IMIM - Institut Hospital del Mar d'Investigacions Mèdiques IMIM - Institut Hospital del Mar d'Investigacions Mèdiques

Epidemiologia i salut pública


Objectius assolits, 2016

Scientific objectives

During 2017,  researchers of the programme  have published  253  papers in scientific journals ranging from Lancet, JAMA, Nat Genet, World Psychiatry, JAMA Psychiatry to journals internationally  recognized  in the fields of molecular, clinical, and environmental epidemiology: such a broad integration of basic, clinical and epidemiologic knowledge  is one of our signs of identity worldwide.

Investigators of the Cardiovascular Epidemiology & Genetics group and others have:

  • Analyzed the burden  of coronary  heart  disease  and cardiovascular risk factors  and their trends  at the population level across all ages.
  • Analyzed the validity of cardiovascular  risk functions  and analyzed the predictive added  value of new biomarkers (glomerular filtration rate, ankle-brachial index).
  • Evaluated the relationship  between environmental exposures (air pollution, noise) and hypertension.
  • Evaluated the effectiveness of cardiovascular  primary prevention strategies (such as the use of statins), and therapeutic interventions (such as revascularization) in patients with an acute  coronary  syndrome.
  • Contributed to the knowledge  of the genetic  and epigenetic architecture of several cardiovascular  traits such as myocardial infarction, stroke, lipid profile, hypertension and obesity.
  • Initiated the follow-up of the 11,000 participants of the REGICOR cohort.

Investigators of the Cardiovascular Risk & Nutrition group and others have:

  • Reported that a Mediterranean diet pattern improves high-density lipoprotein functionality  and LDL atherogenicity, in high cardiovascular  risk individuals.
  • Observed the atherogenic dyslipidemia remission 1 year after bariatric surgery.
  • Surrogate markers of adiposity increased  with concurrent obesogenic behaviors in Spanish children and adolescents.
  • Studied the paracetamol and caffeine pharmacokinetics after the bariatric surgery.
  • Observed that olive oil phenolic compounds have an effect on the expression of blood pressure-related genes.

Investigators of the Clinical and Molecular Epidemiology of Cancer group and others have:

  • Shown that higher blood concentrations of Persistent Toxic Pollutants are associated with unhealthy metabolic phenotypes, not only in obese  and overweight individuals, but also in normal-weight individuals.
  • Described the changes  in the total effective  xenoestrogen burden (TEXB) in breast cancer patients,  at surgery and at different  time points during an 18-month follow-up, showing that the cancer treatment may be responsible for the increase  in the alpha- fraction of TEXB observed in patients with hormone-dependent tumors, which may confer to xenoestrogens a role in the progression of the disease.
  • Described factors that influence perceptions and viewpoints  of citizens on the responsibility for the presence of toxic substances in food, on enforcement of laws and regulations  that control human exposure to toxic substances in food, and on the effectiveness of such regulations.

Investigators of the Drug Abuse Epidemiology group and others have:

  • Assessed  gender  disparities in excess mortality of heroin or cocaine users.
  • Examined the prevalence of psychoactive substance use in Spanish drivers.
  • Estimated  the prevalence and risk factors  (especially those  related to illegal activities and crime) of suicide ideations  and plans, and interpersonal violence among drug users.

Investigators of the Epidemiology and Evaluation group and others have: 

  • Assessed  the clinical and histologic characteristics of breast  cancers in women with previous pathologic diagnosis of benign breast disease.
  • Determined the cost-effectiveness of double reading versus single reading of digital mammograms  in screening  programmes.
  • Analysed the colorectal cancer screening  process  in terms of participants' satisfaction and adherence to follow-up recommendations.
  • Reported socioeconomic inequalities  in both uptake  of colorectal cancer screening and outcomes.
  • Described the variability of surgery treatment in breast  cancer patients.
  • Described breast  cancer survival according to breast  density and phenotypes.
  • Analysed the incremental  cost of nosocomial bacteraemia according to the causative focus and antibiotic sensitivity of the microorganism.
  • Estimated  the cost and detection rate of glaucoma screening  with imaging devices in a primary care centre.

Investigators of the Health Services Research group and others have:

  • Described,  for the first time, the disability associated with psychotic experiences among individuals without  psychotic  disorders,  based on the World Mental Health surveys.
  • Systematically reviewed  the risk factors  of suicidal thoughts and behaviors  in adolescents and young adults, and quantitatively estimated the risk associated to early exposure to interpersonal violence (abuse, maltreatment, neglect, bullying and community violence), and sexual orientation (LGBT).
  • Obtained competitive funding to study the risk of serious suicidal attempts and re- attempts in Catalonia, based  on the innovative prevention programme  Suicide Risk Code.
  • Identified very limited available evidence  supporting cost-effectiveness of new treatment modalities for localized prostate cancer over traditional procedures.
  • Shown that men with pretreatment lower urinary tract symptoms may experience benefit rather than harm from primary localized prostate cancer treatment.

Investigators of the Healthy Cities and Environmental Justice group and others have: 

  • Started  the analysis of the urban greening trajectories of 100  cities in the US, Canada and Europe and assessed the extent  to which they consider  issues of health needs/ priorities and equity in their plans and interventions.
  • Initiated the spatial and quantitative analysis of green gentrification trends  in the US, Canada, and Europe through  an extensive collection of demographic,  real estate, and development data.
  • Initiated a study in New York City and Barcelona on the effects of gentrification on health and on the mediating role of gentrification in the relationship between green space and improved health outcomes.
  • Worked in collaboration  with the Ajuntament  de Barcelona to assess the social impact of healthy cities interventions, such as the "superilles" and others, on local residents.

Investigators of the Infertility/Barcelona group and others have: 

  • Evaluated the relationship  between air pollution and sperm quality.
  • Contributed to the knowledge  of the effects  of assisted reproduction technology on the perinatal outcomes (pre-term delivery and birth weight).

Investigators of the Occupational & Environment Epidemiology group and others have:

  • Identified night shift work and circadian disruption  as risk factors for breast  and prostate cancer.
  • Developed bioinformatics  tools to characterize the exposome and its interaction with omics and health data.
  • Shown new associations between specific antibodies to 'P. falciparum' and Epstein Barr virus in children with Endemic Burkitt Lymphoma, which is the most prevalent paediatric   tumour  in Sub-Saharan Africa.
  • Associated  air pollution with cancer mortality beyond  lung cancer. A large scale epidemiological study associates some air pollutants with kidney, bladder and colorectal cancer death.
  • Associated  swimming in a chlorinated pool with changes  in levels of metabolites in blood.

Investigators of the Nursing Care Research group and others have:

  • Started  a quasi-experimental study to determine the effectiveness of a nurse intervention on epileptic patients and their perception of risk.
  • Finalized a qualitative study to assess women's satisfaction with childbirth in the hospital.

Investigators of the Respiratory Health, Air Pollution &Childhood Development group and others have: 

  • Discovered new evidence  of air pollution effects  on children's neurodevelopment: exposure to air pollution during pregnancy found to have a negative  effect on attentional function  in children; decreased short-term and working memory, and motor performance.
  • Shown for the first time that lifelong residential  exposure to greenness in children is associated with better attention.
  • Discovered that physical activity in early childhood favors the development of working memory.
  • Completed a study with more than 1,200  pregnant women  from the INMA birth cohort  finds higher blood levels of PFAS may influence lipid metabolism  and glucose tolerance.
  • Published the first epidemiological study that evaluates prenatal exposure to different DBPEs and neurodevelopment during the first years of life, showing that child neuropsychological development does not seem to be affected by exposure to water disinfection by-products.

Investigators of the Social Epidemiology & Occupational Health group and others have:

  • Completed a Basic Working and Employment Questionnaire, providing nationally representative, comparable data on work and health status  of workers in eight Latin America and Caribbean countries.
  • Established  an association  between unstable  labour market trajectories and early retirement due to permanent disability and mortality, based  on analyses of the Spanish Continuous Working Life Sample.
  • Initiated a cluster randomised trial to reduce  musculoskeletal morbidity and disability among health care workers.
  • Identified cases series of patients admitted  in the PSMar with suspected occupational disease.

Technological and translational objectives

  • 3 patents have been  transferred to a biotechnology company, related  to the prediction  of cardiovascular  and thromboembolic diseases  risk.
  • BiblioPRO, the online library of reference for Patient  Reported Outcomes (PRO) in Spanish, has reached 10,000 monthly visits and 3,000  new users in 2017 (
  • The CASSANDRA model, an open  access web application, is used to assess  the impact of preventive interventions at the population level ( cassandra/es/).
  • A standardized benchmarking  tool was developed by EPISAP researchers to monitor hospitals coronary  artery disease  outcomes (
  • Online platform with the trends  of the incidence  of mortality and permanent disability from 2004 to 2016 of the social security affiliates included in the Muestra  Contínua de Vidas Laborales.
  • A mathematical model developed by EPISAP researchers is being used by the Director Plan of Oncology to predict future  need  of colonoscopies in Catalonia.
  • EPISAP researchers have continued participating in national and international expert committees, such as: WHO, European Research  Council, Expert Boards, European Medicines Agency (EMA), European Monitoring Center for Drugs and Drug Addiction (EMCDDA), Generalitat de Catalunya, and the Spanish Ministry of Health, among others.
  • Elaboration of lifestyle recommendations for the prevention and management of metabolic syndrome (Nutrition ReviewsVR Vol. 75(5):307-326).

Educational objectives

In 2017 investigators of EPISAP have:

  • Mentored 11 doctoral  theses which were successfully defended.
  • Led a number of formal educational education activities:

− Postgraduate programmes: Master's in Public Health (120 ECTS) with 2 specialties: research and professional;  Master's Degree  in Occupational Health and Safety, in collaboration  with the Universitat Politècnica de Barcelona (UPC) and Universitat de Barcelona (UB); and the Postgraduate Diploma in Public Health (30 ECTS).

− Graduate courses: The Health System; Epidemiology; Community Health; Health Management; Preventive Medicine and Public Health (Medicine), among many others.

− Other  programmes: EPISAP researchers have continued actively participating in the Medical Specialties Residency Programme,  as part of the educational units for the medical specialties  of Preventive Medicine & Public Health, and Occupational Medicine. Collaboration  with other  programmes include: European Educational Programme  in Epidemiology (EEPE), Master in Nursing Sciences, Master in Cardiology Nursing, Bachelor's degree  in Biology, Biotechnology  and Biochemistry, among many others.

− Other  courses:  "Nutrition and Cardiovascular  Risk", Institut de Formació Continua IL3, Barcelona University.  Subject: "Life-style effects  on health", Innovation Master of Nutrition, Chronic diseases  and healthy ageing. Medicine Faculty, Barcelona University.

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