Many time-series studies have shown positive associations between air pollutants and asthma morbidity. However, few studies have included pollen as a potential confounder when examining this relationship.This study analysed the short-term association between air pollutants (sulphur dioxide (SO 2 ), particles measured with a median aerodynamic diameter of v10 mm (PM10), nitrogen dioxide (NO 2 ) and ozone (O 3 )) and asthma emergency room admissions in Madrid, Spain, in 1995-1998, adjusting for four types of pollen with allergenic potential (Olea europaea, Plantago sp., Poaceae and Urticaceae). Data were analysed using autoregressive Poisson regression and generalised additive models (GAM).The strongest associations were observed at 1 day lag for O 3 , and 3 days lag for the remaining pollutants. Using Poisson regression, a single-pollutant model showed that a 10-mg?m -3 rise in pollutant level led to relative risks of: 1.039 for PM10; 1.029 for SO 2 ; 1.033 for NO 2 ; and 1.045 for O 3 . Adjustment for the different types of pollen led to no substantial variation in these associations. In the multipollutant models for cold-season pollutants (including PM10, SO 2 and the four types of pollen) and photochemical pollutants (including NO 2 , O 3 and the four types of pollen) the associations for PM10, NO 2 and O 3 held, but no relationship with SO 2 was evident. GAM analysis yielded the same results, both in terms of lags and of quantification of the effect for all pollutants.In conclusion, the usual air pollution levels in Madrid were associated with an increase in asthma emergency room admissions, and this association remained controlling for the presence of ambient pollen. Eur Respir J 2003; 22: 802-808.

Our results show that there is a strong association between parental education and parent-reported child mental health, and that this is indeed stronger than that for income and social class. Among adolescents, however, the effect of parental education would appear to be outweighed by other factors.

ObjectivesLittle is known about the dose–response relationship between physical activity and health benefits among young people. Our objective was to analyse the association between the frequency of undertaking moderate-to-vigorous physical activity (MVPA) and the self-reported health status of the adolescent population.DesignCross-sectional study.SettingAll regions of Spain.ParticipantsStudents aged 11–18 years participating in the Spanish Health Behaviour in School-aged Children survey 2006. A total of 375 schools and 21 188 students were selected.Main outcomesThe frequency of undertaking MVPA was measured by a questionnaire, with the following four health indicators: self-rated health, health complaints, satisfaction with life and health-related quality of life. Linear and logistic regression models were used to analyse the association, adjusting for potential confounding variables and the modelling of the dose–response relationship.ResultsAs the frequency of MVPA increased, the association with health benefits was stronger. A linear trend (p<0.05) was found for self-rated health and health complaints in males and females and for satisfaction with life among females; for health-related quality of life this relationship was quadratic for both sexes (p<0.05). For self-reported health and health complaints, the effect was found to be of greater magnitude in males than in females and, in all scales, the benefits were observed from the lowest frequencies of MVPA, especially in males.ConclusionsA protective effect of MVPA was found in both sexes for the four health indicators studied, and this activity had a gradient effect. Among males, health benefits were detected from very low levels of physical activity and the magnitude of the relationship was greater than that for females.

Background: Few studies have used time series to investigate the relationship between asthma attacks and aeroallergen levels on a daily basis. Methods: This study, based on time series analysis adjusting for meteorological factors and air pollution variables, assessed the short term effects of different types of allergenic pollen on asthma hospital emergencies in the metropolitan area of Madrid (Spain) for the period 1995-8. Results: Statistically significant associations were found for Poaceae pollen (lag of 3 days) and Plantago pollen (lag of 2 days), representing an increase in the range between the 99th and 95th percentiles of 17.1% (95% confidence interval (CI) 3.2 to 32.8) and 15.9% (95% CI 6.5 to 26.2) for Poaceae and Plantago, respectively. A positive association was also observed for Urticaceae (lag of 1 day) with an 8.4% increase (95% CI 2.8 to 14.4). Conclusions: There is an association between pollen levels and asthma related emergencies, independent of the effect of air pollutants. The marked relationship observed for Poaceae and Plantago pollens suggests their implication in the epidemic distribution of asthma during the period coinciding with their abrupt release into the environment.

Behavior-related risk factors tend to aggregate, and this accumulation is higher among men, younger age groups, and subjects with a low educational level. A greater level of clustering is associated with a higher frequency of suboptimal perceived health.

Pollens with allergenic capacity in Madrid are positively associated with asthma-related hospital emergencies. These associations remain stable when simultaneous adjustment is made for the four types of pollen and for air pollutants and meteorological variables. In terms of non-linear effects, Poaceae register the strongest association with asthma emergency room admissions.

In an adolescent population from Southern Europe, the GHQ-12 showed high internal consistency. The factor structure that best fitted the data was the Graetz three-dimensional model. However, the high correlations observed between factors suggest that the GHQ-12 should be used as a unidimensional scale, as currently done.

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