Subjective well-being, happiness, and environmental health factors related to women planning a pregnancy or pregnant, using mobile health intervention.

Objectives: To compare the environmental health results in women trying to get pregnant or pregnant using a mobile health application (Green Page) through healthcare professionals or self-completed by women, and to explore the relationship between the subjective well-being of these women with their lifestyles and environmental factors. Methods: A descriptive study with mixed methods was conducted in 2018. A mobile health survey was used in two phases. Phase 1 was a cross-sectional study through professionals (n = 1100) followed by phase 2, a convenience sampling through women's self-reporting (n = 3425). A personalized report was downloadable with health recommendations for the well-being of the mother and child. Results: Of the 3205 participants (mean age = 33 years, SD = 0.2 years), 1840 were planning a pregnancy and 1365 were pregnant. One in five pregnant women had a low level of happiness. Globally, subjective well-being and happiness were found to be negatively associated with lack of contact with nature, sedentary lifestyle, excess weight, environmental exposure, and older age in pregnancy. Precisely 45%, 60%, and 14% of women were exposed to tobacco, alcohol, and illegal drugs, respectively. The women self-reported levels of risk factors higher than when the tool was used by or through professionals. Conclusions: The use of mobile health interventions focused on environmental health during planning or pregnancy periods could help improve the quality of healthcare and foster greater involvement of women in their self-care process, thus promoting empowerment, healthier environments, and lifestyles. Ensuring equity of access and data protection are global challenges to be addressed.

Exploring Urban Green Spaces' Effect against Traffic Exposure on Childhood Leukaemia Incidence.

BACKGROUND: Several environmental factors seem to be involved in childhood leukaemia incidence. Traffic exposure could increase the risk while urban green spaces (UGS) exposure could reduce it. However, there is no evidence how these two factors interact on this infant pathology. OBJECTIVES: to evaluate how residential proximity to UGS could be an environmental protective factor against traffic exposure on childhood leukaemia incidence. METHODS: A population-based case control study was conducted across thirty Spanish regions during the period 2000-2018. It included 2526 incident cases and 15,156, individually matched by sex, year-of-birth, and place-of-residence. Using the geographical coordinates of the participants' home residences, a 500 m proxy for exposure to UGS was built. Annual average daily traffic (AADT) was estimated for all types of roads 100 m near the children's residence. Odds ratios (ORs) and 95% confidence intervals (95% CIs), UGS, traffic exposure, and their possible interactions were calculated for overall childhood leukaemia, and the acute lymphoblastic (ALL) and acute myeloblastic leukaemia (AML) subtypes, with adjustment for socio-demographic covariates. RESULTS: We found an increment of childhood leukaemia incidence related to traffic exposure, for every 100 AADT increase the incidence raised 1.1% (95% CI: 0.58-1.61%). UGS exposure showed an incidence reduction for the highest exposure level, Q5 (OR = 0.63; 95% CI = 0.54-0.72). Regression models with both traffic exposure and UGS exposure variables showed similar results but the interaction was not significant. CONCLUSIONS: Despite their opposite effects on childhood leukaemia incidence individually, our results do not suggest a possible interaction between both exposures. This is the first study about the interaction of these two environmental factors; consequently, it is necessary to continue taking into account more individualized data and other possible environmental risk factors involved.

Revisión de los cuestionarios utilizados para la detección del consumo de alcohol durante el embarazo y la Hoja Verde / Review of the questionnaires used to detect alcohol consumption during pregnancy and the Green Page

El consumo de alcohol en el embarazo es la causa del trastorno del espectro alcohólico fetal (TEAF). La información aportada por las mujeres en edad fértil o embarazadas es el estándar para la detección temprana del consumo de alcohol. La Hoja Verde (HV) es una herramienta de cribado de salud medioambiental que incluye el registro de la ingesta de alcohol durante el embarazo y/o lactancia. El objetivo del presente trabajo es revisar las características de los distintos cuestionarios de detección del consumo de alcohol durante la gestación y de la HV, así como hacer una comparación entre ellos. Revisión de la literatura científica publicada en los últimos 10 años de los artículos indexados en Medline. Estrategia de búsqueda combinada con los descriptores MeSH: ‘pregnancy, alcohol drinking, surveys and/or questionnaires’. AUDIT, AUDIT-C y SUPR-P se realizan mayoritariamente autoadministrados y no requieren entrenamiento. SUPR-P y 4P´s Plus están validados en embarazadas. Otros detectan cantidad y frecuencia, requieren entrenamiento previo y se realizan cara a cara: TLFB, RD, ACOG antepartum record y la HV. ACOG antepartum record y la HV son específicos para embarazadas. La HV detecta el consumo de alcohol al inicio del embarazo tanto en la gestante como en su pareja con un enfoque holístico y global de la salud medioambiental. Un cuidadoso registro de la ingesta de alcohol de forma presencial, con profesionales entrenados y con un enfoque holístico y global de la salud medioambiental durante el embarazo ayudaría a mejorar la prevención y cribado de embarazos en riesgo de TEAF. (AU)

Alcohol consumption during pregnancy is a leading cause of fetal alcohol spectrum disorder (FASD). Maternal reporting in childbearing women or pregnant women is the standard for the early detection of alcohol consumption. The Green Page (GP) is a screening questionnaire of environmental health which includes the alcohol intake record during pregnancy and/or lactation period. The aim of this paper is to review the features of the different questionnaires for the detection of alcohol consumption during the gestation period and the GP, as well as to make a comparison between them. Review of the scientific literature published over the last 10 years of indexed articles in Medline. Combined searching strategy with MeSH descriptors: ‘pregnancy, alcohol drinking, surveys and/or questionnaires. AUDIT, AUDIT-C and SURP-P are mainly self-administered and do not require training. SURP-P and 4P´s are validated in pregnant women. Others detect quantity and frequency of exposure, need specific training and are administered face to face: TLFB, RD, ACOG antepartum record and the GP. ACOG antepartum record and GP are specific for pregnant population. GP detects alcohol consumption at the beginning of pregnancy in both women and their partner on a holistic and global environmental health approach. A careful face-to-face recording of alcohol exposure with trained staff, with an integrative and global environmental health focus throughout pregnancy, may help improve prevention and screening of pregnancy at risk for FASD. (AU)

Review of the questionnaries used to detect alcohol consumption during pregnancy and the Green Page. / Revisión de los cuestionarios utilizados para la detección del consumo de alcohol durante el embarazo y la Hoja Verde.

Alcohol consumption during pregnancy is a leading cause of fetal alcohol spectrum disorder (FASD). Maternal reporting in childbearing women or pregnant women is the standard for the early detection of alcohol consumption. The Green Page (GP) is a screening questionnaire of environmental health which includes the alcohol intake record during pregnancy and/or lactation period. The aim of this paper is to review the features of the different questionnaires for the detection of alcohol consumption during the gestation period and the GP, as well as to make a comparison between them. Review of the scientific literature published over the last 10 years of indexed articles in Medline. Combined searching strategy with MeSH descriptors: 'pregnancy, alcohol drinking, surveys and/or questionnaires. AUDIT, AUDIT-C and SURP-P are mainly self-administered and do not require training. SURP-P and 4P´s are validated in pregnant women. Others detect quantity and frequency of exposure, need specific training and are administered face to face: TLFB, RD, ACOG antepartum record and the GP. ACOG antepartum record and GP are specific for pregnant population. GP detects alcohol consumption at the beginning of pregnancy in both women and their partner on a holistic and global environmental health approach. A careful face-to-face recording of alcohol exposure with trained staff, with an integrative and global environmental health focus throughout pregnancy, may help improve prevention and screening of pregnancy at risk for FASD.

El consumo de alcohol en el embarazo es la causa del trastorno del espectro alcohólico fetal (TEAF). La información aportada por las mujeres en edad fértil o embarazadas es el estándar para la detección temprana del consumo de alcohol. La Hoja Verde (HV) es una herramienta de cribado de salud medioambiental que incluye el registro de la ingesta de alcohol durante el embarazo y/o lactancia. El objetivo del presente trabajo es revisar las características de los distintos cuestionarios de detección del consumo de alcohol durante la gestación y de la HV, así como hacer una comparación entre ellos. Revisión de la literatura científica publicada en los últimos 10 años de los artículos indexados en Medline. Estrategia de búsqueda combinada con los descriptores MeSH: 'pregnancy, alcohol drinking, surveys and/or questionnaires'. AUDIT, AUDIT-C y SUPR-P se realizan mayoritariamente autoadministrados y no requieren entrenamiento. SUPR-P y 4P´s Plus están validados en embarazadas. Otros detectan cantidad y frecuencia, requieren entrenamiento previo y se realizan cara a cara: TLFB, RD, ACOG antepartum record y la HV. ACOG antepartum record y la HV son específicos para embarazadas. La HV detecta el consumo de alcohol al inicio del embarazo tanto en la gestante como en su pareja con un enfoque holístico y global de la salud medioambiental. Un cuidadoso registro de la ingesta de alcohol de forma presencial, con profesionales entrenados y con un enfoque holístico y global de la salud medioambiental durante el embarazo ayudaría a mejorar la prevención y cribado de embarazos en riesgo de TEAF.

Cadmium (Cd) and Lead (Pb) topsoil levels and incidence of childhood leukemias.

There are few well-established risk factors for childhood leukemias. While the frequency of childhood leukemias might be partially attributable to some diseases (accounting for a small fraction of cases) or ionizing radiation, the role of heavy metals has not been assessed. The objective of our study was to assess the potential association between levels of cadmium (Cd) and lead (PB) in soil and childhood leukemias incidence. We conducted a population-based case-control study of childhood leukaemia in Spain, covering 2897 incident cases gathered from the Spanish Registry of Childhood Tumours and including 14 Spanish Regions with a total population of 5,307,433 children (period 1996-2015). Cd and Pb bioavailable levels at every children's home address were estimated using data from the Geochemical Atlas of Spain. We used logistic regression to estimate odds ratios (ORs) and their 95% confidence intervals (95%CIs); we included as covariates: sex, rurality, employment rate and socioeconomic status. Metal levels were analysed according to two definitions: as continuous variable assuming linearity and as categorical variables to explore a potentially nonlinear association (quantiles). Increases in both Cd and Pb topsoil levels were associated with increased probability of childhood leukemias incidence. The results for the models with the continuous variables showed that a unit increase on the topsoil level was associated with an OR of 1.11 for Cd (95%CI 1.00-1.24) and an OR of 1.10 for Pb (95%CI 0.99-1.21). Our study may point towards a possible link between residential Cd and Pb topsoil levels and the probability of childhood leukemias incidence. Residing in a location with the highest concentrations of these heavy metals compared to those locations with the lowest could increase the risk around a 20%, for both Cd and Pb.

[Occupational exposures, diet and storing: Recommendations to reduce environmental pollutants in breastfeeding]. / Exposiciones laborales, dieta y envasado: recomendaciones para reducir los contaminantes medioambientales en la lactancia materna.

The pollution of the planet also reaches the breastfeeding ecosystem, one of the most intimate and inviolable that links us as an animal species to the rest of mammals. Nursing mothers may be concerned about whether the quality of their milk will be adequate for their baby and whether environmental pollutants through work, diet, and storing may adversely affect their child. Breast milk is a source of exposure to environmental pollutants, and at the same time it counteracts much of the effects of these exposures. An approach based on the principles of reality and precaution of environmental health to avoid, reduce or eliminate the production and use of harmful chemicals during pregnancy and lactation would improve the human and planetary health for the offspring.

Enfermería Medioambiental: recuperando el vínculo con la salud reproductiva / Environmental Nursing: Recovering the link with the reproductive health / Enfermagem Ambiental: Recuperando a ligação com a saúde reproductiva

El período periconcepcional, embrionario/fetal y lactancia/crianza constituyen una de las ventanas de vulnerabilidad a exposiciones medioambientales más importante de la vida de un individuo. Enfermeras y matronas por su forma de entender el binomio salud/enfermedad ocupan un lugar estratégico para el desarrollo de tareas relacionadas con la salud medioambiental en general y durante estos periodos en particular. Diferentes asociaciones enfermeras, así como instituciones sanitarias internacionales instan a los profesionales de enfermería a ejercer tareas que permitan reconocer y manejar factores de riesgo medioambiental (riesgos físicos, químicos, biológicos, sociales y psicosociales) y a promover factores de protección en sus comunidades, en la pareja embarazada y en su descendencia. Existen experiencias enfermeras como la consulta de enfermería de salud medioambiental reproductiva y la hoja verde como herramienta clínica de cribado medioambiental que permiten, de manera sistemática y organizada, identificar, modificar y promover estilos de vida más sanos y más saludables. La capacitación de los profesionales de enfermería y el aumento de la conciencia medioambiental en los cuidados, tiene un impacto positivo en la calidad de los embarazos, su descendencia, sus familias y la comunidad que los rodea

The periconcepcional and prenatal periods, as well as breastfeeding and breeding periods, constitute the most important windows of vulnerability for environmental exposures. Midwifes and nurses have an specific and insight regarding the duality of health and illness. They are strategic health professionals to develop the environmental health approach during these vulnerable periods of life. International institutions and nursery asociations urge nurse professionals to recognise environmental risk factors (physicochemical, biologic and psychosocial) and to promotives factors in communities, during pregnancy and childhood. There are environmental health experiences, such as the use of "Green Page questionnaire" during the reproductive environmenral health assessment. This questionnaire is a sistematic screening that promotes healthier lifestyles. Incresing the general awareness about environmental health as well as health professionals further education have a positive impact in pregnancies, their offspring, families and communities in a broader perspective

O periconcepcional, período embrionário / fetal e amamentação / parentalidade constituem uma das mais importantes opções/ possibilidades de vulnerabilidade às exposições ambientais na vida de um indivíduo. Enfermeiras e parteiras, para sua compreensão do binômio saúde / doença, ocupam um lugar estratégico para o desenvolvimento de tarefas relacionadas à saúde ambiental em geral e durante esses períodos em particular. Diferentes associações de enfermagem, bem como instituições internacionais de saúde, eles pedem os profissionais de enfermagem a realizar tarefas que lhes permitam reconhecer e gerenciar os fatores de risco ambientais (físicos, químicos, biológicos, sociais e psicossociais) e promover fatores de proteção em suas comunidades, no casal grávido e sua prole. Há experiências de enfermeiros como a da consulta de enfermagem em saúde reprodutiva ambiental e a "Folha Verde" como ferramenta clínica de triagem ambiental que permite, de forma sistemática e organizada, identificar, modificar e promover estilos de vida mais saudáveis e saudáveis. A capacitação dos profissionais de enfermagem e o aumento da conscientização ambiental no cuidado têm impacto positivo na qualidade das gestações, seus filhos, suas famílias e a comunidade que os cerca

Contaminación atmosférica urbana e ingresos hospitalarios por asma y enfermedades respiratorias agudas en la ciudad de Murcia (España) / Urban air pollution and hospital admissions for asthma and acute respiratory disease in Murcia city (Spain)

INTRODUCCIÓN: La contaminación atmosférica urbana es una amenaza principal para la salud infantojuvenil. Los niños son más vulnerables a sus efectos asociando mayor morbimortalidad de enfermedades agudas y crónicas, especialmente respiratorias. Pretendemos estudiar los efectos de la contaminación atmosférica urbana en la tasa de ingresos hospitalarios por causa aguda respiratoria. PACIENTES Y MÉTODOS: Estudio ecológico durante 2015 de las visitas con patología respiratoria (CIE-9) de urgencias hospitalarias en menores de 17 años en el municipio de la ciudad de Murcia. Regresión logística para el riesgo de ingreso hospitalario entre las consultas en relación con los niveles promedios diarios de contaminantes ambientales (NO2, O3, PM10, SO2) obtenidas de la Red de Vigilancia y Control de la Calidad del Aire de la Región de Murcia. Otras variables de control: sexo, edad, temperatura ambiental media diaria, y estación del año. RESULTADOS: Un total de 12354 niños consultaron en urgencias por patología respiratoria, 56% niños y 44% niñas. Ingresaron el 3,5%, con edad media de 2,54 (IC 95% 2,16-2,91) años. Para el riesgo de ingreso hospitalario por enfermedades respiratorias: NO2 1,02 (IC 95% 1,01-1,04; p < 0,01), O3 1,01 (IC 95% 1,00-1,03; p < 0,01) sexo masculino 1,4 (IC 95% 1,11-1,79; p < 0,01) e invierno 2,10 (IC 95% 1,40-3,21; p < 0,01). Ingresos por asma: PM10 1,02 (IC 95% 1,01-1,04; p < 0,05), O3 1,04 (IC 95% 1,01-1,06; p < 0,01). Ingresos por bronquiolitis: edad 0,69 (IC 95% 0,48-0,99; p < 0,05); NO2 1,03(IC 95% 1,01-1,05; p < 0,01). CONCLUSIONES: La contaminación atmosférica urbana aumenta los ingresos hospitalarios en pediatría por patología aguda respiratoria, especialmente por crisis de asma y bronquiolitis. Poner en marcha medidas preventivas, ampliar las series temporales y estudios colaborativos con datos en abierto ayudarían a mejorar la salud pública y la calidad del aire en las ciudades

INTRODUCTION: Urban air pollution is a major threat to child and adolescent health. Children are more vulnerable to its effects, being associated with higher morbidity and mortality due to acute and chronic diseases, especially respiratory ones. A study is performed on the relationship between urban air pollution and the rate of hospital admissions due to acute respiratory diseases. PATIENTS AND METHODS: An ecological study was conducted on young people under 17 years-old in the city of Murcia, who had visited hospital emergency departments due to respiratory diseases (ICD-9) during 2015. A logistic regression was performed on the risk of hospital admission that included consultations in relation to the average daily levels of environmental pollutants (NO2, O3, PM10, SO2) obtained from the Air Quality Surveillance and Control network of the Region of Murcia. Other control variables, such as gender, age, average daily ambient temperature, and season of the year. RESULTS: A total of 12,354 (56% boys and 44% girls) children consulted in the emergency department for respiratory disease. Of those, 3.5% were admitted, with a mean age of 2.54 (95% CI; 2.16-2.91) years. The odds ratio (OR) of hospital admission for respiratory diseases: NO2 1.02 (95% CI; 1.01-1.04; P <.01), O3 1.01 (95% CI; 1.00-1.03; P <.01) male 1.4 (95% CI 1.11-1.79; P <.01) and winter 2.10 (95% CI 1.40-3.21; P <.01). Admissions for asthma: PM10 1.02 (95% CI; 1.01-1.04; P <.05), O3 1.04 (95% CI; 1.01-1.06; P <.01). Admissions for bronchiolitis: Age 0.69 (95% CI; 0.48-0.99; P <.05); NO2 1.03 (95% CI; 1.01-1.05; P <.01). CONCLUSIONS: Urban air pollution increases hospital admissions in children due to acute respiratory diseases, especially asthma and bronchiolitis. Implementing preventive measures, expanding time series and collaborative studies with open data, would help improve public health and air quality in the cities

[Urban air pollution and hospital admissions for asthma and acute respiratory disease in Murcia city (Spain)]. / Contaminación atmosférica urbana e ingresos hospitalarios por asma y enfermedades respiratorias agudas en la ciudad de Murcia (España).

INTRODUCTION: Urban air pollution is a major threat to child and adolescent health. Children are more vulnerable to its effects, being associated with higher morbidity and mortality due to acute and chronic diseases, especially respiratory ones. A study is performed on the relationship between urban air pollution and the rate of hospital admissions due to acute respiratory diseases. PATIENTS AND METHODS: An ecological study was conducted on young people under 17 years-old in the city of Murcia, who had visited hospital emergency departments due to respiratory diseases (ICD-9) during 2015. A logistic regression was performed on the risk of hospital admission that included consultations in relation to the average daily levels of environmental pollutants (NO2, O3, PM10, SO2) obtained from the Air Quality Surveillance and Control network of the Region of Murcia. Other control variables, such as gender, age, average daily ambient temperature, and season of the year. RESULTS: A total of 12,354 (56% boys and 44% girls) children consulted in the emergency department for respiratory disease. Of those, 3.5% were admitted, with a mean age of 2.54 (95% CI; 2.16-2.91) years. The odds ratio (OR) of hospital admission for respiratory diseases: NO2 1.02 (95% CI; 1.01-1.04; P<.01), O3 1.01 (95% CI; 1.00-1.03; P<.01) male 1.4 (95% CI 1.11-1.79; P<.01) and winter 2.10 (95% CI 1.40-3.21; P<.01). Admissions for asthma: PM10 1.02 (95% CI; 1.01-1.04; P<.05), O3 1.04 (95% CI; 1.01-1.06; P<.01). Admissions for bronchiolitis: Age 0.69 (95% CI; 0.48-0.99; P<.05); NO2 1.03 (95% CI; 1.01-1.05; P<.01). CONCLUSIONS: Urban air pollution increases hospital admissions in children due to acute respiratory diseases, especially asthma and bronchiolitis. Implementing preventive measures, expanding time series and collaborative studies with open data, would help improve public health and air quality in the cities.

An Integrative Screening Tool of Alcohol Exposure During Early Pregnancy: Combining of the CDT Biomarker with Green Page Questionnaire.

AIMS: In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman by applying questionnaires. An alternative method for detecting alcohol use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy. METHODS: A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data. RESULTS: About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women's body mass index and European white race. CONCLUSION: Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.

Sociocultural aspects of drug dependency during early pregnancy and considerations for screening: Case studies of social networks and structural violence.

OBJECTIVE: To contribute in closing the current gap in literature that holistically examines sociocultural influences on perinatal drug dependency. This article draws from social network theory and structural violence to qualitatively consider the contextual components of addiction and substance use during pregnancy, which purposefully moves away from situating this issue from solely being within the contexts of pathologized disorders or products of social inequalities. DESIGN: Face-to-face semi-structured interviews with drug-dependent pregnant women identified during a reproductive environmental health consultation. SETTING: Interviews were conducted at a university hospital in southeastern Spain between October 2015 and June 2016. PARTICIPANTS: 10 pregnant women with confirmed perinatal substance use and/or drug dependency. FINDINGS: The sociocultural perspective offers a useful lens by which providers can understand the reasons for initial substance use and progress of multi-drug dependency as way of individually tailoring intervention strategies for expecting mothers. This perspective draws from the frameworks of social network analysis (SNA) and structural violence to dialectically examine drug dependency in this unique patient population not to be solely an individual occurrence, but rather a combination of macro and micro-level factors at play. KEY CONCLUSIONS: The sociocultural approach in examining maternal health allows for the holistic exploration of the already taboo and symbolically paradoxical phenomenon of drug dependency in pregnant women. IMPLICATIONS FOR PRACTICE: The "Hoja Verde" and similar perinatal screening methods that comprehensively assess for the potential of environmental risks can be a key instrument in the practice of preventing developmental issues of children as early as pregnancy and into adolescence.

Amenazas, desafíos y oportunidades para la salud medioambiental pediátrica en Europa, América Latina y el Caribe / Threats, challenges and opportunities for paediatric environmental health in Europe, Latin America and the Caribbean

En un mundo cada vez más tecnológico e interconectado, pero también más violento, esquilmado y contaminado, la salud medioambiental pediátrica (SMAP) constituye una de las mejores contribuciones para mejorar la salud global. Pocas zonas del planeta tienen una afinidad tan alta en valores e intereses como la Unión Europea (UE), América Latina y el Caribe (ALC). Las inversiones y actuaciones de la SMAP en periodos pre y posnatales durante las dos primeras décadas de vida generarán incontables beneficios en la salud y en el bienestar general en todas las épocas posteriores de la vida. Detectar, disminuir o eliminar los contaminantes físicos, químicos, biológicos y sociales es una de las principales misiones y acciones de la SMAP. En este artículo especial describimos, actualizamos y divulgamos las amenazas, los desafíos y las oportunidades de cooperación en la SMAP entre los profesionales biosanitarios y restantes sectores sociales implicados de la UE y de ALC. Surgen nuevos perfiles profesionales, estructuras de conocimiento y arquitecturas para el compromiso. Se requerirán liderazgos valientes, nuevos recursos sustanciales, amplios cambios sociales y la necesaria colaboración entre ambas regiones para mejorar la salud de las generaciones presentes y futuras

In a world that is increasingly technological and interconnected, but also more violent, overexploited and polluted, Paediatric Environmental Health (PEH) is one of the best contributions to improve global health. Few areas of the planet have a high affinity with common values and interests, such as the European Union (EU), Latin America and the Caribbean (LAC). The investments and actions of the PEH in pre- and postnatal periods during the first two decades of life will generate countless benefits in the health and well-being during the human life span. Detecting, reducing, or eliminating physical, chemical, biological and social pollutants is one of the main missions and actions of the PEH. In this special article, an update review is presented on the threats, challenges and cooperation opportunities in PEH among bio-health professionals and other social sectors involved, from the EU and LAC. New professional profiles, knowledge structures and architectures for engagement emerge. Courageous leaderships, new substantial resources, broad social changes, and the necessary collaboration between the two regions will be required to improve the health of present and future generations

[Threats, challenges and opportunities for paediatric environmental health in Europe, Latin America and the Caribbean]. / Amenazas, desafíos y oportunidades para la salud medioambiental pediátrica en Europa, América Latina y el Caribe.

In a world that is increasingly technological and interconnected, but also more violent, overexploited and polluted, Paediatric Environmental Health (PEH) is one of the best contributions to improve global health. Few areas of the planet have a high affinity with common values and interests, such as the European Union (EU), Latin America and the Caribbean (LAC). The investments and actions of the PEH in pre- and postnatal periods during the first two decades of life will generate countless benefits in the health and well-being during the human life span. Detecting, reducing, or eliminating physical, chemical, biological and social pollutants is one of the main missions and actions of the PEH. In this special article, an update review is presented on the threats, challenges and cooperation opportunities in PEH among bio-health professionals and other social sectors involved, from the EU and LAC. New professional profiles, knowledge structures and architectures for engagement emerge. Courageous leaderships, new substantial resources, broad social changes, and the necessary collaboration between the two regions will be required to improve the health of present and future generations.

Contaminación atmosférica y salud de los niños / Air pollution and children's health

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Full Breastfeeding and Obesity in Children: A Prospective Study from Birth to 6 Years.

BACKGROUND: Obesity is a major public health crisis among both children and adults and contributes to significant physical, psychological, and economic burden. We aim to investigate the effect of duration of breastfeeding on excessive weight and obesity at 6 years of age. SUBJECTS/METHODS: Data on breastfeeding and child anthropometric measurements were collected in a birth-cohort study in Murcia, Spain (n = 350). Breastfeeding status and body mass index (BMI) were established according to WHO definitions. Other factors potentially related to children's weight were considered. Multiple log-linear and ordinal regressions were used to analyze the effects of breastfeeding on overweight and obesity when considering potential confounders. RESULTS: 33% and 17.3% of children in the study were of excess weight and obesity, respectively. Univariate predictors of BMI in children aged 6 were as follows: pregestational maternal BMI (kg/m2) (R2 = 0.127, p < 0.01); full breastfeeding (weeks) R2 = -0.035, p < 0.01); infant weight gain (kg) (R2 = 0.348, p < 0.01); and maternal alcohol consumption during pregnancy (g/day) (R2 = 0.266, p < 0.01) at age 6. In the ordinal logistic regression, full breastfeeding was associated with a significant decrease in obesity -0.052 (95% CI, -0.10 to -0.003). CONCLUSIONS: The delay of bottle feeding introduction may have a protective effect against obesity at 6 years of age. Our findings reinforce the need for greater support of breastfeeding and to promote a healthy environment and antipoverty interventions during pregnancy and infancy, alongside other strategies for obesity prevention.