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Lopez-Bueno, Jose Antonio

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Jose Antonio

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Lopez-Bueno

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ISCIII

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ISCIII::Escuela Nacional de Sanidad (ENS)

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Now showing 1 - 10 of 23

Effects of local factors on adaptation to heat in Spain (1983-2018)
(Elsevier, 2022-06) Navas-Martin, Miguel Angel; Lopez-Bueno, Jose Antonio; Diaz-Jimenez, Julio; Follos, F; Vellón, J. M.; Mirón, I.J.; Luna, MY; Sánchez-Martínez, G; Culqui, Dante Roger; Linares-Gil, Cristina; Instituto de Salud Carlos III; Ministerio para la Transición Ecológica y el Reto Demográfico (España); National University of Distance Education (España)
The European Union is currently immersed in policy development to address the effects of climate change around the world. Key plans and processes for facilitating adaptation to high temperatures and for reducing the adverse effects on health are among the most urgent measures. Therefore, it is necessary to understand those factors that influence adaptation. The aim of this study was to provide knowledge related to the social, climate and economic factors that are related to the evolution of minimum mortality temperatures (MMT) in Spain in the rural and urban contexts, during the 1983-2018 time period. For this purpose, local factors were studied regarding their relationship to levels of adaptation to heat. MMT is an indicator that allows for establishing a relationship to between mortality and temperature, and is a valid indicator to assess the capacity of adaptation to heat of a certain population. MMT is obtained through the maximum daily temperature and daily mortality of the study period. The evolution of MMT values for Spain was established in a previous paper. An ecological, longitudinal and retrospective study was carried out. Generalized linear models (GLM) were performed to identify the variables that appeared to be related to adaptation. The adaptation was calculated as the difference in variation in MMT based on the average increase in maximum daily temperatures. In terms of adaptation to heat, urban populations have adapted more than non-urban populations. Seventy-nine percent (n = 11) of urban provinces have adapted to heat, compared to twenty-one percent (n = 3) of rural provinces that have not adapted. In terms of urban zones, income level and habituation to heat (values over the 95th percentile) were variables shown to be related to adaptation. In contrast, among non-urban provinces, a greater number of housing rehabilitation licenses and a greater number of health professionals were variables associated with higher increases in MMT, and therefore, with adaptation. These results highlight the need to carry out studies that allow for identifying the local factors that are most relevant and influential in population adaptation. More studies carried out at a small scale are needed.
Heat adaptation among the elderly in Spain (1983-2018)
(Elsevier, 2023) Navas-Martin, Miguel Angel; Lopez-Bueno, Jose Antonio; Follos, Fernando; Vellón, José Manuel; Mirón, Isidro Juan; Luna, Yolanda; Sánchez-Martínez, Gerardo; Linares-Gil, Cristina; Diaz-Jimenez, Julio; Instituto de Salud Carlos III
Background/Objectives: The aim of this study was to ascertain, firstly, adaptation to heat among persons aged ≥ 65 years across the period 1983 to 2018 through analysis of the MMT; and secondly, the trend in such adaptation to heat over time with respect to the total population. Methods: A retrospective longitudinal ecological time series study was conducted, using data on daily mortality and maximum daily temperature across the study period. Results: Over time, the MMT was highest among elderly people, with a value of 28.6 oC (95%CI 28.3-28.9) versus 28.2 oC (95%CI 27.83-28.51) for the total population, though this difference was not statistically significant. A total of 62% of Spanish provinces included populations of elderly people that had adapted to heat during the study period. In general, elderly persons’ level of adaptation registered an average value of 0.11 (oC/decade). Conclusions/Recommendations: Although the Spanish provincial population aged ≥ 65 years showed adaptation to heat, heterogeneities were found among the various provinces, highlighting the fact that in a given country vulnerability to ambient temperature varies, and that its relationship with the process of adaptation is thus influenced by the geographical, climatic and socio-economic characteristics of each particular area.
Prevalencia de las infecciones por virus de las hepatitis B, C, D y E en Bolivia
(Organización Panamericana de la Salud (OPS), 1999-03) Leon-Rega, Pilar; Venegas, E; Bengoechea, L; Rojas, E; Lopez-Bueno, Jose Antonio; Elola, C; Echevarria, Jose Manuel
[ES] En Bolivia no se han realizado estudios específicos sobre los virus de la hepatitis, por lo que su prevalencia y patrones de circulación son prácticamente desconocidos. De 1992 a 1996 se realizó un estudio seroepidemiológico con el fin de adquirir una primera visión de conjunto sobre las prevalencias de las infecciones por virus de la hepatitis B (VHB), C (VHC), D (VHD) y E (VHE) en distintas poblaciones de Bolivia. Sobre la base de los datos obtenidos en otros lugares de América Latina, se prestó atención especial al estudio de las comunidades autóctonas de la región amazónica. En las zonas rurales del altiplano andino, la infección por VHB presentó una prevalencia general que correspondería a una situación de endemia media o baja (11,2%) y no se encontró ningún portador de anticuerpos contra VHC o VHD. En dos poblaciones de alto riesgo de la ciudad de Cochabamba (niños sin hogar y trabajadoras del sexo), la prevalencia de infección por VHB fue similar (11,6%) y podría considerarse baja en comparación con la de otras poblaciones análogas de núcleos urbanos en América Latina. La correspondiente al VHC (un caso positivo, 0,5%) sería parecida a la descrita en esas mismas poblaciones, si bien el escaso número de muestras estudiadas no permite extraer conclusiones más firmes. En concordancia con observaciones anteriores de comunidades similares de zonas tropicales de Suramérica, en las poblaciones autóctonas de la Amazonia boliviana la infección por VHB es sumamente endémica (prevalencia general de 74,0%), pero no se ha detectado la circulación de VHC. Se sabe que la transmisión de VHB es horizontal y tiene lugar desde edades muy tempranas, pero se desconocen los mecanismos de esa actividad. A los 10 años de edad, más de la mitad de la población ya ha experimentado la infección natural que, 10 años más tarde, se habrá difundido a prácticamente toda la población. La tasa muy baja de individuos positivos al HbsAg (1,6%), la ausencia de ADN vírico en las muestras con reactividad aislada a anti-HBc y la alta prevalencia de anti-HBs entre los individuos que presentan marcadores de infección natural (92,4%) excluyen la participación de la transmisión vertical en el mantenimiento de la endemia. Hasta el momento, no se ha documentado ningún brote de infección por VHD en estas comunidades, pero la alta endemia de infección por VHB alerta sobre el riesgo de posibles brotes en el futuro. Los resultados obtenidos con las pruebas de anticuerpos contra VHE sugieren que este virus circula ampliamente en Bolivia y que podría haber producido brotes recientes en el departamento de Cochabamba. Se recomienda vacunar contra VHB en las poblaciones endémicas como medida de corto plazo; buscar activamente en todo el país brotes y casos esporádicos de hepatitis E y continuar realizando estudios que permitan evaluar las repercusiones sanitarias de la situación documentada en este estudio. [EN] In Bolivia, no studies have been carried out specifically on hepatitis viruses. Thus, their prevalence and circulation patterns are virtually unknown. A seroepidemiologic study was performed from 1992 to 1996 to generate a preliminary idea of the overall prevalence of infection from hepatitis B, C, D, and E viruses (HBV, HCV, HDV, and HEV, respectively) in different Bolivian population groups. Prompted by the data obtained in other areas of Latin America, the study focused on indigenous communities in the Amazon region. In rural areas of the high Andean plateau, HBV infection showed an overall prevalence compatible with medium to low endemicity (11.2%), and no carriers of HCV or HDV antibodies were found. In two high-risk groups in the city of Cochabamba (homeless children and sexual workers), the prevalence of HBV infection was similar (11.6%) and could be considered low by comparison to that of similar population groups in Latin American urban centers. The prevalence of HCV (one positive case, or 0.5%) was similar to that found in similar population groups, although the small number of samples precludes drawing more definite conclusions. As has been noted previously with similar communities in tropical areas of South America, HBV infection is highly endemic in indigenous populations of the Bolivian Amazon (with an overall prevalence of 74.0%), but circulation of HCV has not been detected. It is a well-known fact that HBV is horizontally transmitted and that transmission can take place very early in life, but the mechanisms involved are unknown. By 10 years of age, more than half the population has already had the natural infection that, in approximately 10 more years will have affected virtually the entire population. The very low rate of positivity to HBsAg (1.6%), the absence of viral DNA in samples showing isolated positivity to anti-HBc, and the high prevalence of anti-HBs among individuals who show markers for natural infection (92.4%) suggest vertical transmission plays no role in persistent endemicity. So far, no outbreak of HDV infection has been documented in these communities, but the high endemicity shown by HBV points to the possibility of future outbreaks. Results obtained with tests for the detection of antibodies against HEV suggest that this virus is circulating widely in Bolivia and that it could have caused recent outbreaks in Cochabamba state. Vaccination against HBV in endemic populations is recommended as a short-term measure. Also recommended are actively searching for outbreaks and sporadic cases of hepatitis E in the entire country and performing additional research that will help in assessing the public health consequences of the situation described in this article.
Mortality due to COVID-19 in Spain and its association with environmental factors and determinants of health
(Springer, 2022) Culqui, Dante Roger; Diaz-Jimenez, Julio; Blanco, Alejandro; Lopez-Bueno, Jose Antonio; Navas-Martin, Miguel Angel; Sánchez-Martínez, Gerardo; Luna, M Yolanda; Hervella, Beatriz; Belda, Fernando; Linares-Gil, Cristina; Instituto de Salud Carlos III
The objective of this study was to identify which air pollutants, atmospheric variables and health determinants could influence COVID-19 mortality in Spain. This study used information from 41 of the 52 provinces in Spain (from Feb. 1, to May 31, 2021). Generalized Linear Models (GLM) with Poisson link were carried out for the provinces, using the Rate of Mortality due to COVID-19 (CM) per 1,000,000 inhabitants as dependent variables, and average daily concentrations of PM10 and NO2 as independent variables. Meteorological variables included maximum daily temperature (Tmax) and average daily absolute humidity (HA). The GLM model controlled for trend, seasonalities and the autoregressive character of the series. Days with lags were established. The relative risk (RR) was calculated by increases of 10 g/m3 in PM10 and NO2 and by 1 ℃ in the case of Tmax and 1 g/m3 in the case of HA. Later, a linear regression was carried out that included the social determinants of health. Statistically significant associations were found between PM10, NO2 and the CM. These associations had a positive value. In the case of temperature and humidity, the associations had a negative value. PM10 being the variable that showed greater association, with the CM followed of NO2 in the majority of provinces. Anyone of the health determinants considered, could explain the differential geographic behavior. The role of PM10 is worth highlighting, as the chemical air pollutant for which there was a greater number of provinces in which it was associated with CM. The role of the meteorological variables-temperature and HA-was much less compared to that of the air pollutants. None of the social determinants we proposed could explain the heterogeneous geographical distribution identified in this study. The online version contains supplementary material available at 10.1186/s12302-022-00617-z.
Routines, Time Dedication and Habit Changes in Spanish Homes during the COVID-19 Lockdown. A Large Cross-Sectional Survey
(Multidisciplinary Digital Publishing Institute (MDPI), 2021-11-19) Navas-Martin, Miguel Angel; Lopez-Bueno, Jose Antonio; Oteiza, Ignacio; Cuerdo-Vilches, Teresa; Consejo Superior de Investigaciones Científicas (España)
Many countries chose to establish social distancing as lockdowns after the COVID-19 outbreak. Households had to adapt their day-to-day lifestyles to new circumstances, affecting routines and time dedication to tasks. This national study was carried out to find out how the confinement by COVID-19 affected Spanish households on the perceived habit changes during this period, in relation to their socio-demographic characteristics and household composition. An online questionnaire was launched during the COVID-19 lockdown, from 30 April to 22 June 2020. Descriptive statistics were analyzed, stratified by gender, on time dedication, routine, home leaving, and habit change variables. Chi-square tests were used to explore the relations of significance with socio-demographic characteristics and home composition. All contrast analyses were performed for a 95% confidence level (significance considered for p < 0.05). In total, 1673 respondents participated from different age groups, educational level, employment status and household composition. Sixty percent of respondents maintained their routines. A third tried to establish a new one, being related to women, young people, not a university student, and living with others, including minors. Regarding dedication to tasks, adults aged 35-54 years, with more cohabitants, especially women, devoted themselves intensively to the home or to care, while those under 35 were dedicated more to rest, leisure, television or reading. People with university studies were more related to teleworking. The frequency of going outside was related to gender, age, educational level and living with elders, specifically for grocery shopping and taking out garbage. Changes in habits, routines and time dedication in confinement were strongly linked to the sociodemographic and coexistence conditions in Spanish homes. The greatest impacts were suffered by women, people with children, and adults between 35-54 years of age, especially on care and domestic chores.
Short-term effects of traffic noise on suicides and emergency hospital admissions due to anxiety and depression in Madrid (Spain)
(Elsevier, 2020) Diaz-Jimenez, Julio; Lopez-Bueno, Jose Antonio; López-Ossorio, J.J.; Gónzález, J.L.; Sánchez, F.; Linares-Gil, Cristina; Instituto de Salud Carlos III
Studies show a relationship between some mental illnesses and suicides and different environmental variables such as air pollution, characterized by stress at the neuropsychological level. Despite the fact that traffic noise is also a powerful neurological stressor, studies that relate traffic noise to these mental disorders are practically non-existent. The objective is to analyze the short-term impact that chemical air pollution, traffic noise and thermal extremes have on emergency hospital admissions due to anxiety, dementia and suicides in the city of Madrid. This ecological, longitudinal study uses generalized linear models with Poisson link to analyze the short-term impact of the average daily concentrations of chemical pollutants (NO2, PM10, PM2.5, O3), noise pollution indicators (Leqday, Leqnight and Leq24h) and temperatures during heat waves (Theat) and cold waves (Tcold) on daily admissions to emergency services in the city of Madrid from 2010 to 2013 due to anxiety (ICD-10: F32), depression (ICD-10: F40-F42) and suicide (ICD-10: X60-X84). The results show no association between any of the chemical pollutants considered and the dependent variables studied. On the contrary, the values of Leqday are associated with the three variables analyzed in lag 0 for the cases of anxiety and depression and in lag 1 for suicides, with RR: 1.20 (IC95% 1.14 1.26), RR: 1.11 (IC95% 1.06 1.16) and RR: 1.17 (IC95% 1.05 1.30), respectively, for increases of 1 dB(A) in the values of Leqday. An association was also found between Tcold and admissions for anxiety in lag 9 with RR: 1.62 (IC95% 1.18 2.22) for increases of 1 °C in the values of Tcold. Traffic noise can be considered an important risk factor related to the illnesses and anxiety and depression and for suicides in the city of Madrid, although new studies are needed to support the findings shown here.
The effect of cold waves on mortality in urban and rural areas of Madrid
(Springer, 2021-06-19) Lopez-Bueno, Jose Antonio; Navas-Martin, Miguel Angel; Diaz-Jimenez, Julio; Mirón, Isidro Juan; Luna, María Yolanda; Sánchez-Martínez, Gerardo; Culqui, Dante Roger; Linares-Gil, Cristina; Instituto de Salud Carlos III
Background: While many studies analyze the effect of extreme thermal events on health, little has been written about the effects of extreme cold on mortality. This scarcity of papers is particularly relevant when we search studies about extreme cold on the health of rural population. Therefore, we tried to analyze the effect of cold waves on urban areas and rural areas from Madrid and to test whether differentiated effects exist between both population classes. For this purpose, we analyzed data from the municipalities with over 10,000 inhabitants for the period from January 1, 2000 through December 31, 2013. Municipalities were classified as urban or rural (Eurostat), and they were grouped into similar climatological zones: Urban Metropolitan Centre (UMC), Rural Northern Mountains (RNM), Rural Centre (RC) and Southern Rural (SR). The dependent variable was the daily mortality rate due to natural causes per million inhabitants (CIE-X: A00-R99) that occurred between the months of November and March for the period. The independent variable was minimum daily temperature (ºC) (Tmin). Social and demographic contextual variables were used, including: population > age 64 (%), deprivation index and housing indicators. The analysis was carried out in three phases: (1) determination of the threshold temperature (Tthreshold) which defines the cold waves; (2) determination of the relative risk (RR) for cold waves using Poisson linear regression (GLM); and (3) using GLM of the binomial family, Odds Ratios (OR) were calculated to analyze the relationship between the frequency of the appearance of cold waves and the socioeconomic variables. Results:The UMC zone experienced 585 extreme cold events related to attributable increases in the mortality rate. The average number of cold waves in the rural zones was 319. The primary risk factor was the percentage of population over age 64, and the primary protective factor was housing rehabilitation. As a whole, the period experienced more cold waves (1542) than heat waves (1130). Conclusion: The UMC was more vulnerable than the rural areas. Furthermore, the results support the development of prevention policies, especially considering the fact that cold wave events were more frequent than heat waves.
Heat Adaptation among the Elderly in Spain (1983-2018)
(Multidisciplinary Digital Publishing Institute (MDPI), 2023-01-11) Navas-Martin, Miguel Angel; Lopez-Bueno, Jose Antonio; Ascaso-Sánchez, María Soledad; Follos, Fernando; Vellón, José Manuel; Mirón, Isidro Juan; Luna, María Yolanda; Sánchez-Martínez, Gerardo; Linares-Gil, Cristina; Diaz-Jimenez, Julio; Instituto de Salud Carlos III
The capacity for adaptation to climate change is limited, and the elderly rank high among the most exposed population groups. To date, few studies have addressed the issue of heat adaptation, and little is known about the long-term effects of exposure to heat. One indicator that allows the ascertainment of a population’s level of adaptation to heat is the minimum mortality temperature (MMT), which links temperature and daily mortality. The aim of this study was to ascertain, firstly, adaptation to heat among persons aged ≥ 65 years across the period 1983 to 2018 through analysis of the MMT; and secondly, the trend in such adaptation to heat over time with respect to the total population. A retrospective longitudinal ecological time series study was conducted, using data on daily mortality and maximum daily temperature across the study period. Over time, the MMT was highest among elderly people, with a value of 28.6 ºC (95%CI 28.3–28.9) versus 28.2 ºC (95%CI 27.83–28.51) for the total population, though this difference was not statistically significant. A total of 62% of Spanish provinces included populations of elderly people that had adapted to heat during the study period. In general, elderly persons’ level of adaptation registered an average value of 0.11 (ºC/decade).
Determination of heat wave definition temperatures in Spain at an isoclimatic level: time trend of heat wave duration and intensity across the decade 2009–2018
(Springer, 2024) Lopez-Bueno, Jose Antonio; Alonso, P.; Navas-Martin, Miguel Angel; Mirón, I. J.; Belda, F.; Diaz-Jimenez, Julio; Linares-Gil, Cristina; Instituto de Salud Carlos III
Background: In line with WHO guidelines for the implementation of public health prevention plans targeted at the impacts of high temperatures, a heat wave defnition temperature (Tthreshold) was calculated for 182 so called “isoclimatic zones” (IZ) in Spain. As the dependent variable for determining this Tthreshold, we analysed daily all-cause mortality data (ICD-10: A00-R99) for each IZ across the period 2009–2018. The independent variable used was the mean value of the maximum daily temperature of the summer months recorded at meteorological observatories in each IZ. We used Box–Jenkins models to ascertain mortality anomalies, and scatterplots to link these anomalies to the temperatures at which they occurred, thereby determining the Tthreshold for each IZ. We then calculated how many heat waves had occurred in each IZ, as well as their intensity, and analysed their time trend over this period. Results: The results showed that in 52.5% of the IZ, the percentile of the maximum temperatures series of the summer months to which Tthreshold corresponded was below the 95th percentile of the meteorological heat wave defnition in Spain: indeed, it only coincided in 30.7% of cases. The geographical distribution of these percentiles displayed great heterogeneity as a consequence of the local factors that infuence the temperature–mortality relationship. The trend in the number of heat waves analysed indicated an overall increase in Spain at a rate of 3.9 heat waves per decade, and a similar rise in mean annual intensity of 9.5 °C/decade. These time-trend values were higher than those yielded by analysing the trend in meteorological heat waves based on the 95th percentile. Conclusions: The results obtained in this study indicate the need to use a heat wave defnition based on epidemiological temperature–mortality studies, rather than on values based on meteorological percentiles. This could be minimising estimated health impacts in analyses of future impacts attributable to heat.
The evolution of minimum mortality temperatures as an indicator of heat adaptation: The cases of Madrid and Seville (Spain).
(Elsevier, 2020-08-01) Follos, F.; Linares-Gil, Cristina; Vellón, J.M.; Lopez-Bueno, Jose Antonio; Luna, M.Y.; Sánchez-Martínez, G.; Diaz-Jimenez, Julio; Instituto de Salud Carlos III; Ministerio para la Transición Ecológica y el Reto Demográfico (España); Fundación Biodiversidad
The increase in the frequency and intensity of heat waves is one of the most unquestionable effects of climate change. Therefore, the progressive increase in maximum temperatures will have a clear incidence on the increase in mortality, especially in countries that are vulnerable due to geographical location or their socioeconomic characteristics. Different research studies show that the mortality attributable to heat is decreasing globally, and research is centred on future scenarios. One way of detecting the existence of a lesser impact of heat is through the increase in the so-called temperature of minimum mortality (TMM). The objective of this study is to determine the temporal evolution of TMM in two Spanish provinces (Seville and Madrid) during the 1983-2018 period and to evaluate whether the rate of adaptation to heat is appropriate. We used the gross rate of daily mortality due to natural causes (CIEX: A00-R99) and the maximum daily temperature (°C) to determine the quinquennial TMM using dispersion diagrams and realizing fit using quadratic and cubic curvilinear estimation. The same analysis was carried out at the annual level, by fitting an equation to the line of TMM for each province, whose slope, if significant (p < 0.05) represents the annual rate of variation in TMM. The results observed in this quinquennial analysis showed that the TMM is higher in Seville than in Madrid and that it is higher among men than women in the two provinces. Furthermore, there was an increase in TMM in all of the quinquennium and a clear decrease in the final period. At the annual level, the linear fit was significant for Madrid for the whole population and corresponds to an increase in the TMM of 0.58 °C per decade. For Seville the linear fits were significant and the slopes of the fitted lines was 1.1 °C/decade. Both Madrid and Seville are adapting to the increase in temperatures observed over the past 36 years, and women are the group that is more susceptible to heat, compared to men. The implementation of improvements and evaluation of prevention plans to address the impact of heat waves should continue in order to ensure adequate adaptation in the future.