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Escánez A, Lozano-Bilbao E, Paz S, Hardisson A, González-Weller D, Rubio C, Lozano G, Gutiérrez ÁJ. Assessments of metallic contents in rare cephalopods from the Canary Islands: relationships with depth habitat and body size. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:54161-54169. [PMID: 34402011 DOI: 10.1007/s11356-021-15916-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/07/2021] [Indexed: 06/13/2023]
Abstract
This study investigated 20 elements in the muscle of 11 cephalopod species caught in the Canary Islands inhabiting from coastal to meso-bathypelagic habitats. Among them, trace element contents from large and elusive cephalopods such as Architeuthis dux, Taningia danae, Lepidoteuthis grimaldii, and Haliphron atlanticus were determined. Statistically significant differences in element concentration were found among class sizes and habitat. Large species that are inhabiting in deepest waters such as Loligo forbesii, A. dux, T. danae, H. atlanticus, and L. grimaldii showed a high load and variability in Fe and Al, while coastal species were characterized by a homogeneous element composition, being the Zn loads highest than other elements. Metal contents in large and elusive cephalopod species were dominated by Fe, Ni, Al, Zn, and Sr, with these species being able to carry important amounts of these elements to predators such as deep-diving odontocetes that reside around the Canary waters.
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Lozano-Bilbao E, Lozano G, Jiménez S, Jurado-Ruzafa A, Hardisson A, Rubio C, Weller DG, Paz S, Gutiérrez ÁJ. Influence of Biometric and Seasonal Parameters on the Metal Content of Scomber colias in Northwestern African Waters. Biol Trace Elem Res 2021; 199:3886-3897. [PMID: 33206306 DOI: 10.1007/s12011-020-02493-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 11/30/2022]
Abstract
Studies of the content of heavy metals and trace elements in fish and other marine organisms are of great importance to know the state of the marine ecosystem. This study has been carried out in northwestern African waters, Scomber colias being the target species, sampling a total of 345 specimens over 2 years. For the determination of metals and trace elements (Al, B, Cd, Cr, Cu, Fe, Li, Ni, Pb, V, and Zn) in the muscle, the ICP-OES (inductively coupled plasma optical emission spectrometry) was used. In the statistical study, the factors (oceanographic and maturity in the seasons, size of the specimens) were used. The samples sampled in the cold season that had high concentrations of metals may be due to the influence that African upwelling has on the Canary Islands. The metallic contents of our samples are lower than those found in the studies in Mauritania and Morocco due to the greater influence that upwelling has in these areas.
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Lara-Torres S, Figueiredo D, Paz S, Gutiérrez AJ, Rubio C, González-Weller D, Revert C, Hardisson A. Determination and risk assessment of toxic metals in lipsticks from Europe and China. J Trace Elem Med Biol 2021; 67:126792. [PMID: 34022566 DOI: 10.1016/j.jtemb.2021.126792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/30/2021] [Accepted: 05/14/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND The presence of toxic toxic metals in lipstick can pose a health risk to many consumers of this type of cosmetics, especially for women. Thus, the aim of this study was to assess consequences attributed to dermal and oral exposure to toxic metals in lipsticks manufactured in China and Europe as determined by non-cancer and cancer risks assessment models from SCCS and USEPA, respectively. METHOD The treatment of the samples was carried out by calcination using muffle furnaces and the determination of Al, Cd and Pb were determined by inductively coupled plasma optical emission spectrometry (ICP-OES). CONCENTRATIONS The concentration of Cd and Pb in the study samples does not exceed the limits stablished for the FDA (00,228 mg kg-1·day-1 for Cd and 000,343 mg kg-1·day-1 for Pb, respectively) but they do not comply with the Regulation of the European Parliament, which prohibits the presence of these two metals in cosmetics. Neither European Union nor United States have established maximum levels for Al in cosmetics. CONCLUSIONS The cancer risk assessment of Cd and Pb metals resulted in a total cancer risk less than 1. The results of non-cancer oral risk assessment for Pb had a MoS result of 88 for China and 62 for Europe, suggesting that Pb poses a risk for the human health, especially in samples manufactured in Europe.
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Lozano-Bilbao E, Adern N, Hardisson A, González-Weller D, Rubio C, Paz S, Pérez JA, Zupa R, Gutiérrez ÁJ. Differences in macroelements, trace elements and toxic metals between wild and captive-reared greater amberjack (Seriola dumerili) from the Mediterranean Sea. MARINE POLLUTION BULLETIN 2021; 170:112637. [PMID: 34153858 DOI: 10.1016/j.marpolbul.2021.112637] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 06/13/2023]
Abstract
Despite its legislative regulation and control, the quality and safety of aquatic products is somewhat questioned due to the potential bioaccumulation of pollutants. The elements (Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, Pb, Sr, V and Zn) were determined in the liver and muscle of wild and captive-reared Seriola dumerili with the aim of studying possible differences between origins, and sex-related variations. Additionally, the dietary intake of these elements derived from its consumption was also evaluated. Most of the elements and metals analyzed were accumulated to a higher extent in the liver of wild specimens whereas lower differences were observed in the muscle. Overall, the elements and metal composition of wild females strongly differed from that of captive-reared specimens probably related to the mobilization of nutrients for the spawning season in wild mature females, which were greater than their captive-reared counterparts.
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Rodrigue. Díaz R, Alcaide-Ruggiero L, Blane. Zamora R, Gome. Rodríguez J, Paz S, Hardisso. d. l. Torre A, Gutierrez A, Rubio C, Hess-Medler S. P–059 Association between seminal levels of Fe and semen quality. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
The detection of metals in semen offers a new field in the study of male infertility.
Summary answer
Normozoospermia is associated with higher amounts of Fe. In males with pathological spermiogram, the percentage of men with Fe in semen was lower than expected.
What is known already
Increased levels of Fe in human semen appear to have a significant correlation with male fertility, suggesting that Fe in human seminal plasma has an important factor in male reproductive function. Fe acts as an antioxidant being a co-factor of catalasa, which protects sperm. On the other hand, elevated Fe levels are associated with sperm damage and continues to increase the lipid peroxidation that will affect the plasma membrane and the sperm motility. Most authors associate Fe with sperm motility and higher estimated fertility potential, based on standard semen parameters in fertile men, which are associated with lower levels of Fe.
Study design, size, duration
A prospective study was carried out in 102 men in a Reproduction unit in Tenerife, from February to April 2018 as a part on an epidemiologic study of environmental contaminants and male reproduction. The participant were categorized into two groups, according to the results of semen analysis following the World Health Organization guidelines: the pathological and the normal semen group that constituted the control group. The metal was determined in semen samples.
Participants/materials, setting, methods
Semen quality and levels of Fe were measured in seminal plasma on a total of 102 men attended successively, for the initial infertility evaluation, The collected samples were used for both semen analysis following the World Health Organization (WHO) guidelines and metal detection and carried out using a Makler® counting chamber (Irvine Scientific, CA) and for metals, were determined by ICP-OES (Inductively Coupled Plasma-Optical Emission Spectrometry) in semen samples.
Main results and the role of chance
The percentage of males with the presence of Fe was 97.1% and the average level were 0.6283 mg/Kg. When analyzing the relationship between the spermiogram parameters with the levels of Fe in the semen, significant differences were found. All men with a normal sperm analysis presented Fe in semen, but among men diagnosed with altered spermiogram, the percentage of men with Fe in semen (92.7%) was lower than expected (97%) (χ2 128 1 =4.59; p = 0.032). As for the concentration of Fe in spermiogram in the first quartile (25% lower), measuring 0.33 mg/Kg, more pathological samples were found than expected (X2 133 2 =6.921; p = 0.031) having a higher probability of being more pathological (52% vs 31.4%). On the other hand, men with pathological sperm concentration, have higher levels of Fe, in the fourth quartile (0.61 mg/kg), with more frequency than expected (90.6% vs 97%) (χ2 136 1 =6.48; p = 0.011). The association between BMI and the presence of Fe was statistically significant. In obese males (BMI ≥30.0 kg/m2), the percentage of men with Fe in semen (80%) was lower than expected (97%) (χ2 42 2 =11.302; p = 0.001).
Limitations, reasons for caution
The limitation of this study was the volume of semen that could be obtained for metal detection, only 0.8 mL. because the collected samples were used for both semen analysis and metal detection.
Wider implications of the findings: The determination of metals in semen opens a new field in the study of male infertility and many cases of unknown infertility could be due to metal presence or absence in semen, with the option of performing treatments.
Trial registration number
Not applicable
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Lozano-Bilbao E, Herranz I, González-Lorenzo G, Lozano G, Hardisson A, Rubio C, González-Weller D, Paz S, Gutiérrez ÁJ. Limpets as bioindicators of element pollution in the coasts of Tenerife (Canary Islands). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:42999-43006. [PMID: 34228306 DOI: 10.1007/s11356-021-15212-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Currently, there is an increase in marine pollution around the world; the most affected areas are the coastal ones since on the coast is where anthropogenic pollution first acts. Therefore, it is important to have natural bioindicators as organisms that indicate us in the first instance of this pollution. The main objective of the present research is to determine if Patella aspera and Patella candei crenata show statistical differences in their element content in contaminated areas of the Island of Tenerife and to verify if limpets can be good bioindicators of marine pollution by trace elements and non-essential elements. A total of 160 limpets were taken from 4 slopes of the Island of Tenerife in the Canary Islands. The samples were analyzed using the ICP-OES to obtain results of essential trace elements (Cr, Cu, Fe, Li, Ni, and Zn) and non-essential elements (Al, B, Cd, Pb, and V). P. aspera showed a higher concentration of elements than P. candei crenata, and it was in the Buenavista locality where alarming values of Cd 0.658 ± 0.124 mg/kg were observed for P. aspera. These two limpet species have been found to be useful as bioindicators of marine pollution based on the concentrations of metals especially for Cd and Cu.
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Delgado-Suárez I, Lozano-Bilbao E, Lozano G, Hardisson A, Rubio C, González-Weller D, Paz S, Gutiérrez ÁJ. Characterization of classes of mollusks in the East Atlantic according to their element content. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:30390-30398. [PMID: 33928500 DOI: 10.1007/s11356-021-14112-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
One hundred and ninety-two samples from six species of mollusks classified into the following taxonomic classes: Gastropoda (Patella aspera, Patella candei crenata), Bivalvia (Mytilus galloprovincialis, Ensis directus), and Cephalopoda (Abraliposis morisii, Pyroteuthis margatifera) were investigated. Samples were collected in the Atlantic Ocean (Canary Islands and Galicia). The concentrations of Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, Pb, Sr, V, and Zn were determined by ICP-OES. Statistical analysis verified that the classes of benthic organisms had the highest concentration of elements. However, the Cephalopoda class had the highest Cd (1.685 ± 0.929 mg/kg) and Pb (0.826 ± 1.104 mg/kg) content. On the other hand, the values obtained in this study were compared with studies conducted in other parts of the world to verify the environmental state of the Atlantic Ocean using the organisms studied as bioindicators.
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Rubio C, Paz S, Gutiérrez ÁJ, González-Weller D, Martín R, Hardisson A. Human Exposure to Potentially Toxic Elements from the Consumption of Soybean Beverages Commercialized in Spain. J Food Prot 2021; 84:932-937. [PMID: 32311738 DOI: 10.4315/jfp-19-565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/20/2020] [Indexed: 11/11/2022]
Abstract
ABSTRACT Plant-based beverages have been positioned as an alternative to cow's milk. Some of the most commonly consumed plant-based beverages are those made from soybeans. Soybean beverages can be an important source of essential elements. However, soybean plants can be exposed to high concentrations of contaminants, such as toxic metals, from the soil and the environment. The objective of this study was to determine the concentrations of potentially toxic elements (PTEs; Fe, Cu, Cr, Co, Mn, Mo, Zn, B, Ba, Ni, Li, Sr, V, Al, Cd, and Pb) to evaluate the human exposure and toxic risk from the consumption of these soybean beverages. Forty samples of various brands of soybean beverages were analyzed by inductively coupled plasma-optical emission spectroscopy. The most abundant PTE was Al (3.93 mg/L), followed by Fe (1.91 mg/L) and Ba (0.69 mg/L). Based on a mean consumption of two servings of soybean beverage per day (250 mL per serving), this consumption results in a daily intake of Al and Pb that is significant but still below of the maximum recommended amount. However, higher consumption could exceed the maximum recommended Al and Pb values, with consequent risks to the human health. HIGHLIGHTS
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Rubio-Armendáriz C, Paz S, Gutiérrez ÁJ, González-Weller D, Revert C, Hardisson A. Human Exposure to Toxic Metals (Al, Cd, Cr, Ni, Pb, Sr) from the Consumption of Cereals in Canary Islands. Foods 2021; 10:1158. [PMID: 34064037 PMCID: PMC8223989 DOI: 10.3390/foods10061158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 12/23/2022] Open
Abstract
The Canary Islands is an archipelago that consumes cereals and derivatives imported from other regions of the world. The increase in contamination with toxic metals makes it necessary to assess the content of toxicological metals of interest to ensure quality and safety. The content of toxic metals (Al, Cd, Cr, Pb, Ni, Sr) was determined in 221 samples of cereals and derivatives (corn, wheat, gofio, corn gofio, barley gofio, roasted corn and flour) marketed in the Canary Islands using ICP-OES (inductively coupled plasma optical emission spectrometry) to assess dietary exposure. Al content recorded in barley gofio (29.5 mg/kg fresh weight) stands out. The estimated daily intake (EDI) of Pb is 52 µg/day if 100 g/day of barley gofio is consumed (121% and 240% of the BMDL nephrotoxicity limit set by the EFSA at 0.63 µg/kg body weight/day for adults and children, respectively). The EDI of PB is 16 µg/day if 30 g barley gofio/day is consumed by adults (36.2% of the abovementioned BMDL nephrotoxicity limit). The EDI of Pb is 7.8 µg/day if 15 g barley gofio/day is consumed by children (32.2% of the abovementioned BMDL nephrotoxicity limit). Gofio is a food of high nutritional value. It is necessary to establish monitoring programs for toxic metals in raw materials and processed products to reduce exposure levels.
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Franco-Fuentes E, Moity N, Ramírez-González J, Andrade-Vera S, Hardisson A, González-Weller D, Paz S, Rubio C, Gutiérrez ÁJ. Metals in commercial fish in the Galapagos Marine Reserve: Contribution to food security and toxic risk assessment. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 286:112188. [PMID: 33631518 DOI: 10.1016/j.jenvman.2021.112188] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 06/12/2023]
Abstract
Metal pollution in the marine environment can damage places with exceptional biodiversity such as the Galapagos Islands. For this reason, it is important to evaluate the toxic risk from metals derived from fish consumption and to perform a nutritional assessment. We sampled 20 individuals of demersal (Caulolatilus princeps and Mycteroperca olfax) and pelagic (Thunnus albacares and Seriolella violacea) species. The levels of the toxic elements (Al, B, Ba, Cd, Ni, Pb and Sr), and the macroelements, microelements and trace elements (Ca, Cr, Fe, K, Li, Mn, Mo, Mg, Na, V and Zn) of species muscle tissue were analyzed by Inductively Coupled Plasma Optical Spectrometry (ICP-OES). Demersal species have higher concentrations of Cr, K, Mg and Mo; while pelagic species have higher levels of Zn. M. olfax could potentially cause Cd toxicity so it is recommended not to ingest more than 86 and 73 g of this species (i.e. roughly, one serving) per week for men and women, respectively. None of the species could be marketed in Europe and the USA due to Cd level exceed the allowed limits by EFSA and FAO. Furthermore, the dietary intake of C. princeps is recommended due to its high concentration of Ca, Na, K, Mg and Cr, while T. albacares is recommended for people with Zn deficiency. However, due to the Cd level in C. princeps it is not recommended to ingest more than five servings per week. We attribute the source of metals in the studied fish from the volcanic origin of the islands rather than from human pollution. This is the first study that thoroughly estimate concentration of metals in commercial fish species and its contribution to food security in the Galapagos.
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Rubio G, Araujo F, Aguiar C, Carcedo D, Abreu-Oliveira TP, Paz S, Castellano JM. Cost-effectiveness of a cardiovascular polypill strategy (aspirin, atorvastatin, ramipril) for the secondary prevention of cardiovascular disease based on real life improvement in risk factor control. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Ferrer Internacional
Background
The cardiovascular (CV) polypill has consistently demonstrated cost-effectives in decreasing the risk of CV disease in patients in secondary prevention. Previous pharmacoeconomic studies addressed improvements in adherence as a driver of health gains. This economic assessment focuses on the implications of improved control of risk factors with the polypill as observed in clinical practice.
Purpose
To assess the cost-effectiveness of a fixed-dose combination polypill (ASA 100mg, atorvastatin 20/40mg, ramipril 2.5/5/10mg) strategy for the secondary prevention of CV and cerebrovascular events in adults with a history of coronary heart disease (CHD) or stroke compared to usual care with monocomponents.
Methods
A Markov cost-effectiveness model (1-year cycles; 4 health states: stable disease, subsequent CHD, subsequent stroke, death; payer perspective; direct medical costs; lifetime horizon; 4% discount rate) based on changes in CV risk factors (total cholesterol, 18.3% reduction; high density lipoprotein cholesterol, 2.1% increment; systolic blood pressure, 11.46% reduction) obtained from a real-life effectiveness study was set for Portugal. The probability of transition between health states was based on the SMART risk equation. Cost-effectiveness was calculated for two cohorts (n = 1,000) of secondary prevention patients with previous CHD or stroke. Systematic reviews, Portuguese registries, mortality tables and official reports were searched to identify effectiveness, epidemiological, costs and utility data. Outcomes were costs (€, 2020) per life year (LY) and Quality Adjusted LY (QALY) gained. One-way (OWA) and probabilistic (PSA) sensitivity analyses tested consistency. Assumptions were validated by experts.
Results
In the CHD cohort, the incremental cost-effectiveness ratio for the polypill strategy (ICER) is 2,402 €/LY and the incremental cost-utility ratio (ICUR) is 2,328 €/QALY. Incremental cost reaches 278,927 € (polypill, 13,198,506 €; monocomponents: 12,919,579 €) with less subsequent CV events (552.31 vs 641.88) and CV deaths (102.4 vs 118.68). Assuming a willingness-to-pay (WTP) threshold of 30.000 €/QALY gained, the PSA shows a 81.4% probability for the polypill to be cost-effective and 39.1% chances to be costs saving compared to usual care. In the stroke cohort, the ICER is 386 €/LY and the ICUR is 553 €/QALY. Incremental costs are 34,178 € (polypill, 10,138,807 €; monocomponents: 10,104,629 €) with less subsequent CV events (481.99 vs 564.50) and CV deaths (101.00 vs. 117.23) with the polypill. There is a 75.9% probability for the polypill to be cost-effective and 49.5% chances to be costs saving.
Conclusion
The CV polypill is a cost-effective secondary prevention strategy compared to usual care with monocomponents. Its ICER is well below acceptable thresholds in both CV and cerebrovascular disease patients. It reduces the number of recurrent events at a moderately higher cost compared to monocomponents.
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Rubio G, Aguiar C, Araujo F, Carcedo D, Abreu-Oliveira TP, Paz S, Castellano JM. How consistent are cost-effectiveness estimates of a cardiovascular polypill strategy for the secondary prevention of cardiovascular disease across different cardiovascular risk equations? Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Ferre Internacional
Background
Risk equations (RE) are crucial to individualise estimates and properly adjust preventive treatments in patients with previous cardiovascular (CV) disease. RE are also routinely incorporated into health economic assessments but it is unknown if the cost-effectiveness results vary according to the RE applied.
Purpose
To determine the cost-effectiveness of a CV polypill (ASA 100mg, atorvastatin 20/40mg and ramipril 2.5/5/10mg) strategy compared to usual practice of combining monocomponents in the prevention of recurrent events in patients with previous coronary heart disease (CHD) or stroke applying two different CV RE: SMART and FRAMINGHAM, respectively.
Methods
A Markov cost-effectiveness model (1-year cycles; 4 health states: stable disease, subsequent CHD, subsequent stroke; death; payer perspective; direct medical costs; lifetime horizon; 4% discount rate) was developed for Portugal. Transition probability between health states was based on the SMART RE and an adaptation for secondary CV prevention of the FRAMINGHAM RE, respectively. Cost-effectiveness was calculated for a mixed cohort of secondary prevention patients (weighed post-CHD: 57.9%; post-stroke: 42.1%). Systematic literature reviews, Portuguese registries, mortality tables and official reports ware used to identify effectiveness, epidemiological, costs and utility data. Outcomes were costs (€, 2020) per life year (LY) and Quality Adjusted Life Year (QALY) gained. One-way (OWA) and probabilistic (PSA) sensitivity analyses tested the consistency of results. Assumptions were validated by experts.
Results
Applying the SMART RE, the incremental cost-effectiveness ratio (ICER) is 1,555€/LY gained and the incremental cost-utility ratio (ICUR) is 1,785€/QALY gained for the polypill strategy. The incremental costs of adopting the polypill strategy are 171,378€. Recurrent CV events (550.68 vs 642.13) and CV deaths (106.05 vs 122.81) are also less frequent with the polypill strategy compared with monocomponents. Assuming a willingness-to-pay (WTP) threshold of 30.000 €/QALY gained, there is a 77.80% probability for the polypill strategy to be cost-effective and 43.00% chances to be costs saving when used in a mixed cardiovascular and cerebrovascular disease population. Applying the FRAMINGHAM RE, the ICER is 998€/LY gained and the ICUR is 1,242€/QALY. The incremental costs amount 175,122€. Recurrent CV events (452.66 vs 563.48) and CV deaths (104.77 vs 127.32) are less frequent with the polypill strategy. The PSA shows a 99.5% probability for the polypill strategy to be cost-effective and 46.8% chances to be costs saving.
Conclusion
Both risk equations result in comparable results on the cost-effectiveness of interventions for the secondary prevention of CV disease. The polypill strategy remains cost-effective compared to the common practice of using individual monocomponents concomitantly, reducing recurrent CV events at a moderately higher cost.
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Revelo-Mejía IA, Hardisson A, Rubio C, Gutiérrez ÁJ, Paz S. Dental Fluorosis: the Risk of Misdiagnosis-a Review. Biol Trace Elem Res 2021; 199:1762-1770. [PMID: 32705431 DOI: 10.1007/s12011-020-02296-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/19/2020] [Indexed: 11/25/2022]
Abstract
Fluoride has been considered as the single factor most frequently responsible for causing enamel mottling. However, in humans, either endogenous and/or exogenous factors not related to fluoride exposure may also cause enamel mottling. In this sense, various studies in the international literature have reported severe mottling of the teeth that could not be attributed to fluoride exposure. Thus, misdiagnosis of non-fluoride-induced enamel defects may occur frequently. Reports of unexpectedly high population prevalence and individual cases of fluorosis, where such diagnoses are irreconcilable with the identified fluoride history, highlight the necessity for a more precise definition and diagnosis of dental fluorosis. Also, a more discriminating diagnostic procedure is suggested. Particularly, positive identification of environmental fluoride levels to which the communities and individuals are exposed shall be developed before the confirmation of a diagnosis of fluorosis. It is considered that a more critical methodology for the diagnosis of fluorosis will be helpful in the rational use and control of fluorides for dental health, and in the identification of factors that may induce enamel defects.
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Rubio C, Dominik-Jakubiec M, Paz S, Gutiérrez ÁJ, González-Weller D, Hardisson A. Dietary exposure to trace elements (B, Ba, Li, Ni, Sr, and V) and toxic metals (Al, Cd, and Pb) from the consumption of commercial preparations of Spirulina platensis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:22146-22155. [PMID: 33420686 DOI: 10.1007/s11356-020-12260-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/28/2020] [Indexed: 06/12/2023]
Abstract
Spirulina is a multicellular cyanobacterium that is consumed as a dietary supplement. The content of trace elements (B, Ba, Li, Ni, Sr, V) and toxic metals (Al, Cd, Pb) was determined in 24 spirulina samples marketed in two different formulations (tablets and powder) by ICP-OES (inductively coupled plasma optical emission spectrometry). The highest element concentration was found in the powder presentation, except for Li. The powder presentation element levels (mg/kg dry weight) were Al (28.1), Sr (10.3), B (1.73), Li (1.47), Ba (1.25), Ni (0.63), Pb (88.1 μg/kg dw), Cd (37.2 μg/kg dw), and V (22.9 μg/kg dw). Considering an adult with a body weight of 68.48 kg and the posology guidelines (14 tablespoons per week), the consumption of powdered spirulina contributes greatly to the Al intake by 2.04% of its TWI (tolerable weekly intake) set at 1 mg/kg body weight/week, followed by Cd with 1.05% of its TWI set at 2.5 μg/kg bw/week. Pb intake represents 1.05% of the BMDL (benchmark dose) level associated with nephrotoxicity and 0.44% of the BMDL associated with cardiovascular effects. This assessment suggests that spirulina consumption does not pose risks to the consumer as far as exposure to toxic metals (Al, Cd, Pb) is concerned. However, the presence of trace elements and toxic metals in spirulina preparations should be monitored to ensure its quality and safety.
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Rubio-Armendáriz C, Paz S, Gutiérrez ÁJ, Gomes Furtado V, González-Weller D, Revert C, Hardisson A. Toxic Metals in Cereals in Cape Verde: Risk Assessment Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3833. [PMID: 33917540 PMCID: PMC8038792 DOI: 10.3390/ijerph18073833] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 12/20/2022]
Abstract
Consumption of cereals and cereal-based products represents 47% of the total food energy intake in Cape Verde. However, cereals also contribute to dietary exposure to metals that may pose a risk. Strengthening food security and providing nutritional information is a high-priority challenge for the Cape Verde government. In this study, toxic metal content (Cr, Ni, Sr, Al, Cd, and Pb) is determined in 126 samples of cereals and derivatives (rice, corn, wheat, corn flour, wheat flour, corn gofio) consumed in Cape Verde. Wheat flour samples stand out, with the highest Sr (1.60 mg/kg), Ni (0.25 mg/kg) and Cr (0.13 mg/kg) levels. While the consumption of 100 g/day of wheat would contribute to 13.2% of the tolerable daily intake (TDI) of Ni, a consumption of 100 g/day of wheat flour would contribute to 8.18% of the tolerable weekly intake (TWI) of Cd. Results show relevant Al levels (1.17-13.4 mg/kg), with the highest level observed in corn gofio. The mean Pb average content in cereals is 0.03-0.08 mg/kg, with the highest level observed in corn gofio. Al and Pb levels are lower in cereals without husks. Without being a health risk, the consumption of 100 g/day of wheat contributes to 17.5% of the European benchmark doses lower confidence limit (BMDL) of Pb for nephrotoxic effects; the consumption of 100 g/day of corn gofio provides an intake of 1.34 mg Al/day (13.7% of the TWI) and 8 µg Pb/day (20% of the BMDL for nephrotoxic effects). A strategy to minimize the dietary exposure of the Cape Verdean population to toxic metals from cereals should consider the continuous monitoring of imported cereals on arrival in Cape Verde, the assessment of the population's total diet exposure to toxic metals and educational campaigns.
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Paz S, Rubio C, Gutiérrez ÁJ, González-Weller D, Hardisson A. Human exposure assessment to potentially toxic elements (PTEs) from tofu consumption. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:10.1007/s11356-021-13076-5. [PMID: 33638083 DOI: 10.1007/s11356-021-13076-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
Potentially toxic elements (PTEs) (V, B, Ba, Li, Sr, Cr, Ni, Al, Pb, Cd) were determined in 130 samples of different tofu types (natural, flavored, smoked, and fresh made) by ICP-OES (inductively coupled plasma optical emission spectrometry). Al was the most notable element found with the highest concentration (6.71 mg/kg ww) found in flavored tofu. Ni level (0.38 mg/kg) stands out in smoked tofu. European tofu has higher PTE levels than Chinese tofu. Organic-produced tofu has higher PTE concentrations than conventional produced tofu. A total of 200 g/day of smoked tofu confers a contribution percentage of 39.6% of its TDI (tolerable daily intake). In addition, 200 g/day of flavored tofu would mean a high Pb contribution with a 23.2% of the BMDL (benchmark dose level) set in 0.63 μg/kg bw/day to the development of nephrotoxicity. Mean consumption would not pose a risk to adults' health. Considering the obtained results, it would be advisable to establish limits for certain metals such as Pb, Al, and Ni in this type of product. Furthermore, it is recommendable to set consumer guidelines to some tofu types in order to avoid excessive intake of PTEs.
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Paz S, Rubio C, Gutiérrez ÁJ, González-Weller D, Hardisson A. Dietary Intake of Essential Elements (Na, K, Mg, Ca, Mn, Zn, Fe, Cu, Mo, Co) from Tofu Consumption. Biol Trace Elem Res 2021; 199:382-388. [PMID: 32314142 DOI: 10.1007/s12011-020-02151-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/07/2020] [Indexed: 02/02/2023]
Abstract
Tofu is one of the most consumed soybean products. Currently, tofu is consumed in vegan and vegetarian diets to avoid meat. However, it is necessary to determine the content of essential elements to assess the dietary intake. Essential elements (Na, K, Mg, Ca, Mn, Zn, Fe, Cu, Mo, Co) were determined in 130 samples of tofu by ICP-OES (inductively coupled plasma optical emission spectroscopy). The highest element content was found in flavoured tofu; the most notable were Na (2519 mg/kg wet weight) and Fe (19.5 mg/kg ww). Consumption of 200 g/day of flavoured tofu by adults would mean a high contribution of Cu (46.9% women, 38.1% men), Fe (55.7% women, 65.0% men) and Na (25.2% adults) to its AI (adequate intakes) sets by the EFSA (European Food Safety Authority). Natural tofu would mean a remarkably Mn contribution (50% adults) to the AI. Tofu could be an important source of essential elements such as Mg, Mn, Na, Cu and Fe.
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Iglesias D, Ezcurra C, Garcia Allende N, Sanchez A, Risso Patrón A, Paz S, Antezana Trigo I, Rodríguez V, Freuler C. Thinking about Yellow Fever Vaccine age limit. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Darias-Rosales J, Rubio C, Gutiérrez ÁJ, Paz S, Hardisson A. Risk assessment of iodine intake from the consumption of red seaweeds (Palmaria palmata and Chondrus crispus). ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:45737-45741. [PMID: 32803579 DOI: 10.1007/s11356-020-10478-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/10/2020] [Indexed: 06/11/2023]
Abstract
Seaweeds are a basic food in the Asian diet. The search for functional and healthy foods has increased the seaweed consumption in Europe and the USA. Seaweeds are a source of essential elements such as iodine. However, high intake levels of iodine can cause damages to human health. Red seaweeds like dulse (Palmaria palmata) and Irish moss (Chondrus crispus) are common in shops and large stores. The iodine level in 30 samples of red seaweeds (dulse and Irish moss) has been determined by redox volumetry with sodium thiosulfate to determine the iodine content of both species and to assess the iodine dietary exposure from dulse and Irish moss consumption. Irish moss (3.86 ± 1.49 mg/kg dry weight) has the highest average iodine content. Four grams per day of dehydrated Irish moss seaweeds contributes greatly to the iodine recommended daily intake (DRI) for children (25.7%). The consumption of analyzed seaweeds (4 g/day) does not pose a health risk. However, the consumption of 286 g/day of Irish moss would lead to exceeding the UL for the adult population set at 1100 μg/day. It is necessary that the consumer respects the consumption guidelines of the seaweed packers.
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Rodríguez I, Burgos A, Rubio C, Gutiérrez AJ, Paz S, Rodrigues da Silva Júnior FM, Hardisson A, Revert C. Human exposure to fluoride from tea (Camellia sinensis) in a volcanic region-Canary Islands, Spain. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:43917-43928. [PMID: 32740848 DOI: 10.1007/s11356-020-10319-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
Fluoride is highly present in the environment, especially in water and its derivatives. Excessive fluoride contribution to diet poses a health risk. Tea leaves accumulate fluoride and the consumption of tea (Camellia sinensis) could pose a risk to human by the excessive fluoride intake. Ninety tea samples were analyzed by potentiometry using a selective fluoride ion electrode. Mixed tea samples (2.82 ± 1.11 mg/L) and black tea samples (2.28 ± 0.79 mg/L) recorded the highest fluoride levels. The contribution of drinking water is important for increasing fluoride levels in teas. The daily consumption of two cups (250 mL per cup) of mixed and black teas prepared with La Laguna tap water does pose a health risk for children (4-8 years old) because of the high contribution percentages (74.4% and 63.6%, respectively) of the Tolerable Upper Intake Level set in 2.5 mg/day by the EFSA (European Food Safety Authority). A minor consumption in children (4-8 years old) and adults during pregnancy is advisable.
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Lozano-Bilbao E, Jurado-Ruzafa A, Lozano G, Jiménez S, Hardisson A, Rubio C, Weller DG, Paz S, Gutiérrez ÁJ. Development stage and season influence in the metal content of small pelagic fish in the North-West Africa. CHEMOSPHERE 2020; 261:127692. [PMID: 32721689 DOI: 10.1016/j.chemosphere.2020.127692] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/01/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
Marine organisms are exposed to great changes caused by man due to discharges into the oceans, so the study of marine pollution is of great value for each ecosystem. For this study, 963 specimens of pelagic fish have been collected, of which 345 are Scomber colias, 294 are Trachurus picturatus and 324 are Sardina pilchardus, it was wanted to study the development and ontogeny in the three species observing if there were variations in their metallic content. The study covered a total of 2 years, from June 2016 to May 2018.16 samples of each species were studied each month, during the 2 years of sampling, from the samplings carried out by the Canary Islands Oceanographic Center of the Spanish Institute Oceanography (COC-IEO) in the markets of the Island of Tenerife. The concentration of 11 anthropic metals was determined in each sample using the Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) technique. Statistical studies were carried out with factors such as the oceanographic season, and the level of maturity of the gonads. S. colias was the species that presented the highest concentration in a greater number of metals. S. pilchardus presents higher concentration in Cu, Li and Zn, in the warm season. These are metals of a very anthropic character on coasts; This species tends to get closer to the coasts compared to the other two and is the cause of its higher concentration in these metals due to the influence of pollution linked to the coast. The immature specimens of the three species had a higher concentration in more metals than the mature specimens.
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Lozano-Bilbao E, Lozano G, Jiménez S, Jurado-Ruzafa A, Hardisson A, Rubio C, Weller DG, Paz S, Gutiérrez ÁJ. Seasonal and ontogenic variations of metal content in the European pilchard (Sardina pilchardus) in northwestern African waters. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115113. [PMID: 32622005 DOI: 10.1016/j.envpol.2020.115113] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/09/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
Marine fishes are exposed to great human-induced alterations due to the indiscriminate discharges into the sea, increasing marine pollution. For this study, 324 specimens of Sardina pilchardus from the Canary Islands were analized during a period of 2 years (June 2016 to May 2018). The concentration of 11 metals and trace elements (Al, B, Cd, Cr, Cu, Fe, Li, Ni, Pb, V and Zn) was determined in each individual using the Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) technique. Statistical analyses were carried out considering the following factors: oceanographic season, maturity of the gonads in the seasons, size of the specimens. Sardina pilchardus specimens captured in the hot season presented higher Ni, Li and Pb levels than the specimens caught in the cold season. Immature specimens had higher concentration in more metals than the mature specimens. This fact may be due to the fact that these specimens require a much higher metabolic rate due to their growth and do not detoxify like mature specimens. Significant differences were found in the concentration of metals in all the analyzes performed.
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Gutiérrez-Ravelo A, Gutiérrez ÁJ, Paz S, Carrascosa-Iruzubieta C, González-Weller D, Caballero JM, Revert C, Rubio C, Hardisson A. Toxic Metals (Al, Cd, Pb) and Trace Element (B, Ba, Co, Cu, Cr, Fe, Li, Mn, Mo, Ni, Sr, V, Zn) Levels in Sarpa Salpa from the North-Eastern Atlantic Ocean Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7212. [PMID: 33023091 PMCID: PMC7579030 DOI: 10.3390/ijerph17197212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 01/13/2023]
Abstract
Sarpa salpa is a fish belonging to the Sparidae family and is usually found in local markets. Toxic metals such as aluminum (Al), cadmium (Cd), lead (Pb) and trace elements such as boron (B), barium (Ba), cobalt (Co), copper (Cu), chromium (Cr), iron (Fe), lithium (Li), manganese (Mn), molybdenum (Mo), nickel (Ni), strontium (Sr), vanadium (V) and zinc (Zn) are incorporated into fish tissues and remain there. The liver has the highest concentrations of all the analyzed toxic metals and almost all the analyzed trace elements. The consumption of 100 g/day of S. salpa muscle tissue does not pose a health risk. However, 100 g/day of liver consumption may pose a serious health risk due to the intake of Cd (572% of the tolerable weekly intake for adults with a body weight of 68.48 kg) and Pb (117% of the tolerable daily intake for adults weighing 68.48 kg). The consumption of liver of this species is not recommended due to its possible harmful effects on health.
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González A, Paz S, Rubio C, Gutiérrez ÁJ, Hardisson A. Human Exposure to Iodine from the Consumption of Edible Seaweeds. Biol Trace Elem Res 2020; 197:361-366. [PMID: 31820353 DOI: 10.1007/s12011-019-01996-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
The increasing consumption of wakame algae (Undaria pinnatifida) and kombu (Laminaria ochroleuca) because of their culinary appeal and beneficial properties means there is a need to study the composition of these new foods. Algae stand out for their high iodine content, this being an essential element whenever it is ingested at recommended levels but which, ingested in high quantities, can cause harmful effects to health such as hyperthyroidism and even goiter. The iodine content in 30 samples of algae from different geographical origins (Asia and Europe) has been determined by oxidation-reduction titration with sodium thiosulfate. European kombu algae (27.7 ± 5.4 mg/kg dry weight) have the highest mean average iodine concentrations. European algae have higher iodine content than Asian algae. Significant differences (p < 0.05) have been recorded among wakame algae according to geographical origin. The consumption of 4 g/day of European kombu algae means an intake of 111 μg/day of iodine, which is a value close to the RDI (recommended daily intake) set at 150 μg/day. It is necessary to monitor iodine levels in algae to avoid excessive intakes and harmful effects on health.
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Paz S. Impacts of climate change on Public Health of the Mediterranean population. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The Mediterranean Basin is undergoing a warming trend with longer and warmer summers, an increase in the frequency and the severity of heat waves, changes in precipitation patterns and a reduction in rainfall amounts. This populated region is characterized by significant gaps in the socio-economic levels, parallel with population growth and migration, increased water demand and forest fires risk. Consequently, the vulnerability of the Mediterranean population to human health risks as result of climate change increases significantly.
Climatic changes impact the health of the Mediterranean population directly through extreme heat, drought or storms, or indirectly by changes in water availability, food provision and quality, air pollution and other stressors. The main health effects are related to extreme weather events, changes in the distribution of climate-sensitive diseases and changes in environmental and social conditions. The poorer countries, particularly in North Africa and the Levant, are at highest risk. Climate change affects the vulnerable sectors of the region, including an increasingly older population, with a larger percentage of those with chronic diseases, as well as poor people, which are therefore more susceptible to the effects of extreme temperatures. For those populations, a better surveillance and control systems are especially needed parallel with adaptation planning that become ever more imperative. In order to achieve these goals, it is essential to define indicators of vulnerability and exposure based on health impact assessment, as well as indicators that will promote adaptation planning and resilience for health risk management. In view of the climatic projections and the vulnerability of Mediterranean countries, such indicators will contribute to correct preparedness at the regional and national levels.
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