Oral Health Literacy and Tooth Loss and Replacement in Older Adults at a University Dental Clinic in Colombia.

BACKGROUND: Oral health literacy (OHL) is the ability of individuals to obtain, process, and understand oral health information and services, allowing them to make appropriate oral health decisions. The association between OHL and tooth loss and replacement have not been well understood. OBJECTIVES: We aimed to determine the association between OHL and tooth loss and replacement in a Colombia population. METHODS: A cross-sectional study of 384 older adults age 65 to 89 years from Pasto, Colombia was carried out. The number of lost and replaced teeth was assessed intraorally; sociodemographic and prosthetic characteristics were collected, and the Health Literacy in Dentistry questionnaire was used to evaluate OHL. Generalized linear models were estimated to assess associations between independent variables (including OHL) and the number of lost and replaced teeth. KEY RESULTS: There were 224 (58.3%) men and 160 (41.7%) women. The mean (standard deviation [SD]) number of lost and replaced teeth was 27.78 (4.03) and 12.53 (9.89), respectively. One hundred fifty five (40.4%) individuals had full removable dental protheses, 122 (31.8%) partial removable dental protheses, 68 (17.7%) fixed prosthetics, and 36 (9.4%) dental implants. OHL was 33.29 (6.59) and significantly positively associated with the number of replaced teeth (ß = 0.65, 95% confidence interval [CI]: 0.52-0.78, p < .001), but not with lost teeth. CONCLUSIONS: OHL may foster individuals' capabilities to replace lost teeth, although we did not find it associated with reduced tooth loss, likely as tooth loss was highly common in this older population. [HLRP: Health Literacy Research and Practice. 2024;8(1):e21-e28.].

PLAIN LANGUAGE SUMMARY: The association between OHL and tooth loss and replacement has not been well understood. A study of 384 older adults was designed to evaluate the number of lost and replaced teeth and the association with OHL. We found that OHL may foster tooth replacement but was not associated with tooth loss itself.

Psychometric Testing of HeLD-14 in a Colombian Geriatric Population.

Introduction: The objective of this study was to test the validity and reliability of the Colombian version of the Health Literacy in Dentistry (HeLD-14) in older adults. Materials and Methods: A translation and validation study of HeLD-14 was conducted on 384 non-institutionalized older adults attending the Dental Clinic at Universidad Cooperativa from Pasto, Colombia. A cross-cultural adaptation of a multidimensional HeLD-14 was completed, and the psychometric properties of this scale were evaluated through a cross-validation method using an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). Internal consistency was measured with Cronbach's alpha (α) and Omega's McDonald (É·). The statistical significance was set at P < 0.05. Results: The EFA demonstrated that a single-factor structure with 11 items explained a cumulative 59.86% of the overall variance. The CFA confirmed that goodness of fit indices of this questionnaire had optimal adequateness (χ2S-B = 109.047; χ2S-B/(44) = 2.478, P=0.001; non-normed fit index = 0.901; comparative fit index = 0.908; root mean square error of approximation = 0.079 (90% CI (0.075, 0.083)); standardized root mean residual = 0.080). The coefficients indicated a high internal consistency for the total scale (α = 0.94; É· = 0.96). Conclusion: The developed adaptation of HeLD-14 for the Colombian population, HeLD-Col, is a unidimensional, reliable, and valid instrument to assess oral health literacy in older adults in Colombia.

Patterns of Opioid and Non-Opioid Analgesic Consumption in Patients with Post-COVID-19 Conditions.

Pain is a major health issue for healthcare systems, and access to pain treatment is a fundamental human right. Pain is a common symptom experienced in the post-COVID phase by a significant percentage of patients. This study describes the prevalence and associated factors associated with the use of opioid and non-opioid analgesics in subjects with post-COVID-19 condition. Sociodemographic data, post-COVID symptoms, health profile, and opioid and non-opioid analgesic consumption were collected in 390 subjects with post-COVID-19 condition. We analyzed the independent effect of all variables on opioid/non-opioid analgesic consumption by using logistic multivariate regressions. The prevalence of opioid and non-opioid analgesic consumption was 24.1% and 82.3%, respectively. Tramadol (17.18%) and codeine (7.95%) were the most commonly used opioid analgesics, and Paracetamol (70%) and ibuprofen (45.4%) were the most commonly used non-opioid analgesics. Females were more likely to consume non-opioid analgesics (aOR2.20, 95%CI 1.15, 4.22) than males. Marital status of married/partner vs. single (aOR2.96; 95% CI 1.43, 6.12), monthly income < EUR 1000 VS. > EUR 2000 (aOR3.81; 95% CI 1.37, 10.61), number of post-COVID symptoms < 5 (aOR2.64, 95%CI 1.18, 5.87), and anxiolytics consumption (aOR 1.85, 95%CI 1.05, 3.25) were associated with a greater likelihood of opioid analgesic consumption. Age > 55 years (aOR3.30, 95%CI 1.34, 8.09) and anxiolytics consumption (aOR2.61, 95%CI 1.36, 4.98) were associated with a greater likelihood of non-opioid analgesic consumption. Opioid analgesic consumption was highly associated (aOR 3.41, 95%CI 1.27, 6.11) with non-opioid analgesic consumption. The prevalence of opioid analgesic and non-opioid analgesic consumption in individuals with post-COVID-19 condition was 24.1% and 82.3%. Females with post-COVID-19 condition showed higher non-opioid analgesic consumption than men. Predictors of opioid consumption were marital status, lower monthly income, number of post-COVID symptoms, and anxiolytic consumption. Older age and anxiolytic consumption were predictors of non-opioid consumption.

Benzodiazepines and Z-hypnotics consumption in long-COVID-19 patients: Gender differences and associated factors.

Background: Psychotropic drug consumption has increased during the COVID-19 pandemic. We describe here the prevalence and identifying factors associated with Benzodiazepine (BZD) and Z-hypnotics use among a sample of Spanish adults suffering from long-COVID-19 syndrome, from a gender perspective. Materials and methods: Data were anonymously collected between 15th December 2021 and 15th March 2022. The collection form consisted of several questions gathering sociodemographic information, post-COVID symptom, health profile, and pharmacological drug intake. Using logistic multivariate regression models, we estimated the independent effect of each of these variables on self-medicated consumption. Three models were generated (female, male, and both gender). Results: Prevalence of BZD and Z-hypnotics use was 44.9% (46.5% for women; 37.8% for men). Zolpidem was the most consumed drug among male (20.7%), and lorazepam in female (31.1%). Patterns of drug consumption among female were related with number of post-COVID symptoms and smoking habit (AOR 2.76, 95%CI 1.16-6.52). Males under 40 years of age are more likely to consume BZD and Z-hypnotics (AOR 5.52, 95%CI 1.08-28.27). Conclusion: The prevalence of consumption of BZD and Z-hypnotics in those subjects with long-COVID-19 in our study reaches values of 44.9%. Women with long-COVID-19 declare a higher prevalence of consumption than men. Predictors of BZD and Z-hypnotic in men were, age and number of medication use. Smoking habit and the number of post-COVID symptoms were predictive variables in women.

Nationwide Population-Based Study About Patterns of Prescription Opioid Use and Misuse Among Young Adults in Spain.

Objective: Prescription opioid misuse has become one of the most common ways drugs are consumed among young adults. The objective of our study was to describe the prevalence and factors associated with prescription opioid use and misuse among young adults living in Spain. Methods: A nationwide, cross-sectional epidemiological study on the use and misuse of prescription opioids in Spanish Youngers. We used individualized secondary data provided by the Household Survey on Alcohol and Drugs in Spain 2017-2018. Results: Prevalence of prescription opioid use among young adults was 4.89%. Misuse among this population reached prevalence values of 13.4%, with higher values observed among women . The variables associated with a greater probability of prescription opioid use and misuse were misuse of tranquilizers, sedatives, and sleeping pills, along with using cannabis and other illicit psychoactive drugs (aOR = 2.99; 95% CI: 1.10-8.15). Conclusion: Prescription opioid use and misuse in Youngers has important implications for the Spanish public health system, because, even though not currently comparable to the situation in other countries, this drug use could be on the verge of creating similar problems.

Psychometric Properties of the SOC-13 Scale in Colombian Adults.

The aim of this study was to determine the psychometric properties of the Spanish version of the SOC-13 in Colombian adults. The SOC-13 questionnaire was administered to 489 individuals aged ≥18 years who were in lockdown from March to July 2020 in Nariño County, Colombia. Psychometric properties of the scale were examined using a cross-validation method via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Additionally, configural and metric invariance were tested. To determine the internal consistency of the questionnaire, McDonald's omega (ω), Cronbach's alpha (α), and composite reliability (CR) coefficients were estimated. The EFA determined that a three-factor structure best fit the data (comprehensibility, manageability, and meaningfulness) and CFA confirmed this three-factor model structure showing a good fit (χ2S-B = 188.530, χ2S-B/(62) = 3.615, p = 0.001; NNFI = 0.959; CFI = 0.968; RMSEA = 0.052 (90% CI [0.041-0.063]) and SRMR = 0.052).The invariance analysis indicated the same underlying theoretical structure between genders. Additionally, (ω), (α), and (CR) coefficients confirmed a high internal consistency of the instrument. The SOC-13 scale, reflecting comprehensibility, manageability, and meaningfulness, is a reliable and valid tool for assessing the sense of coherence in Colombian populations.

Influenza hospitalizations in children under 1 year old in Spain: the importance of maternal immunization.

This study estimates the burden of influenza in infants up to 12 months of age in Spain over 8 seasons (2009/10-2016/17). The survey was conducted by reviewing the Spanish Surveillance System for Hospital Data. Over the eight seasons, 5,618 hospital admissions were recorded for patients younger than 12 months that included codes related to influenza in any diagnostic position (487-488 ICD-9-CM and J9, J10 and J11 CIE 10). In total, 2,363 admissions (42.1%) were female patients whose median age was 3.05 months. Patients younger than 6 months accounted for 3,856 admissions (68.6%). Among them, 59.2% were male, and 40.8% were female (p < .05). Overall, 37.1% (2,084 patients) were younger than 2 months. The hospitalization rate for the entire period studied was 156.09 admissions per 100,000 children under 12 months of age (95% CI: 152.4-160.6). The average duration of hospitalization was 6.6 days (95% CI: 6.4-6.8). Eighteen deaths were recorded for hospitalized patients over the entire period. Of these, 12 patients (66.7%) were younger than 6 months. There is a significant burden of influenza disease in children under 1 year of age in Spain, mainly in children under 6 months of age. Improvements to prevention strategies through increased vaccination coverage in family environments and vaccination strategies involving pregnant woman can contribute decisively and effectively to reducing these hospitalizations.

La universidad como comunidad: universidades promotoras de salud. Informe SESPAS 2018 / The university as a community: health-promoting universities. SESPAS Report 2018

La vinculación de la universidad con la comunidad a la que pertenece es uno de los principios básicos en los que esta institución se sustenta. Una comunidad será saludable en la medida en que existan múltiples conexiones entre los individuos y las subagrupaciones que la integran. Al trabajar en promoción de la salud, hablar de participación y de modelos participativos implica asumir que personas y comunidades tienen el derecho de autogestionarse. Viabilizar la participación implicará abrir posibilidades para la cogestión, la autonomía, la comprensión de realidades dinámicas, la formalización de alianzas y la transformación de contextos y formas de relación. Implicará entender la salud como un derecho. El trabajo en red es fundamental en un mundo interconectado y global. El Proyecto de Universidades Promotoras de Salud se construye desde sus inicios con la participación de la comunidad universitaria con el objetivo de mejorar las condiciones para la salud, la calidad de vida y el bienestar de todos los miembros de la comunidad. Las universidades son escenarios idóneos para implementar estrategias de mejora de los estilos de vida de sus miembros, que además trasciendan a los espacios universitarios y afecten positivamente a la vida de las personas dentro y fuera de los campus. Las redes de Universidades Promotoras de la Salud en América Latina se institucionalizaron en el año 2003, y tomaron forma de Red Iberoamericana de Universidades Promotoras de la Salud en 2007, en el marco del III Congreso de Universidades Promotoras de la Salud desarrollado en Ciudad Juárez, México. En España se creó en 2008 la Red Española de Universidades Saludables con el objetivo de reforzar el papel de las universidades como entornos promotores de la salud y el bienestar tanto de sus estudiantes como de su personal y de la sociedad, liderando y apoyando procesos de cambio social

The connection of the University with the community to which it belongs is one of the basic principles on which the former is based. A community will be healthy as long as there are many connections between the individuals and sub-groups that form it. Working on health promotion, talking about participation and participatory models implies the assumption that people and communities have the right to self-manage. Implementing participation will involve opening up possibilities for co-management, autonomy, understanding of dynamic realities, the formalization of alliances, the transformation of contexts, and forms of relationship. It will involve understanding health as a right. Networking is fundamental in an interconnected and global world. Since its inception, the Project of Health Promoting Universities has been built with the participation of the university community towards improving the conditions for health, quality of life and well-being of all members of the community. Universities are ideal scenarios to implement strategies to improve the lifestyles of their members that also transcend to the university spaces and positively affect the lives of people on and off campus. The networks of Health Promoting Universities in Latin America were institutionalized in 2003, and took the form of the Ibero-American Network of Health Promoting Universities in 2007 within the framework of the third Conference on Health Promoting Universities held in the city of Juarez, Mexico. In 2008, the Spanish Network of Healthy Universities was created in Spain, in order to enhance the role of universities as environments that promote the health and well-being of their students, their staff and society, leading and supporting processes of social change

[The university as a community: health-promoting universities. SESPAS Report 2018]. / La universidad como comunidad: universidades promotoras de salud. Informe SESPAS 2018.

The connection of the University with the community to which it belongs is one of the basic principles on which the former is based. A community will be healthy as long as there are many connections between the individuals and sub-groups that form it. Working on health promotion, talking about participation and participatory models implies the assumption that people and communities have the right to self-manage. Implementing participation will involve opening up possibilities for co-management, autonomy, understanding of dynamic realities, the formalization of alliances, the transformation of contexts, and forms of relationship. It will involve understanding health as a right. Networking is fundamental in an interconnected and global world. Since its inception, the Project of Health Promoting Universities has been built with the participation of the university community towards improving the conditions for health, quality of life and well-being of all members of the community. Universities are ideal scenarios to implement strategies to improve the lifestyles of their members that also transcend to the university spaces and positively affect the lives of people on and off campus. The networks of Health Promoting Universities in Latin America were institutionalized in 2003, and took the form of the Ibero-American Network of Health Promoting Universities in 2007 within the framework of the third Conference on Health Promoting Universities held in the city of Juarez, Mexico. In 2008, the Spanish Network of Healthy Universities was created in Spain, in order to enhance the role of universities as environments that promote the health and well-being of their students, their staff and society, leading and supporting processes of social change.

Violencia de pareja hacia la mujer y profesionales de la salud especializados / Partner violence against women and specialized care health professionals

La violencia de pareja hacia la mujer representa uno de los problemas de salud pública más relevantes. Causa graves consecuencias en la salud. Este estudio plantea detectar el nivel de conocimientos y las opiniones de los profesionales de atención especializada, conocer sus dificultades en la intervención y plantear propuestas de mejora. Para ello se realizó un estudio transversal, llevado a cabo en el Hospital Universitario Fundación Alcorcón, a través de una encuesta voluntaria y anónima. La recogida de datos se realizó en un Excel asociado a la plataforma utilizada. Para el análisis estadístico se utilizaron el SPSS 17 y el STATA 12. La tasa de respuesta total fue del 15%. El 31.5% de los profesionales conocían casos en su entorno; el 24.7% los detectaron en su trabajo. El 25.9% no hicieron nada, consideraron que no tenían la formación necesaria. El 82.5% pensaban que es un problema muy importante. El 50.9% creían que no hay consenso en la actuación; el 19% no sabían que existe un protocolo de actuación. Los profesionales encuestados necesitan formación para poder realizar sus competencias. Cada vez están más concienciados, tienen menos estereotipos y más herramientas de intervención, pero es necesario difundir los protocolos de actuación

Nowadays, partner violence against women is one of the main public health issues. Therefore, it has a severe impact in our health. Objectives: finding the degree of knowledge and thoughts of the specialised health care professionals, knowing the challenges they face when they have to take action as well as suggesting improvements. A transversal study was carried out at the Hospital Universitario Fundación Alcorcón, using a voluntary and anonymous survey. The data was collected in an excel file linked to the platform used to take the survey, and the statistical analysis was performed using SPSS 17 and STATA 12. The total response rate was 15%. Out of the 31.5% health care professionals that took the survey and knew about partner violence against women cases in their working environment, 24.7% said they detected them whilst working; on the other hand, 25.9% of them did not take any action as they considered they were not properly trained to act. Moreover, 82.5% of those who took the survey considered this to be a serious issue, whilst 50.9% said there was no consensus on action and 19% did not know about the action protocol. Health care professionals need training to conduct their skills in the field; they are increasingly becoming aware of this issue, they are less affected by the preconceptions that may condition their work and have more intervention tools; nevertheless, there is a need to spread action protocols

Relación entre diabetes y enfermedad periodontal en una población adulta española / Relation between diabetes and periodontal disease in an Spanish adult population

No disponible

Consensus document on the prevention of methylmercury exposure in Spain: Study group for the prevention of Me-Hg exposure in Spain (GEPREM-Hg).

The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methylmercury, mainly from contaminated fish and shellfish, can have adverse health effects. The study group on the prevention of exposure to methylmercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies, has prepared a consensus document in a question and answer format, containing the group's main conclusions, recommendations and proposals. The objective of the document is to provide broader knowledge of factors associated with methylmercury exposure, its possible effects on health amongst the Spanish population, methods of analysis, interpretation of the results and economic costs, and to then set recommendations for fish and shellfish consumption. The group sees the merit of all initiatives aimed at reducing or prohibiting the use of mercury as well as the need to be aware of the results of contaminant analyses performed on fish and shellfish marketed in Spain. In addition, the group believes that biomonitoring systems should be set up in order to follow the evolution of methylmercury exposure in children and adults and perform studies designed to learn more about the possible health effects of concentrations found in the Spanish population, taking into account the lifestyle, eating patterns and the Mediterranean diet.

Respiratory Syncytial Virus Bronchiolitis in Children up to 5 Years of Age in Spain: Epidemiology and Comorbidities: An Observational Study.

This epidemiological survey in Spain estimates the burden of respiratory syncytial virus (RSV) infection in children up to 5 year of age during a 15-year period (1997-2011). Observational retrospective survey was conducted by reviewing data of the National Surveillance System for Hospital Data, including >98% of Spanish hospitals. All hospitalizations related to RSV infection for children up to 5 years, reported during 1997-2011 period, were analyzed. Codes were selected by using the International Classification of Diseases 9th Clinical Modification 466.0-466.19, 480.1, and 079.6. A total of 326,175 and 286,007 hospital discharges for children up to 5 and 2 years of age were reported during the study period. The annual incidence was 1072 and 2413 patients per 100,000, respectively. The average length of hospital stay was 5.7 (standard deviation 8.2) days. Four hundred forty-six deaths were reported; of those, 403 occurred in children <2 years and 355 (80%) occurred in children <12 months of age. Hospitalization and mortality rates were significantly higher in boys and decrease significantly with age. The higher rate of hospitalization and mortality rates were found in the first year of life. Annual average cost for National Health Care System was € 47 M with a mean hospitalization cost of €2162. The average length of hospitalization and costs were significantly higher in high-risk children. RSV infections in children up to 5 year of age still pose a significant health threat in Spain, especially in the infants. The development of preventive, diagnostic, and therapeutic guidelines focused in children with comorbidities may help reduce the hospital and economic burden of the disease.

Metilmercurio: Recomendaciones existentes; métodos de análisis e interpretación de resultados; evaluación económica / Methylmercury: existing recommendations; methods of analysing and interpreting the results; economic evaluation

Los efectos beneficiosos del consumo de pescado son bien reconocidos. Sin embargo, existe preocupación a nivel mundial sobre los niveles de metilmercurio en el pescado, por lo que muchos países como Estados Unidos, Australia, Nueza Zelanda, Canadá y muchos países europeos han realizado recomendaciones de consumo de pescado a la población , especialmente a los grupos vulnerables con el fin de reducir la ingesta de metilmercurio. La sangre y el pelo son las mejores muestras biológicas para medir el metilmercurio. El método de análisis más empleado ha sido la espectroscopia de absorción atómica con la técnica del vapor frío, aunque existen también métodos directos que se basan en la descomposición térmica de la muestra. En los últimos años han aumentado los laboratorios que miden el mercurio por espectrometría de masas con plasma acoplado por inducción. Además, se puede diferenciar las distintas especies de mercurio acoplando métodos de separación cromatográficos. Es necesario que los laboratorios que analizan mercurio en muestras biológicas participen en programas de garantía externa de la calidad. Aunque se logre reducir las emisiones de mercurio, el mercurio del medio ambiente altodavía puede permanecer muchos años, por lo que es fundamental el consejo dietético para disminuir la exposición. No es aconsejable el uso de terapia quelante con fines diagnósticos o en pacientes asintomáticos. Es preciso proponer medidas de salud pública encaminadas a la disminución de la exposición al mercurio y que se evalúe también los beneficios de las mismas desde el punto de vista económico y social (AU)

The beneficial effects of fish consumption are well-known. Nevertheless, there is worldwide concern regard methylmercury concentrations in fish, which is why many countries such as the United States, Australia, New Zealand, Canada and numerous European countries have made fish consumption recommendations for their populations, particularly vulnerable groups, in order to México methylmercury intake. Blood and hair are the best biological samples for measuring methylmercury. The most widely-used method to analyse ethylmercury is cold vapor atomic absorption spectrometry, although there are also direct methods based on the thermal decomposition of the sample. In recent years, the number of laboratories that measure mercury by inductively coupled plasma mass spectrometry has increased. In addition, the different kinds of mercury can be distinguished by coupling chromatography methods of separation. Laboratories that analyse mercury in biological samples need to participate in external quality control programmes. Even if mercury emissions are reduced, mercury may remain in the environment for many years, so dietary recommendations are fundamental in order to reduce exposure. It is necessary to propose public health measures aimed at decreasing mercury exposure and to evaluate the benefits of such measures from the economic and social standpoints (AU)

Documento de consenso sobre la prevención de la exposición al metilmercurio en España / Consensus document on the prevention of exposure to methylmercuty in Spain

Los efectos beneficiosos del consumo de pescado tanto en niños como en adultos han sido bien reconocidos. Sin embargo, la ingesta de metilmercurio principalmente a través del pescado y marisco contaminado puede producir efectos adversos en la salud. El grupo de estudio para la prevención de la exposición al metilmercurio (GEPREM-Hg), constituido por representantes de diferentessociedades científicas españolas, ha elaborado un documento de consenso donde se recogen en forma de preguntas y respuestas las principales conclusiones, recomendaciones y propuestas planteadas en el grupo. El objetivo del documento es profundizar en el conocimiento de los factores asociados a la exposición al metilmercurio, los posibles efectos sobre la salud en la población española, los métodos de análisis, la interpretación de los resultados, el coste económico y establecer finalmente recomendaciones de consumo de pescados y mariscos. El grupo considera acertadas todas las iniciativas encaminadas a reducir o prohibir el uso del mercurio y la necesidad de conocer los resultados de los análisis de contaminantes que se realizan en los pescados y mariscos que se comercializan en España. Además, opina que se deberían establecer sistemas de biomonitorización para conocer la evolución de la exposición al metilmercurio en niños y adultos y realizar estudios diseñados para conocer los posibles efectos sobre la salud de las concentraciones halladas en la población española, teniendo en cuenta el estilo de vida, los patrones de consumo alimentarios y la dieta mediterránea (AU)

The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methylmercury, mainly from contaminated fish and shellfish, can have adverse health effects. The study group on the prevention of exposure to methylmercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies, has prepared a consensus document in a question and answer format, containing the group’s main conclusions, recommendations and proposals. The objective of the document is to provide broader knowledge of factors associated with methylmercury exposure, its possible effects on health among the Spanish population, methods of analysis, interpretation of the results and economic costs, and to then set recommendations for fish and shellfish consumption. The group sees the merit of all initiatives aimed at reducing or prohibiting the use of mercury as well as the need to be aware of the results of contaminant analyses performed on fish and shellfish marketed in Spain. In addition, the group believes that biomonitoring systems should be set up in order to follow the evolution of methylmercury exposure in children and adults and perform studies designed to learn more about the possible health effects of concentrations found in the Spanish population, ta combusking into account the lifestyle, eating patterns and the Mediterranean diet (AU)

Documento de consenso sobre la prevención de la exposición al metilmercurio en España / Consensus document on the prevention of exposure to methylmercury in Spain

Los efectos beneficiosos del consumo de pescado tanto en niños como en adultos han sido bien reconocidos. Sin embargo, la ingesta de metilmercurio principalmente a través del pescado y marisco contaminado puede producir efectos adversos en la salud. El grupo de estudio para la prevención de la exposición al metilmercurio (GEPREM-Hg), constituido por representantes de diferentes sociedades científicas españolas, ha elaborado un documento de consenso donde se recogen en forma de preguntas y respuestas las principales conclusiones, recomendaciones y propuestas planteadas en el grupo. El objetivo del documento es profundizar en el conocimiento de los factores asociados a la exposición almetilmercurio, los posibles efectos sobre la salud en la población española, los métodos de análisis, la interpretación de los resultados, el coste económico y establecer finalmente recomendaciones de consumo de pescados y mariscos. El grupo considera acertadas todas las iniciativas encaminadas a reducir o prohibir el uso del mercurio y la necesidad de conocer los resultados de los análisis de contaminantes que se realizan en los pescados y mariscos que se comercializan en España. Además, opina que se deberían establecer sistemas de biomonitorización para conocer la evolución de la exposicional metilmercurio en niños y adultos y realizar estudios diseñados para conocer los posibles efectos sobre la salud de las concentraciones halladas en la población española, teniendo en cuenta el estilo de vida, los patrones de consumo alimentarios y la dieta mediterránea (AU)

The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methyl mercury, mainly from contaminated fish and shellfish, can have adverse health effects. The study group on the prevention of exposure to methyl mercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies, has prepared a consensus document in a question and answer format, containing the group's main conclusions, recommendations and proposals. The objective of the document is to provide broader knowledge of factors associated with methyl mercury exposure, its possible effects on health among the Spanish population, methods of analysis, interpretation of the results and economic costs, and to then set recommendations for fish and shellfish consumption. The group sees the merit of all initiatives aimed at reducing or prohibiting the use of mercury as well as the need to be aware of the results of contaminant analyses performed on fish and shellfish marketed in Spain. In addition, the group believes that biomonitoring systems should be set up in order to follow the evolution of methyl mercury exposure in children and adults and perform studies designed to learn more about the possible health effects of concentrations found in the Spanish population, taking into account the lifestyle, eating patterns and the Mediterranean diet (AU)

[Methylmercury exposure in the general population; toxicokinetics; differences by gender, nutritional and genetic factors]. / Exposición al metilmercurio en la población general; toxicocinética; diferencias según el sexo, factores nutricionales y genéticos.

Mercury is an environmental toxicant that causes numerous adverse effects on human health and natural ecosystems. The factors that determine the existance of adverse effects, as well as their severity are, among others: the chemical form of mercury (elemental, inorganic, organic), dosis, age, period of exposure, pathways of exposure and environmental, nutritional and genetic factors. In the aquatic cycle of mercury, once it has been deposited, it is transformed into methylmercury due to the action of certain sulphate-reducing bacteria, which bioaccumulates in the aquatic organisms and moves into the food chain. The methylmercury content of large, long-lived fish such as swordfish, shark, tuna or marlin, is higher. Methylmercury binds to protein in fish and is therefore not eliminated by cleaning or cooking the fish. Fetuses and small children are more vulnerable to the neurotoxic effects of methylmercury from the consumption of contaminated fish. Methylmercury is absorbed in the gastrointestinal tract and crosses the blood-brain barrier and the placenta. The intake of certain dietary components such as polyunsaturated fatty acids, selenium, fiber, thiol compounds, certain phytochemicals and other nutrients can modify methylmercury bioaccesibility and its toxicity. Apart from environmental factors, genetic factors can influence mercury toxicity and explain part of the individual vulnerability.

El mercurio es un tóxico ambiental que causa numerosos efectos adversos en la salud humana y en los ecosistemas naturales. Los factores que determinan la aparición de efectos adversos y su severidad son entre otros: la forma química del mercurio (elemental, inorgánico, orgánico), la dosis, la edad, la duración de la exposición, la vía de exposición y los factores ambientales, nutricionales y genéticos. En el ciclo acuático del mercurio, una vez que se ha depositado, se transforma en metilmercurio por la acción de determinadas bacterias sulfato reductoras y se bioacumula en los organismos acuáticos incorporándose a la cadena trófica de alimentos. El contenido de metilmercurio es mayor en las especies depredadoras de mayor tamaño y que viven más años como el emperador, pez espada, tiburón, atún o marlín. El metilmercurio se halla unido a las proteínas del pescado por lo que no se elimina mediante la limpieza ni el cocinado del mismo. El feto en desarrollo y los niños pequeños son los más vulnerables a los efectos neurotóxicos del metilmercurio procedente de la ingesta de pescado contaminado. El metilmercurio se absorbe en el tracto gastrointestinal y atraviesa la barrera hematoencefálica y la placenta. Algunos componentes de la dieta como los ácidos grasos poliinsaturados, el selenio, la fibra, los compuestos tiol, algunos fitoquímicos y otros nutrientes pueden modificar la bioaccesibilidad del mercurio y su toxicidad. Además de los factores ambientales, los factores genéticos pueden influir en la toxicidad del mercurio y explicar parte de la vulnerabilidad individual.

[The effects of methylmercury on health in children and adults; national and international studies]. / Efectos sobre la salud del metilmercurio en niños y adultos; estudios nacionales e internacionales.

The benefit of fish consumption in children and adults is well-known. However, it has been pointed out that excessive methylmercury intake due to consumption of contaminated fish leads to neurological toxicity in children, affecting cognitive function, memory, visual-motor function and language. After the intoxications in Minamata and Iraq, wide-ranging epidemiological studies were carried out in New Zealand, the Faroe Islands and the Seychelles and international recommendations were established for fish consumption in pregnant women and small children. In Spain, the Childhood and Environmental project (INMA, its Spanish acronym) has studied the effects of diet and the environment on fetal and childhood development in different geographic areas of Spain. National and international sudies have demonstrated that mercury concentrations are mainly dependent on fish consumption, although there are variations among countries which can be explained not only by the levels of fish consumption, but also by the type or species of fish that is consumed, as well as other factors. Although the best documented adverse effects of methylmercury are the effects on nervous sytem development in fetuses and newborns, an increasing number of studies indicate that cognitive function, reproduction and, especially, cardiovascular risk in the adult population can also be affected. However, more studies are necessary in order to confirm this and establish the existance of a causal relationship.

Los efectos beneficiosos del consumo de pescado tanto en niños como en adultos han sido bien reconocidos. Sin embargo, se ha referido que la ingesta excesiva de metilmercurio procedente del pescado contaminado produce toxicidad neurológica en los niños afectando a la función cognitiva, la memoria, la función visual-motora y al lenguaje. Después de las intoxicaciones de Minamata e Iraq, se realizaron grandes estudios epidemiológicos en Nueva Zelanda, las islas Féroe y las islas Seychelles y se establecieron recomendaciones internacionales sobre el consumo de pescado y marisco en las mujeres embarazadas y niños pequeños. En España, el proyecto Infancia y Medio Ambiente (INMA) ha estudiado los efectos del medio ambiente y de la dieta sobre el desarrollo fetal e infantil en diversas zonas geográficas de España. Los estudios realizados nacionales e internacionales muestran que la concentración de mercurio depende principalmente del consumo de pescado, aunque existe una variabilidad entre los países que podría explicarse no solo por la cantidad de pescado consumida, sino también por el tipo o especies de pescados que se consumen, así como por otro tipo de factores. Aunque los efectos perjudiciales del metilmercurio mejor documentados son los que se producen sobre el desarrollo del sistema nervioso en el feto y en el recién nacido, cada vez hay más estudios que indican que también puede afectar a la función cognitiva, reproducción y especialmente al riesgo cardiovascular en la población adulta. Sin embargo, son necesarios más estudios para confirmarlo y establecer la existencia de una relación causal.