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Abstract Background Current evidence suggests that childhood leukaemia can be associated with residential traffic exposure; nevertheless, more results are needed to support this conclusion. Objectives To ascertain the possible effects of residential proximity to road traffic on childhood leukaemia, taking into account traffic density, road proximity and the type of leukaemia (acute lymphoid leukaemia or acute myeloid leukaemia). Methods We conducted a population-based case-control study of childhood leukaemia in Spain, covering the period 1990–2011. It included 1061 incidence cases gathered from the Spanish National Childhood Cancer Registry and those Autonomous Regions with 100% coverage, and 6447 controls, individually matched by year of birth, sex and autonomous region of residence. Distances were computed from the respective participant's residential locations to the different types of roads and four different buffers. Using logistic regression, odds ratios (ORs) and 95% confidence intervals (95%CIs), were calculated for four different categories of distance to roads. Results Cases of childhood leukaemia had more than three-fold increased odds of living at <50 m of the busiest motorways compared to controls (OR = 2.90; 95%CI = 1.30–6.49). The estimates for acute lymphoid leukaemia (ALL) were slightly higher (OR = 2.95; 95%CI = 1.22–7.14), while estimates for cases with the same address at birth and at diagnosis were lower (OR = 2.40; 95%CI = 0.70–8.30). Conclusions Our study agrees with the literature and furnishes some evidence that living near a busy motorway could be a risk factor for childhood leukaemia. Highlights • Association between residing close to a busy major road and risk for childhood leukaemia. • Leukaemia cases had a higher odds of exposure to motorways compared to controls. • Leukemia cases had a higher odds of exposure to higher traffic density compared to controls. [ABSTRACT FROM AUTHOR]

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Objective: To analyse the relationship of the risk of breast cancer (BC) to meat intake, preference regarding degree of cooking ('doneness') and cooking methods, using data from a population-based case-control study (MCC-Spain).Study Design: 1006 Histologically confirmed incident BC cases and 1370 controls were recruited in 10 Spanish provinces. Participants were 23-85 years old. They answered an epidemiological survey and a food frequency questionnaire. BC risk was assessed overall, by menopausal status and by pathological subtypes, using logistic and multinomial regression mixed models adjusted for known confounding factors and including province as a random effects term.Main Outcome Measures: Breast cancer and pathological subtype.Results: High total intake of meat (ORQ4-Q1 (95% IC) = 1.39 (1.03-1.88)) was associated with increased BC risk among post-menopausal women. Similar results were found for processed/cured meat (ORQ4-Q1 (95% IC) = 1.47 (1.10-1.97)), and this association was particularly strong for triple-negative tumours (ER-, PR- and HER2-) (ORQ4-Q1 (95% IC) = 2.52 (1.15-5.49)). Intakes of well-done (ORwell-donevsrare (95% CI) = 1.62 (1.15-2.30)) and stewed (OR (95% CI) = 1.49 (1.20-1.84)) red meat were associated with increased BC risk, with a high risk observed for HR+ tumours (ER+/PR+ and HER2-). Pan-fried/bread-coated fried white meat, but not doneness preference, was associated with an increased BC risk for all women (OR (95% CI) = 1.38 (1.14-1.65)), with a stronger association for pre-menopausal women (OR (95% CI) = 1.78 (1.29-2.46)).Conclusion: The risk of developing BC could be reduced by moderating the consumption of well-done or stewed red meat, pan-fried/bread-coated fried white meat and, especially, processed/cured meat. [ABSTRACT FROM AUTHOR]

Objective: To externally validate the previously identified effect on breast cancer risk of the Western, Prudent and Mediterranean dietary patterns.Study Design: MCC-Spain is a multicase-control study that collected epidemiological information on 1181 incident cases of female breast cancer and 1682 healthy controls from 10 Spanish provinces. Three dietary patterns derived in another Spanish case-control study were analysed in the MCC-Spain study. These patterns were termed Western (high intakes of fatty and sugary products and red and processed meat), Prudent (high intakes of low-fat dairy products, vegetables, fruits, whole grains and juices) and Mediterranean (high intake of fish, vegetables, legumes, boiled potatoes, fruits, olives, and vegetable oil, and a low intake of juices). Their association with breast cancer was assessed using logistic regression models with random province-specific intercepts considering an interaction with menopausal status. Risk according to tumour subtypes - based on oestrogen (ER), progesterone (PR) and human epidermal growth factor 2 (HER2) receptors (ER+/PR+ & HER2-; HER2+; ER-/PR- & HER2-) - was evaluated with multinomial regression models.Main Outcome Measures: Breast cancer and histological subtype.Results: Our results confirm most of the associations found in the previous case-control study. A high adherence to the Western dietary pattern seems to increase breast cancer risk in both premenopausal women (OR4thvs.1stquartile (95% CI):1.68 (1.02;2.79); OR1SD-increase (95% CI):1.19 (1.02;1.40)) and postmenopausal women (OR4thvs.1stquartile(95% CI):1.48(1.07;2.05); OR1SD-increase(95% CI): 1.14 (1.01;1.29)). While high adherence to the Prudent pattern did not show any effect on breast cancer, the Mediterranean dietary pattern seemed to be protective, but only among postmenopausal women (OR4thvs.1stquartile (95% CI): 0.72 (95% CI 0.53;0.98); p-int=0.075). There were no significant differences by tumour subtype.Conclusion: Dietary recommendations based on a departure from the Western dietary pattern in favour of the Mediterranean diet could reduce breast cancer risk in the general population. [ABSTRACT FROM AUTHOR]

Abstract: Background: Health effects linked to exposure to high air pollutant levels have been described in depth, and many recent epidemiologic studies have also consistently reported positive associations between exposure to air pollutants at low concentrations (particularly PM2.5) and adverse health outcomes. Objective: To estimate the number of avoidable deaths associated with reducing PM2.5 levels in Spain. Materials and methods: For exposure assessment, we used the US Environmental Protection Agency''s Community Multiscale Air Quality model to simulate air pollution levels with a spatial resolution of 18×18km2. Two different scenarios were compared, namely, a baseline 2004 scenario based on Spain''s National Emissions Inventory and a projected 2011 scenario in which a reduction in PM2.5 was estimated on the basis of the benefits that might be attained if specific air quality policies were implemented. Using an 18×18km2 grid, air pollution data were estimated for the entire Iberian Peninsula, the Balearic Islands, Ceuta and Melilla. For these strata, crude all-cause mortality rates (ICD-10: A00-Y98) were then calculated for the over-30 and 25–74 age groups, taking into account the 2004 population figures corresponding to these same age groups, selected in accordance with the concentration–response functions (Pope CA 3rd, Burnett RT, Thun MJ, Calle EE, Krewski D, Ito K et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA 2002; 287:1132–41; Laden F, Schwartz J, Speizer FE, Dockery DW. Reduction in fine particulate air pollution and mortality: extended follow-up of the Harvard Six Cities study. Am J Respir Crit Care Med 2006; 173:667–72.). Health impacts were assessed using the Environmental Benefits Mapping and Analysis Program (BenMAP). Results: Air quality improvement was defined as an average annual reduction of 0.7μg/m3 in PM2.5 levels. Using long-term health impact assessment analysis, we estimated that 1720 (673–2760) all-cause deaths (6 per 100,000 population) in the over-30 age group and 1450 (780–2108) all-cause deaths (5 per 100,000 population) in the 25–74 age group could be prevented annually. Conclusions: The results showed the potential benefits in general mortality which could be expected if pollution control policies were successfully implemented by 2011. A specifically adapted BenMAP could be used as a tool for estimating health impacts associated with changes in air pollution in Spain. [Copyright &y& Elsevier]

It is likely that pollution from chemical facilities will affect the health of any exposed population; however, the majority of scientific evidence available has focused on occupational exposure rather than environmental. Consequently, this study assessed whether there could have been an excess of cancer-related mortality associated with environmental exposure to pollution from chemical installations – for populations residing in municipalities in the vicinity of chemical industries. To this end, we designed an ecological study which assessed municipal mortality due to 32 types of cancer in the period from 1999 to 2008. The exposure to pollution was estimated using distance from the facilities to the centroid of the municipality as a proxy for exposure. In order to assess any increased cancer mortality risk in municipalities potentially exposed to chemical facilities pollution (situated at a distance of ≤5 km from a chemical installation), we employed Bayesian Hierarchical Poisson Regression Models. This included two Bayesian inference methods: Integrated Nested Laplace Approximations (INLA) and Markov Chain Monte Carlo (MCMC, for validation). The reference category consisted of municipalities beyond the 5 km limit. We found higher mortality risk (relative risk, RR; estimated by INLA, 95% credible interval, 95%CrI) for both sexes for colorectal (RR, 1.09; 95%CrI, 1.05–1.15), gallbladder (1.14; 1.03–1.27), and ovarian cancers (1.10; 1.02–1.20) associated with organic chemical installations. Notably, pleural cancer (2.27; 1.49–3.41) in both sexes was related to fertilizer facilities. Associations were found for women, specifically for ovarian (1.11; 1.01–1.22) and breast cancers (1.06; 1.00–1.13) in the proximity of explosives/pyrotechnics installations; increased breast cancer mortality risk (1.10; 1.03–1.18) was associated with proximity to inorganic chemical installations. The results suggest that environmental exposure to pollutants from some types of chemical facilities may be associated with increased mortality from several different types of cancer. Image 1 • Excess risk of cancer mortality was found in the vicinity of chemical facilities. • Colorectal, gallbladder and ovary cancer mortality related to organic chemical facilities. • Ovarian and breast cancer mortality related to explosives/pyrotechnics facilities. • Excess of pleural cancer mortality in municipalities close to fertilizer facilities. • Excess of Breast cancer mortality in municipalities close to inorganic chemical facilities. Environmental exposure to pollutants from some chemical facilities, measured by proximity, may be associated with increased mortality risk from different types of cancer. [ABSTRACT FROM AUTHOR]

Abstract: Pleural cancer mortality is an acknowledged indicator of exposure to asbestos and mesothelioma mortality but in 15%–20% of cases no exposure can be recalled. In the past, asbestos was used in many industries and it is still found in many installations. Our objective was to ascertain whether there might be excess pleural cancer mortality among populations residing in the vicinity of Spanish industrial installations that are governed by the Integrated Pollution Prevention and Control (IPPC) Directive and the European Pollutant Release and Transfer Register Regulation and report their emissions to air. An ecological study was designed to examine pleural cancer mortality at a municipal level (8098 Spanish towns) over the period 1997–2006, during which 2146 deaths were registered. We conducted an exploratory “near vs. far” analysis to estimate the relative risks (RRs) of towns situated at a distance of <2km from installations. This analysis was repeated for each of the 24 industrial groups. RR and their 95% credible intervals (95% CIs) were estimated on the basis of a Poisson conditional autoregressive Bayesian model with explanatory variables. Integrated nested Laplace approximations were used as a Bayesian inference tool. Analysis showed statistically significant RRs in both sexes in the vicinity of 7 of the 24 industrial groups studied (RR, 95% CI), namely, biocide facilities (2.595, 1.459–4.621), ship-building (2.321, 1.379–3.918), glass and mineral fibre production (1.667, 1.041–2.665), non-hazardous waste treatment (1.737, 1.077–2.799), galvanising (1.637, 1.139–2.347), organic chemical plants (1.386, 1.075–1.782) and the food and beverage sector (1.255, 1.006–1.562). In the proximity of sources pertaining to the biocide, organic chemical and galvanising sectors, the risk was seen to be rising among men and women, a finding that could indicate airborne environmental exposure. These results support that residing in the vicinity of IPPC-registered industries that release pollutants to the air constitutes a risk factor for pleural cancer. [Copyright &y& Elsevier]

Abstract: Background: Releases to the environment of toxic substances stemming from industrial metal production and processing installations can pose a health problem to populations in their vicinity. Objectives: To investigate whether there might be excess leukemia-related mortality in populations residing in towns in the vicinity of Spanish metal industries included in the European Pollutant Emission Register. Methods: Ecologic study designed to examine mortality due to leukemia at a municipal level, during the period 1994–2003. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Poisson regression models, we analyzed: risk of dying from leukemia in a 5-kilometer zone around installations which had become operational prior to 1990; effect of pollution discharge route and type of industrial activity; and risk gradient within a 50-kilometer radius of such installations. Results: Excess mortality (relative risk, 95% confidence interval) was detected in the vicinity of pre-1990 installations (1.07, 1.02–1.13 in men; 1.05, 1.00–1.11 in women), with this being more elevated in the case of installations that released pollution to air versus water. On stratifying by type of industrial activity, statistically significant associations were also observed among women residing in the vicinity of galvanizing installations (1.58, 1.09–2.29) and surface-treatment installations using an electrolytic or chemical process (1.34, 1.10–1.62), which released pollution to air. There was an effect whereby risk increased with proximity to certain installations. Conclusions: The results suggest an association between risk of dying due to leukemia and proximity to Spanish metal industries. [Copyright &y& Elsevier]

Background: Installations that burn fossil fuels to generate power may represent a health problem due to the toxic substances which they release into the environment. Objectives: To investigate whether there might be excess mortality due to tumors of lung, larynx and bladder in the population residing near Spanish combustion installations included in the European Pollutant Emission Register. Methods: Ecologic study designed to model sex-specific standardized mortality ratios for the above three tumors in Spanish towns, over the period 1994–2003. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using mixed Poisson regression models, we analyzed: risk of dying from cancer in a 5-kilometer zone around installations that commenced operations before 1990; effect of type of fuel used; and risk gradient within a 50-kilometer radius of such installations. Results: Excess mortality (relative risk, 95% confidence interval) was detected in the vicinity of pre-1990 installations for lung cancer (1.066, 1.041–1.091 in the overall population; 1.084, 1.057–1.111 in men), and laryngeal cancer among men (1.067, 0.992–1.148). Lung cancer displayed excess mortality for all types of fuel used, whereas in laryngeal and bladder cancer, the excess was associated with coal-fired industries. There was a risk gradient effect in the proximity of a number of installations. Conclusions: Our results could support the hypothesis of an association between risk of lung, laryngeal and bladder cancer mortality and proximity to Spanish combustion installations. [Copyright &y& Elsevier]

Background: Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes.Methods: This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors.Results: Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93).Conclusion: These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli. [ABSTRACT FROM AUTHOR]

Abstract: The need for a better quantification of the influence of Saharan dust transport processes on the air quality modelling in the Mediterranean basin led to the formulation of a dust emission module (DEM) integrated into the Air Quality Risk Assessment System for the Iberian Peninsula (SERCA). This paper is focused on the formulation of DEM based on the GOCART aerosol model, along with its integration and execution into the air quality model. It also addresses the testing of the module and its evaluation by contrasting results against satellite products such as MODIS and CALIPSO and ground-level observations of aerosol optical thickness (AOT) and concentration levels of PM10 for different periods in July 2007. DEM was found capable of reproducing the spatial (horizontal and vertical) and temporal profiles of Saharan dust outbreaks into the Mediterranean basin and the Atlantic coast of Africa. Moreover, it was observed that its combination with CMAQ increased the correlation degree between observed and modelled PM10 concentrations at the selected monitoring locations. DEM also enhanced CMAQ capabilities to reproduce observed AOT, although significant underestimations remain. The implementation of CMAQ + DEM succeeded in capturing Saharan dust transport into the Iberian Peninsula, with contributions up to 25 and 14 μg m− 3 in 1 h and 24 h average PM10 respectively. The general improvement of total PM10 predictions in Spain are however moderate. The analysis of model performance for the main PM components points out that remaining PM10 underestimation is due to dust local sources missing in the inventories and misrepresentation of organic aerosol processes, which constitutes the main areas for future improvement of CMAQ capabilities to simulate particulate matter within SERCA. [Copyright &y& Elsevier]

Abstract: Background: Waste treatment plants release toxic emissions into the environment which affect neighboring towns. Objectives: To investigate whether there might be excess cancer mortality in towns situated in the vicinity of Spanish-based incinerators and installations for the recovery or disposal of hazardous waste, according to the different categories of industrial activity. Methods: An ecologic study was designed to examine municipal mortality due to 33 types of cancer, across the period 1997–2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Using Besag–York–Mollié (BYM) regression models with Integrated Nested Laplace approximations for Bayesian inference, and Mixed Poisson regression models, we assessed the risk of dying from cancer in a 5-kilometer zone around installations, analyzed the effect of category of industrial activity, and conducted individual analyses within a 50-kilometer radius of each installation. Results: Excess cancer mortality (BYM model: relative risk, 95% credible interval) was detected in the total population residing in the vicinity of these installations as a whole (1.06, 1.04–1.09), and, principally, in the vicinity of incinerators (1.09, 1.01–1.18) and scrap metal/end-of-life vehicle handling facilities, in particular (1.04, 1.00–1.09). Special mention should be made of the results for tumors of the pleura (1.71, 1.34–2.14), stomach (1.18, 1.10–1.27), liver (1.18, 1.06–1.30), kidney (1.14, 1.04–1.23), ovary (1.14, 1.05–1.23), lung (1.10, 1.05–1.15), leukemia (1.10, 1.03–1.17), colon–rectum (1.08, 1.03–1.13) and bladder (1.08, 1.01–1.16) in the vicinity of all such installations. Conclusions: Our results support the hypothesis of a statistically significant increase in the risk of dying from cancer in towns near incinerators and installations for the recovery or disposal of hazardous waste. [Copyright &y& Elsevier]

Abstract: Mining installations are releasing toxic substances into the environment which could pose a health problem to populations in their vicinity. We sought to investigate whether there might be excess cancer-related mortality in populations residing in towns lying in the vicinity of Spanish mining industries governed by the Integrated Pollution Prevention and Control Directive, and the European Pollutant Release and Transfer Register Regulation, according to the type of extraction method used. An ecologic study was designed to examine municipal mortality due to 32 types of cancer, across the period 1997 through 2006. Population exposure to pollution was estimated on the basis of distance from town of residence to pollution source. Poisson regression models, using the Bayesian conditional autoregressive model proposed by Besag, York and Molliè and Integrated Nested Laplace Approximations for Bayesian inference, were used: to analyze risk of dying from cancer in a 5-kilometer zone around mining installations; effect of type of industrial activity; and to conduct individual analyses within a 50-kilometer radius of each installation. Excess mortality (relative risk, 95% credible interval) of colorectal cancer (1.097, 1.041–1.157), lung cancer (1.066, 1.009–1.126) specifically related with proximity to opencast coal mining, bladder cancer (1.106, 1.016–1.203) and leukemia (1.093, 1.003–1.191) related with other opencast mining installations, was detected among the overall population in the vicinity of mining installations. Other tumors also associated in the stratified analysis by type of mine, were: thyroid, gallbladder and liver cancers (underground coal installations); brain cancer (opencast coal mining); stomach cancer (coal and other opencast mining installations); and myeloma (underground mining installations). The results suggested an association between risk of dying due to digestive, respiratory, hematologic and thyroid cancers and proximity to Spanish mining industries. These associations were dependent on the type of mine. [Copyright &y& Elsevier]

Abstract: Several studies conducted in urban areas have pointed out that road dust resuspension contributes significantly to PM concentration levels. Street washing is one of the methods proposed to reduce resuspended road dust contributions to ambient PM concentrations. As resuspended particles are mainly found in the coarse mode, published studies investigating the effects of street washing have focused on PM10 size fraction. As the PM2.5 mass fraction of particles originating from mechanical abrasion processes may still be significant we conducted a study in order to evaluate the effects of street washing on the mitigation of resuspension of fine particles. The PM2.5 mass concentration data were examined and integrated with the occurrence of street washing activities. In addition, the effect of the meteorological variability, traffic flow and street washing activities, on ambient PM2.5 levels was evaluated by means of a multivariate regression model. The results revealed that traffic flow is the most important factor that controls PM2.5 hourly concentrations while street washing activities did not influence fine particle mass levels. [Copyright &y& Elsevier]

Abstract: The primary aim of this study was to quantify the contribution of road dust to airborne particulate matter (PM10) and evaluate the effects of street washing on the mitigation of resuspension. With this purpose an intensive campaign was carried out in a heavily trafficked central road of Madrid (Spain) including PM10 sampling and chemical analysis. PM10 daily levels during dry, unwashed conditions were 2–15% higher than those present during the day after nightly street washing. However, this reduction is lower than the standard deviation of the PM10 measurements. The diurnal variation of PM10 revealed that a reduction in PM10 was noticeable only during the morning hours. The emission sources for the urban area of Madrid were resolved by means of a receptor model, Positive Matrix Factorization, PMF. The results showed that the main sources were vehicle emissions, road dust, secondary aerosol including sulphate and nitrate, and soil. Vehicle emissions and road dust were the major contributor to PM10 particle mass with similar average contributions of 31% and 29% respectively. The effect of street washing was also evaluated by examining the daily variation of the road dust source contribution between days with and without street washing. The mass contribution from the road dust source was ∼2 μg m−3 lower during the days that street washing was implemented with this corresponding to a reduction of 15% of its mass contribution during the days that the road surface was left untreated. [Copyright &y& Elsevier]