Epidemiología de los accidentes en una cohorte de adultos mayores de 64 años de la Comunidad Autónoma del País Vasco / Epidemiology of accidents in a cohort of adults over 64 years old in the Autonomous Community of the Basque Country

Introducción. Los accidentes son un problema importante de salud para las personas mayores. El objetivo de este estudio ha sido valorar la incidencia de accidentes en la población mayor de 64 años y describir las características que se asocian a la accidentalidad. Material y métodos. Estudio descriptivo de una cohorte de 15.192 personas mayores de 64 años, no institucionalizadas, realizado a través de Red Vigía de la CAPV y durante el periodo de un año. Por cada accidente se realizó una encuesta. Se calcularon las tasas de accidentalidad y los riesgos por grupos de edad y sexo. Resultados. La tasa de accidentalidad fue 46,52 y 81,87 por 1.000 hombres y mujeres, respectivamente. El tipo de accidente más frecuente fue la caída (92%), la lesión más severa la fractura (17%) con un riesgo significativamente superior para las mujeres y los mayores de 75 años. Conclusiones. Los datos presentados confirman la importante dimensión de los accidentes no intencionados en la población mayor de 64 años en la CAPV. El accidente más frecuente ha sido la caída, que constituye un fenómeno de gran transcendencia en los adultos mayores ya que son una de las principales causas de lesiones, incapacidad e institucionalización (AU)

Introduction. Accidents represent a significant health problem for elderly people. The objective of this study was to assess the incidence of accidents in over-64-year-olds in the Basque Country population, and to describe the clinical-epidemiological features leading to them. Material and methods. This was a prospective cohort study of 15,192 non-institutionalised individuals over 64 years of age, conducted under the auspices of the Basque Sentinel Practice Network (Red Vigía) over one year. A questionnaire was completed for each accident. The rates and risks of accidents were calculated by sex and age group of the individuals who had the accidents. Results. The rates of accidents were 46.52 and 81.87 per 1000 men and women, respectively. The most common type of accident was a fall (92%), and the most severe injuries were fractures (17%), with the risk of an accident being significantly higher in women and in the over-75-year-olds. Conclusions. These data reflect the scale of accidents in over-64-year-olds in the Basque Country. The most frequent accident was the fall, which represents a dramatic event among the elderly, being one of the main causes of injury, disability and institutionalisation among this population group (AU)

Brote de Shigella sonnei en un centro escolar de Gipuzkoa / Shigella sonnei outbreak in a school in Northern Spain

En octubre de 2012 se detectó un brote de gastroenteritis aguda por Shigella sonnei en una escuela del norte de España que afectó a 112 personas: el 63,7% fueron escolares y docentes y el 35,7% convivientes. El origen fue un niño enfermo con antecedente de viaje a país endémico, y el desencadenante, las deficiencias higiénicas existentes en uno de los aseos de la escuela. La aplicación de estrictas medidas de higiene fueron determinantes para el control del brote

In October 2012, an outbreak of acute gastroenteritis caused by Shigella sonnei was detected in a nursery and primary school in the north of Spain affecting 112 people: 63.7% were pupils and teachers and 35.7% their co-habitants. The source was a sick child who had travelled to an endemic country, and the key trigger factor was inadequate hygiene in one of the toilets of the school. The enforcement of strict hygiene measures was essential for controlling the outbreak

[Epidemiology of accidents in a cohort of adults over 64 years old in the Autonomous Community of the Basque Country]. / Epidemiología de los accidentes en una cohorte de adultos mayores de 64 años de la Comunidad Autónoma del País Vasco.

INTRODUCTION: Accidents represent a significant health problem for elderly people. The objective of this study was to assess the incidence of accidents in over-64-year-olds in the Basque Country population, and to describe the clinical-epidemiological features leading to them. MATERIAL AND METHODS: This was a prospective cohort study of 15,192 non-institutionalised individuals over 64 years of age, conducted under the auspices of the Basque Sentinel Practice Network (Red Vigía) over one year. A questionnaire was completed for each accident. The rates and risks of accidents were calculated by sex and age group of the individuals who had the accidents. RESULTS: The rates of accidents were 46.52 and 81.87 per 1000 men and women, respectively. The most common type of accident was a fall (92%), and the most severe injuries were fractures (17%), with the risk of an accident being significantly higher in women and in the over-75-year-olds. CONCLUSIONS: These data reflect the scale of accidents in over-64-year-olds in the Basque Country. The most frequent accident was the fall, which represents a dramatic event among the elderly, being one of the main causes of injury, disability and institutionalisation among this population group.

[Shigella sonnei outbreak in a school in Northern Spain]. / Brote de Shigella sonnei en un centro escolar de Gipuzkoa.

In October 2012, an outbreak of acute gastroenteritis caused by Shigella sonnei was detected in a nursery and primary school in the north of Spain affecting 112 people: 63.7% were pupils and teachers and 35.7% their co-habitants. The source was a sick child who had travelled to an endemic country, and the key trigger factor was inadequate hygiene in one of the toilets of the school. The enforcement of strict hygiene measures was essential for controlling the outbreak.

Brote de conjuntivitis folicular por adenovirus en un centro gerontológico / Outbreak of follicular conjunctivitis caused by adenovirus in a geriatric centre

Introducción Adenovirus serotipo 4a es un virus respiratorio que causa ocasionalmente conjuntivitis. En el presente trabajo se describe un brote de conjuntivitis folicular que tuvo lugar en un centro gerontológico. Material y métodos Descripción del brote e investigación epidemiológica mediante encuesta. Para el estudio microbiológico se recogieron frotis conjuntivales con medios de transporte viral y bacteriano. Adenovirus se detectó mediante un ensayo de reacción en cadena de la polimerasa en tiempo real. El serotipo se conoció mediante secuenciación de un fragmento de los genes hexón y E1.Resultados En otoño de 2008 se detectó un brote de conjuntivitis folicular por adenovirus serotipo 4a que afectó al 23% (69/300) de los residentes internos y al 5% (9/180) de los trabajadores de un centro gerontológico de Gipuzkoa. El cuadro clínico fue de duración prolongada (11±5 días). La asociación temporal de los casos sugirió transmisión de persona a persona. Las medidas higienico sanitarias establecidas (asepsia y lavado frecuente de manos, limpieza y desinfección de objetos y superficies) fueron efectivas, interrumpiendo la transmisión de la enfermedad en un breve período. Conclusión La rápida detección, identificación del agente causal e implantación de las medidas de control adecuadas pueden disminuir de manera importante el impacto tanto en la salud como en el coste económico de este tipo de brote (AU)

Introduction Adenovirus serotype 4a is a respiratory virus that occasionally causes conjunctivitis. This paper describes an outbreak of follicular conjunctivitis that occurred in a geriatric centre. Material and methods Outbreak description and epidemiological research through a survey. For the microbiological study conjunctival swabs were collected using viral and bacterial transport media. Adenovirus was detected by real-time polymerase chain reaction. The serotype was determined by sequencing of a fragment of the hexon and E1 genes. Results In autumn 2008 an outbreak of follicular conjunctivitis caused by adenovirus serotype 4a was detected. Twenty three percent 23% (69/300) of residents and 5% (9/180) of workers in a geriatric centre in Gipuzkoa were affected. The clinical symptoms were of prolonged duration (11±5 days). The temporal association of the cases suggested transmission from person to person. The sanitary measures established (asepsis and frequent hand washing, cleaning and disinfection of objects and surfaces) were effective, interrupting the transmission of the disease within a short period of time. Conclusion Rapid detection, identification of the causative agent and implementing appropriate control measures can significantly reduce the impact on both health and economic costs of these outbreaks (AU)

[Outbreak of follicular conjunctivitis caused by adenovirus in a geriatric centre]. / Brote de conjuntivitis folicular por adenovirus en un centro gerontológico.

INTRODUCTION: Adenovirus serotype 4a is a respiratory virus that occasionally causes conjunctivitis. This paper describes an outbreak of follicular conjunctivitis that occurred in a geriatric centre. MATERIAL AND METHODS: Outbreak description and epidemiological research through a survey. For the microbiological study conjunctival swabs were collected using viral and bacterial transport media. Adenovirus was detected by real-time polymerase chain reaction. The serotype was determined by sequencing of a fragment of the hexon and E1 genes. RESULTS: In autumn 2008 an outbreak of follicular conjunctivitis caused by adenovirus serotype 4a was detected. Twenty three percent 23% (69/300) of residents and 5% (9/180) of workers in a geriatric centre in Gipuzkoa were affected. The clinical symptoms were of prolonged duration (11±5 days). The temporal association of the cases suggested transmission from person to person. The sanitary measures established (asepsis and frequent hand washing, cleaning and disinfection of objects and surfaces) were effective, interrupting the transmission of the disease within a short period of time. CONCLUSION: Rapid detection, identification of the causative agent and implementing appropriate control measures can significantly reduce the impact on both health and economic costs of these outbreaks.

[Indoor air and bathing water pollution in indoor swimming pools in Guipúzcoa (Spain)]. / Contaminación del aire interior y del agua de baño en piscinas cubiertas de Guipúzcoa.

OBJECTIVE: To describe levels of pollutants found in indoor swimming pools in Guipúzcoa (Basque Country, Spain), both in the bathing water and in the air, and to study the association between these pollutants and other variables related to ventilation systems and the use of installations. METHODS: Of the 35 indoor swimming pools registered in Guipúzcoa, the 20 most frequently used by swimmers were studied. Each installation was sampled on two nonconsecutive days. Free and combined chlorine and trihalomethane levels were measured in the water, while total chlorine and chloroform levels were measured in the air. Carbon dioxide (CO(2)) was measured as an indicator of air renewal. RESULTS: The average chlorine level in the air was 0.4 mg/m(3) and that of chloroform was 22 microg/m(3). In all the swimming pools, free and combined chlorine levels were within the permitted values. The average chloroform level in bathing water was 13.7 microg/l. Chloroform levels in the air could be reasonably predicted (R(2) = 0.85), the predictive factors being chloroform levels in the water, CO(2) concentrations, and the number of bathers on the day of measurement. CONCLUSIONS: Levels of pollutants in the water and in the air of swimming pools in Guipúzcoa were lower than those reported in other studies. However, 20% of the installations exceeded the concentration of total chlorine in the air proposed as a reference value to protect swimmers carrying out intense activities (0.5 mg/m(3)).

Contaminación del aire interior y del agua de baño en piscinas cubiertas de Guipúzcoa / Indoor air and bathing water pollution in indoor swimming pools in Guipúzcoa (Spain)

Objetivo: Describir los niveles de contaminantes presentes en las piscinas cubiertas de Guipúzcoa, tanto en el agua de baño como en el aire, y estudiar la relación entre estos contaminantes y otras variables relacionadas con los sistemas de ventilación y el uso de las instalaciones. Métodos: De las 35 piscinas cubiertas registradas en Guipúzcoa se estudiaron las 20 más utilizadas por nadadores. Cada instalación se muestreó 2 días no consecutivos y se midieron los niveles de cloro libre y combinado y trihalometanos en el agua, así como los de cloro total y cloroformo en el aire. Como indicador de la renovación del aire se midió el dióxido de carbono (CO2).Resultados: El nivel medio de cloro en el aire fue de 0,4mg/m3 y el de cloroformo de 22¼g/m3. Los valores de cloro libre y combinado de todas las piscinas se mantuvieron dentro de los valores reglamentarios. El nivel medio de cloroformo del agua de baño fue de 13,7¼g/l. El valor del cloroformo del aire puede predecirse razonablemente (R2=0,85), y las variables predictoras son el cloroformo del agua, el CO2 y el número de bañistas del día.Conclusiones:Los niveles de contaminantes en el agua y en el aire de las piscinas de Guipúzcoa son inferiores a los descritos en otros estudios. Sin embargo, utilizando la concentración de 0,5mg/m3 de cloro total en aire, propuesta como valor de referencia para la protección de los nadadores con actividad intensa, un 20% de las instalaciones superarían dicho valor (AU)

Objective: To describe levels of pollutants found in indoor swimming pools in Guipúzcoa (Basque Country, Spain), both in the bathing water and in the air, and to study the association between these pollutants and other variables related to ventilation systems and the use of installations.Methods: Of the 35 indoor swimming pools registered in Guipúzcoa, the 20 most frequently used by swimmers were studied. Each installation was sampled on two nonconsecutive days. Free and combined chlorine and trihalomethane levels were measured in the water, while total chlorine and chloroform levels were measured in the air. Carbon dioxide (CO2) was measured as an indicator of air renewal.Results: The average chlorine level in the air was 0.4mg/m3 and that of chloroform was 22¼g/m3. In all the swimming pools, free and combined chlorine levels were within the permitted values. The average chloroform level in bathing water was 13.7¼g/l. Chloroform levels in the air could be reasonably predicted (R2=0.85), the predictive factors being chloroform levels in the water, CO2 concentrations, and the number of bathers on the day of measurement.Conclusions: Levels of pollutants in the water and in the air of swimming pools in Guipúzcoa were lower than those reported in other studies. However, 20% of the installations exceeded the concentration of total chlorine in the air proposed as a reference value to protect swimmers carrying out intense activities (0.5mg/m) (AU)