Since July 2009, there has been a community outbreak of leishmaniasis in the south-west area of the Madrid autonomous community, Spain, affecting residents from four towns that are geographically ...close together and share extensive park areas. As of December 2012, 446 cases were reported (6 in 2009, 97 in 2010, 196 in 2011 and 147 in 2012), a mean incidence rate of 22.2 per 100,000 inhabitants during July 2009 and December 2012. The mean age was 44 years (range: 2 months to 95 years); 61.0% were male. A total of 68 (15.2%) had immunosuppressive conditions; 160 (35.9%) had visceral leishmaniasis and 286 (64.1%) cutaneous. A total of 421 (94.4%) cases were confirmed. Leishmania infantum was identified as the agent. Monitoring revealed high densities of the vector Phlebotomus perniciosus. The surveillance system for canine leishmaniasis did not detect any increase in prevalence during the period. Environmental control measures have been taken, such as improvements in sanitation and disinsection in the risk areas and control of the overpopulation of Leporidae, as xenodiagnosis studies have shown that hares play a role as active reservoirs. This is the largest reported community outbreak of leishmaniasis in Europe. The discovery of the new reservoir stands out in the multifactorial aetiology of the outbreak. Epidemiological research and environmental intervention measures are continuing.
Many time-series studies have shown positive associations between air pollutants and asthma morbidity. However, few studies have included pollen as a potential confounder when examining this ...relationship. This study analysed the short-term association between air pollutants (sulphur dioxide (SO2), particles measured with a median aerodynamic diameter of <10 microm (PM10), nitrogen dioxide (NO2) and ozone (O3)) and asthma emergency room admissions in Madrid, Spain, in 1995-1998, adjusting for four types of pollen with allergenic potential (Olea europaea, Plantago sp., Poaceae and Urticaceae). Data were analysed using autoregressive Poisson regression and generalised additive models (GAM). The strongest associations were observed at 1 day lag for O3, and 3 days lag for the remaining pollutants. Using Poisson regression, a single-pollutant model showed that a 10-microg x m(-3) rise in pollutant level led to relative risks of: 1.039 for PM10; 1.029 for SO2; 1.033 for NO2; and 1.045 for O3. Adjustment for the different types of pollen led to no substantial variation in these associations. In the multipollutant models for cold-season pollutants (including PM10, SO2 and the four types of pollen) and photochemical pollutants (including NO2, O3 and the four types of pollen) the associations for PM10, NO2 and O3 held, but no relationship with SO2 was evident. GAM analysis yielded the same results, both in terms of lags and of quantification of the effect for all pollutants. In conclusion, the usual air pollution levels in Madrid were associated with an increase in asthma emergency room admissions, and this association remained controlling for the presence of ambient pollen.
Summary
Several studies have demonstrated that the soil of public parks presents an important source of infection which has a significant impact on public health. Children are the main group affected ...by accidentally ingestion of contaminated soil. This study was performed in order to identify the presence of zoonotic parasites in dog and cat faecal and soil samples from public parks of Madrid, Spain. Six hundred twenty‐five and seventy‐nine soil and faecal samples (presumably from dogs and cats) respectively were collected from 67 parks. Intestinal parasites were identified in 27 parks (40.3%), which were contamined with Giardia sp. (19.4%), microsporidia (19.4%), Toxocara spp. (16.4%), Cryptosporidium sp. (6%), Entamoeba histolytica (3%) and Ancylostomidae (3%). Combinations of two or more intestinal parasites were found in 11 parks, and it was common to find Giardia and microsporidia together in samples. Intestinal parasites were detected in 18% (112/625) of soil samples. The most frequent parasite species found in the examined soil samples were Toxocara spp. (16.4%), followed by Giardia sp. (4.5%) and Strongyloides sp. larvae (3%). The zoonotic parasites found in the 79 faecal samples were Giardia sp. (17.7%), Cryptosporidium sp. (9%), E. histolytica (2.5%), Trichuris vulpis (1.3%), Toxascaris leonina (1.3%) and microsporidia spores (28%). Microsporidia characterization by amplification of DNA confirmed 10 samples as positive, eight for E. bieneusi and two for E. hellem by PCR. The role of those parasites in the environment are discussed.
Background: Few studies have used time series to investigate the relationship between asthma attacks and aeroallergen levels on a daily basis. Methods: This study, based on time series analysis ...adjusting for meteorological factors and air pollution variables, assessed the short term effects of different types of allergenic pollen on asthma hospital emergencies in the metropolitan area of Madrid (Spain) for the period 1995–8. Results: Statistically significant associations were found for Poaceae pollen (lag of 3 days) and Plantago pollen (lag of 2 days), representing an increase in the range between the 99th and 95th percentiles of 17.1% (95% confidence interval (CI) 3.2 to 32.8) and 15.9% (95% CI 6.5 to 26.2) for Poaceae and Plantago, respectively. A positive association was also observed for Urticaceae (lag of 1 day) with an 8.4% increase (95% CI 2.8 to 14.4). Conclusions: There is an association between pollen levels and asthma related emergencies, independent of the effect of air pollutants. The marked relationship observed for Poaceae and Plantago pollens suggests their implication in the epidemic distribution of asthma during the period coinciding with their abrupt release into the environment.
In this study we examined the shape of the association between temperature and mortality in 13 Spanish cities representing a wide range of climatic and socio-demographic conditions. The temperature ...value linked with minimum mortality (MMT) and the slopes before and after the turning point (MMT) were calculated. Most cities showed a V-shaped temperature-mortality relationship. MMTs were generally higher in cities with warmer climates. Cold and heat effects also depended on climate: effects were greater in hotter cities but lesser in cities with higher variability. The effect of heat was greater than the effect of cold. The effect of cold and MMT was, in general, greater for cardio-respiratory mortality than for total mortality, while the effect of heat was, in general, greater among the elderly.
Air pollutants and their monitoring Aránguez, E; Ordóñez, J M; Serrano, J ...
Revista española de salud pública,
1999 Mar-Apr, Letnik:
73, Številka:
2
Journal Article
Recenzirano
Some basic concepts regarding air pollution are set out. Although, from a health care standpoint, our interest revolves around the impact which pollution has on human health, it being important to ...ascertain the main pollutants, the sources of emissions, the physiochemical properties thereof, the sampling and analysis methods which are used at the air pollution control stations, the limits set by the laws currently in impact and the World Health Organization recommendations with regard to the levels of immission. This study reviews these concepts with regard to the pollutants which have been analyzed in the Spanish Multicenter Study of Air Pollution and Mortality (EMECAM): particles, sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3). For this purpose, the most recent publications on this subject have been used, including part of what is going to be the line around which all of the measures aimed at combating air pollution are going to be revolving in the very near future, that is, the new set of European Union Directives (some currently in the proposal stage) and the latest recommendations (not as yet published) of the World Health Organization. Lastly, a wide range of aspects are set out which involve Public Health in the field of air pollution, despite the monitoring and control thereof falling to the environmental affairs authorities in terms of government organization.
In the context of Public Health in Spain, Environmental Health does not possess the consideration it should have, according to the General Health Law and to the attention given to it frequently by ...our politicians in their speeches. The objectives of this paper are, on the one hand, to make a working proposal in the Environmental Health arena for the different Autonomous Communities in our country that takes into consideration, both the historical context from which we depart, and the philosophical standpoint we believe must underlie in the proposals; and on the other hand, that this working proposal be able to connect with the concerns and the social sectors that can give it the sufficient energy it requires to be reactivated on behalf of the prevention of environmental hazards. Besides, another underlying purpose of this group is that starting from this opinion paper, we can open a debate about the role of Environmental Health. We consider that this debate has been delayed for much time. We propose a serious debate; scientific, reflexive, critical, deep and vehement, so that Environmental Health will come out to the light with its own tools; those of the fields of Environmental Epidemiology, Toxicology and the Evaluation of the Environmental Impacts on Health.
Despite the changes which have taken place in the sources of emissions, the levels of particles, SO2 and CO continue to be high in the municipality of Madrid. Apart from this, photochemical ...pollutants, such as NO2 and O3 are taking on growing importance due to the increased number of cars and trucks on the road and the major degrees of sunlight in this city. The objective of this article is to set out the short-term relationship between the major pollutants and the daily death rate in the city of Madrid for the 1992-1995 period, using the standardized procedure of the EMECAM Projects (Spanish Multicenter Study of Air Pollution and Death Rate).
The daily fluctuations in the death rate for all causes except external ones for all ages and for those individuals over age 69, in addition to those of the circulatory system and respiratory apparatus are related to the daily fluctuations in particles (PM10), SO2, NO2, CO and O3, by means of autoregressive Poisson regression models. The seasonality, tendency, temperature, relative humidity, flu, day of the week, holidays and events out of the ordinary are controlled.
Statistically significant positive relationships were found to exist between SO2 and all of the death rate series analyzed, between CO and the death rate of individuals over age 69, as well as with cardiovascular and respiratory deaths and of the particles to the death rate as the result of cardiovascular disease. A statistically significant relationship was also found to exist between NO2 and the cardiovascular death rate. These impact are immediate, that is to say, they occur with the pollutants of the same day. No significant positive relationships were found to exist for O3.
These findings suggest that, for a broad spectrum of major pollutants, the current levels of air pollution in Madrid are related to a rise in the death rate.
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