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Background: studies examining associations of early-life cat and dog ownership with childhood asthma have reported inconsistent results. Several factors could explain these inconsistencies, including type of pet, timing, and degree of exposure.Objective: our aim was to study associations of early-life cat and dog ownership with asthma in school-aged children, including the role of type (cat vs dog), timing (never, prenatal, or early childhood), and degree of ownership (number of pets owned), and the role of allergic sensitization.Methods: we used harmonized data from 77,434 mother-child dyads from 9 birth cohorts in the European Union Child Cohort Network when the child was 5 to 11 years old. Associations were examined through the DataSHIELD platform by using adjusted logistic regression models, which were fitted separately for each cohort and combined by using random effects meta-analysis.Results: the prevalence of early-life cat and dog ownership ranged from 12% to 45% and 7% to 47%, respectively, and the prevalence of asthma ranged from 2% to 20%. There was no overall association between either cat or dog ownership and asthma (odds ratio [OR] = 0.97 [95% CI = 0.87-1.09] and 0.92 [95% CI = 0.85-1.01], respectively). Timing and degree of ownership did not strongly influence associations. Cat and dog ownership were also not associated with cat- and dog-specific allergic sensitization (OR = 0.92 [95% CI = 0.75-1.13] and 0.93 [95% CI = 0.57-1.54], respectively). However, cat- and dog-specific allergic sensitization was strongly associated with school-age asthma (OR = 6.69 [95% CI = 4.91-9.10] and 5.98 [95% CI = 3.14-11.36], respectively). There was also some indication of an interaction between ownership and sensitization, suggesting that ownership may exacerbate the risks associated with pet-specific sensitization but offer some protection against asthma in the absence of sensitization.Conclusion: our findings do not support early-life cat and dog ownership in themselves increasing the risk of school-age asthma, but they do suggest that ownership may potentially exacerbate the risks associated with cat- and dog-specific allergic sensitization.

Background The European Environment Agency estimates that 75% of the European population lives in cities. Despite the many advantages of city life, the risks and challenges to health arising from urbanization need to be addressed to tackle the growing burden of disease and health inequalities in the cities. This article presents the study protocol of the Urban Environment and Health: a cross-sectional multiregional project based on Population Health Surveys in Spain (DAS-EP project), that aims to investigate the complex association between the urban environmental exposures (UrbEE) and health. Methods DAS-EP is a Spanish multiregional cross-sectional project that combines Population Health Surveys (PHS) and Geographical Information System (GIS) allowing to collect rich individual level data from 17,000 adult citizens participating in the PHS conducted in the autonomous communities of the Basque Country and Andalusia, the Valencian Community, and the city of Barcelona in years 2021–2023. This study focuses on the population living in cities or metropolitan areas with more than 100,000 inhabitants. UrbEE are described by objective estimates at participants’ home addresses by GIS and subjective indicators present in PHS. The health outcomes included in the PHS and selected for this study are self-perceived health (general and mental), prevalence of chronic mental disorders, health-related quality of life, consumption of medication for common mental disorders, and sleep quality. We aim to further understand the direct and indirect effect between UrbEE and health as well as to estimate the impact at the population level taking respondents’ socio-demographic and socio-economic characteristics, and lifestyle into account. Discussion This study is a clear commitment to the generation of urban environment indicators within the field of public health with a health equity perspective. The results will be novel for the inclusion of objective & subjective UrbEE as well as the combination of PHS from different study areas and GIS estimates. This methodological approach will provide a large volume of information and a large sample size of the study. The results will ultimately help identify urban indicators, increasing the capacity to detect and intervene in community health, improving the routine surveillance and monitoring of the cities’ health information systems.

While prior studies report associations between fine particulate matter (PM2.5) exposure and fetal growth, few have explored temporally refined susceptible windows of exposure. We included 2328 women from the Spanish INMA Project from 2003 to 2008. Longitudinal growth curves were constructed for each fetus using ultrasounds from 12, 20, and 34 gestational weeks. Z-scores representing growth trajectories of biparietal diameter, femur length, abdominal circumference (AC), and estimated fetal weight (EFW) during early (0-12 weeks), mid- (12-20 weeks), and late (20-34 weeks) pregnancy were calculated. A spatio-temporal random forest model with back-extrapolation provided weekly PM2.5 exposure estimates for each woman during her pregnancy. Distributed lag non-linear models were implemented within the Bayesian hierarchical framework to identify susceptible windows of exposure for each outcome and cumulative effects [βcum, 95% credible interval (CrI)] were aggregated across adjacent weeks. For comparison, general linear models evaluated associations between PM2.5 averaged across multi-week periods (i.e., weeks 1-11, 12-19, and 20-33) and fetal growth, mutually adjusted for exposure during each period. Results are presented as %change in z-scores per 5 μg/m3 in PM2.5, adjusted for covariates. Weeks 1-6 [βcum = -0.77%, 95%CrI (-1.07%, -0.47%)] were identified as a susceptible window of exposure for reduced late pregnancy EFW while weeks 29-33 were positively associated with this outcome [βcum = 0.42%, 95%CrI (0.20%, 0.64%)]. A similar pattern was observed for AC in late pregnancy. In linear regression models, PM2.5 exposure averaged across weeks 1-11 was associated with reduced late pregnancy EFW and AC; but, positive associations between PM2.5 and EFW or AC trajectories in late pregnancy were not observed. PM2.5 exposures during specific weeks may affect fetal growth differentially across pregnancy and such associations may be missed by averaging exposure across multi-week periods, highlighting the importance of temporally refined exposure estimates when studying the associations of air pollution with fetal growth. This work was supported by grant R01ES028842 from the National Institutes of Health / National Institute of Environmental Health Sciences (NIH/ NIEHS); grants Red INMA G03/176, CB06/02/004; ISCIII-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI04/2018, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/02311, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI13/02429, PI14/00891, PI14/01687, PI16/1288, PI16/00118, PI17/00663, PI18/00909, PI18/01142, PI18/01237; Miguel Servet-FEDER CP11/00178, CP15/00025, CPII16/00051, CPII18/00018, and CP16/00128 from Instituto de Salud Carlos III, grant 1999SGR 00241 from Generalitat de Catalunya- CIRIT, grant FP7-ENV-2011 cod 282957 and HEALTH. 2010.2.4.5–1 from the EU Commission, Assistance Award No. R-82811201 from the Health Effects Institute, grant UGP 15-230, UGP-15-244, and UGP-15-249 from Generalitat Valenciana: FISABIO, grant 2005111093 from Alicia Koplowitz Foundation (2017), Department of Health of the Basque Government, grant DFG06/002 from the Provincial Government of Gipuzkoa, and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain), Obra Social Cajastur/Fundación Liberbank, and Universidad de Oviedo. We also acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. KWW and ES were partially supported by the P30 Environmental Health Sciences Core Center grant P30ES030285 from the NIH/NIEHS and by funding from the NIH/National Institute on Minority Health and Health Disparities (NIMHD) under Award Number P50MD015496. JI was supported by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences.

Circadian rhythms have been identified in cardiovascular diseases, and cardiovascular risk factors can modify the circadian rhythm. The purpose of this study was to describe the onset of ischaemic heart disease symptomatology in relation to the date and time, the day of the week of presentation, the season, AMI location and severity and the level of influence of individual patient characteristics in a retrospective cross-sectional study involving 244 ischaemic heart disease patients from the intensive care unit of La Ribera Hospital (Spain). The onset of pain was more frequent in the morning, the season with the highest frequency of ischaemic events was winter, and the lowest incidence was during weekends. Regarding the severity of ischaemic heart disease, the circadian rhythm variables of weekdays vs. weekends and seasons did not show a significant association. The length of hospital stay was associated with the onset of pain in the afternoon. The onset of pain at night was associated with the subendocardial location of the infarction. In conclusion, living in a Mediterranean country, the Spanish population showed a circadian pattern of AMI, where the onset of pain has an influence on AMI location and on the length of hospital stay and is the same in patients with different individual risk factors.

BackgroundInternational sharing of cohort data for research is important and challenging. The LifeCycle project aimed to harmonise data across birth cohorts and develop methods for efficient federated analyses of early life stressors on offspring outcomes.AimTo explore feasibility of federated analyses of associations between four different types of pregnancy exposures (maternal education, area deprivation, proximity to green space and gestational diabetes) with offspring BMI from infancy to 17 years.MethodsWe used harmonised exposure and outcome data from 17 cohorts (n=200,650 mother-child pairs) from the EU Child Cohort Network. For each child, we derived BMI at five age periods: (i) 0-1 years, (ii) 2-3, (iii) 4-7, (iv) 8-13 and (v) 14-17 years. Associations were estimated using linear regression via one-stage individual participant data meta-analysis using the federated analysis platform DataSHIELD.ResultsAssociations between lower maternal education and higher child BMI emerged from age 4 years and increased with age (difference in BMI z-score comparing low with high education age 0-1 years = 0.02 [95% CI 0.00, 0.03], 2-3 years = 0.01 [CI -0.02, 0.04], 4-7 years = 0.14 [CI 0.13, 0.16], 8-13 years = 0.22 [CI 0.20, 0.24], 14-17 years = 0.20 [CI 0.16, 0.23]). A similar pattern was found for area deprivation. Gestational diabetes was positively associated with BMI from 8 years (8-13 years = 0.17 [CI 0.10, 0.24], 14-17 years = 0.012 [CI -0.13, 0.38]) but not at younger ages. The normalised difference vegetation index measure of maternal proximity to green space was weakly associated with higher BMI in the first year of life but not at older ages.ConclusionsAssociations between maternal education, area-based socioeconomic position and GDM with BMI increased with age. Maternal proximity to green space was not associated with offspring BMI, other than a weak association in infancy. Opportunities and challenges of cross-cohort federated analyses are discussed.

An accumulating body of evidence has associated exposure to greenspace with improved birth outcomes, including higher birth weight and lower risk of low birth weight; however, evidence on such association with in-utero fetal growth is scarce. We explored the influence of maternal exposure to residential greenspace and fetal growth in four INMA (Infancia y Medio Ambiente) Spanish birth cohorts (2003-2008), with 2,465 participants. Residential greenspace was characterised by the Normalised Difference Vegetation Index (NDVI) average across 100 m, 300 m, and 500 m buffers around the residence. Repeated ultrasound measurements of the abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW) were used. We created customised-generalised least squares models to evaluate associations of residential greenspace exposure on each fetal growth parameter, controlled for the relevant confounders. There were associations be-tween the 500 m buffer and BPD, FL, and AC. We also found associations in the 300 m buffer and FL and AC. The associations in the 100 m buffer were null. Estimates were higher among participants with lower socioeconomic status. Mediation analyses found that air pollution might explain 15-37% of our associations. Mediation by physical activity was not observed. Greenspace exposure may be beneficial for fetal growth. We are grateful to all the participants for their generous collaboration. A full roster of the INMA Project founders can be found at: https://www.proyectoinma.org/proyecto-inma/financiadores/. Maria Torres Toda is funded by a PFIS (Contrato Predoctoral de Formación en Investigación en Salud) fellowship (FI17/00128) awarded by Instituto de Salud Carlos III. Maria Foraster is beneficiary of an AXA Research Fund grant. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation and State Research Agency through the “Centro de Excelencia Severo Ochoa 2019–2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.

Despite extensive study, the role of air pollution in gestational diabetes remains unclear, and there is limited evidence of the beneficial impact of residential greenness on metabolic dysfunction during pregnancy. We used data from mothers in the Spanish INfancia y Medio Ambiente (INMA) Project from 2003–2008. We obtained spatiotemporally resolved estimates of fine particulate matter (PM2.5) and nitrogen dioxide (NO2) exposures in early pregnancy and estimated residential greenness using satellite-based Normal Difference Vegetation Index (NDVI) within 100, 300 and 500 m buffers surrounding the mother’s residence. We applied logistic regression models to evaluate associations between each of the three exposures of interest and (a) glucose intolerance and (b) abnormal lipid levels. We found limited evidence of associations between increases in PM2.5 and NO2 exposures and the metabolic outcomes. Though not statistically significant, high PM2.5 exposure (≥25 µg/m3) was associated with increased odds of glucose intolerance (OR = 1.16, 95% CI: 0.82, 1.63) and high cholesterol (OR = 1.14, 95% CI: 0.90, 1.44). High NO2 exposure (≥39.8 µg/m3) was inversely associated with odds of high triglycerides (OR = 0.70, 95% CI: 0.45, 1.08). Whereas NDVI was not associated with glucose intolerance, odds of high triglycerides were increased, although the results were highly imprecise. Results were unchanged when the air pollutant variables were included in the regression models. Given the equivocal findings in our study, additional investigations are needed to assess effects of air pollution and residential greenness on metabolic dysfunction during pregnancy. This work is supported by a National Institute of Environmental Health Sciences (NIEHS) fellowship from the Training in Precision Environmental Health Sciences (TPEHS) Program (NIH Grant No. T32ES027801). E.S., K.W.W., and C.I.A. were partially supported by a NIEHS P30 Environmental Health Sciences Core Center grant (P30ES030285). The INMA study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI17/00663, FIS-PI18/01142 incl. FEDER funds; Miguel Servet-FEDER CP11/00178, CP15/00025, and CPII16/00051, CPII18/00018), Generalitat de Catalunya-CIRIT 1999SGR 00241, EU Commission (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249), and Alicia Koplowitz Foundation 2017, Department of Health of the Basque Government (2005111093), Provincial Government of Gipuzkoa (DFG06/002), and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain). We also acknowledge support from the Spanish Ministry of Science and Innovation and the State Research Agency through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.

espanolObjetivo Describir el riesgo de pobreza y exclusion social en ninos/as de 8-11 anos de Gipuzkoa y Valencia (Espana), mediante los indicadores AROPE (At Risk Of Poverty or Social Exclusion), y evaluar sus factores asociados en el Proyecto INMA (Infancia y Medio Ambiente). Metodo Familias de Gipuzkoa y Valencia (394 y 382, respectivamente) completaron un cuestionario en 2015-2016. Se estimaron la baja intensidad de trabajo (BIT), el riesgo de pobreza (RP) y la privacion material (PM). AROPE consistio en cumplir cualquiera de estos subindicadores. Se consideraron caracteristicas sociodemograficas, familiares y parentales. Se usaron diagramas de Venn, los test de Ji-cuadrado y Fisher en los analisis bivariados, y regresion logistica en los analisis multivariados. Resultados Se obtuvieron prevalencias para BIT, RP, PM y AROPE del 2,5%, 5,6%, 2,3% y 7,2% en Gipuzkoa, y del 8,1%, 31,5%, 7,8% y 34,7% en Valencia, respectivamente. En el analisis multivariado, el AROPE se asocio en ambas areas con la clase social materna y la familia no nuclear. En Gipuzkoa, tambien se relaciono con la educacion materna. En Valencia, otros factores fueron el origen extranjero materno y la educacion y el tabaquismo paternos. Conclusion Hay un AROPE mas alto en Valencia. La clase social y el tipo de familia fueron factores compartidos, pero se observa un patron diferencial en otros determinantes sociales. Es esencial implementar politicas sociales para reducir este eje de desigualdad en salud, especialmente en la infancia. EnglishObjective Describe the risk of poverty and social exclusion in children aged 8-11 years from Gipuzkoa and Valencia (Spain), through AROPE (At Risk Of Poverty or Social Exclusion) indicators, and evaluate their associated factors in the INMA Project (Childhood and Environment). Method Families in Gipuzkoa and Valencia (394 and 382, respectively) completed a questionnaire in 2015-2016. Low work intensity (LWI), at risk of poverty (RP) and material deprivation (MD) were estimated. AROPE consisted in meeting any of the previous sub-indicators. Socio-demographic, family and parental characteristics were considered. Frequencies, Venn's diagrams, and chi-square and Fisher tests were used in bivariate analysis and logistic regression in multivariate analysis. Results For LWI, RP, MD and AROPE, prevalence of 2.5%, 5.6%, 2.3% and 7.2% were obtained in Gipuzkoa, and 8.1%, 31.5%, 7.8% and 34.7% in Valencia, respectively. In the multivariate analysis, the AROPE was associated in both areas with maternal social class and non-nuclear families. In Gipuzkoa, it was also related to maternal education. In Valencia, other factors were the mother's foreign origin, and paternal education and smoking. Conclusion There is higher AROPE prevalence in Valencia. Social class and family type were shared factors, but a differential pattern is observed in other social determinants. It is essential to implement social policies to reduce this axis of inequalities in health, especially in childhood.

Mental health problems are common in childhood and tend to be more frequent in populations at risk of poverty or social exclusion (AROPE). The family environment can play a role in reducing the impact of economic hardship on these problems. The aim of this study was to assess the effect of multidimensional poverty on the mental health of children aged 7–11 years and the role of the family environment in two areas of Spain. Participants were 395 and 382 children aged 7 and 11 from Gipuzkoa and Valencia, respectively. Internalizing and externalizing problem scales of the child behaviour checklist (CBCL) were used. AROPE indicators were obtained by questionnaire, and three dimensions of the family context (Organization of the Physical Environment and Social Context, Parental Stress and Conflict, and Parental Profile Fostering Development) were measured through subscales 3, 4 and 5 of the Haezi-Etxadi family assessment scale (7–11) (HEFAS 7–11), respectively. Data were analysed using negative binomial regression and Structural Equation Modelling. AROPE prevalence was 7.1 and 34.5% in Gipuzkoa and Valencia, respectively. In both cohorts, there was a significant increase in internalizing and externalizing problems among participants with a higher AROPE score. However, AROPE did not affect internalizing problems in children from families living in a better physical environment and with social support (Subscale 3). The AROPE effect was jointly mediated by subscales 4 and 5 in 42 and 62% of internalizing and externalizing problems, respectively. Preventing economic inequities by economic compensation policies, improving the neighbourhood and immediate environment around the school, and promoting positive parenting programmes can improve mental health in childhood. Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This study was funded by Grants from the European Union (FP7-ENV-2011 code 282957 and HEALTH.2010.2.4.5-1), Spain Instituto de Salud Carlos III (ISCIII) (Red INMA G03/176, CB06/02/0041, FIS-FEDER PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI05/1079, PI05/1052, PI06/0867, PI06/1213, PI07/0314, PI09/00090, PI09/02647, PI11/01007, PI11/02591, PI11/02038, PI13/1944, PI13/2032, PI13/02187, PI14/00891, PI14/01687, PI16/1288, PI17/00663, and PI19/01338), Generalitat Valenciana Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) (UGP 15-230, UGP-15-244, and UGP-15-249), Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Department of Health of the Basque Government (2005111093, 2009111069, 2013111089 and 2015111065), and the Provincial Government of Gipuzkoa (DFG06/002, DFG08/001 and DFG15/221) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia, Azpeitia, and Beasain).

Effects of mercury on maturing immune system have been reported, however the association with respiratory and allergy problems during infancy remains unclear. The aim of this study is to evaluate the association between pre and postnatal mercury exposure and respiratory and allergy problems among preschool children and to examine the role of potential modifying factors. Study subjects were children participant in Spanish Childhood and Environment Project (INMA, 2003-2008). We measured total mercury levels in cord blood (n = 1868) and hair at 4 years of age (n = 1347). Respiratory outcomes (wheezing, severe wheezing, chestiness, persistent cough, eczema and otitis) were obtained by questionnaires administered to parents. Associations were investigated by logistic regression adjusted for socio-demographic and lifestyle-related variables in each cohort and subsequent meta-analysis. We tested effect modification by factors related to individual susceptibility, diet and co-exposure with other pollutants. The geometric mean of cord blood and hair total mercury was 8.20 μg/L and 0.97 μg/g, respectively. No statistically significant association between pre or postnatal mercury exposure and respiratory and allergy outcomes was found. Notwithstanding, lower maternal intake of fruits and vegetables increased the risk of some respiratory outcomes due to the prenatal exposure to mercury (pint < 0.05). Moreover, an inverse association between prenatal mercury exposure and some respiratory outcomes was observed among children with higher maternal exposure to organocholorine compounds or smoking (pint < 0.05). Also, sex and postnatal smoking exposure modulated mercury postnatal effects on persistent cough (pint < 0.05). In conclusion, no association between pre and postnatal mercury exposure and respiratory and allergy problems among the whole population at study was found. However, diet and other toxicants could modulate this relation, especially during prenatal period. More research on this topic is warranted due to the limited evidence. This study was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), Spain: ISCIII (Red INMA G03/176, CB06/02/0041; FIS-FEDER: PI03/1615, PI04/1509, PI04/1112, PI04/1931, PI04/2018, PI04/1436, PI05/1079, PI05/1052, PI06/1213, PI06/0867, PI07/0314, PI08/1151, PI09/00090, PI09/02647, PI09/2311, PI11/01007, PI11/02591, PI11/02038, PI13/2429, PI13/02187, PI13/1944, PI13/2032, PI14/00891, PI14/01687, PI16/1288, PI17/00663, PI18/01142, PI18/0909, PI19/1338; Miguel Servet-FEDER: CP15/0025; Miguel Servet-FSE: MS15/0025, MS20/0006), Generalitat Valenciana: FISABIO (UGP 15-230, UGP-15-244, and UGP-15-249), BEST/2020/059, AICO/2020/285 and GV/2020/058, Alicia Koplowitz Foundation 2017, Generalitat de Catalunya-CIRIT 1999SGR 00241, Fundació la Marató de TV3 (090430), CIBERESP, Obra Social Cajastur/Fundación Liberbank, Universidad de Oviedo, Department of Health of the Basque Government (2005111093, 2009111069, 2013111089 and 2015111065), and the Provincial Government of Gipuzkoa (DFG06/002, DFG08/001 and DFG15/221) and annual agreements with the municipalities of the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain).

Mental health problems are common in childhood and tend to be more frequent in populations at risk of poverty or social exclusion (AROPE). The family environment can play a role in reducing the impact of economic hardship on these problems. The aim of this study was to assess the effect of multidimensional poverty on the mental health of children aged 7-11 years and the role of the family environment in two areas of Spain. Participants were 395 and 382 children aged 7 and 11 from Gipuzkoa and Valencia, respectively. Internalizing and externalizing problem scales of the child behaviour checklist (CBCL) were used. AROPE indicators were obtained by questionnaire, and three dimensions of the family context (Organization of the Physical Environment and Social Context, Parental Stress and Conflict, and Parental Profile Fostering Development) were measured through subscales 3, 4 and 5 of the Haezi-Etxadi family assessment scale (7-11) (HEFAS 7-11), respectively. Data were analysed using negative binomial regression and Structural Equation Modelling. AROPE prevalence was 7.1 and 34.5% in Gipuzkoa and Valencia, respectively. In both cohorts, there was a significant increase in internalizing and externalizing problems among participants with a higher AROPE score. However, AROPE did not affect internalizing problems in children from families living in a better physical environment and with social support (Subscale 3). The AROPE effect was jointly mediated by subscales 4 and 5 in 42 and 62% of internalizing and externalizing problems, respectively. Preventing economic inequities by economic compensation policies, improving the neighbourhood and immediate environment around the school, and promoting positive parenting programmes can improve mental health in childhood.

Objectives: We investigated the association between outdoor air pollutants exposure in the first trimester of pregnancy, and growth and cardio-metabolic risk at four years of age, and evaluated the mediating role of birth weight. Methods: We included mother-child pairs (N = 1,724) from the Spanish INMA birth cohort established in 2003-2008. First trimester of pregnancy nitrogen dioxide (NO2) and fine particles (PM2.5) exposure levels were estimated. Height, weight, waist circumference, blood pressure, and lipids were measured at four years of age. Body mass index (BMI) trajectories from birth to four years were identified. Results: Increased PM2.5 exposure in the first trimester of pregnancy was associated with decreased z-scores of weight (zWeight) and BMI (zBMI) (zWeight change per interquartile range increase in PM2.5 exposure = -0.12; 95% CI: -0.23, -0.01; zBMI change = -0.12; 95% CI: -0.23, -0.01). Higher NO2 and PM2.5 exposure was associated to a reduced risk of being in a trajectory with accelerated BMI gain, compared to children with the average trajectory. Birth weight partially mediated the association between PM2.5 and zWeight and zBMI. PM2.5 and NO2 were not associated with the other cardio-metabolic risk factors. Conclusions: This comprehensive study of many growth and cardio-metabolic risk related outcomes suggests that air pollution exposure during pregnancy may be associated with delays in physical growth in the early years after birth. These findings imply that pregnancy exposure to air pollutants has a lasting effect on growth after birth and require follow-up at later child ages. This study was funded by grants from the Eulji University (grant numbers ESCAPE project FP7-ENV-2007-1-211250, DENAMIC project FP7-ENV-2011-282957, HELIX project FP7-ENV-2012-308333, and MEDALL project HEALTH.2010.2.4.5-1), from the Spanish Instituto de Salud Carlos III (grant numbers Red INMA G03/176; CB06/02/0041; PI03/1615 incl. FEDER funds, PI04/1112 incl. FEDER funds, PI041436, PI04/1509 incl. FEDER funds, PI04/1931 incl. FEDER funds, PI042018 incl. FEDER funds, PI05/1079 incl. FEDER funds, PI05/1052 incl. FEDER funds, FIS-PI06/0867, PI06/1213 incl. FEDER funds, PI07/0314 incl. FEDER funds, PI081151 incl. FEDER funds, FIS-PI09/00090, PI09/02311 incl. FEDER funds, PI09/02647 incl. FEDER funds, PI11/01007 incl. FEDER funds, PI11/02591 incl. FEDER funds, PI11/02038 incl. FEDER funds, PI13/1944 incl. FEDER funds, PI13/2032 incl. FEDER funds, PI13/02429 incl. FEDER funds, PI14/00891 incl. FEDER funds, PI14/01687 incl. FEDER funds, PI15/00118 incl. FEDER funds, PI16/1288 incl. FEDER funds, and PI17/00663 incl. FEDER funds, PI18/00547 incl. FEDER funds, PI18/00909 incl. FEDER funds; CP11/00178, CP15/00025, and CPII16/00051; MS13/00054 incl. FEDER funds), CIBERESP, Department of Health of the Basque Government (grant numbers 2005111093, 2013111089), Generalitat de Catalunya-CIRIT (grant numbers 1999SGR 00241), Generalitat Valenciana: FISABIO (grant numbers UGP 15-230, UGP-15-244, and UGP-15-249), Provincial Government of Gipuzkoa (grant number DFG06/002), Alicia Koplowitz Foundation 2017, Fundacio La marato de TV3 (grant number 090430), Obra Social Cajastur/Fundacion Liberbank, Universidad de Oviedo, and annual agreements with the municipalities of the study area of the Gipuzkoa sub-cohort (Zumarraga, Urretxu, Legazpi, Azkoitia, Azpeitia and Beasain). ISGlobal is a member of the Agency for the Research Centres of Catalonia (CERCA) Programme, Generalitat de Catalunya.

Exposure to greenspace has been related to improved mental health, but the available evidence is limited and findings are heterogeneous across different areas. We aimed to evaluate the associations between residential exposure to greenspace and specific psychopathological and psychosomatic symptoms related to mental health among mothers from a Spanish birth cohort. Our study was based on data from 1171 women participating in two follow-ups of a population-based cohort in Valencia, Sabadell, and Gipuzkoa (2004&ndash, 2012). For each participant, residential surrounding greenspace was estimated as the average of the satellite-based Normalized Difference Vegetation Index (NDVI) across different buffers around the residential address at the time of delivery and at the 4-year follow-up. The Symptom Checklist 90 Revised (SCL-90-R) was applied to characterize mental health at the 4-year follow-up. We developed mixed-effects logistic regression models controlled for relevant covariates to evaluate the associations. Higher residential surrounding greenspace was associated with a lower risk of somatization and anxiety symptoms. For General Severity Index (GSI), obsessive&ndash, compulsive, interpersonal sensitivity, depression, hostility, phobic anxiety, paranoid ideation, and psychoticism symptoms, we generally observed protective associations, but none attained statistical significance. Findings from this study suggested a potential positive impactof greenspace on mental health.

Lungs are highly vulnerable to permanent harmful effects of environmental factors during their in-utero and early life development. The detrimental effects of air pollution on lung development are well known although studies mainly focused on the postnatal exposure period. We investigated the windows of susceptibility during pregnancy and first 7 postnatal years on the association between nitrogen dioxide (NO2) and lung function at the age of 7 years in the INMA cohort in Spain. We estimated monthly average exposure to NO2 for the prenatal and postnatal period at home address of 1230 children with temporally-adjusted land use regression models. Spirometry was performed at age 7. We estimated the change in lung function associated with 10 µg/m3 increase in NO2 concentrations with distributed lag models, which consider the association at a specific time point while controlling for exposure at all other periods. Mean NO2 concentration was 30.3 (±15.2) µg/m3 and the average interquartile range was 19.9 µg/m3. Results on complete cases (n=856) identified two sensitive exposure periods associated with a reduction of the FVC: (i) from the half of the second trimester until the end of pregnancy (e.g. prenatal month 7: -3.3 [95% CI: -5.4, -1.2] ml for 10 µg/m3 increase in NO2) and (ii) at 3 years old (e.g. postnatal month 46: -1.9 [95%CI: -3.5, -0.3] ml). Moreover, a sensitive window when the children turn 3 years old was identified with a decrease on FEV1 of -1.7 [95% CI: -3.0, -0.3] ml for each 10 µg/m3 increase of NO2 (in postnatal month 36). Exposure to NO2 at sensitive periods including pregnancy and first years of life is associated with a lower lung function at 7 years.

Objective: We integratively assessed the effect of different indoor and outdoor environmental exposures early in life on respiratory and allergic health conditions among children from (sub-) urban areas. Methods: This study included children participating in four ongoing European birth cohorts located in three different geographical regions: INMA (Spain), LISAplus (Germany), GINIplus (Germany) and BAMSE (Sweden). Wheezing, bronchitis, asthma and allergic rhinitis throughout childhood were assessed using parental-completed questionnaires. We designed “environmental scores” corresponding to different indoor, green- and grey-related exposures (main analysis, a-priori-approach). Cohort-specific associations between these environmental scores and the respiratory health outcomes were assessed using random-effects meta-analyses. In addition, a factor analysis was performed based on the same exposure information used to develop the environmental scores (confirmatory analysis, data-driven-approach). Results: A higher early exposure to the indoor environmental score increased the risk for wheezing and bronchitis within the first year of life (combined adjusted odds ratio: 1.20 [95% confidence interval: 1.13–1.27] and 1.28 [1.18–1.39], respectively). In contrast, there was an inverse association with allergic rhinitis between 6 and 8 years (0.85 [0.79–0.92]). There were no statistically significant associations for the outdoor related environmental scores in relation to any of the health outcomes tested. The factor analysis conducted confirmed these trends. Conclusion: Although a higher exposure to indoor related exposure through occupants was associated with an increased risk for wheezing and bronchitis within the 1st year, it might serve as a preventive mechanism against later childhood allergic respiratory outcomes in urbanized environments through enhanced shared contact with microbial agents. This study was funded by Grants from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), and from Spain: Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041, FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314, 09/02647, 11/0178, 11/01007, 11/02591, 11/02038, 13/1944, 13/2032, 14/0891, and 14/1687) and the Conselleria de Sanitat, Generalitat Valenciana. The BAMSE study has been supported by the Swedish Research Council, the Swedish Heart-Lung Foundation, the Swedish Research Council Formas, the Swedish Environment Protection Agency, the European Community's Seventh Framework Program (FP7/2007–2011 under grant agreement no. 211250), the Swedish Asthma and Allergy Association Research Foundation, and the Stockholm County Council. Christina Tischer is a recipient of a European Respiratory Society Fellowship (RESPIRE2 – 2015– 7251). Payam Dadvand is funded by a Ramón y Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and Competitiveness. Elaine Fuertes is supported by a Marie Skłodowska-Curie Individual Fellowship (H2020-MSCA-IF-2015; proposal number 704268).

Background: Prenatal and postnatal exposure to air pollution has been linked to cognitive impairment in children, but very few studies have assessed its association with attentional function. Objectives: To evaluate the association between prenatal and postnatal exposure to nitrogen dioxide (NO2) and attentional function in children at 4–5 years of age. Methods: We used data from four regions of the Spanish INMA—Environment and Childhood—Project, a population-based birth cohort. Using land-use regression models (LUR), we estimated prenatal and postnatal NO2 levels in all of these regions at the participants' residential addresses. We assessed attentional function using the Kiddie-Conners Continuous Performance Test (K-CPT). We combined the region-specific adjusted effect estimates using random-effects meta-analysis. Results: We included 1298 children with complete data. Prenatal exposure to NO2 was associated with an impaired standard error of the hit reaction time (HRT(SE)) (increase of 1.12 ms [95% CI; 0.22 a 2.02] per 10 μg/m3 increase in prenatal NO2) and increased omission errors (6% [95% CI; 1.01 to 1.11] per 10 μg/m3 increase in prenatal NO2). Postnatal exposure to NO2 resulted in a similar but borderline significant increase of omission errors (5% [95% CI; =0.99 to 1.11] per 10 μg/m3 increase in postnatal NO2). These associations did not vary markedly between regions, and were mainly observed in girls. Commission errors and lower detectability were associated with prenatal and postnatal exposure to NO2 only in some regions. Conclusions: This study indicates that higher exposure to ambient NO2, mainly during pregnancy and to a lesser extent postnatally, is associated with impaired attentional function in children at 4–5 years of age., This study was funded by grants from the Instituto de Salud Carlos III (Red INMA G03/176; CB06/02/0041 and PI031615; PI041931; PI041112; PI041436; PI041509; PI042018; PI051079; PI051052; PI060867; PI061213; PI070314; CP1100178; PI081151 incl. FEDER funds; PS0900090 incl. FEDER funds; PI0902311 incl. FEDER funds; PI0902647 incl. FEDER funds; PI1102591 incl. FEDER funds; PI1102038 incl. FEDER funds; PI131944 incl. FEDER funds; PI132032 incl. FEDER funds; PI1302429 incl. FEDER funds; PI1302187 incl. FEDER funds; PI140891 incl. FEDER funds; PI141687 incl. FEDER funds and MS13/00054), Generalitat de Catalunya-CIRIT 1999SGR 00241, Fundació La marató de TV3 (090430), Department of Health of the Basque Government (2005111093, 2009111069 and 2013111089), the Provincial Government of Gipuzkoa (DFG06/002 and DFG08/001), Convenios anuales con los ayuntamientos de la zona del estudio (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain), from UE (FP7-ENV-2011 cod 282957 and HEALTH.2010.2.4.5-1), from the European Research Council under the ERC Grant Agreement number ERC-AdG 2010 GA#268479 – the BREATHE project, from the Conselleria de Sanitat of Generalitat Valenciana (AP212/11, 002/008, 012/009, 013/2009, 014/009, 015/008, 016/009, 021/007, 021/008, 023/008 and 024/007) and from Obra Social Cajastur/Fundación Liberbank and Universidad de Oviedo. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya.

Purpose Median urinary iodine concentration (UIC) is used to describe the iodine status of a population. However, the link between UIC and iodine intake may vary during pregnancy. The aim of this study was to compare UIC during and after pregnancy, adjusting for factors that affect iodine intake. Methods Two repeated measures of UIC and data on maternal iodine intake estimated through questionnaires were collected during pregnancy and 1–4 years after pregnancy in a subsample of women (n = 598) from a mother and child cohort study in Spain. Random-effects interval regression was used to assess the changes in UIC according to pregnancy status. Results Median UIC was similar during (133 μg/L) and after pregnancy (139 μg/L). After adjusting for iodised salt, iodine supplement consumption, and socio-demographic related variables, UIC was 24.0% (95% CI 11.3, 38.2) higher after than during pregnancy. This difference was maintained in a subsample of women with exhaustive information on diet (n = 291): 26.2%, 95% CI 10.3, 44.4. Conclusions In an iodine sufficient area for the general population, iodine excretion was lower during than after pregnancy when factors affecting iodine intake were controlled for. Current recommendations of median UIC during pregnancy are based on the equivalence between iodine intake and UIC estimated from studies in non-pregnant populations, which might lead to overestimation of iodine deficiency during gestation. Further studies should evaluate the equivalence between iodine intake and its urinary excretion during pregnancy.

Airborne ultrafine particles (UFP) have been related to adverse health effects, but exposure in vulnerable population groups such as children is still not well understood. We aim to review the scientific literature regarding personal exposure to UFP in different microenvironments in populations until 18 years of age. The bibliographical search was carried out in July 2019 using the online database PubMed and was completed with references in articles found in the search. We selected the studies that used continuous counters and measured UFP levels in both specific microenvironment (houses, schools, transport, etc) and personal exposure. Finally, 32 studies fulfilled the criteria: of these, 10 analyzed personal exposure and 22 examined UFP levels in the microenvironment (especially in schools or nurseries (18/22)) and five in various microenvironments (including dwellings and means of transport, where exposure levels were higher). The characteristics of the microenvironments with the greatest levels of UFP were being close to heavy traffic or near cooking and cleaning activities. This review revealed the wide differences in exposure assessment methodologies that could lead to a lack of uniform and comparable information about the real UFP exposure in children.

Key Points Question Is exposure to ambient air pollution in the first trimester associated with thyroid function throughout pregnancy? Findings Among 9931 pregnant women in 4 European cohorts and 1 US cohort, an increase of 5 μg/m3 in exposure to particulate matter with an aerodynamic diameter of 2.5 μm or less was associated with 20% higher odds of hypothyroxinemia. Meaning The findings of this study raise the possibility that exposure to particulate matter might disrupt thyroid function in pregnant women., This cohort study evaluates the short-term association of exposure to air pollution in the first trimester with thyroid function throughout pregnancy among European and US cohorts., Importance Air pollutants interact with estrogen nuclear receptors, but their effect on thyroid signaling is less clear. Thyroid function is of particular importance for pregnant women because of the thyroid’s role in fetal brain development. Objective To determine the short-term association of exposure to air pollution in the first trimester with thyroid function throughout pregnancy. Design, Setting, and Participants In this cohort study, 9931 pregnant women from 4 European cohorts (the Amsterdam Born Children and Their Development Study, the Generation R Study, Infancia y Medio Ambiente, and Rhea) and 1 US cohort (Project Viva) with data on air pollution exposure and thyroid function during pregnancy were included. The recruitment period for the Amsterdam Born Children and Their Development Study was January 2003 to March 2004; for Generation R, April 2002 to January 2006; for Infancia y Medio Ambiente, November 2003 to January 2008; for Rhea, February 2007 to February 2008; and for Project Viva, April 1999 to November 2002. Statistical analyses were conducted from January 2018 to April 2019. Main Outcomes and Measures Residential air pollution concentrations (ie, nitrogen oxide and particulate matter [PM]) during the first trimester of pregnancy were estimated using land-use regression and satellite-derived aerosol optical depth models. Free thyroxine, thyrotropin, and thyroid peroxidase antibody levels were measured across gestation. Hypothyroxinemia was defined as free thyroxine below the fifth percentile of the cohort distribution with normal thyrotropin levels, following the American Thyroid Association guidelines. Results Among 9931 participants, the mean (SD) age was 31.2 (4.8) years, 4853 (48.9%) had more than secondary educational levels, 5616 (56.6%) were nulliparous, 404 (4.2%) had hypothyroxinemia, and 506 (6.7%) tested positive for thyroid peroxidase antibodies. Concentrations of nitrogen dioxide and PM with an aerodynamic diameter of 2.5 μm or less (PM2.5) were lower and had less variation in women in the US cohort than those in European cohorts. No associations of nitrogen oxide with thyroid function were found. Higher exposures to PM2.5 were associated with higher odds of hypothyroxinemia in pregnant women (odds ratio per 5-μg/m3 change, 1.21; 95% CI, 1.00-1.47). Although exposure to PM with an aerodynamic diameter of 10 μm or less was not significantly associated with hypothyroxinemia, the coefficient was similar to that for the association of PM2.5 with hypothyroxinemia (odds ratio per 10-μg/m3 change, 1.18; 95% CI, 0.93-1.48). Absorbances of PM2.5 and PM with aerodynamic diameter from 2.5 to 10 μg and were not associated with hypothyroxinemia. There was substantial heterogeneity among cohorts with respect to thyroid peroxidase antibodies (P for heterogeneity

Background. Prenatal exposure to air pollutants including particulate matter (< 2.5 mu m of diameter,PM2.5)and nitrogen dioxide (NO2) has been identified as a potential risk factor for neuropsychological developmental and mental health disorders. Objective: This study aimed to analyze the associations between prenatal PM2.5 and NO2 exposure and cognitive functions in children at 4-6 years of age, including sex differences, and the modification effect of the duration predominant breastfeeding these associations. Design: This study was conducted as part of the INMA project, a population-based birth cohort study in Spain (n = 1119). Each of the pregnant mothers was assigned a prenatal exposure to PM2.5 and NO2 for their whole pregnancy based on their place of residence. At the 4-6 year-old follow-up, infants' neuropsychological development was assessed using McCarthy scales: Verbal, Perceptive-Manipulative, Numeric, General Cognitive, Memory and Motor (gross and fine). Between 6 and 14 months of age, information concerning breastfeeding was gathered with a questionnaire. Regression analyses were performed to estimate the associations between exposure and outcomes, accounting for potential confounders. The analyses were stratified by child sex and breastfeeding duration. Results: The majority of coefficients for the different cognitive domains were negative either for PM2.5 and NO2, though none was statistically significant. After stratifying by sex, the associations become even more negative for boys, with some of the associations becoming statistically significant (memory both for PM2.5 and NO2), and global cognition and verbal for NO2. Duration of predominant breastfeeding was not found to have a modifying effect. Conclusions: These findings suggest a sex-dependent effects on neuropsychological development at 4-6 years of age, with a greater vulnerability in boys, specifically in domains related to memory, verbal and general cognition. No modifying effect was observed for duration of predominant breastfeeding.

This study was funded by grants from Instituto de Salud Carlos III (Red INMA G03/176, CB06/02/0041), Spanish Ministry of Health (FIS-97/1102, FIS07/0252,FIS-PS09/00362, 97/0588, 00/0021-2, PI061756, PS0901958, PI14/00677 incl. FEDER funds, FIS-PS09/00090, PI041436, FIS-PI042018, FIS-PI06/0867,PI081151 incl. FEDER funds, FIS-PI09/02311, and FIS-PI13/02187 and FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314, 09/02647, 11/01007, 11/0178, 11/02591, 11/02038, PI12/01890 incl. FEDER funds, 13/1944, 13/2032, FIS-PI13/02429, 14/0891, 14/1687, and CP13/00054 incl. FEDER funds), Spanish Ministry of Economy and Competitiveness (SAF2012-32991 incl. FEDER funds), CIBERESP, Generalitat de Catalunya-CIRIT 1999SGR 00241, Generalitat de Catalunya-AGAUR (2009 SGR 501, 2014 SGR 822), the Conselleria de Sanitat Generalitat Valenciana, Department of Health of the Basque Government (2005111093,2009111069, 2013111089), the Provincial Government of Gipuzkoa (DFG06/004, DFG08/001), Fundacio La Caixa (97/009-00, 00/077-00), Beca de la IV convocatoria de Ayudas a la Investigacion en Enfermedades Neurodegenerativas de La Caixa, Fundacio La maratœ de TV3 (090430), Obra Social Cajastur/Fundacion Liberbank, Universidad de Oviedo, the EU Commission (QLK4-1999-01422, QLK4-CT-2000-00263, QLK4-2002-00603, CONTAMED FP7-ENV-212502, FP7-ENV-2011 cod 282957, HEALTH.2010.2.4.5-1, 261357, 308333, 603794), Agence Nationale de Securite Sanitaire de l’Alimentation de l’Environnement et du Travail (1262C0010), Consejeria de Salud de la Junta de Andalucia (183/07), and annual agreements with municipalities in the study area (Zumarraga, Urretxu, Legazpi, Azkoitia y Azpeitia y Beasain).

Prenatal exposure to air pollutants including particulate matter (2.5 μm of diameter,PMThis study aimed to analyze the associations between prenatal PMThis study was conducted as part of the INMA project, a population-based birth cohort study in Spain (n = 1119). Each of the pregnant mothers was assigned a prenatal exposure to PMThe majority of coefficients for the different cognitive domains were negative either for PMThese findings suggest a sex-dependent effects on neuropsychological development at 4-6 years of age, with a greater vulnerability in boys, specifically in domains related to memory, verbal and general cognition. No modifying effect was observed for duration of predominant breastfeeding.

Background/aim Exposure to radiofrequency electromagnetic fields (RF-EMF) has rapidly increased and little is known about exposure levels in children. This study aims to describe personal RF-EMF environmental exposure levels from handheld devices and fixed site transmitters in European children and its day-to-day and year-to-year repeatability. Methods Environmental RF-EMF exposure (µW/m 2 ) was measured in 529 children (ages 8–18) in Denmark, the Netherlands, Slovenia, Switzerland, and Spain using personal portable exposure metres over 3 days in 2014–2016, and repeated in 28 children one year later. Metres captured exposure every 4 s. Activity diaries collected children’s location and use of mobile devices. Six general frequency bands were defined: total, digital enhanced cordless telecommunications (DECT), television and radio antennas (broadcast), mobile phones (uplink), mobile phone base stations (downlink), and WiFi. We used mixed effects models with region random effects to estimate associations between mobile device use and exposure. Day-to-day and year-to-year repeatability was calculated through Spearman correlations. Results Median total exposure was 75.5 µW/m 2 . Downlink was the largest contributor to total exposure (27.2 µW/m 2 ) followed by broadcast (9.9 µW/m 2 ). Exposure from uplink was lower (4.7 µW/m 2 ). WiFi and DECT contributed very little to exposure levels. Exposure was higher during day (94.2 µW/m 2 ) than night (23.0 µW/m 2 ), and slightly higher during weekends than weekdays, although varying across regions. Exposure was generally highest while children were travelling (171.3 µW/m 2 ) and outside (157.0 µW/m 2 ). Children living in urban environments had higher exposure. Older children, girls, and users of mobile phones had higher uplink exposure but not total exposure. Repeatability was high for total, downlink, and broadcast in the year-to-year repeatability (rho between 0.54 and 0.66). Conclusion Largest contributors to total RF-EMF exposure were downlink and broadcast, which was consistent one year later. Location of home (region and urbanicity) was associated with higher exposure. More frequent mobile phone use was associated with higher uplink exposure. It is important to continue evaluating RF-EMF exposure in children as mobile devices, use habits, and technologies continue to evolve.

Background/Aim: In recent years, the effect of greenness on birth weight has been studied in different analyses across multiple countries; however, the available evidence on such an effect on measu...

To analyze the association between exposure to nitrogen dioxide (NOThe study population included 624 children from the INMA-Valencia cohort. Individual exposure to NOThe cumulative incidence was 16.3% for persistent cough, 34.9% for wheezing and 27.6% for lower respiratory tract infections. No association was found between respiratory symptoms and exposure to NONO

C.T. is a recipient of a European Respiratory Society Fellowship (RESPIRE2–2015–7251) P.D. is funded by a Ramón y Cajal fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and Competitiveness. S.L. is funded by a Miguel Servet-FEDER fellowship (MS15/0025) awarded by the Spanish Ministry of Economy and Competitiveness. M.G. is funded by a Miguel Servet-FEDER fellowship (MS13/00054) awarded by the Spanish Ministry of Economy and Competitiveness, Dadvand, P., Tischer, C., Estarlich, M., Llop, S., Dalmau-Bueno, A., López-Vicente, M., Valentín, A., de Keijzer, C., Fernández-Somoano, A., Lertxundi, N., Rodriguez-Dehli, C., Gascon, M., Guxens, M., Zugna, D., Basagaña, X., Nieuwenhuijsen, M.J., Ibarluzea, J., Ballester, F., Sunyer, J.

We assessed the effect of three different indices of urban built environment on allergic and respiratory conditions.This study involved 2472 children participating in the ongoing INMA birth cohort located in two bio-geographic regions (Euro-Siberian and Mediterranean) in Spain. Residential surrounding built environment was characterised as 1) residential surrounding greenness based on satellite-derived normalised difference vegetation index (NDVI), 2) residential proximity to green spaces and 3) residential surrounding greyness based on urban land use patterns. Information on wheezing, bronchitis, asthma and allergic rhinitis up to age 4 years was obtained from parent-completed questionnaires. Logistic regression and generalised estimating equation modelling were performed.Among children from the Euro-Siberian region, higher residential surrounding greenness and higher proximity to green spaces were negatively associated with wheezing. In the Mediterranean region, higher residential proximity to green spaces was associated with a reduced risk for bronchitis. A higher amount of residential surrounding greyness was found to increase the risk for bronchitis in this region.Associations between indices of urban residential greenness and greyness with respiratory diseases differ by region. The pathways underlying these associations require further exploration.

This study aims to systematically review epidemiological studies that evaluate the relationship between meteorology and the incidence of hip fracture (HF). After a search in Scopus, PubMed, and Embase, two independent authors assessed the relevance of studies and extracted data for description. From each study, we extracted the geographic and temporal scope, design, study variables (meteorological and related to HF), statistical analysis, and estimated associations. Of a total of 134 works, 20 studies were selected. All use an ecological design but one case-crossover. Most studies have been conducted in northern latitudes. The analysis methodology did not take into account the temporal structure of the data in 10 studies (regression and linear correlations); the rest used Poisson regression (7) and ARIMA model (3). Most studies showed significant positive associations with rainfall, especially in the form of snow: HF relative risk (RR) on days with precipitation vs. days without precipitation that ranged from 1.14 (95 % confidence interval (CI)1.04 to 1.24) to 1.60 (95 % CI 1.06 to 2.41), the temperature, with RR by one degree Celsius decline from 1.012 (95 % CI 1.004 to 1.020) to 1.030 (95 % CI 1.023 to 1.037), and wind (3) RR FC windiest days vs. calm days: 1.32 (95 % CI 1.10 to 1.58) to 1.35 (95 % CI 0.88 to 2.08). This review shows that analytic methods are very heterogeneous and poorly adapted to the temporary nature of the data. Studies confirm a certain seasonality, with more fractures in winter and meaningful relationships with meteorological conditions typical of this season.

In utero tobacco exposure has been associated with fetal growth restriction, but uncertainty remains about critical windows of exposure and specific effects on body segments. In the present study, we aimed to examine the association of maternal smoking with fetal biometry in different stages of pregnancy. The study population comprised 2,478 fetuses from a Spanish birth cohort study that was established between 2003 and 2008. Biparietal diameter, femur length, abdominal circumference, and estimated fetal weight were evaluated at 12, 20, and 34 weeks of gestation. Fetal size and growth were assessed by standard deviation scores adjusted by maternal and fetal characteristics. Maternal smoking was assessed using questionnaire and a sample of urinary cotinine at week 32 of gestation. Associations were estimated using multiple regression analysis. Smokers at week 12 of gestation showed decreased fetal growth as reflected by all growth parameters at 20–34 weeks, leading to a reduced fetal size at week 34. The reduction was greatest in femur length, at �9.4% (95% confidence interval �13.4, �5.4) and least in abdominal circumference, at �4.4% (95% CI: �8.7, �0.1). Fetuses of smokers who quit smoking before week 12 showed reduced growth only in femur length (�5.5; 95% CI: �10.1, �0.9). Dose–response curves for smoking versus fetal growth parameters (abscissa: log2 cotinine) were linear for biparietal diameter and femur length. cohort studies; fetal development; pregnancy; prenatal exposure; tobacco smoke

Prenatal and postnatal exposure to air pollution has been linked to cognitive impairment in children, but very few studies have assessed its association with attentional function.To evaluate the association between prenatal and postnatal exposure to nitrogen dioxide (NOWe used data from four regions of the Spanish INMA-Environment and Childhood-Project, a population-based birth cohort. Using land-use regression models (LUR), we estimated prenatal and postnatal NOWe included 1298 children with complete data. Prenatal exposure to NOThis study indicates that higher exposure to ambient NO

Benzene exposure represents a potential risk for children's health. Apart from being a known carcinogen for humans (group 1 according to IARC), there is scientific evidence suggesting a relationship between benzene exposure and respiratory problems in children. But results are still inconclusive and inconsistent. This study aims to assess the determinants of exposure to indoor and outdoor residential benzene levels and its relationship with respiratory health in infants. Participants were 1-year-old infants (N = 352) from the INMA cohort from Valencia (Spain). Residential benzene exposure levels were measured inside and outside dwellings by means of passive samplers in a 15-day campaign. Persistent cough, low respiratory tract infections and wheezing during the first year of life, and covariates (dwelling traits, lifestyle factors and sociodemographic data) were obtained from parental questionnaires. Multiple Tobit regression and logistic regression models were performed to assess factors associated to residential exposure levels and health associations, respectively. Indoor levels were higher than outdoor ones (1.46 and 0.77 μg/m3, respectively; p

Background: Asthma is a heterogeneous syndrome with complex patterns of symptoms whose origin seems to be early in life. Its evolution during childhood is not yet fully understood. Aim: To identify...

Introduction: Ultrafine particles (UFPs) are the airborne particulate matter of less than 0.1 µm in size. Since personal exposure to UFP and its health-related effects in children are still to be w...