacco, and Cannabis Consumption in Adolescents in Galicia.

This study aimed at exploring the association of nomophobia with alcohol, tobacco, and/or cannabis consumption among high school students. We carried out a cross-sectional study among high school and vocational training students in Galicia, Northwest Spain (N = 3,100). Collected data included nomophobia, sociodemographic variables, and alcohol, tobacco, and cannabis consumption. Nomophobia was measured using the validated Nomophobia Questionnaire. Adjusted odds ratios (ORs) and their 95 percent confidence intervals (CIs) were estimated using generalized linear mixed models. More than a quarter of the adolescents (27.7 percent) had nomophobia. We found an association between nomophobia and a high level of tobacco smoking in the last month in boys (OR = 2.16; 95 percent CI: 1.55-3.03). Nomophobia was also associated with higher odds of binge drinking in both genders (girls: OR = 1.86; 95 percent CI: 1.61-3.52; boys: OR = 2.29; 95 percent CI: 1.68-3.13) and with cannabis consumption in boys (OR = 1.74; 95 percent CI: 1.07-2.81). Our findings highlight the importance of a comprehensive investigation of the factors underlying alcohol, tobacco, and cannabis consumption in the adolescent population.

Wood dust exposure and small cell lung cancer: a systematic review and meta-analysis.

INTRODUCTION: Occupational exposure role on small cell lung cancer (SCLC) onset has been little studied. Wood dust has been recognized as a human carcinogen, and many occupations have high wood-dust exposure. The aim of this study was therefore to perform a systematic review and meta-analysis of the scientific literature to summarize and analyse the risks of wood dust-related occupations on development of SCLC, taking tobacco use into account. METHODS: We conducted a literature search of PubMed, EMBASE, Web of Science and Cochrane using a predefined strategy and including case-control and cohort studies assessing occupational exposure to wood dust or wood dust-related occupations. To perform the meta-analysis, the odds ratio (OR) and 95% confidence interval (CI) of each of the studies were extracted. A random-effects model was fitted using the DerSimonian Laird method. Sensitivity and subgroup analyses were performed. Quality was assessed using the Office and Health Assessment and Translation (OHAT) for human and animal studies instrument. RESULTS: Eleven studies with a total of 2,368 SCLC cases and 357,179 controls were included. Overall, exposure to wood dust significantly increases risk of SCLC (RR = 1.41, 95% CI 1.11-1.80), with low heterogeneity between studies (I2 = 40%). The association was maintained in studies conducted on males (RR = 1.41, 95% CI 1.12-1.78) but not in those conducted on females/both sexes (RR = 1.37, 95% CI 0.35-3.44). Sensitivity analysis showed that none of the studies significantly modified the results. CONCLUSIONS: Our results support that exposure to wood-dust can increase the risk of SCLC. Although the level of evidence is low, there are strong arguments to recommend the implementation of effective control measures to reduce exposure in occupational settings, as a means of preventing SCLC. IMPACT STATEMENT: The results of this study support that exposure to wood-dust can increase the risk of developing small cell lung cancer. Determining the impact of occupational exposure on workers is essential to improve their individual protection and prevention. There is a strong case for recommending the implementation of control measures to reduce occupational exposure to wood dust, specifically for highly exposed occupations such as carpenters and sawmills, in order to prevent small cell lung cancer.

Analysis of AUDIT Domains in Freshman Students in Spain: Three Cross-Sectional Surveys (2005, 2012 and 2016).

Purpose: We aimed to evaluate changes in the frequency of drinking, alcohol dependence and alcohol-related harm in freshman college students from 2005, 2012 and 2016, and identify risk-associated factors. Method: A cross-sectional study involving 5009 freshman students was carried out in Spain in 2005, 2012 and 2016. The Dimensions of Alcohol Use Disorders Identification Test (frequency of drinking, symptoms of dependence and alcohol-related harm) was analysed. Adjusted relative risks (RRs) and their 95% confidence intervals were estimated using negative binomial regression. Results: Place of residence, positive expectancies and early onset of alcohol consumption continue to be crucial conditions for developing patterns of risky consumption, alcohol dependence and harm. Women and men were more vulnerable to alcohol harm and dependence when living away from home, having higher economic status and positive alcohol expectancies. Cohorts from 2012 and 2016 were at lower risk of risky alcohol consumption. Men belonging to the 2012 and 2016 cohorts were at lower risk of alcohol negative consequences compared with the 2005 cohort. However, women remained vulnerable over time to alcohol dependence and harm. Starting drinking after 16 protects them both from alcohol dependence and harm. Conclusions: Women are more vulnerable to alcohol dependence and harm in recent cohorts of freshmen. Limiting access to alcohol at a younger age and working on false positive expectancies could benefit freshmen by avoiding alcohol damage and alcohol dependence.

Alcohol Use and Sexual and Physical Assault Victimization Among University Students: Three Years of Follow-Up.

The aim of this study was to determine the incidence of sexual and physical assault among university students and its association with alcohol use. The research is part of a wider cohort study (Spit for ScienceTM) at a large public university in the United States. The follow-up data include the first two cohorts (2011, 2012; n = 5,170). The dependent variables were victim of sexual assault and victim of physical assault. The independent variables were alcohol dependence and abuse according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.), cannabis use, residence, ethnicity, sexual orientation, and previous experience of sexual assault and/or physical assault. We used multilevel logistic regression for repeated measures. All data were analyzed using generalized linear mixed models. Incidence rates of sexual and physical assault (per 100 students a year) were 15.1 and 27.6 among nonabusers/dependents versus 36.4 and 56.7 among alcohol-dependent females at the first year, and 2.8 and 4.7 versus 7.7 and 23.1 at the third year; while in males, incident rates were 6.0 and 3.1 versus 18.5 and 66.6, and 2.3 and 7.4 versus 18.9 and 15.1, respectively. Our results show that alcohol abuse and dependence constitute risk factors to be victim of sexual assault in males (odds ratio [OR] = 2.21 and OR = 2.73) and alcohol dependence in females (OR = 2.16). Similarly, alcohol abuse and dependence are risk factors to physical assault among both males (OR = 1.52 and OR = 2.03) and females (OR = 1.70 and OR = 2.88). Ethnicity, sexual orientation, and whether the individual had been victimized in the past were associated with sexual assault. Regarding physical assault, cannabis use and past victimization are also risk factors. Our study has shown that assault victimization is strongly related to alcohol abuse and dependence diagnoses in both genders. Ethnicity and sexual orientation are also associated to both assaults. Our results show that incidence rates of both types of assaults were clearly higher in the first 6 months of university, probably explained by the novel and potentially risky environment.

Alcohol Consumption among Freshman College Students in Spain: Individual and Pooled Analyses of Three Cross-Sectional Surveys (2005, 2012 and 2016).

Objective: We aimed to evaluate changes in the prevalence of Heavy Episodic Drinking (HED) and Risky Consumption (RC) in freshman college students between 2005, 2012 and 2016; and to identify the explanatory variables of these patterns of consumption using individual and pooled analyses. Methods: A cross-sectional study involving 5260 students was carried out in Spain in 2005, 2012 and 2016. HED and RC were determined using the Alcohol Use Disorders Identification Test. Another questionnaire was used to measure parental education level and alcohol use, alcohol-related problems, age of onset of alcohol use and alcohol-related expectancies. Adjusted Odds Ratios (ORs) of RC and HED and their 95% Confidence Intervals were estimated using logistic regression. Results: An increase in the prevalence rates of HED and RC was observed among women during the three-study periods, nonetheless there was no statistically significant difference in the prevalence rates among men. High maternal educational level, living away from parental home, initiating drinking before the age of 15 and having positive expectancies about drinking are associated with higher prevalence of RC in both genders. High positive expectancies and early onset of alcohol use are associated with higher rates of HED among men and women. Students recruited in 2012 and 2016 are protected against RC in comparison to those recruited in 2005. Conclusions: The age of alcohol consumption onset is the most influencing factor on HED and RC for both genders in the three-study periods. Alcohol prevention campaigns targeting youth at early ages can reduce risky drinking behaviors.

Contextual Determinants in Alcohol, Tobacco and Cannabis Consumption, Mood and Bullying during Adolescence.

The present study aimed to explore the differences in the consumption of alcohol, tobacco and cannabis, mood and bullying between adolescents. A cross-sectional study was carried out in five regions of Northern Spain (one in Galiza and four in central Catalonia) that share similar socioeconomic characteristics and encompass around 10,000 inhabitants each. Students living in Burela, Galiza (N = 71) were compared to those of Central Catalonia (N = 193). The independent variable was the municipality of residence. The dependent variables encompassed: weekly available pocket money, Family Affluence Scale, self-classified academic qualification, place of origin, alcohol consumption, tobacco and cannabis smoking, negative mood and bullying. The mean age and their 95% confidence intervals (95% CI) of participants were similar between the regions (Burela: 15.90 years (15.68-16.13) and Central Catalonia: 15.36 years (15.28-15.44)). More than half of the participants were females (Burela, Galiza (53.5%) and Catalonia (54.9%)). Prevalence ratios (PR) and their 95% CI were estimated using Poisson regression models. In comparison with adolescents from Burela (Galiza), those living in Central Catalonia had higher prevalence of diverse academic levels (adjusted PR = 3.92 (1.78-8.66)), tobacco consumption (adjusted PR = 2.41 (1.47-3.97)) and negative mood (adjusted PR = 5.97 (3.05-11.70)). Even when dealing with regions with similar socioeconomic characteristics and number of inhabitants, differences exist in terms of the socioeconomic level, tobacco consumption, mood and bullying, as reported by adolescents.

We Need to Delay the Age of Onset of Alcohol Consumption.

In recent years, new consumption patterns, such as binge drinking, have increased among young people and have not always been recognized as problematic either by health personnel or by society in general, as they are intensive episodes, interspersed with no consumption periods. Although the prevalence of alcohol use disorders in the adult population continues to be higher in men than in women, these gender differences in relation to alcohol consumption are barely observed in adolescents between 14 and 18. Therefore, we are witnessing a change in the pattern of consumption, from regular to episodic, and an attenuation of gender differences. New patterns of alcohol consumption have not only been associated with an increased risk of alcohol use disorders in adult life, but also with neurocognitive involvement in youth. Understanding the risk and resilience factors of alcoholism or problematic drinking patterns will not only allow us to identify the most vulnerable group, but also to guide prevention programs towards protective factors; the skills that contribute to the natural abandonment of the pattern. Knowing the variables involved in the trajectories of abandonment and dependency would contribute to personalizing the interventions and increasing their efficacy and success-a lower relapse rate-, reducing the economic and socio-sanitary costs associated with alcohol dependency, as well as improving the health and well-being, family relations, work and social status of alcohol-dependent people.

Population Attributable Fraction of Early Age of Onset of Alcohol Use in Alcohol Abuse and Dependence: A 3-Year Follow-Up Study in University Students.

BACKGROUND: we aimed to determine the risk factors and associated population attributable fractions (PAFs) for the age of onset of alcohol use and also to identify protective factors. METHODS: we analyzed follow-up data collected between autumn 2011 and spring 2016 (n = 5170) from the first two cohorts (2011, 2012) of the Spit for ScienceTM project. The dependent variables were alcohol abuse and dependence, and the independent variables were age of drinking onset, residence, ethnicity, religiosity, sexual orientation and work status. We determined the odds ratios (OR) using multilevel logistic regression for repeated measures in SPSSv.20. RESULTS: the early onset of alcohol use was associated with an increased risk of alcohol abuse and dependence among females (OR = 14.98; OR = 11.83) and males (OR = 7.41; OR = 6.24). The PAFs for the early onset of alcohol use in alcohol abuse and dependence were respectively 80.9% and 71.7% in females and 71.0% and 63.5% in males. Among females, being white (OR = 1.58; OR = 1.51), living off-campus (OR = 1.73; OR = 2.76) and working full-time (OR = 1.69; OR = 1.78) were also risk factors. Strong religious beliefs were found to protect males from alcohol abuse (OR = 0.58), while same-gender sexual orientation increased the risk among females (OR = 2.09). CONCLUSION: delaying the age of onset by one year would reduce alcohol abuse among young adults.

[Alcohol outlet density and alcohol consumption in Galician youth]. / Densidad de los puntos de venta de alcohol y su consumo en jóvenes de Galicia.

OBJECTIVE: To assess the influence that alcohol outlet density, off- and on-alcohol premises, and alcohol consumption wield on the consumption patterns of young pre-university students in Galicia (Spain). METHOD: A cross-sectional analysis of a cohort of students of the University of Santiago de Compostela (Compostela Cohort 2016) was carried out. Consumption prevalence were calculated for each of the municipalities from the first-cycle students' home residence during the year prior to admission. The association with risky alcohol consumption (RC) and binge-drinking (BD) was assessed with a logistic model considering as independent variables the municipality population, alcohol outlet density of off- premises, density of off- and on- premises and total density of both types of premises in the municipality. RESULTS: The prevalence of RC was 60.5% (95% confidence interval [95%CI]: 58.4-62.5) and the BD was 28.5% (95%CI: 26.7-30.2). A great variability was observed according to the municipality of provenance. The multivariate logistic model showed municipalities with a density of 8.42-9.34 of both types of premises per thousand inhabitants presented a higher risk of RC (odds ratio [OR]: 1,39; 95%CI: 1.09-1.78) and BD (OR: 1.29; 95%CI: 1.01-1.66). CONCLUSION: These data suggest the importance of including environmental information when studying alcohol consumption. Knowing our environment better could help plan policies that encourage healthier behaviour in the population.

The Use of Non-Prescribed Prescription Drugs and Substance Use Among College Students: A 9-Year Follow-Up Cohort Study.

The use of non-prescribed prescription drugs (NPPD) is common in post-modern societies and a significant proportion of youth consume NPPD concomitantly to other drugs. We studied the prevalence of this consumption among university students in Spain, and its relationship to different patterns of alcohol, tobacco, and cannabis use. A cohort study among university students (n=1,380) (2005-2015) was carried out. Students completed self-administered questionnaires at initial (n=1,363, 98.7%), at 2 years (n=875, 75%) and 9 years of follow-up (n=415, 30.5%). Consumption of medicines (last 15 days), risky alcohol consumption (RC), heavy episodic drinking (HED), and tobacco and cannabis use were measured. Multilevel logistic regressions for repeated measures were generated using consumption of medicines with or without medical prescription as dependent variables. Prevalence of RC, HED, tobacco and cannabis had significant reductions during the follow-up. The use of NPPD increased over time, from 35.5% and 33.3% at 18 and 22 years old, respectively, to 49.6% at 27 years old. The highest rates were found among cannabis, tobacco, RC and HED users. For females, cannabis and RC constitute signitifant risk factors for use of NPPD. Conversely, for males, tobacco and cannabis were risk factors for such use of medicines. Later onset of alcohol consumption constitutes a protective factor for females. Our results reveal high prevalence of NPDD among university students. Those who consume NPPD are -at the same time- more likely to be alcohol, tobacco, and cannabis users than those who take medication under prescription. Preventive strategies should be reinforced and focused on this target population to decrease these high levels of poly-consumption.

Heavy Drinking and Non-Medical Use of Prescription Drugs among University Students: A 9-Year Follow-Up.

Purpose: Investigations suggest non-medical use of prescription drugs (NMUPD) is associated with heavy drinking and polydrug use among university students. Our aim is to determine the prevalence of NMUPD among university students and to analyze its association with alcohol, tobacco, and cannabis use, and to study the role of the age of drinking onset. Methods: Cohort study among university Spanish students (n = 1382). Heavy drinking (HED) and risky consumption (RC) were measured with the Alcohol Use Disorders Identification Test. Questions related to tobacco and cannabis consumption were also formulated. NMUPD refers to sedative, anxiety, or pain medication intake within the last 15 days without medical prescription. All variables were measured at 18, 20, and 27 years. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (odds ratios). We analyzed the results from a gender perspective. Results: Prevalence of NMUPD were higher in students who already partook in NMUPD at the beginning of the study. NMUPD in women at 27 is 3 times higher than at 18, while in men it is twice. Among females, RC (OR = 1.43) and cannabis consumption (OR = 1.33) are risk factors for NMUPD, while later onset of alcohol use (OR = 0.66) constitutes a protective factor. No significant differences were found for males. Conclusions: NMUPD is prevalent among university students. RC and early onset of alcohol use were associated with higher prevalence of NMUPD in females. The prevalence of NMUPD increased with age in both sexes. Strategies for reducing risky drinking and delaying onset of drinking should be provided for university students. Pharmacists and parents should be alerted to the risk of NMUPD.

Perceptions and attitudes of patients and health care workers toward patient empowerment in promoting hand hygiene.

BACKGROUND: Patient empowerment is a component of the World Health Organization's multimodal strategy to improve hand hygiene (HH). Its successful implementation requires knowledge of the perceptions and attitudes of patients and health care workers (HCWs) toward patient empowerment in HH. METHODS: A cross-sectional study, through a self-administered questionnaire of patients and their families and HCWs, was conducted in a 433-bed block of an 850-bed university hospital in Galicia, Spain. RESULTS: A total of 337 patients and their families and 196 HCWs completed the questionnaire. Among patients and their families, 49.9% were willing to remind HCWs about HH. However, only 31.6% of HCWs (41.8% of physicians and 24.8% of nurses) supported patient participation. The most common reason for patients and their families not being willing to ask caregivers to perform HH was fear of causing annoyance or receiving worse treatment as a consequence (76%). The main reasons that physicians disagreed with patient participation was patients' lack of knowledge (40%) and possible negative effects on the HCW/patient relationship (40%). Nurses considered this participation unnecessary (58%). CONCLUSIONS: There were significant differences between patients and their families and HCWs regarding support for patient empowerment in promoting HH. In our setting, a cultural change is needed in the HCW/patient relationship to create a facilitating environment.

Trends in alcohol use among young people according to the pattern of consumption on starting university: A 9-year follow-up study.

AIM: To identify differences in Risky Consumption (RC) and Binge drinking (BD) trends in students who already followed these patterns of alcohol consumption on starting university and those who did not, and also to try to understand what leads students to engage in these types of behaviour at university. MATERIAL AND METHODS: Cohort study among university students in Spain (n = 1382). BD and RC were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27 years. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). RESULTS: The prevalence rates of RC and BD were lower throughout the study in students who did not follow these patterns of consumption at age 18. For RC and BD, the differences at age 27 years, expressed as percentage points (pp), were respectively 24 pp and 15 pp in women and 29 pp and 25 pp in men. Early age of onset of alcohol use increased the risk of engaging in RC and BD patterns at university, for men (OR = 2.91 & 2.80) and women (OR = 8.14 & 5.53). The same was observed in students living away from the parental home for BD (OR = 3.43 for men & 1.77 for women). Only women were influenced by having positive expectancies for engaging in RC (OR = 1.82) and BD (OR = 1.96). CONCLUSIONS: The prevalence rates of both RC and BD at age 27 years were much higher among university students who already followed these patterns of consumption at age 18 years, with the differences being proportionally higher among women. Focusing on the age of onset of alcohol consumption and hindering access to alcohol by minors should be priority objectives aimed at preventing students from engaging in these patterns of alcohol consumption at university.

Patterns of Alcohol Consumption in Spanish University Alumni: Nine Years of Follow-Up.

The aim of this study was to empirically identify different profiles of Spanish university alumni, based on their alcohol use over 9 years, and to further characterize them. A cohort study was carried out between 2005 and 2015 among university students (Compostela Cohort-Spain; n2015 = 415). Alcohol consumption was measured using the Alcohol Use Disorder Identification Test (AUDIT). A two-stage cluster analysis, based on their AUDIT total scores was carried out separately for males and females. The further characterization of every profile was based on demographic data, age at onset of alcohol use, positive alcohol-related expectancies, tobacco and cannabis use, as well as their answers to some European Addiction Severity Index items. Five different clusters were identified: Low users (29.2%), Moderated users (37.2%), At-risk users (14.2%), Decreasing users (13.2%) and Large users (6.2%) for females, and Low users (34.4%), At-risk users (25.6%), High-risk users (15.6%), Decreasing users (14.4%) and Large users (10.0%) for males. Being a cannabis user or a smoker was positively associated to those more hazardous clusters in both genders. Regarding females, significant differences in the age of onset and high positive expectancies were found. However, there were few significant differences among the groups in relation to their employment status and social relations. The results reveal the existence of different typologies of alcohol users among university alumni, with differences among males and females. Modifying positive expectancies, limiting access to alcohol at a young age, and reducing uses of other substances uses are key to promote healthier alcohol use profiles and to prevent hazardous uses.

Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students.

AIM: The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. METHODS: We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. RESULTS: The incidence rate of alcohol-related injuries was 0.028year-1 for females and 0.036year-1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR]=2.64 and OR=3.68), while being more than 23 is a protective factor (OR=0.34). For males, bivariate analysis also showed HED like risk factor (OR=4.69 and OR=2.51). Finally, the population attributable fraction for HED among females was 37.12%. CONCLUSIONS: HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED.

Identifying Predictors and Prevalence of Alcohol Consumption among University Students: Nine Years of Follow-Up.

AIM: To evaluate the prevalence of alcohol consumption among university students during late adolescence and young adulthood and to identify the associated factors. MATERIAL AND METHODS: Cohort study among university students in Spain (n = 1382). Heavy Episodic Drinking (HED) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test (AUDIT) at ages 18, 20, 22, 24 and 27 years. Data on potential factors associated with alcohol use were obtained with an additional questionnaire. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (Odds Ratios). RESULTS: The rates of prevalence of RC were lower, but not statistically significant, in women. The age-related changes in these rates were similar in both genders, and the prevalence of RC peaked at 20 years. By contrast, the prevalence of HED was significantly lower in women and peaked at 18 years in women and at 22 years in men. Multivariate models showed that early age of onset of alcohol use (OR = 10.6 and OR = 6.9 for women; OR = 8.3 and OR = 8.2 for men) and positive expectations about alcohol (OR = 7.8 and OR = 4.5 for women; OR = 3.6 and OR = 3.3 for men) were the most important risk factors for RC and HED. Living away from the family home was also a risk factor for both consumption patterns among women (OR = 3.16 and OR = 2.34), while a high maternal education level was a risk factor for RC among both genders (OR = 1.62 for women; OR = 2.49 for men). CONCLUSIONS: Alcohol consumption decreases significantly at the end of youth, with higher rates of prevalence and a later peak among men. Prevention strategies should focus on beliefs and expectations about alcohol and on delaying the age of onset. Women are at particular risk for these consumption patterns if they live away from their parents. Belonging to a high-income family is a strong risk factor for RC.

[Heavy episodic drinking, cannabis use and unsafe sex among university students]. / Consumo intensivo de alcohol y cannabis, y prácticas sexuales de riesgo en estudiantes universitarios.

OBJECTIVE: To determine the incidence of unsafe sex among university students and its association with heavy episodic drinking (HED) and cannabis use. METHOD: A cohort study was carried out from 2005 to 2011 among university students of the Compostela Cohort (n=517). HED was measured using the third question of the Alcohol Use Disorders Identification Test (AUDIT). Unsafe sex was considered to be sex under the influence of alcohol (SUA) and sex without a condom (SWC). Logistic regression models were created. RESULTS: The incidence of SUA was 40.9% for women and 53.0% for men, while the SWC incidence ranged from 13.7% for women to 25.7% for men. HED and cannabis use were associated with SUA in both women (OR=2.08, 95% CI: 1.03-4.21; OR=2.78, 95%CI: 1.57-4.92) and men (OR=4.74 (95%CI: 1.49-15.09; OR=4.37, 95%CI: 1.17- 16.36). Moreover, cannabis use in women was associated with SWC (OR=2.96, 95%CI: 1.52-5.75). The population attributable fractions of SUA for HED were 24.7% and 52.9% for women and men, respectively. CONCLUSIONS: HED and cannabis use represent a public health problem due to their association with a variety of problems, including engagement in unsafe sex. Our results suggest that a significant proportion of unsafe sex could be avoided by reducing this consumption pattern of alcohol.