Ambient air pollution (AAP) is recognized a cardiovascular risk factor and lipid profile dysregulation seems to be one of the potential mediators involved. However, results from epidemiologic research on the association between exposure to AAP and altered lipid profile have been inconsistent. This study aims to systematically review and meta-analyse epidemiologic evidence on the association between exposure to ambient air pollutants (particulate matter, nitrogen oxides, sulphur dioxide, ozone, carbon monoxide, back carbon) and lipid profile parameters (Total cholesterol; High-Density Lipoprotein Cholesterol; Low-Density Lipoprotein Cholesterol; TG-Triglycerides) or dyslipidaemia.Systematic electronic literature search was performed in PubMed, Web of Science and Scopus databases (last search on 24th May 2019) using keywords related to the exposure (ambient air pollutants) and to the outcomes (lipid profile parameters/dyslipidaemia). Qualitative and quantitative information of the studies were extracted and fixed or random-effects models were used to obtain a pooled effect estimate per each pollutant/outcome combination.22 studies were qualitatively analysed and, from those, 3 studies were quantitatively analysed. Particulate matters were the most studied pollutants and a considerable heterogeneity in air pollution assessment methods and outcomes definitions was detected. Age, obesity related measures, tobacco consumption, sex and socioeconomic factors were the most frequent considered variables for confounding adjustment in the models. In a long-term exposure scenario, we found a 3.14% (1.36%e4.95%) increase in TG levels per 10 mg/m 3 PM 10 increment and a 4.24% (1.37%e7.19%) increase in TG levels per 10 mg/m 3 NO 2 increment. No significant associations were detected for the remaining pollutant/outcome combinations.Despite the few studies included in the meta-analysis, our study suggests some epidemiologic evidence supporting the association between PM 10 and NO 2 exposures and increased TG levels. Due to the very low level of evidence, more studies are needed to clarify the role of lipid profile dysregulation as a mediator on the AAP adverse cardiovascular effects.

Cancer is a major concern among chronic diseases today. Spatial epidemiology plays a relevant role in this matter and we present here a review of this subject, including a discussion of the literature in terms of the level of geographic data aggregation, risk factors and methods used to analyse the spatial distribution of patterns and spatial clusters. For this purpose, we performed a websearch in the Pubmed and Web of Science databases including studies published between 1979 and 2015. We found 180 papers from 63 journals and noted that spatial epidemiology of cancer has been addressed with more emphasis during the last decade with research based on data mostly extracted from cancer registries and official mortality statistics. In general, the research questions present in the reviewed papers can be classified into three different sets: i) analysis of spatial distribution of cancer and/or its temporal evolution; ii) risk factors; iii) development of data analysis methods and/or evaluation of results obtained from application of existing methods. This review is expected to help promote research in this area through the identification of relevant knowledge gaps. Cancer's spatial epidemiology represents an important concern, mainly for public health policies design aimed to minimise the impact of chronic disease in specific populations. IntroductionGiven the relevance of spatial epidemiology in health research and the emphasis of cancer among chronic diseases, as well as the growing amount of studies in this area, it is important to know what the literature says about spatial epidemiology of cancer as well as provide its structured description. According to the World Health Organization (WHO), cancer is a leading cause of death in the world (WHO, 2015). It is also the cause of various morbidities and co-morbidities and can be responsible for loss of years of life years as well as loss of years without disability. Considering the aging population, it is predicted that the number of new cases of cancer will increase by more than 12% over the next decade in the European Union (EU) (DGS, 2013). The fight against cancer is a major challenge in public health. This challenge is due in part to the inequalities in terms of incidence, mortality, and survival. Therefore, a multidisciplinary approach is needed (Bastos et al., 2010). Among the various fields that can contribute to the development of knowledge about this disease, spatial epidemiology plays an important role. It can promote the understanding of spatial and temporal distribution patterns, helping to better identify the risk factors that influence them.Three types of approach can be established in spatial epidemiology: i) mapping; ii) geographic correlation; and iii) clustering (Elliott and Wartenberg, 2004). Mapping or map design regarding health and disease situations is the most often mentioned and used of these three approaches. Further, geographic correlation studies have the goal to spatially compare the health with several types of factors such as e...

INSEF has set up an experienced national and regional structure for HES implementation. Nationally representative quality epidemiological data is now available for public health monitoring, planning and research.

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