Search

Hospitalizations for ischemic heart disease have an uneven distribution throughout Spain, in which Asturias is the community with the highest rates of acute myocardial infarction (AMI) and angina pectoris (AP). Cardiovascular diseases are related to environmental, socioeconomic and previous medical conditions, which result in geographical differences in the incidence of hospital admissions and mortality. The goal of this study was to describe the spatial distribution of hospital admissions in the central area of Asturias and explore the existence of spatial patterns or clusters. Urgent hospital admissions for AMI and angina AP in the hospitals of the central area of Asturias were registered, geocoded and grouped by census tracts. Standardized admission ratio, smoothed relative risk, posterior risk probability and analysis of spatial clusters between relative risks throughout the study area were calculated and mapped. Geographical differences were found in the distribution of hospital admissions for AMI and AP across the area and between men and women. The cluster analysis indicated contiguous census tracts with high relative risk values in the northwest region of the study area and low relative risk in the east, particularly for men. The geographical analysis shows the existence of patterns and spatial clusters in the incidence of AMI and AP, for both men and women, in the central area of Asturias.

BackgroundCardiovascular diseases are the leading cause of death worldwide; it is estimated that they cause 17 million deaths annually. In 2019, there were more than 29,000 deaths, and in 2018, ischemic heart diseases cause more than 118,000 hospitalisations in Spain. There is an unevenly distribution throughout the different autonomous communities, being Asturias the community with the highest rate for acute myocardial infarction (AMI) and angina pectoris (AP) of the country. Cardiovascular diseases are related to environmental, socioeconomic and previous medical conditions which result in geographical differences in the incidence of hospital admissions and mortality. To know the distribution of hospital admissions in the central area of Asturias and the existence of spatial patterns or clusters is the goal of this study.MethodsUrgent hospital admissions for AMI and angina AP in the hospitals of the central area of Asturias were registered, geocoded and grouped by census tracts. Standardised admission ratio, smoothed relative risk and posterior risk probability, together with analysis of spatial clusters between relative risks throughout the study area were calculated and mapped.ResultsGeographical differences were found in the distribution of hospital admissions for AMI and AP in the study area. The cluster analysis indicated aggregates of census tracts with high relative risk values in the northwest region of the study area.ConclusionThe geographical analysis shows the existence of patterns and spatial aggregations in the incidence of AMI and AP, for men and women, in the central area of Asturias.

There are several initiatives to develop systems for the notification of suspected occupational disease (OD) in different autonomous communities. The objective was to describe the status of development and characteristics of these systems implemented by the health authorities.A cross-sectional descriptive study was carried out on the existence of systems for the information and surveillance of suspected OD, their legal framework, responsible institution and availability of information. A specific meeting was held and a survey was designed and sent to all autonomous communities and autonomous cities (AACC). Information was collected on the existence of a regulatory standard, assigned human resources, notifiers, coverage and number of suspected OD received, processed and recognized.18 of 19 AACC responded. 10 have developed a suspected OD notification system, 3 of them supported by specific autonomic law. The notifiers were physicians of the public health services, physicians of the occupational health services and, in 2 cases, medical inspectors. 7 AACC had specific software to support the system. The OD recognition rate of suspected cases was 53% in the Basque Country; 41% in Castilla-La Mancha; 36% in Murcia; 32.6% in the Valencian Community and 31% in La Rioja.The study has revealed an heterogeneous development of suspected OD reporting systems in Spain. Although the trend is positive, only 55% of the AACC have some type of development and 39% have specific software supporting it. Therefore unequal OD recognition rates have been obtained depending on the territory.En algunas comunidades autónomas existen diversas iniciativas de sistemas para la comunicación de las sospechas de enfermedades profesionales (EP). El objetivo de este trabajo fue describir su grado de desarrollo y características de los sistemas puestos en marcha desde las administraciones sanitarias a nivel autonómico.Se realizó un estudio descriptivo transversal sobre la existencia de sistemas de información y vigilancia de las enfermedades laborales, marco legal, institución responsable y disponibilidad de la información. Se celebró una reunión y se diseñó una encuesta que se remitió a todas las comunidades y ciudades autónomas (CCAA). Se recogió información sobre existencia de normas reguladoras, recursos humanos asignados, responsables de la notificación, cobertura y número de sospechas de EP recibidas, tramitadas y reconocidas.Respondieron 17 CCAA y 1 ciudad autónoma. Tenían desarrollados sistemas de comunicación de sospecha de EP 10 de ella, de los cuales 3 se apoyaban en norma legal autonómica específica. Las personas responsables de la notificación fueron médicos de los servicios públicos de salud, de los servicios de prevención y, en 2 casos, médicos inspectores. 7 CCAA disponían de aplicación informática para dar soporte al sistema. La tasa de reconocimiento de EP de las sospechas tramitadas fue del 53% en el País Vasco; 41% en Castilla-La Mancha; 36% en Murcia; 32,6% en la Comunidad Valenciana y 31% en La Rioja.El estudio pone de manifiesto un desarrollo desigual de los sistemas de declaración de sospecha de EP en España. Aunque la tendencia es positiva, sólo la mitad de las CCAA tienen algún sistema de comunicación aunque no todos disponen de una aplicación informática que lo soporte, obteniéndose tasas de reconocimiento EP desiguales según la comunidad autónoma.

BACKGROUND: The studies conducted to date regarding the possibility that air pollutants are capable of having impact on human health have not led to homogenous findings. This study is aimed at estimating the degrees of relationship between the daily levels of the pollutants and the death rate on a short-terms basis in the two most populated cities in Asturias (Gijon and Oviedo), as well as contributing to increasing the statistical importance and the representative nature of the EMECAM Project, within which this study is comprised. METHODS: Ecological time series study, Estimate of degrees of group exposure based on the readings taken at the pollution control stations. Modeling of the death rate series, including control variables, by means of Poisson regression. Estimating risks related to each pollutant for the death rate, controlling the series-based autocorrelation. FINDINGS: Throughout the 1993-1996 period, the pollution by means of particles in suspension and CO was greater in Gijon, that involving SO2 and NO2 having been greater in Oviedo. In these two cities, the levels can be considered to be low and to fall within what is considered admissible under the laws currently in impact. Most of the relative risk forecasts neared the zero impact point, although significant positive (especially for NO2) as well as negative relationships have been found to exist. The significant relationships found were not proven to be consistent in these two cities for the periods studied. CONCLUSIONS: Based on the findings of this study, the conclusion cannot be drawn that a clear-cut relationship exists between the pollutants studied (particles, SO2, NO2, CO) and the death rate on a short-term basis, at least at the levels detected in Gijon and Oviedo.