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Objective: To describe serum levels of calcium, copper, selenium, magnesium, iron and zinc and evaluate their relationship with maternal socio-demographic characteristics and dietary variables in women in the first trimester of pregnancy. Method: Cross-sectional study with 1279 participants from the INMA cohorts. Results: The concentrations of the elements analyzed were within the normal range. Associations with higher levels of these metals were found for calcium with white meat intake (p = 0.026), for cop-per with excess body weight (p < 0.01), low social class (p = 0.03) and being multipara (p < 0.01), for magnesium with being over 35 years old (p = 0.001), high social class (p = 0.044), primiparous status (p = 0.002) and low daily intake of bread (p = 0.009) and legumes (p = 0.020); for zinc with university edu-cation (p = 0.039) and residence in Gipuzkoa (p < 0.01), and for selenium with residence in Valencia (p < 0.01), university education (p = 0.001), vitamin B6 supplementation (p = 0.006), fish intake (> 71 g/day) (p = 0.014) and having been born in Spain (p = 0.001). Further, lower iron levels were associated with being overweight (p = 0.021) or obese (p < 0.001) and vitamin B12 supplementation (p = 0.006). Conclusions: Our results suggest that trace elements in the analyzed cohorts are adequate for this stage of pregnancy. The variability in these elements is mainly linked to socio-demographic and anthropometric variables. This study is part of the INMA (Infancia y Medio Ambiente) project. It was supported by grants from Instituto de Salud Carlos III (FIS-FEDER: 06/0867, 09/00090, 13/1944, 16/1288, 19/1338; Miguel Servet-FEDER: CP15/0025; Miguel Servet-FSE: MS15/0025) , by the Council of Gipuzkoa (DFG15/009) and by the Health Department of the Basque Government.

This research examines the levels and trends of pollutants, specifically 17 congeners of PCDD/Fs and 12 dl-PCBs, in the air measured in the province of Gipuzkoa (Basque Country, Spain). The study used PCDD/Fs, dl-PCB, and the sum of dioxin-like compounds as separate response variables. A total of 113 air samples were collected and analyzed using the method described in the European Standard (EN-1948:2006) from two industrial areas. The results were analyzed using non-parametric test to assess the variability of these pollutants based on different factors (year, season and day of the week) and General Linear Models to assess the weight of each factor. The study found that the toxic equivalents (TEQs) for PCDD/Fs were 12.29 fg TEQm-3 and for dl-PCBs were 1.63 fg TEQm-3, which were in a similar range or lower than those observed in other national and international studies in industrial areas. The results showed temporal variations, with higher levels of PCDD/Fs in autumn-winter than in spring-summer and higher levels of PCDD/Fs and dl-PCBs during weekdays than on weekends. The industrial area where the energy recovery plant (ERP) will be located had higher levels of air pollutants due to the presence of two PCDD/Fs emitting industries nearby, as indicated by the Spanish Registry of Polluting Emission Sources. Both industrial areas showed similar profiles of PCDD/Fs and dl-PCBs, with the PCDD/F profiles dominated by OCDD, 1,2,3,4,6,7,8-HpCDD, and 1,2,3,4,6,7,8-HpCDF in terms of concentrations and 1,2,3,7,8-PeCDD, 2,3,4,7,8-PeCDF, and 2,3,7,8-TCDD in terms of TEQs. The dl-PCB profiles were dominated by PCB 118, PCB 105, and PCB 77 in terms of concentrations and PCB 126 in terms of TEQs. The findings of this study can serve as an indicator of the potential impact of ERP on the health of the resident population and the environment., This research, conducted between 2017 and 2019 before the operation of the Energy Recovery plant, was funded through a public tender (017/11-HH-ZE) by the Gipuzkoa Provincial Council. However, the funding source did not play any part in the study's design, data collection and analysis, or the interpretation and writing of the manuscript.

The polycyclic aromatic hydrocarbons (PAHs) are a group of persistent pollutants that are globally distributed. The objectives of this study are as follows: (1) to analyze the levels of the priority PAHs in the PM2.5 fraction of air: naphthalene, acenaphthene, fluorene, phenanthrene, anthracene, fluoranthene, pyrene, benzoanthracene, chrysene, benzo(b)fluoranthene, benzo(k)fluoranthene, benzo(a)pyrene, dibenzoanthracene, benzo(g,h,i)perylene, indenepyrene, acenaphthylene, in two urban industrial areas of the province of Gipuzkoa (Basque Country, Spain), (2) to describe seasonal variation, and (3) to identify the source of PAHs. The ∑PAH concentrations ranged from 0.85 to 9.86 ng/m3. We found statistical differences between sites of sampling (p

Background: Near infrared spectroscopy can be used to monitor cerebral oxygen saturation in out-of-hospital cardiac arrest (OHCA). Brain oxygen saturation increase has been associated to cardiopulmonary resuscitation therapy (CPR), and higher saturation values are observed during return of spontaneous circulation (ROSC) and in survivors. In this study we evaluate cerebral oxygen saturation to identify ROSC, and compare its value for patients treated with manual or mechanical CPR. Materials and Methods: A total of 87 OHCA patients treated by the Emergency medical system (EMS) of the Basque Country were included, 32 treated with manual CPR and 55 with the LUCAS-3 device (Stryker). Brain oxygen saturation was measured in the left and right lobes using the NIRO NX-200 (Hamamatsu) in the manual group, and the SenSmart X-100 (NONIN) in the LUCAS-3 group. For each patient the mean value of the left and right lobe saturation in the first minute after the end of chest compressions was computed. Saturation values for the ROSC/no-ROSC groups were compared using the Wilcoxon rank sum test, p Results: In the manual CPR group median (IQR) saturation values were 39.2% (33.6-49.7) for the no-ROSC (n=23) and 64.3% (55.2-67.0) for ROSC (n=9) (p Conclusions: Differences in cerebral oximetry were significant between ROSC and no-ROSC patients. No differences were observed in saturation between the manual and mechanical CPR groups, despite using different oximeter models. Cerebral oximetry could be used to predict outcome regardless of the type of CPR.

There is a great concern in the Basque Country regarding emissions from waste incineration, in particular that of organochlorines (OCs), including dioxins, furans and polychlorinated biphenyls (PCBs), and their potential effect on human health. In 2005, a municipal solid waste plant (MSWP) started to operate in Bilbao, representing an opportunity to assess the exposure to the aforementioned pollutants among people living at various distances from the plant. In 2006 and 2008, we carried out two cross-sectional studies to quantify and assess changes in levels of these pollutants. The objective of this study was to describe the levels of OCs in the blood serum in 2013 of 127 adults of this prospective cohort, in four centres of population, near to and further away from the MSWP, and to study trends over time since it started to operate. This study shows the levels of OCs have decreased significantly, from 37.2% to 80.1%. Further, levels of OCs in areas near to the MSWP were not found to be higher than those in areas further afield.

Inorganic arsenic (i-As) is a non-threshold human carcinogen that has been associated with several adverse health outcomes. Exposure to i-As is of particular concern among pregnant women, infants and children, as they are specifically vulnerable to the adverse health effects of i-As, and in utero and early-life exposure, even low to moderate levels of i-As, may have a marked effect throughout the lifespan. Ion chromatography-mass spectrometry detection (IC-ICP-MS) was used to analyse urinary arsenic speciation, as an exposure biomarker, in samples of 4-year-old children with relatively low-level arsenic exposure living in different regions in Spain including Asturias, Gipuzkoa, Sabadell and Valencia. The profile of arsenic metabolites in urine was also determined in samples taken during pregnancy (1st trimester) and in the children from Valencia of 7 years old. The median of the main arsenic species found in the 4-year-old children was 9.71 mug/l (arsenobetaine-AsB), 3.97 mug/l (dimethylarsinic acid-DMA), 0.44 mug/l (monomethylarsonic acid-MMA) and 0.35 mug/l (i-As). Statistically significant differences were found in urinary AsB, MMA and i-As according to the study regions in the 4-year-old, and also in DMA among pregnant women and their children. Spearman's correlation coefficient among urinary arsenic metabolites was calculated, and, in general, a strong methylation capacity to methylate i-As to MMA was observed.

ResumenObjetivoDescribir la estrategia del Programa de Cribado de Cáncer Colorrectal en el País Vasco y los principales resultados de participación en la primera ronda (2009-2011).MétodoEstudio retrospectivo de las invitaciones realizadas en 2009-2011 y comparación de las tasas de participación y positividad de la prueba de sangre oculta en heces por sexo y grupos de edad.ResultadosSe obtuvieron 235.371 invitaciones válidas (personas correctamente localizadas), con una participación media del 64,3% (intervalo de confianza del 95% [IC95%]: 64,1-64,5) y con diferencias significativas (p

Introduction PAHs are compounds widely distributed in atmosphere. They are formed as by-products of incomplete combustion of organic materials, such as coal combustion, oil spills, vehicle exhaust ...

It is well known that municipal solid waste incinerators (MSWI) produce dioxins and furans. The aim of this study was to assess the serum levels of compounds with dioxin-like activity such as polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like PCBs after the commissioning of a MSWI plant. In 2006 and 2008 serum samples were obtained from 322 and 326 volunteers, respectively, from the general population, some living in the vicinity of the plant and others, as a control group, living further away from the MSWI plant and out of the path of prevailing winds. Samples for sets of 20 individuals, grouped by age and sex, were pooled, obtaining 16 pooled samples per year. No significant differences were observed in PCDD/Fs as a function of area of residence or proximity to the plant over the time of the study, with levels of WHO-TEQ/g lipid nearby and far from the MSWI being 26.9 and 20.0pg, respectively, in 2006 and 20.8 and 26.4pg, respectively, in 2008. There was a significant decrease in the concentration of non-ortho PCBs in the nearby areas, whilst there was a significant increase in the concentration of mono-ortho PCBs, both in the nearby areas and in those further away from the MSWI. Age was significantly associated with PCDD/Fs and dioxin-like PCBs, but sex showed no significant association. Overall, this study found that there was no increase in the levels of compounds with dioxin-like activity in a population living close to an MSWI, in agreement with the literature reviewed, for plants of recent construction using state-of-the-art technology.

Despite the measures adopted, levels of organochlorine compounds (OCs) are still being detected in the human body. This study aimed to explore factors related to changes in the concentrations of polychlorinated biphenyls (PCBs) and pesticide OCs in blood samples obtained from a general population cohort. Two cross-sectional samples were taken from 162 adults (2–75 years of age), with a gap of 2 years, from four areas in Biscay (Spain). More than 75 % had quantifiable levels of hexachlorobenzene (HCB), beta-hexachlorocyclohexane (β-HCH), dichlorodiphenyldichloroethylene, and PCBs 138 153 and 180. During this time, significant changes were observed: PCB 180 and HCB levels increased, and PCB 138 and β-HCH levels decreased. Regarding age, this study shows a decrease suggesting a cohort effect. The period was not related to the decrease of levels in all age intervals, but a statistically significant increase of PCBs in older people was found. High body mass index was associated with lower PCB 180 levels and greater HCH levels. Inversely, greater levels of HCB and β-HCH were in those who had lost weight before the study. Levels of HCB and β-HCH were also greater in women who had had children, although they were lower in those who breastfed. Levels of these same OCs were greater in fish consumers, whereas those of PCBs 138 and 153 were greater in those who consumed local produce; all of these trends were close to significance. Efforts should continue to decrease exposure to these pollutants and to assess their influence on general population.

Background: The aim of screening for colorectal cancer is to improve prognosis by the detection of cancer at its early stages. In order to inform the decision on the specific test to be used in the population-based programme in the Basque Autonomous Region (Spain), we compared two immunochemical faecal occult blood quantitative tests (I-FOBT). Methods: Residents of selected study areas, aged 50-69 years, were invited to participate in the screening. Two tests based on latex agglutination (OC-Sensor and FOB Gold) were randomly assigned to different study areas. A colonoscopy was offered to patients with a positive test result. The cut-off point used to classify a result as positive, according to manufacturer’s recommendations, was 100 ng/ml for both tests. Results: The invited population included 37,999 individuals. Participation rates were 61.8% (n=11,162) for OC-Sensor and 59.1% (n=11,786) for FOB Gold, (p=0.008). Positive rate for OC-Sensor was 6.6% (n=737) and 8.5% (n=1,002) for FOB Gold, (p< 0.0001). Error rates were higher for FOB gold (2.3%) than for OC-Sensor (0.2%), (p< 0.0001). Predictive Positive Value (PPV) for total malignant and premalignant lesions was 62.4% for OC-Sensor and 58.9% for FOB Gold, (p=0.137), respectively. Conclusions: OC-Sensor test appears to be superior for I-FOBT based CRC screening, given its acceptance, ease of use, associated small number of errors and its screening accuracy. FOB-Gold on the other hand, has higher rate of positive values, with more colonoscopies performed, it shows higher detection incidence rates, but involves more false positives.

To describe the procedures of the colorectal cancer screening program in the Basque Country (Spain), and the main results of the first rounds in 2009-2011.We carried out a retrospective study of invitations to attend screening between 2009 and 2011. Participation rates and the number of positive results of the fecal occult blood test (FOBT) were analyzed by sex and age group.There were 235.371 valid invitations (sent to the correct addresses), with an average participation rate of 64.3% (95%CI: 64.1-64.5%). Significant differences were found (p0,001) between women (67.1%; 95%CI: 66.9-67.4) and men (61.4%; 95%CI: 61.1-61.7). The rate of positive FOBT results was higher (p0,001) among men (9.1%; 95%CI: 8.9-9.2) than among women (4.8%; 95%CI: 4.7-4.9).Participation rates were adequate compared with those in the reviewed literature. These rates were probably affected by the invitation strategy and by cultural and social factors.

In 2005 an urban solid waste incinerator (SWI) was commissioned in Bilbao (Basque Country, Spain). Serum and urine samples were collected from 95 and 107 volunteers in 2006 and 2008 respectively, of which 62 were repeats from the same individuals. Blood lead levels (BPb) were determined, as were the concentrations of cadmium (Cd), chromium (Cr) and mercury (Hg) in urine (UCd, UCr and UHg). The town of Alonsotegi and a borough of Bilbao (Altamira, Rekalde) were considered to be close, less than 2 km from the plant, and correspond to an urban environment with high traffic density. The areas of reference were a borough of Bilbao (Santutxu-Zurbaran), 5 km from the plant, also in an urban area with high traffic density, and a small town with little industrial activity and low traffic density (Balmaseda) 20 km from the plant; neither of these is downwind from the site with respect to prevailing winds. There was a significant correlation for BPb, r=0.63 (p0.001), between the two surveys. However, there was no linear correlation for the other three metals (UCd, UCr and UHg), between the two sampling periods (p0.05). Multiple linear regression models did not show increases over time of the levels of BPb, UCd, UCr and UHg in the areas close to the SWI compared to those of areas located further away, after adjusting for confounding variables. These results reinforce the hypothesis that populations near modern plants for solid waste incineration do not manifest increased levels of heavy metals.

To identify and analyze levels of seven organochlorine pesticides [hexachlorobenzene (HCB), beta-hexachlorocyclohexane (β-HCH), gamma-hexachlorocyclohexane (γ-HCH), heptachlor epoxide, beta-endosulfan, dichlorodiphenyldichloroethylene (p,p'-DDE) and dichlorodiphenyltrichloroethane (p,p'-DDT)] in the serum of adults of four areas of Biscay (Spain) not exposed to known sources of pesticides.We analyzed 283 individual samples from volunteers recruited from the census. The volunteers were interviewed using a questionnaire with items on demographic variables and consumption. Data were analyzed using the chi-square test for discrete variables and analysis of variance and multiple linear regression models for continuous variables.We detected p,p'-DDE in 100% of the volunteers (mean: 191.43ng/g lipid), while 31% had detectable levels of p,p'-DDT (mean: 18.9ng/g lipid). Detectable levels of HCB were found in 96.5% of the volunteers (mean: 78.56ng/g lipid), β-HCH in 90.4% (mean: 42.78ng/g lipid) and γ-HCH in 3.5%. Heptachlor epoxide and beta-endosulfan were not detected. In the regression model higher levels of all pesticides were found with increasing age (p0.05). There were no significant differences by area of residence, except for HCB and p,p'-DDE. Women had significantly higher levels of HCB and β-HCH (p0.001). Body mass index showed a significant positive gradient in HCB and β-HCH (p0.05). There was no association between pesticides and other variables, breast feeding, occupation or social class.These results indicate that the general adult population of Biscay has been and is exposed to organochlorine pesticides. However, their levels are within the range observed by other authors.

Levels of PCDD/Fs and dioxin-like PCBs were measured in 16 pooled samples of serum from a total of 322 adults in the general population, to coincide with the start-up of a new municipal solid urban waste treatment plant in Biscay, Basque Country (Spain). Two hundred and eighty-three individual serum samples were also obtained, in which the most common PCBs (28, 52, 101, 118, 138, 153 and 180) were quantified. The samples were taken from four geographical zones: two from the metropolitan area of Bilbao, located less than 2 km from the plant and with high traffic density (Zones E1 and E2), a third located 5 km from the plant in an urban area of Bilbao, also with high traffic density (Zone C1) and the fourth located 20 km from the plant, in a municipality with minimal industrial activity and low traffic density (Zone C2), the latter two being out of the path of the prevailing winds. The median levels of dioxins+furans were similar by zone: E1=24.3, E2=27.3, C1=21.3, C2=18.8 pg g(-1) lipid (p=0.362); by sex: 20.2 vs. 22.6 pg g(-1) lipid in men and women (p=0.328); and by age: 20.8 vs. 21.3 pg g(-1) lipid in subjects aged 20-44 and 45-69 (p=0.505). No detectable levels of PCBs 52 and 101 were found. Significant differences by zone were found only for PCB 180 (p=0.041), with higher values in Zone C2, the zone with the lowest presumed contamination levels. Dioxin-like PCBs (p

ResumenObjetivoDeterminar y analizar las concentraciones de siete plaguicidas organoclorados; hexaclorobenceno (HCB), beta-hexaclorociclohexano (β-HCH), gamma-hexaclorociclohexano (γ-HCH), heptacloro epóxido, beta-endosulfán, diclorodifenildicloroetileno (p,p′-DDE) y diclorodifeniltricloroetano (p,p′-DDT) en suero de adultos de cuatro zonas de Bizkaia no expuestos a fuentes conocidas de plaguicidas.MétodoSe analizaron 283 muestras individuales de voluntarios captados a partir del censo. Se les entrevistó utilizando un cuestionario con variables sociodemográficas y de consumo. Se analizaron los datos utilizando la ji al cuadrado para variables discretas, y el análisis de varianza y un modelo de regresión lineal múltiple para las variables continuas.ResultadosEl p,p′-DDE fue detectado en el 100% de los individuos (media: 191,43ng/g lípido), mientras que el 31% mostró valores detectables de p,p′-DDT (media: 18,9ng/g lípido). Un 96,5% de los individuos presentaban valores detectables de HCB (media: 78,56ng/g lípido); el 90,4% β-HCH (media: 42,78ng/g lípido) y un 3,5% γ-HCH. No se detectó heptacloro epóxido ni beta-endosulfán. En el modelo de regresión, el incremento de la edad aumentaba los valores de todos los plaguicidas (p