Publications by authors named "Xabier Aguinagalde"

9 Publications

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Postnatal exposure to mercury and neuropsychological development among preschooler children.

Eur J Epidemiol 2020 Mar 13;35(3):259-271. Epub 2020 Mar 13.

Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain.

The objective of this study was to describe the postnatal exposure to Hg and to evaluate its association with neuropsychological development among preschool children. The study population are 4-5 years old children (n = 1252) participant in the Spanish INMA Project. Total Hg was measured in cord blood and in hair samples taken at 4 years of age (2008-2012). Neuropsychological development was assessed using the McCarthy Scales of Children's Abilities (MSCA). Information on covariates and possible confounders was obtained by questionnaires during pregnancy and childhood. Generalized additive and linear regression models were built in order to assess the relationship between MSCA scores and Hg exposure. We also evaluated the magnitude of the possible bias generated from measurement error in seafood intake estimate from questionnaire and Hg determination. The geometric mean of hair Hg was 0.98 µg/g [95% confidence interval (CI) 0.94, 1.03]. In the regression analysis, the association between Hg and the MSCA scores was positive for all the scales and statistically significant for the verbal (β = 0.89; 95%CI 0.38, 1.39), memory (β = 0.42; 95%CI 0.09, 0.76) and general cognitive scales (β = 1.35; 95%CI 0.45, 2.25). However, these associations were clearly attenuated when we adjusted by the children's fish intake variables or when took into account theoretical scenarios of low precision in fish intake and Hg measurements. Hg levels in this Spanish population were high in comparison with other European countries; however, we did not observe adverse effects on child neuropsychological development associated with this postnatal exposure to Hg.
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March 2020

Exposure to mercury among 9-year-old Spanish children: Associated factors and trend throughout childhood.

Environ Int 2019 09 19;130:104835. Epub 2019 Jun 19.

Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address:

Mercury is considered a neurotoxicant and human exposure occurs mainly from the consumption of marine species. We aimed to describe total mercury concentrations (THg) and associated factors in 9-year old children, as well as to explore the trend in THg from 4 to 9 years of age. The study population consisted of 9-year-old children participating in the INMA (Environment and Childhood) birth cohort study in Valencia, Spain (n = 405, 2013-2014). THg in hair samples was measured by atomic absorption spectrometry at the age of 4 and 9 years. Sociodemographic and dietary data was obtained through questionnaires. Multiple linear regression was used to explore the association between THg and covariates. The geometric mean (95% confidence interval) of hair THg at 9 years old was 0.89 μg/g (0.81, 0.98). Thirteen percent of children had THg above the equivalent to the Provisional Tolerable Weekly Intake proposed by the World Health Organization. THg were higher among children whose mothers had a healthy body mass index before pregnancy. Children with non-smoker mothers and worker fathers had also higher THg. Children's fish intake at 9 years-old was positively associated with THg, being swordfish, canned tuna and lean fish (i.e. hake, sea bream and sole) the most associated categories. Levels decreased by around 22% between 4 and 9 years old. Birth cohort studies, such as the INMA Project, allow the longitudinal evaluation of Hg exposure and the possible effects on children's health. This information can be used to formulate diet recommendations in vulnerable populations.
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September 2019

Are the Pyrenees a barrier for the transport of birch (Betula) pollen from Central Europe to the Iberian Peninsula?

Sci Total Environ 2017 Jan 2;575:1183-1196. Epub 2016 Oct 2.

Departament de Biologia Animal, Biologia Vegetal i Ecologia, Universitat Autònoma de Barcelona (UAB), Edifici C, 08193 Bellaterra, Spain; Institut de Ciencia i Tecnologia Ambientals (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z, 08193 Bellaterra, Spain.

This work provides a first assessment of the possible barrier effect of the Pyrenees on the atmospheric transport of airborne pollen from Europe to the North of the Iberian Peninsula. Aerobiological data recorded in three Spanish stations located at the eastern, central and western base of the Pyrenees in the period 2004-2014 have been used to identify the possible long range transport episodes of Betula pollen. The atmospheric transport routes and the origin regions have been established by means of trajectory analysis and a source receptor model. Betula pollen outbreaks were associated with the meteorological scenario characterized by the presence of a high-pressure system overm over Morocco and Southern Iberian Peninsula. France and Central Europe have been identified as the probable source areas of Betula pollen that arrives to Northern Spain. However, the specific source areas are mainly determined by the particular prevailing atmospheric circulation of each location. Finally, the Weather Research and Forecasting model highlighted the effect of the orography on the atmospheric transport patterns, showing paths through the western and easternmost lowlands for Vitoria-Gasteiz and Bellaterra respectively, and the direct impact of air flows over Vielha through the Garona valley.
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January 2017

Synergism between exposure to mercury and use of iodine supplements on thyroid hormones in pregnant women.

Environ Res 2015 Apr 5;138:298-305. Epub 2015 Mar 5.

FISABIO-Universitat de València-Universitat Jaume I Joint Research Unit of Epidemiology and Environmental Health, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.

Objective: To evaluate the association between mercury exposure and thyroid-stimulating hormone (TSH), total triiodothyronine (TT3) and free thyroxine (FT4) levels during pregnancy as well as to explore if there is any synergic action between mercury and intake of iodine from different sources.

Methods: The study population was 1407 pregnant women participating in the Spanish INMA birth cohort study. Total mercury concentrations were analyzed in cord blood. Thyroid hormones (THs) were measured in serum samples collected at 13.2±1.5 weeks of gestation. The association between mercury and TH levels was evaluated with multivariate linear regression models. Effect modification caused by iodine intake from supplements and diet was also evaluated.

Results: The geometric means of TSH, TT3, FT4 and mercury were 1.1μU/L, 2.4nmol/L, 10.5pmol/L and 7.7μg/L, respectively. Mercury levels were marginally significantly associated with TT3 (β: -0.05; 95%CI: -0.10, 0.01), but were neither associated with TSH nor FT4. The inverse association between mercury and TT3 levels was stronger among the iodine supplement consumers (-0.08; 95%CI: -0.15, -0.02, interaction p-value=0.07). The association with FT4 followed the same pattern, albeit not significant.

Conclusion: Prenatal mercury exposure was inversely associated with TT3 levels among women who took iodine supplements during pregnancy. These results could be of public health concern, although further research is needed.
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April 2015

Exposure to mercury among Spanish preschool children: trend from birth to age four.

Environ Res 2014 Jul 16;132:83-92. Epub 2014 Apr 16.

Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, Av. Catalunya 21, 46020 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Faculty of Nursing, University of Valencia, Jaume Roig s/n, 46010 Valencia, Spain.

The purpose of this study is to describe the total hair mercury concentrations and their determinants in preschool Spanish children, as well as to explore the trend in mercury exposure from birth to the age four. This evolution has been scarcely studied in other birth cohort studies. The study population was 580 four year old children participating in the INMA (i.e. Childhood and Environment) birth cohort study in Valencia (2008-2009). Total mercury concentration at age four was measured in hair samples by atomic absorption spectrometry. Fish consumption and other covariates were obtained by questionnaire. Multivariate linear regression models were conducted in order to explore the association between mercury exposure and fish consumption, socio-demographic characteristics and prenatal exposure to mercury. The geometric mean was 1.10 µg/g (95%CI: 1.02, 1.19). Nineteen percent of children had mercury concentrations above the equivalent to the Provisional Tolerable Weekly Intake proposed by WHO. Mercury concentration was associated with increasing maternal age, fish consumption and cord blood mercury levels, as well as decreasing parity. Children whose mothers worked had higher mercury levels than those with non working mothers. Swordfish, lean fish and canned fish were the fish categories most associated with hair mercury concentrations. We observed a decreasing trend in mercury concentrations between birth and age four. In conclusion, the children participating in this study had high hair mercury concentrations compared to reported studies on children from other European countries and similar to other countries with high fish consumption. The INMA study design allows the evaluation of the exposure to mercury longitudinally and enables this information to be used for biomonitoring purposes and dietary recommendations.
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July 2014

[Trend in lead exposure in the Spanish child population in the last 20 years. An unrecognized example of health in all policies?].

Gac Sanit 2013 Mar-Apr;27(2):149-55. Epub 2012 Apr 12.

Centro Superior de Investigación en Salud Pública (CSISP), Valencia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.

Objective: To describe the time trend in atmospheric lead concentrations in Spain, from before lead was banned as a gasoline additive to the present, and to determine the trend in lead body burden in the Spanish child population.

Methods: We obtained the annual average for atmospheric lead levels in several Spanish cities from the 1980s to the present. A literature search was conducted to identify published studies on lead concentrations in populations of Spanish children.

Results: Overall, atmospheric lead levels decreased, particularly between 1991 and 1999. This downward trend was related to a decrease in lead concentrations in Spanish children from 1989, the year in which the first study of childhood lead exposure was published, until the present. The decreased concentrations in both air and in children was most probably a result of legislative measures regulating the maximum amount of lead in gasoline in 1987 until a complete ban in August 2001.

Conclusions: From a public health point of view, the banning of leaded gasoline has significantly increased health protection in the Spanish population.
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February 2014

Prenatal exposure to lead in Spain: cord blood levels and associated factors.

Sci Total Environ 2011 May 12;409(11):2298-305. Epub 2011 Mar 12.

Centre of Public Health Research, Av Catalunya 21, 46020, Valencia, Spain.

Introduction And Objective: Lead is a known neurotoxic. Fetuses and infants are very vulnerable to lead exposure, since their blood-brain barrier is not completely formed. Hence, there is an importance for monitoring of blood lead levels prenatally and during early infancy. The aim of this study is to evaluate the prenatal exposure to lead and its association with maternal factors in four population based mother-child cohorts in Spain. The present research was carried out within the framework of the INMA project INfancia y Medio Ambiente (Environment and Childhood).

Methods: A total of 1462 pregnant women were recruited between 2004 and 2008. Lead was analyzed in a sample of cord blood by thermal decomposition, amalgation, and Atomic Absorption Spectrometry. Maternal sociodemographic, lifestyle and dietary factors were obtained by questionnaires during pregnancy. A multivariate logistic regression model was constructed. The dependent variable was a dichotomous lead level variable (detected vs no detected, i.e. ≥ vs < 2μg/dL).

Results: A low percentage of cord blood samples with lead levels ≥ 2μg/dL were found (5.9%). Geometric mean and maximum were 1.06μg/dL and 19μg/dL, respectively. Smoking at the beginning of pregnancy, age, social class, weight gain during pregnancy, gravidity, and place of residence were the maternal factors associated with detectable cord blood lead levels. Mother's diet does not appear to be a determining factor of lead exposure. Nevertheless, daily intake of iron and zinc may act as a protective factor against having cord blood lead levels ≥ 2μg/dL.

Conclusion: In the different regions of Spain taking part in this study, lead levels to which newborns are exposed are low. Mobilization of lead from bones may be the main contributor to the cord blood levels.
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May 2011

Fish consumption during pregnancy, prenatal mercury exposure, and anthropometric measures at birth in a prospective mother-infant cohort study in Spain.

Am J Clin Nutr 2009 Oct 26;90(4):1047-55. Epub 2009 Aug 26.

CIBER en Epidemiología y Salud Pública, Barcelona, Spain.

Background: Birth size has been shown to be related to maternal fish intake, although the results are inconsistent.

Objective: The objective was to assess the association of consumption of different types of fish and prenatal mercury exposure with birth weight, birth length, and classification as small for gestational age (SGA) in newborns.

Design: Cord blood total mercury was measured in 554 newborns in a population-based cohort born from 2004 to 2006. Fish consumption was classified in 4 frequency categories (<1 portion/mo, 1-3 portions/mo, 1 portion/wk, and > or =2 portions/wk).

Results: When multivariate models were adjusted, newborns in the higher quartile of total mercury weighed 143.7 g less (95% CI: -251.8, -35.6; P for trend = 0.02) and had higher odds of being SGA for length (odds ratio: 5.3; 95% CI: 1.2, 23.9; P from likelihood ratio test = 0.03) without a linear relation (P for trend = 0.13) compared with those in the lowest quartile. Mothers consuming >/=2 portions/wk of canned tuna had newborns who weighed more than those who consumed <1 portion/mo (P for trend = 0.03) and a lower risk of having infants who were SGA for weight (P for trend = 0.01). Consumption of > or =2 portions/wk of large oily fish was associated with a higher risk of being SGA for weight and consumption of lean fish with a lower risk of being SGA for length compared with the consumption of <1 portion/mo, but in neither case was there a linear relation (P for trend >0.05).

Conclusions: The role of fish in fetal growth depends on the amount and type of fish consumed. The findings for mercury warrant further investigation in other settings.
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October 2009

Prenatal exposure to mercury in a prospective mother-infant cohort study in a Mediterranean area, Valencia, Spain.

Sci Total Environ 2008 Mar 26;392(1):69-78. Epub 2007 Dec 26.

CIBER en Epidemiología y Salud Pública (CIBERESP), Spain.

Background: Mercury (Hg) is a ubiquitous pollutant that negatively affects fetal and child neurodevelopment at accidental high-dose exposure. Some studies indicate that Mediterranean populations could be at risk of prenatal exposure to mercury through fish consumption.

Objectives: To assess the prenatal exposure to total mercury (T-Hg), both inorganic and organic, in newborns by analyzing the T-Hg concentration in cord blood, and to evaluate the role of maternal fish consumption in this exposure.

Methods: In the context of a multi-center project (INMA project), a prospective birth cohort was set up in Valencia, Spain, from 2005 to 2006. A total of 253 newborns were included in this study. We compared cord blood T-Hg concentration by levels of fish intake assessed by a food frequency questionnaire completed at 28-32 weeks of gestation. Maternal covariates were obtained through a questionnaire.

Results: The geometric mean of T-Hg at birth was 9.9 microg/L (95% CI: 9.0, 10.8). Seventy five percent of cord blood samples were above the estimated level assumed to be without appreciable harm (5.8 microg/L). Women who consumed a portion of large oily fish, lean fish, or mixed fried fish two or more times per week had mean cord blood levels 1.6, 1.4 and 1.3 times higher, respectively, than those who rarely or never consumed fish. Other factors such as the mother's age, country of origin, smoking and season of delivery were also significantly and independently associated with cord blood T-Hg concentrations.

Conclusions: Newborns from a Mediterranean area presented elevated levels of T-Hg in cord blood. Higher concentrations of T-Hg were related to maternal fish intake, particularly in the case of large oily fish species.
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March 2008