Trends in leisure time and work-related physical activity in the Spanish working population, 1987-2006

Objective

To analyze time trends in the prevalence of leisure time (LTPA) and work-related (WRPA) physical activity between 1987 and 2006 in the Spanish working population.

Methods

We analyzed data taken from the Spanish National Health Surveys for 1987 (n = 29,647), 1993 (n = 20,707), 1995-1997 (n = 12,800), 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). The main variables were LTPA and WRPA in working adults aged 18-64 years old. We analyzed sociodemographic characteristics, self-perceived health status, lifestyle habits and associated comorbidities using multivariate logistic regression models.

Results

The prevalences of LTPA and WRPA were lower in women than in men (p < 0.05). The practice of LTPA (OR: 1.54, 95%CI: 1.32-1.80 for women; OR = 1.15, 95%CI: 1.02-1.31 for men) and WRPA (OR = 1.73, 95%CI: 1.38-2.19 for women; OR = 1.55, 95%CI: 1.44-1.91 for men) significantly increased from 1987 to 2006. In both genders, the variables associated with a higher likelihood of practicing LTPA were greater age, higher educational level and being an ex- or non-smoker, while negative predictors included being married, worse self-perceived health, and obesity. Factors that increased the probability of reporting WRPA were being married, worse self-rated health status, and sleeping > 8 h per day. The only factor that reduced the probability of reporting WRPA was being an ex- or non-smoker.

Conclusions

We found an increase in LTPA and WRPA in the last 20 years in the Spanish working population. Several factors were associated with a higher or lower likelihood of practicing LTPA or WRPA in this population.     

Principales resultados del programa de cribado de cáncer colorrectal en el País Vasco

Objective

To describe the procedures of the colorectal cancer screening program in the Basque Country (Spain), and the main results of the first rounds in 2009-2011.

Method

We carried out a retrospective study of invitations to attend screening between 2009 and 2011. Participation rates and the number of positive results of the fecal occult blood test (FOBT) were analyzed by sex and age group.

Results

There were 235.371 valid invitations (sent to the correct addresses), with an average participation rate of 64.3% (95%CI: 64.1-64.5%). Significant differences were found (p < 0,001) between women (67.1%; 95%CI: 66.9-67.4) and men (61.4%; 95%CI: 61.1-61.7). The rate of positive FOBT results was higher (p < 0,001) among men (9.1%; 95%CI: 8.9-9.2) than among women (4.8%; 95%CI: 4.7-4.9).

Conclusions

Participation rates were adequate compared with those in the reviewed literature. These rates were probably affected by the invitation strategy and by cultural and social factors.     

Consumo de alcohol y otras drogas en el medio laboral en España

Objective

To describe consumption patterns of alcohol and other drugs in the active population in Spain by gender.

Methods

Based on 15,082 active persons selected from the Domiciliary Survey of Alcohol and Drugs (Encuesta Domiciliaria de Alcohol y Drogas [EDADES]) 2007, we estimated prevalences for high-risk alcohol consumption (>50 g/day in males, >30 g/day in females), daily intake of tranquilizers, cannabis consumption in the last 30 days, and consumption of any other illegal drug in the last 12 months, by employment status, economic sector and occupational categories. Odds ratios (OR) and their confidence intervals (95% CI) were estimated by logistic regression models.

Results

The following prevalences were found: high-risk alcohol consumption, 3.4%; daily use of tranquilizers, 2.3%; cannabis consumption in the last 30 days, 7.9%; and consumption of any illegal drug in the last 12 months, 11.9%. Except for tranquilizer use, prevalences were higher in men than in women. Consumption of tranquilizers (OR = 1.68; 95%CI: 1.04-2.73), cannabis and other illegal drugs were all higher in unemployed men than in employed men, while only tranquilizer consumption was higher in unemployed women (OR = 1.70; 95% CI: 1.23-2.34). High-risk alcohol consumption was greater among men engaged in the catering, primary production and construction sectors in comparison to manufacturing industries: OR = 1.63 (95% CI: 1.11-2.38), OR = 1.52 (95% CI: 1.04-2.20), and OR = 1.50 (95% CI: 1.10-2.04), respectively. For women, those in catering showed higher consumptions of cannabis (OR = 2.34; 95% CI: 1.28-4.27) and of other illegal drugs (OR = 2.85; 95% CI: 1.71-4.76); the latter were also higher in commerce, transport and administration sectors than in manufacturing industries.

Conclusions

These findings could serve as a useful reference for companies wanting to carry out preventive programs, and also for future studies assessing the impact of preventive measures.     

El estado de salud de las personas mayores que sufren insomnio

Objectives

To evaluate the perceived health status of elderly patients with insomnia, whether primary, secondary to a medical illness, or associated with another mental disorder.

Methods

We conducted a cross-sectional study in a representative sample of 926 persons aged over 65 years. A psychiatric interview was used to verify the presence of insomnia (DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, fourth ed., revised text). Interviews were conducted by health professionals to assess perceived health status (EuroQol-5D), health problems, and socio-demographic characteristics.

Results

The prevalence of primary insomnia was 8.9% (95% CI: 7.1-11.0), that of insomnia associated with another mental disorder was 9.3% (95% CI: 7.5-11.4) and that of insomnia secondary to medical illness was 7.0% (95% CI: 5.4-8.9). Patients with insomnia who used hypnotics/sedatives scored lower in self-reported health (57.6; 95% CI: 53.7-61.4), significantly lower (p < 0.05) than participants with insomnia not taking these drugs (65.1; 95% CI: 53.7-61.4). The mean health status score in individuals without insomnia was 0.87 and was significantly lower (p < 0.05) in persons with any type of insomnia: 0.80 in primary insomnia, 0.73 in insomnia secondary to a mental disorder and 0.76 in insomnia associated with medical illness.

Conclusions

Health status was worse in older people with insomnia, whether primary, secondary to other mental illnesses or organic, and when the elderly patients consumed hypnotics/sedatives. Limitations were less severe in primary insomnia.     

The end of the Australia antigen? An ecological study of the impact of universal newborn hepatitis B vaccination two decades on

Background

A universal newborn hepatitis B (HBV) vaccination program was introduced in the Northern Territory of Australia in 1990, followed by a school-based catch-up program. We evaluated the prevalence of hepatitis B infection in birthing women up to 20 years after vaccination and compared this to women born before the programs commenced.

Methods

A cohort of birthing mothers was defined from Northern Territory public hospital birth records between 2005 and 2010 and linked to laboratory confirmed notifications of chronic HBV, based principally on a record of hepatitis B surface antigen detection. Prevalence of HBV was compared between women born before or after implementation of the newborn and catch-up vaccination programs.

Findings

Among 10797 birthing mothers, 138 (1.3%) linked to a chronic HBV record. HBV prevalence was substantially higher in Aboriginal women compared to non-Indigenous women (2.4% versus 0.04%; p < 0.001). Among 5678 Aboriginal women, those eligible for catch-up and newborn HBV vaccination programs had a significantly lower HBV prevalence than older women born prior to the programs: HBV prevalence respectively 2.2% versus 3.5%, (OR 0.61, 95%CI 0.43–0.88) and 0.8% versus 3.5% (OR 0.21, 95%CI 0.11–0.43). This represents a risk reduction of respectively 40% and 80% compared to unvaccinated women.

Interpretation

The progressively greater reduction in the prevalence of chronic HBV in adult Aboriginal women co-inciding with eligibility for catch-up and newborn vaccination programs is consistent with a significant impact from both programs. The use of data derived from antenatal screening to track ongoing vaccine impact is applicable to a range of settings globally.     

Prevalence of chronic head, neck and low back pain and associated factors in women residing in the Autonomous Region of Madrid (Spain)

Objective

To compare the prevalence of chronic headache (CH), chronic neck pain (CNP) and chronic low back pain (CLBP) in the autonomous region of Madrid by analyzing gender differences and to determine the factors associated with each pain location in women in 2007.

Methods

We analyzed data obtained from adults aged 16 years or older (n = 12,190) who participated in the 2007 Madrid Regional Health Survey. This survey includes data from personal interviews conducted in a representative population residing in family dwellings in Madrid. The presence CH, CNP, and CLBP was analyzed. Sociodemographic features, self-perceived health status, lifestyle habits, psychological distress, drug consumption, use of healthcare services, the search for alternative solutions, and comorbid diseases were analyzed by using logistic regression models.

Results

The prevalence of CH, CNP and CLBP was significantly higher (P<0.001) in women (7.3%, 8.4%, 14.1%, respectively) than in men (2.2%, 3.2%, 7.8%, respectively). In women, CH, CNP and CBLP were significantly associated with having ≥3 chronic diseases (OR 7.1, 8.5, 5.8, respectively), and with the use of analgesics and drugs for inflammation (OR: 3.5, 1.95, 2.5, respectively). In the bivariate analysis, the factors associated with pain in distinct body locations differed between men and women.

Conclusions

This study found that CH, CNP and CLBP are a major public health problem in women in central Spain. Women have a higher overall prevalence of chronic pain than men. Chronic pain was associated with a higher use of analgesics and healthcare services.     

Cumplimiento de las recomendaciones sobre actividad física en personas hipertensas asistidas en atención primaria

Objective

To determine the prevalence of adherence to physical activity recommendations in the hypertensive population of Lerida (Spain) attended in primary care and to identify related factors.

Methods

A cross sectional study was carried out in hypertensive adults. The dependent variable was adherence to physical activity recommendations measured with the Minnesota Questionnaire. The independent variables were sociodemographic factors, the information received, and attitudes to physical activity.

Results

A total of 786 hypertensive patients participated in this study; 53.9% were women and the mean age was 66.0 ± 10.2 years. Adherence to recommendations was found in 64.3% (95% CI: 60.9-67.6); this percentage was 65.2% in men (95% CI: 60.2-70.0) and 63.4% in women (95% CI: 58.8-67.9). Greater adherence was associated with age in men and with residence in a rural area in women. In both genders, greater adherence was associated with unpaid work and with having a favorable attitude to physical activity. No association was observed with the number of recommendations received in the last 6 months.

Conclusions

More than half the hypertensive population adhered to physical activity recommendations. To improve physical activity levels, recommendations can be tailored to the attitudes of individual patients.     

Prevalencia de consumo de tabaco en vehículos privados

Objective

To determine the prevalence of smoking among drivers of private vehicles in the city of Lleida (Spain).

Methods

A random sample of 1600 cars passing through six intersections regulated by traffic lights were selected. The variables were age, sex, smoking driver, adult passengers, intersection (urban/interurban), day (working day/weekend), hour (morning/evening) and simultaneous smokers. We calculated the prevalence of smoking drivers and the corresponding odds ratios (ORs), adjusted for the potential confounding variables, as well as their 95% confidence intervals (95% CI).

Results

The prevalence was 6.0% (95% CI: 4.9-7.3) and was higher in men (6.4%), in the group aged 41 to 60 years (6.9%), and in unaccompanied drivers (6.5%). The probability of the driver smoking increased if there was a smoking passenger (aOR = 10.8; 95% CI: 3.6-32.5). The frequency of smoking drivers was higher on working days (aOR = 1.7; 95% CI: 1.0-2.8) and in the morning (aOR = 1.6; 95% CI: 1.0-2.4).

Conclusions

The prevalence of smoking drivers can be considered dangerously high. We recommend avoiding smoking while driving.     

Prevalence of overweight and obesity in schoolchildren in rural areas

Objectives

To estimate the prevalence of overweight and obesity in schoolchildren in rural areas.

Methods

A cross-sectional study was carried out in a sample of 1,513 schoolchildren aged 6, 11 and 14 years. Data were collected on height and weight with digital scales equipped with a measuring rod. We used three criteria to define overweight and obesity: Cole's points, the Centers for Disease Control and Prevention (CDC) criteria and Hernandez's tables.

Results

When Cole's points were used, 24.6% (95%CI: 22.5 - 26.8) were overweight and 11.6% (95%CI: 10-13.3) were obese; these percentages were higher in children aged 11 and 6 years, respectively. According CDC growth charts, 19.8% of children (95%CI: 17.9-21.9) were overweight and 16.5% (95%CI: 14.7-18.4) were obese, corresponding to higher percentages at 14 and 6 years. When Hernandez's tables were used, 11.5% (95%CI: 10-13.2) were overweight and 18.6% (95%CI: 16.7-20.6) were obese, and both disorders were higher in children aged 11 years. The risk of obesity and overweight was higher in small rural areas (<5,000 people), with OR = 1.49 (95%CI: 1.13-1.95) and OR = 1.33 (95%CI: 1.06-1.67), respectively.

Conclusions

The prevalence of overweight and obesity in schoolchildren in rural areas is very high and is even higher in towns with less than 5,000 inhabitants.     

Factores asociados a la consulta odontológica en niños/as y jóvenes de Talca (Chile) e inmigrantes chilenos de Montreal (Canadá)

Objective

To identify the factors that influence the use of dental services in 4-7-year-olds and in 10-13-year-olds resident in the cities of Talca (Chile) and Montreal (Canada).

Methods

A nonprobabilistic cross-sectional study was carried out in 147 boys and girls in Talca and in 94 boys and girls in Montreal between 2009 and 2011. Sociodemographic variables were recorded in parents and children, including age and sex. Data were also gathered on parental education, family composition, and proximity to health centers within neighborhoods. The data were analyzed with Fisher's exact test and the robust Cox regression model (with constant time) with a significance level of 0,05.

Results

In Talca, parental education was significantly associated with dental care visits at least twice a year. The children of parents with university education were 2.20 times more likely to consult a dentist (95% CI: 1.30-3.73). Children whose parents perceived their children's health positively were 53% (OR = 0,47; 95% CI: 0,28-0,77) less likely to consult a dentist. In Montreal, the children of parents with university education were 2.10 times more likely to consult a dentist (95%CI: 1.17-3.76), while older children (10-13 years) were 2.11 (95% CI: 1.15-3.88) times more likely to consult a dentist.

Conclusions

In both cities, parental education level was associated with the use of dental services.     

Socioeconomic inequalities in the incidence and prevalence of type 2 diabetes mellitus in Europe

Objective

The aim of this study was to analyze socioeconomic position (SEP) inequalities in the prevalence and incidence of type 2 diabetes mellitus (T2DM) in people aged 50 years and over in Europe and to describe the contribution of body mass index (BMI) and other possible mediators.

Methods

This was a cross-sectional and longitudinal study including men and women ≥50 years old in 11 European countries in 2004 and 2006 (n = 21,323). The prevalence and cumulative incidence of T2DM were calculated with self-reported T2DM or when the individual took drugs for diabetes. Prevalence ratio (PR) and relative risk (RR) of prevalent and incident T2DM were calculated according to educational level and adjusted by BMI and other possible mediators.

Results

The age-adjusted and country-adjusted prevalence of T2DM in 2004 was 10.2% in men and 8.5% in women. Compared to those with higher education, men and women with lower education had a PR [95% CI] of T2DM of 1.29 [1.12–1.50] and 1.61 [1.39–1.86], respectively. SEP-related inequalities in incidence (RR [95%CI]) were 1.88 [1.35–2.62] in women and 1.04 [0.78–1.40] in men. Adjusting for potential mediators reduced inequalities in the prevalence and incidence of T2DM among women by 26.2% and 21.6%, respectively, and inequalities in prevalence among men by 44.8%.

Conclusions

We observed significant inequalities in the prevalence and incidence (women only) of T2DM as a function of socioeconomic position. These inequalities were mediated by BMI.     

Work,family and daily mobility: a new approach to the problem through a mobility survey

Objectives

To analyze gender inequalities in socioeconomic factors affecting the amount of time spent travelling for work-related and home-related reasons among working individuals aged between 30 and 44 years old during a weekday in Catalonia (Spain).

Methods

A cross-sectional study was conducted. Data were obtained from employed individuals aged between 30 and 44 years of age who reported travelling on the day prior to the interview in the Catalan Mobility Survey 2006 (N = 23,424). Multivariate logistic regression models were adjusted to determine the factors associated with longer time spent travelling according to the reason for travelling (work- or home-related journeys). Odds ratios and 95% confidence intervals are presented.

Results

A higher proportion of men travelled and spent more time travelling for work-related reasons, while a higher proportion of women travelled and spend more time travelling for home-related reasons. A higher educational level was associated with greater time spent travelling for work-related reasons in both men and women but was related to an increase in travelling time for home-related reasons only in men. In women, a larger household was associated with greater travel time for home-related reasons and with less travel time for work-related reasons.

Conclusion

This study confirms the different mobility patterns in men and women, related to their distinct positions in the occupational, family and domestic spheres. Gender inequalities in mobility within the working population are largely determined by the greater responsibility of women in the domestic and family sphere. This finding should be taken into account in the design of future transport policies.     

Estado de salud y violencia contra la mujer en la pareja

Objective

To describe the prevalence of intimate partner violence (IPV) in Spain in the last year and at some point during the lifetime, to determine health status in women according to whether they had experienced IPV or not, and to analyze the individual variables associated with IPV in Spain.

Methods

A cross-sectional study was performed of the database, Macrosurvey on Gender Violence in Spain 2011. This database includes data on 7,898 women older than 18 years old. The dependent variables were IPV-last year, IPV-ever in life. Covariates consisted of sociodemographic characteristics, socioeconomic status, maternal experience of IPV, social support, and self-care. The measure of association used was the OR with its 95% confidence interval (95% CI).

Results

A total of 3.6% of women had experienced IPV-last year and 12.2% ever in life. Female victims of IPV had poorer health than women who had not experienced IPV. Immigrant women living in Spain for 6 years or more were more likely to experience IPV-ever in life than Spanish women [OR (95% CI): 1.95 (1.50, 2.53)]. An interaction was found between nationality and the existence of children under 18 years old. Among women with children under 18 years old, immigrant women were more likely to experience IPV-last year than Spanish women [OR (95% CI): 1.99 (1.25, 3.17)]. Other variables associated with IPV were age, low socioeconomic status, low social support and having a mother who had experienced IPV.

Conclusions

In Spain, some women have a higher probability of experiencing IPV. The variables associated with greater vulnerability to IPV should be taken into account when implementing measures to prevent or alleviate IPV.     

Gender inequalities in occupational health in Spain

Objectives

To analyze gender inequalities in employment and working conditions, the work-life balance, and work-related health problems in a sample of the employed population in Spain in 2007, taking into account social class and the economic sector.

Methods

Gender inequalities were analyzed by applying 25 indicators to the 11,054 workers interviewed for the VI edition of the National Working Conditions Survey. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (95% CI), stratifying by occupational social class and economic sector.

Results

More women than men worked without a contract (OR = 1.83; 95% CI: 1.51-2.21) and under high-effort/low-reward conditions (1.14:1.05-1.25). Women also experienced more sexual harassment (2.85:1.75-4.62), discrimination (1.60:1.26-2.03) and musculoskeletal pain (1.38:1.19-1.59). More men than women carried out shift work (0.86:0.79-0.94), with high noise levels (0.34:0.30-0.40), and high physical demands (0.58:0.54-0.63). Men also suffered more injuries due to occupational accidents (0.67:0.59-0.76). Women white-collar-workers were more likely than their male counterparts to have a temporary contract (1.34:1.09-1.63), be exposed to psychosocial hazards and discrimination (2.47:1.49-4.09) and have occupational diseases (1.91:1.28-2.83). Gender inequalities were higher in the industry sector.

Conclusions

There are substantial gender inequalities in employment, working conditions, and work-related health problems in Spain. These gender inequalities are influenced by social class and the economic sector, and should be considered in the design of public policies in occupational health.     

Inmigración y salud: desigualdades entre la población autóctona e inmigrante en el País Vasco

Objective

To analyze health inequalities between native and immigrant populations in the Basque Country (Spain) and the role of several mediating determinants in explaining these differences.

Methods

A cross-sectional study was performed in the population aged 18 to 64 years in the Basque Country. We used data from the Basque Health Survey 2007 (n = 4,270) and the Basque Health Survey for Immigrants 2009 (n = 745). We calculated differences in health inequalities in poor perceived health between the native population and immigrant populations from distinct regions (China, Latin America, the Maghreb and Senegal). To measure the association between poor perceived health and place of origin, and to adjust this association by several mediating variables, odds ratios (OR) were calculated through logistic regression models.

Results

Immigrants had poorer perceived health than natives in the Basque Country, regardless of age. These differences could be explained by the lower educational level, worse employment status, lower social support, and perceived discrimination among immigrants, both in men and women. After adjustment was performed for all the variables, health status was better among men from China (OR: 0.18; 95% confidence interval [CI95%]: 0.04-0.91) and Maghreb (OR: 0.26; 95% CI: 0.08-0.91) and among Latin American women (OR: 0.36; 95% CI: 0.14-0.92) than in the native population.

Conclusions

These results show the need to continue to monitor social and health inequalities between the native and immigrant populations, as well as to support the policies that improve the socioeconomic conditions of immigrants.     

Patrón evolutivo de la incidencia de cáncer de tiroides en la Región de Murcia de 1984 a 2008

Objective

To study the trend pattern of the incidence of thyroid cancer.

Methods

We selected incident cases of thyroid cancer occurring in the Region of Murcia (Spain) in 1984-2008. The variables gathered were age, sex, date of diagnosis, and morphology. We calculated incidence rates and the annual percentage of change using Bayesian age-period-cohort models.

Results

During the study period, 1414 cases were diagnosed, representing an increase in adjusted rates from 2.9/100000 in 1984-1988 to 7.3 in 2004-2008. The incidence was 3.5 times higher in women than in men and the most frequent morphology was papillary carcinoma (67.7%). An increasing trend was found in both genders; these increments were more pronounced in papillary carcinoma. In women, the incidence increased with age, calendar year, and in those born in 1945-1963. The incidence of papillary microcarcinoma increased four-fold in women.

Conclusions

Thyroid cancer used to be a rare cancer but has become an emerging tumor. The greatest changes were found in papillary thyroid cancer, including a gradual increase in the proportion of microcarcinoma.