Revista Espanola De Salud Publica最新文献

Objective: Many teenagers experiment with addictive substances such as alcohol. The objective of this study was to estimate the frequency of binge drinking among secondary school students and its relationship with sex, grade, and type of school, as well as with urban contextual factors of the school neighborhood: socioeconomic level, density of alcohol outlet premises, and tourist pressure.

Methods: This was an observational cross-sectional study. The study population were the students of 8th and 10th grade (2nd and 4th year of ESO) in the city of Barcelona in 2016. Alcohol use, sex, grade, type of school and school neighborhood were taken from the FRESC survey. The wealth of the neighborhood and tourist pressure were extracted from municipal statistics. The density of alcohol outlets was obtained by direct observation with the OHCITIES instrument. We estimated the prevalence of binge drinking (consumption of five or more units on one occasion) stratifying by age, sex and ownership of the school. We calculated a robust Poisson regression model with the individual and contextual variables and analyzed the situation of those neighborhoods with the highest prevalence of binge.

Results: The self-declared frequency of binge drinking in the last 30 days was 6.1% in this sample of 2,329 students, 2.2% in 8th grade and 10.3% in 10th grade. It was higher in boys (7%) than in girls (5.1%), and slightly higher in private subsidized schools (6.4%) than in public schools (5.5%). In the Poisson regression models, neither the coefficients of the three contextual variables nor the type of school reached statistical significance, contrary to those obtained with the individual variables of sex and year. The adjusted prevalence of binge in the 36 neighborhoods ranged from 0 to 18.2%. Comparing the contextual variables of the 8 neighborhoods with the lowest prevalence of binge with the others, both a greater density of local alcohol sales and higher tourism pressure were associated with a higher prevalence of binge drinking, while for wealth there were no significant differences.

Conclusions: The use of alcohol in early adolescence is related to individual variables such as sex and age. Urban contextual factors such as a higher tourist pressure and the density of premises that sell alcohol may exert also some influence.

Heavy episodic drinking, or binge drinking, is a drinking pattern characterized by the intake of large amounts of alcohol in a short period of time, which often leads to alcohol intoxication. There is no consensus on its operational definition, finding large methodological differences between studies in estimating the amount of alcohol consumed, as well as in defining the occasion of drinking and the reference time period. Keep in mind that most drinkers with this pattern have a low risk total average alcohol consumption. Therefore, actively detecting binge drinking is essential to be able to identify and classify all risk drinkers and characterize the global impact of alcohol consumption on health, society or the economy. Its negative effects affect the drinker himself (intoxication, cardiovascular diseases, dependence, neurocognitive and developmental disorders, among others), but also causes harm to others (accidents, violence, harmful effects on fetal and perinatal neuronal development). These effects can be acute or chronic, even among those who adopt binge drinking sporadically. Different thresholds or ways of characterizing this pattern of alcohol consumption could more adequately predict each of the associated acute and chronic effects, especially if we consider the intensity and frequency of the episodes. However, the absence of a safe threshold for alcohol consumption, both regularly and occasionally, is clear; Any intake with a binge drinking pattern, regardless of the threshold we establish, carries significant risks, not only for the health of the drinker, but also for the people around them.

This paper presents a strategic analysis of the prevention of the harm caused by alcohol in Spain. The alcohol action plan of the European Office of the WHO offers a guide for the development of the most effective control policies. Following its scheme, the current situation and the prevention policies are reviewed with data available in 2020. Strategies and key actions for the future are proposed, considering as major goals to curb the early abuse of alcohol by adolescents and to reduce the risk consumption of the population at large. Besides helping persons with abuse criteria from health services, key actions for prevention include public policies such as fiscal, marketing and availability regulations, and drink driving measures. Some have followed a favorable evolution in Spain, but for others there is wide room for improvement.

Objective: A retrospective study (2007-2012) of acute alcohol intoxication (AAI) in the paediatric Emergency Department (ED) (Hospital Sant Joan de Déu, Barcelona) demonstrated a decrease in the rates of AAI over the last two years. Aim: to determine if this decile continued during the following 5 years and to describe the profile and clinical management of these patients.

Methods: Descriptive, retrospective and observation study. Adolescents who presented to the ED (Hospital Sant Joan de Déu, Barcelona) with AAI were included (2007-2017). Patients were classified in two groups: mil and moderate/severe; we compared the differences in the clinical management (monitoring of vital signs, lab test and treatment). We defined the AAI incidence rate: number of AAI every 1000 ED adolescent consultations/year.

Results: We included 836 AII, incidence rate: 7.7;2007, 8.5;2008, 6.6;2009, 7.8;2010, 6.4;2011, 6.4;2012, 4.8;2013, 4.6;2014, 5.5;2015, 4.8;2016 and 3.4;2017. The mean age was 15.9 (SD 1.2) years, 54.9% (459) were women. 54.5% had mild AAI, 45.4% moderate/severe. The temperature was taken to 607 patients, capillary blood glucose to 573 and blood pressure to 633. We found no differences in the monitoring of vital signs regardless of the symptoms of the patients. Patients with moderate/severe AAI underwent blood test more frequently than those with mild AAI (ethanol levels 88.2% vs 50.4%; p<0.001; electrolytes 81.2% vs 48%, p<0.001; glucose levels 64.4% vs 37.1%, p<0.001). Four hundred and twelve patients (49.3%) received fluid therapy. Twenty-two patients were admitted.

Conclusions: The incidence of AAI decreased over the last years. The profile of these patients remains unchanged (adolescents with moderate AAI during weekends). Even though lab test were performed more frequently to patients with moderate/severe AAI, clinical management should be improved by taking vital signs and capillary glycemia to all patients, keeping the blood analysis for moderate-severe AAI.

Objective: Botellón has established itself as a recreational ritual of great importance in the leisure of young people and it has contributed to the expansion of a worrying pattern of alcohol and other substances consumption. However, there are few papers that take an integrated approach to this issue. The aim of this work was to have new data to characterize this practice, while providing evidence of its consequences and identifying relevant prognostic factors for prevention.

Methods: A cross-sectional study was carried out with a sample of 4,867 Galician adolescents between 12 and 18 years of age (Mean=14.68; SD=1.67). Data were collected in schools through an ad hoc questionnaire and they were analyzed through of a bivariate tabulation, with the application of the opportune contrasts according to the nature of the variables.

Results: 27.3% of the teenagers in the sample went to botellón during the last year. 96.6% admitted to drinking alcohol when they went to a botellón, 53.4% alcohol and tobacco and 30.2% three or more substances. This practice was associated with significantly higher rates of Intensive Alcohol Consumption (28% vs. 0.9%), as well as of consumption of risk of alcohol, cannabis and drugs in general. The modulating role of variables such as risk perception and beliefs and expectations associated with consumption, money available or time of arrival at home was also found.

Conclusions: At least 1 in 4 teenagers continue to go to botellones. This practice associated with risky consumption. The evidence found reinforces the multidimensional nature of the problem and suggests reorienting prevention policies.

Objective: The association between alcohol and traffic collision injuries is well established. Our objective was to analyze the frequency of driving with a positive result in on-road tests for alcohol with considering different concentrations of alcohol in exhaled air, as well as driving while positive only for alcohol or for alcohol and drugs.

Methods: In 2018, a cross-sectional study was carried out in a representative sample of motor vehicle drivers on Spanish public roads, excluding cyclists and drivers of vehicles weighing more than 3,500 kg. 2,881 drivers were included in this study. Data was analysed with the statistics program SPSS 24.0.

Results: 10.9% (95% CI, 9.8-12.1) of the drivers were positive cases for any substance: In 3.9% (3.2-4.6) alcohol alone (i.e., without any other substance), and in 0.8% (0.6-1.3) alcohol plus another substance, were observed. 2.1% (1.6-2.7) of the drivers had a level of alcohol in expired air higher than the legal allowed limit for drivers (>0.25 mg/L, that excluding novice and profesional drivers). 0.4% (0.2-0.7) of the drivers had an alcohol concentration in expired air >0.60 mg/L. Driving with the presence of alcohol and drugs is observed in two out of ten positive cases for alcohol.

Conclusions: Driving while positive for alcohol is common among Spanish drivers, and drivers positive for alcohol and drugs should not be ignored.

This work places in context Spain's recent update of the defined limits for low risk alcohol consumption to 20g/day for men and 10g/day for women, and summarises data on the impact on individual health and the social costs of alcohol consumption. Furthermore, it considers the challenges that arise related to awareness of the risks of alcohol consumption, in the general population and among health professionals. The paper also reviews the implications of the new definitions in relation to the most effective policies for reducing alcohol-related harm. It looks at this from a public health perspective with particular emphasis on how to seize the opportunity to better promote the implementation of strategies for early identification and brief interventions in primary care in this country.

Background: Alcohol is associated with all-cause mortality increase. However, when this increase takes place has not been clearly established. The objective of this study was to establish the levels of alcohol consumption that can be considered low risk for overall mortality.

Methods: Systematic review of cohort studies published since 2014 that established a relationship between general mortality and alcohol consumption in the general population. Those studies not conducted in countries with Spain socio-cultural environment and those that present conflicts of interest were excluded.

Results: The median of alcohol consumption (in grams) from which mortality increased was 23-25 g/day. Differentiating by sex, these values were 20 g/day in women and 24 g/day in men. The minimum value of the median from which an increase in mortality was observed was 17-21 g/day of alcohol; 12 g/day in women and 20 g/day in men.

Conclusions: If we take into account caution principle, taking more conservative levels of average alcohol consumption from which an increase in mortality was observed, low-risk consumption should be 20 g/day in men and 10 g/day in women, assuming that there is no safe level of alcohol consumption.

Background: There is great controversy about whether the consumption of different types of alcoholic beverages has different effects on health. The objective was to carry out an umbrella review of the studies that described the association between the consumption of different types of alcoholic beverages and various health indicators.

Methods: Search through PubMed (from January 2000 to February 2019) of systematic reviews and meta-analysis that reported quantitative results of the association between the consumption of different types of alcoholic beverages and health effects. 26 studies were identified: 21 related to cancer, three to cardiometabolic diseases, two to neurodegenerative diseases, and one to general mortality.

Results: The results were heterogeneous. The great methodological differences in the estimation of alcohol intake, control of confounding variables, and the evaluation of statistical difference between types of beverages, made it very difficult to conclude whether they cause an unequal effect on health. In general mortality and cardiometabolic diseases, it was suggested that beer and spirits appear to have a greater negative effect than wine, but the differences were not statistically significant. Regarding cancer, in those types where the causal evidence is totally consistent: oropharynx, colorectal and breast (women), the reviews did not show a differentiated effect according to the type of alcoholic beverages. Regarding neurodegenerative diseases, the available information did not allow clear conclusions to be drawn.

Conclusions: The reviewed evidence does not allow to conclude that the consumption of wine, beer or spirits, has a differential effect on cardiometabolic, cancer or neurodegenerative diseases.

The COVID-19 respiratory manifestations go from mild symptoms similar to those of a common cold to severe pneumonia with respiratory distress syndrome, septic shock and multiorgan failure. The disease is caused by the SARS-CoV-2 virus, whose transmission mechanism most relevant to dentistry is through respiratory droplets and possibly also aerosols, as well as direct contact with mucous membranes of the nose, mouth or eye via contaminated hands or objects. The professionals of the dental health units have a high risk exposure since they work at short distances (less than 1 m from the head of the patient) in the oral cavity, where a maximal expression of possible cell receptors for the virus has been reported. Also, most procedures in the dental cabinet imply aerosol generation. Cross-infection is possible during dental care, not only with diagnosed COVID-19-positive patients but also with patients who remain undetected due to asymptomatic or presymptomatic disease. For all these reasons, dental care in the primary health setting has had to change in order to adapt to the pandemic. The changes affect both the appointment scheduling and the care itself and imply the establishment of general and specific barrier protections as well as measures related to ventilation, cleaning, disinfection and sterilization, reinforced with additional infection prevention and control measures. This article summarizes the available scientific evidence about this adaptation.