RESUMENFundamento: La infección por citomegalovirus (CMV) es frecuentemente asintomática. Sin embargo, constituye una importante causa de infección congénita y de patología severa en sujetos inmunodeprimidos, por lo que representa un problema en Salud Pública. El objeto de este trabajo fue conocer la prevalencia de IgG frente a CMV (IgG-CMV) en la población general madrileña.Métodos: Estudio transversal en el que se detectó IgG-CMV en una muestra representativa de la población general de la Comunidad de Madrid entre 2 y 60 años (n=2030). Se realizó un muestro bietápico estratificado por conglomerados (octubre de 1993 y febrero de 1994). Para el análisis estadístico se emplearon los test de c 2 y c 2 de tendencia lineal y se calcularon los porcentajes de seroprevalencia y los odds ratios con intervalos de confianza del 95%.Resultados: La seroprevalencia global fue del 62,8% (IC95%: 60,6-64,9); 66,7% (IC95%: 63,7-69,5) en mujeres y del 58,4% (IC95%: 55,2-61,5) en hombres. Se observó una asociación significativa entre el aumento de la edad y el incremento de la seroprevalencia. Fueron factores significativos de riesgo la consulta al dentista, antecedentes de cirugía, acupuntura y tatuajes. Los estudios superiores constituyeron un factor protector.Conclusión: Aunque los factores de riesgo detectados indican una posible transmisión vía sanguínea, la elevada prevalencia apunta a la existencia de otras vías mas comunes. El aumento de la seroprevalencia dependiente de la edad sugiere que se produce un número importante de infecciones en la edad adulta. No se puede excluir, sin embargo, que este aumento responda a un efecto cohorte debido a mejoras socioeconómicas similar al detectado para otros virus.

Background: In 1978, asbestos-related occupational cancers were added to the Spanish list of occupational diseases. However, there are no full accounts of compensated cases since their inclusion. Objective: To analyze the cases of asbestos-related cancer recognized as occupational in Spain between 1978 and 2011. Methods: Cases were obtained from the Spanish Employment Ministry. Specific incidence rates by year, economic activity, and occupation were obtained. We compared mortality rates of mesothelioma and bronchus and lung cancer mortality in Spain and the European Union. Results: Between 1978 and 2011, 164 asbestos-related occupational cancers were recognized in Spain, with a mean annual rate of 0.08 per 10 5 employees (0.13 in males, 0.002 in females). Under-recognition rates were an estimated 93.6% (males) and 99.7% (females) for pleural mesothelioma and 98.8% (males) and 100% (females) for bronchus and lung cancer. In Europe for the year 2000, asbestos-related occupational cancer rates ranged from 0.04 per 10 5 employees in Spain to 7.32 per 10 5 employees in Norway. Conclusions: These findings provide evidence of gross under-recognition of asbestos-related occupational cancers in Spain. Future work should investigate cases treated in the National Healthcare System to better establish the impact of asbestos on health in Spain.

The magnitude of cancer attributable to work in the Basque Country is much higher than reflected in the official Registry of Occupational Diseases. Underreporting of work-related cancers hampers prevention and shifts funding of medical costs from social security to the tax-financed public health system.

The social security system is not compensating the complex and chronic diseases that are prevalent today. Despite improvements in disease reporting from 1990-2005, the decrease observed from 2006-07 and, above all, the gap among autonomous communities show that provision is not working with equity, generating inequality and lack of cohesion and posing a challenge for the definition of efficient prevention policies.

The objective of this article was to estimate the medical costs derived from malignant ARD treatment in the Spanish National Health System (NHS) between 2004 and 2011. Estimation of direct healthcare costs was based on national primary data on the cost of specialized care for inpatients and outpatients treated at NHS hospitals and on national and regional secondary data on costs of primary healthcare and pharmaceutical prescriptions. A prevalence approach was used to estimate the overall burden of ARDs. Direct medical costs of 37,557 ARDs attended in Spanish NHS facilities in 2004–2011 were estimated at 464 million euros; specialist care accounted for 50.9% of total costs, primary healthcare 10.15%, and drug prescription 38.9%. The cost was 27.8-fold higher in males than in females. Bronchopulmonary cancers represented the greatest healthcare cost, 281 million euros. The cost of delivering healthcare to ARDs victims in Spain has a negative economic impact on the NHS due to the gross under-recognition of occupational victims under the Spanish National Insurance System.