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Biomedical subjects

F G Benavides

Publications and source records attributed to F G Benavides.

At least 37 records · Page 2Linked to original sources
PubMed1999

Parental agricultural work and selected congenital malformations.

The authors conducted a case-control study in Comunidad Valenciana, Spain, to assess the relation between occupational exposure to pesticides, mainly as a result of agricultural work, and the prevalence of congenital malformations. A total of 261 cases and 261 controls were selected from those infants born in eight public hospitals during 1993-1994. The cases were those who were diagnosed with selected defects (nervous system, cardiovascular, oral clefts, hypospadias/epispadias, musculoskeletal, and unspecified anomalies) during their first year of life. Information on occupational exposures and potential confounding variables was collected from the parents. For the mothers who were involved in agricultural activities during the month before conception and the first trimester of pregnancy, the adjusted odds ratio was 3.16 (95% confidence interval 1.11-9.01) primarily due to an increased risk for nervous system defects, oral clefts, and multiple anomalies. Paternal agricultural work did not increase the risk, although fathers who reported ever handling pesticides had an adjusted odds ratio of 1.49 (95% confidence interval 0.94-2.35) mainly related to an increased risk for nervous system and musculoskeletal defects. Although the power of this study regarding some associations is limited, the results justify further attention to maternal agricultural work and paternal pesticide exposure.

Adult↗
PubMed1998

Paternal exposure to pesticides and congenital malformations.

OBJECTIVES: A case-referent study with 261 matched pairs was carried out in 8 hospitals of Comunidad Valenciana, Spain, to assess the relation between occupational exposure to pesticides and selected congenital malformations. In this paper, the results concerning paternal exposure are presented. METHODS: The parents of the case patients and the referents were interviewed to collect information about exposure to pesticides and potential confounding variables. Detailed information on direct involvement in the handling of pesticides was collected for the interviewees involved in agricultural activities during a previously defined period in relation to conception and pregnancy. Exposure data were reviewed by 2 experts who assigned ordinal scores for the probability and intensity of exposure to pesticide classes and active ingredients. RESULTS: The dichotomous analysis of exposure (absent, present) yielded some increased risks, although not statistically significant, for aliphatic hydrocarbons [adjusted odds ratio (adjusted OR) 2.05, 95% confidence interval (95% CI) 0.62-6.80], inorganic compounds (adjusted OR 2.02, 95% CI 0.53-7.72), and glufosinate (adjusted OR 2.45, 95% CI 0.78-7.70), and a significant association for pyridil derivatives (adjusted OR 2.77, 95% CI 1.19-6.44). The analysis based on the experts' scores (2 levels of exposure) showed some consistent associations for these compounds. CONCLUSIONS: This research indicates a possible risk of congenital malformations for paternal exposure to some pesticides, notably, pyridils, aliphatic hydrocarbons, inorganic compounds, and glufosinate. It did not find an increased risk for paternal exposure to pesticides in the classes of organophosphates, carbamates, organochlorines, chloroalkylthio fungicides and organosulfurs. These findings warrant further investigation.

Agriculture↗
PubMed1995

[The incidence of occupational diseases: a study of medical evaluations for work incapacity in Barcelona (1987-1991)].

BACKGROUND: The number of professional diseases (PD) declared in Spain is low. The existence of diseases of labor etiology treated as a common disease is recognized, thus disregarding important labor health risks. METHODS: The incidence of PD in the province of Barcelona from 1987-1991 was prospectively studied by the Units of Medical Evaluation of Incapacities (UMEI). The sociodemographic, medical and administrative data of the cases of PD were reported by a protocol of data collection. The cases of PD are described and the annual incidence in relation with the active working population calculated. RESULTS: The UMEI of Barcelona confirmed 554 cases of PD of which 331 were evaluated as permanent invalidity over the five years of the study. The most frequent diagnoses of PD were pneumoconiosis, skin diseases, diseases causing tendinous fatigue and hypoacusis or deafness. Eleven neoplasms were reported, 9 being caused by asbestos. During the five years the incidence of PD increased from 76 cases to 144 per 100,000 active workers. The procedure of information probably underreported the incidence of PD. CONCLUSIONS: A low incidence of professional disease was observed. The clinical-labor history is generally not carried out. The way in which the Units of Medical Evaluation of Incapacities report data concerning incidence may contribute to greater detection of professional diseases on registration being integrated into a system of epidemiologic surveillance in which all the health care, labor and administrative centers were effectively coordinated.

Adult↗
PubMed1992

Adding years to life: effect of avoidable mortality on life expectancy at birth.

STUDY OBJECTIVE: The aim was to determine the number of years that could be gained by preventing avoidable deaths. DESIGN: The study arose from the concept of avoidable causes of death and life expectancy at birth. Four abbreviated life tables were computed. The first included all causes of death; the second excluded all avoidable causes of death; the third and fourth excluded respectively primary and secondary avoidable causes of death. SETTING: Mortality and population data were taken from Mortality Statistics Offices in Valencia Region, Spain. MAIN RESULTS: Life expectancy at birth (LEB) was 75.7 years. After removing all avoidable deaths, LEB increased by 1.74 years. This improvement is attributed to avoidable deaths by primary prevention (1.09 years) and avoidable death by secondary prevention (0.37 year). CONCLUSIONS: According to these results the greatest improvement in LEB would be gained by primary prevention.

Cause of Death↗
PubMed1991

[Preventable mortality in Andalusian hospitals, 1982-1985].

BACKGROUND: The hospital mortality has been proposed as an indicator of the quality of care, particularly the mortality defined as premature, which is considered as preventable with health care. METHODS: In the hospitals from Andalusia 2.364.934 disease episodes were cared for 1982 to 1985, with a death rate of 2.27%, as estimated in the Hospital Morbidity Survey published by the Instituto Nacional de Estadística. RESULTS: 2.8% of these deaths were caused by some of the diseases considered as preventable. Of these, hypertension and cerebrovascular disease accounted for 60% and tuberculosis for 16%. Lethality due to these conditions has increased from 0.25 in 1982 to 0.46. In addition, in the Málaga and Huelva provinces the lethality rates (0.63 and 0.61, respectively) and the standardized mortality ratios (225.6 and 174.2, respectively) corresponding to the above mentioned conditions were significantly higher than the mean values in Andalusia. CONCLUSIONS: The preventable mortality in hospitals could be used to evaluate the quality of hospital care from a double standpoint: a) the occurrence of one of these deaths could warrant an inquiry of its reasons; b) the comparison of the preventable mortality rates could identify hospital areas where health care may be provided with some inefficiencies.

Cause of Death↗
PubMed1989

Quality of death certificates in Valencia, Spain.

Certificates of 1,454 deaths occurring over 11 months were retrieved from the Civil Register in Valencia, Spain. Relevant medical information was systematically gathered from hospital records, questionnaires, and Coroner reports. We compared the underlying cause of death (UCD) from the original death certificate, and a reference cause of death (RCD) determined by a panel of experts based on all available information. Overall, 80.2 percent of the certificates were concordant for disease category, but there was a great disparity among some specific disease categories.

Cause of Death↗
PubMedDate not supplied

[Description of psychosocial risk factors in four companies].

OBJECTIVE: To describe the distribution of work-related psychosocial risk factor scores in four companies according to the personal and occupational characteristics of the workers. METHODS: Cross-sectional study of a sample of 890 workers in four companies who participated in this study voluntarily. The overall response rate was 34.5%. A self-administrated questionnaire was used to measure the presence of demand, control and social support according to the workers' perceptions. Statistical analyses were performed using median and dispersion measures of psychosocial risk factors for each company separately, as well as description of their distribution according to personal and occupational variables. RESULTS: The median score for social support was almost always equal to 5 for all four companies. However, there was greater variability in psychological demand (between 13 and 16), and for control (between 20 and 26). Comparison of the scores for social and occupational variables revealed similar values for social support but not for control and demand, which showed greater variation according to sex (men), age group (less than 40 years) and occupation (clerks). CONCLUSIONS: Although the low response rate could limit the validity of our results, this is the first study to value the distribution of work-related psychosocial risk factor scores in four companies in Spain. Variability among companies for different groups of workers was found. This study could be useful for future studies exploring the feasibility of defining reference values for use in preventive measures.

Administrative Personnel↗
PubMedDate not supplied

[Analysis of the mechanisms of minor occupational injuries in the construction industry in Spain].

OBJECTIVES: The construction industry produces the highest number of occupational injuries in Spain (25.6%). Of these, 98.5% were minor injuries with 5 million workdays lost in 2000. This occurred even after the recent introduction of numerous health and occupational safety regulations. The objective of the present study was to identify the specific mechanisms of minor occupational injuries in the construction sector. METHODS: In 2000, there were 235,853 minor occupational injuries in the construction industry. From these, injuries in general construction and civil engineering were selected (n = 155,044). These injuries affected both the total number of workers in the sector as well as bricklayers and unskilled construction workers. Insurance and financial activities (n = 2,019) were selected as a reference economic sector. Minor occupational injuries due to nontraumatic processes (heart attack, etc.) were taken as a control group (n = 167), assuming that the risk of nontraumatic processes was independent of economic activities. Odds ratios (OR) were adjusted by age, sex, years of work experience, type of employment and company size through nonconditional logistic regression models. RESULTS: The mechanisms with the highest risk of minor occupational lesions in construction workers as a group compared with employees in the financial sector were projection of fragments (OR = 33.0; 95% CI, 15.3-70.8) and being struck by objects (OR = 18.2; CI 95%, 9.7-34.1). These were also the most specific mechanisms of injury in the subgroup of bricklayers and unskilled construction workers. CONCLUSIONS: Activities aimed at preventing minor occupational injuries in the construction sector should be orientated towards these mechanisms, especially projection of fragments despite the low frequency of this mechanism compared with that of other mechanisms. Case-control design is a useful alternative approach for research into occupational injuries.

Accidental Falls↗
PubMedDate not supplied

[Avoidable years of life lost ratio: an indicator to identify excess mortality in health areas. Mortality workshop of the Valencia region].

Avoidable mortality has been proposed as an outcome indicator of health services. Until now the Standardized Mortality Ratio (SMR) has been the effect measure most used to detect excesses in avoidable mortality. We propose the use, as a complementary measure, of the Avoidable Years of Life Lost Ratio (AYLLR). We show that for tuberculosis, hypertension and for all avoidable deaths both measures provide complementary information, since in some areas where observed deaths are below the expected number (SMR less than 100) we detect an observed number of years of life lost higher than expected (AYLLR greater than 100), due to the occurrence of these deaths at younger ages. The AYLLR is a standardized effect measure that puts a higher weight to premature deaths.

Catchment Area, Health↗
PubMedDate not supplied

[The work situation and mental health. The results of a cross-sectional study].

The aim of the study is to assess the relationship between employment situation and mental health in the city of Valencia. Between May and July of 1992, a cross sectional study by means of personal interviews was carried out. The total sample was 411 people of these 101 were selected through a random sampling of the working population, the rest (310) consisted of people registered with INEM selected through a predetermined sampling according to age and sex. The variable dependent (psychological morbidity) was measured through the General Health Questionnaire (GHQ) consisting of 28 items. The results obtained show that 36.4% of the unemployed sample displayed psychological morbidity as opposed to 23.3% of those is employment (p = 0.01). The prevalence Odds Ratio (OR) was calculated by means of a logistic regression model. Those in causal employment had a OR of 8.62 (95% CI = 2.66-27.9) as opposed to those in regular employment after adjusting for age, sex and professional status. Those that had been unemployed for more than a year had a OR of 16.02 (95% CI = 4.60-55.75) as opposed to those employment after adjusting for the same variables. These results seem to confirm a greater psychological morbidity among those with casual employment and the unemployed as opposed to those in regular employment although the transversal design of the study does not highlight any relation of casualty that might exist among the variables.

Age Distribution↗
PubMedDate not supplied

[The mortality of a retrospective cohort of workers in a Spanish iron and steel plant. The methodological problems in defining the cohort].

The work environment of an iron foundry involved a large number of exposures related to several health problems, mainly lung cancer. "Altos Hornos del Mediterráneo (AHM)" fron Sagunto is an iron industry that stopped its foundry plant production in 1984. The present paper shows the methodological problems merged during the reconstruction of AHM workers' cohort. From personnel files a male cohort was defined for 7,018 males who worked at least one year and started work between 1950 and 1970, following them through 1991. The cause of death was obtained from de Civil register, Life insurance and reference hospitals. By means of experts the work areas were rated in three exposure levels. 6% of cohort members were lost during the follow-up. 2786 deaths were reported and 88% causes of death were retrieved. The enterprise data files let us to reconstruct the cohort, but the availability of a National Death Index, as there is in other countries would have made easier the job and would have improved the data quality.

Cause of Death↗
PubMedDate not supplied

[Changing the epidemiological surveillance into the public health surveillance. Work Group on Information Systems in Public Health].

Although epidemiological surveillance include originally a strategic function, beyond epidemic control, in Spain the communicable diseases control system has been the only surveillance scheme. This system suffer a severe crisis, probably due to the scarce uses of the information and/or because the system produce exclusively information about communicable diseases or outbreaks. In the last few years, information sources and procedure have been developed out of the official surveillance, such as cancer register, traffic accidents or air contamination statistics and so on. Moreover, national and regional health plans which signify specific health objectives entail information tools with ability to rank and evaluate the interventions. The principal health information system useful to surveillance has been described. We conclude that the expression public health surveillance define much better the functions of a) monitoring and evaluation of the health policy and b) detection and research of epidemics. Finally, we identify some elements for the change, such as: a) to include information related to adverse effects of the sanitary interventions, and environmental and occupational hazards; b) to facilitate the access of information by means of self-operating database and c) to make comparable the different information sources.

Health Policy↗
PubMedDate not supplied

[Validity of the municipality of residence in mortality statistics: findings based on municipality census update in 2 municipalities of the Valencian community].

This study was designed to assess the validity of the variable "city of residence" in mortality statistics in relation to the information available in municipal census. Monthly record-linkages between mortality register and two municipal population census corresponding to the period 1991-1992 have been studied. The population census belong to Benidorm, an important Spanish coastal tourist centre, and Alcoi, a traditional industrial city. Results show that of those listed in the Alcoi mortality statistics (602 deaths), 83% were registered in its municipal population census. In Benidorm (282 deaths), this percentage was 54%; in this last city, having a private address (in contrast with hotel, apartment or clinic address...) was positively related with being registered (66.2% versus 8.8%). Likewise, deceased with Spanish names were in more likely to be registered names in municipal population census: 70.2% versus 11.9%, respectively. The evidence obtained shows that tourist area mortality statistics could be unreliable due to the incorrect reporting of the city of residence on the death certificate, and suggests actions to improve it, which should take into account the town authorities and funeral services.

Demography↗
PubMedDate not supplied

[Causality in occupational health: the Ardystil case].

Establishing causal relationships has been and is today a matter of debate in epidemiology. The observational nature of epidemiological research rends difficult the proving of these relationships. Related to this, different models and causal criteria have been proposed in order to explain health and disease determinants, from pure determinism in Koch postulates, accepting unicausal explanation for diseases, to more realistic multicausal models. In occupational health it is necessary to formulate causal models and criteria to assess causality, and frequently causal assessment in this field has important social, economic and juridical relevance. This paper deal with evaluation of causal relationships in epidemiology and this evaluation is illustrated with a recent example of an occupational health problem in our milieu: the Ardystil case.

Adult↗
PubMedDate not supplied

[Problems of the use of the trend test as a dose-response measurement in epidemiology].

BACKGROUND: The objective of the dose-response analysis is to reveal the presence of a progressively response to an increased dose. One of the usual ways of doing so is the carrying out of the so-called trend test. However, the fact that this test may show statistical significance does not necessarily indicate that there is a uniform response between dose and response. This study aims to examine the various situations in which the use of the trend test is not always appropriate as well as given an overview of the use of potential alternatives. METHODS: Five theoretical dose-response scenarios have been created using for supposed case-control studies, in which the relationship was not always linear. The results-tables obtained have been analysed, leading to the attainment of the Chi-squared trent test, as well as the calculation of the linear component by means of the logistical regression. Subsequently, other alternative methods of trends analysis, such as categorical analysis, the transformation of the findings within the logistical model and the use of risk incrementals have been employed. RESULTS: The test of trends invariably proved to be significant, despite the fact that in four of the theoretical models there did not exist a clear relationship between dose and response. This significant result could lull its readers into proposing a linear dose-response relationship which, in fact, proves false. The alternative use of incremental risk models, or categorical analysis, permits the identification of situations in which there is no relationship. CONCLUSIONS: The trend test should only be employed in cases where the data demonstrates the existence of monotonous, lineal relationship that can be deduced from the results of categorical analysis, the use of incremental risk or the adjustment of various no linear models, although, in this cases, the significance of the test may bring forward no new information.

Case-Control Studies↗