@misc{10481/72462,
year = {2021},
month = {7},
url = {http://hdl.handle.net/10481/72462},
abstract = {Background

Despite restrictions on their production and use, most of the population is still exposed to Persistent Organic Pollutants (POPs), including organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs). These chemicals are thought to contribute to the aetiology of highly prevalent chronic conditions, such as cardiovascular diseases (CVDs), although current evidences are still controversial.
Objectives

To explore the potential contribution of historical POP exposure to 15-year pharmaceutical consumption in relation to CVD.
Methods

This study is framed within GraMo adult cohort. Participants (n = 387) were recruited in two hospitals in Granada province, Southern Spain (2003–2004). Historical exposure to 5 OCPs and 3 non-dioxine-like PCBs was estimated by analysing adipose tissue concentrations at recruitment. Pharmaceutical consumption from recruitment until year 2017 was quantified by reviewing dispensation databases. Average consumption increase (ACI) in CVD medication was calculated by subtracting average consumption in 2002 to the average yearly consumption during follow-up. ACI was expressed as Defined Daily Dose (DDD)/year units. Data analyses were carried out using a multivariable multinomial logistic regression and weighted quantile sum regression (WQS), with ACI categorized in quartiles (Q) as the dependent variable.
Results

Concentrations of most pollutants showed a positive trend with the quartiles of ACI. Particularly, PCB-153 showed increasing and statistically significant odds ratios (ORs) for Q2 (OR: 1.27, 95% confidence interval (CI): 1.07–1.52), Q3 (OR: 1.49, 95 %CI: 1.17–1.88) and Q4 (OR: 1.42, 95 %CI: 1.13–1.78) vs Q1. Similarly, beta-hexachlorocyclohexane (β-HCH) also showed increasing ORs, that reached statistical significance in Q4 (OR: 1.36, 95 %CI: 1.06–1.74) vs Q1. These findings were corroborated by WQS analyses, that revealed a significant mixture effect, predominantly accounted for by PCB-153 and β-HCH.
Discussion

Our results suggest that long-term POP exposure might represent a modifiable risk factor for CVD. These findings are relevant for public health campaigns and management, since pharmaceutical consumption is considered an indicator of both morbidity and health expenditure.},
organization = {CIBER de Epidemiología y Salud Pública},
organization = {Santa Ana and San Cecilio Hospitals
	RYC-2016-20155},
organization = {European Commission},
organization = {Instituto de Salud Carlos III

PI16/01858, PI18/01573, PI20/01568	ISCIII



Ministerio de Economía, Industria y Competitividad, Gobierno de España},
organization = {European Regional Development Fund},
organization = {Ministerio de Economía, Industria y Competitividad, Gobierno de España},
publisher = {Elsevier},
keywords = {Organochlorine pesticides},
keywords = {Polychlorinated biphenyls},
keywords = {Persistent organic pollutants},
keywords = {Cardiovascular disease},
keywords = {Pharmaceutical consumption},
keywords = {Health expenditure},
title = {Historical exposure to persistent organic pollutants and cardiovascular disease: A 15-year longitudinal analysis focused on pharmaceutical consumption in primary care},
doi = {10.1016/j.envint.2021.106734},
author = {Pérez Carrascosa, Francisco Miguel and Gómez Peña, Celia and Echeverría, Ruth and Jiménez Moleón, José Juan and Melchor Rodríguez, Juan Manuel and García Ruiz, Antonio and Navarro Espigares, José Luis and Cabeza Barrera, José and Martín-Olmedo, Piedad and Ortigosa-García, Juan Carlos and Arrebola Moreno, Juan Pedro},
}