Cartagena Centre

Personnel

• Professor Luis García-Marcos

The ISAAC story in Cartagena (Spain)

Cartagena entered ISAAC as an individual centre and as the coordinator centre for Spain after some small local epidemiological studies which several young investigators carried out in the city in the late 80’s. Those studies tried to establish the association between air pollution produced by several factories and respiratory diseases in children, especially asthma. This starting group of young researchers knew from a colleague from Barcelona about a new international survey on asthma in children that was being prepared. The group was specifically interested in the video-questionnaire. Very fortunately that colleague had a name and a mail address to ask for some information. A request letter was sent in February 1992 to Prof. Neil Pearce at the Wellington School of Medicine (New Zealand). Although the information took some time to arrive, as the study instruments were being developed, a letter from Wellington was received during the summer of 1992 in which Prof. Pearce advised to contact Prof. Weiland, at the University of Bochum (Germany), who was starting to coordinate five other centres in Europe (see attachment). After contacting Prof. Weiland the group joined the ISAAC study and started to organize the net in Spain.

The first task in Cartagena was to translate and back translate the original written questionnaire in English and to prepare the Spanish version of the video-questionnaire which arrived soon from Bochum after the first contact with Prof. Weiland in October 1992. Furthermore, a meeting in Madrid with researchers interested in the ISAAC study, previously contacted by phone from several parts of Spain, was organised. The meeting was held in Madrid in March 1993. Both Prof. Pearce (spending a sabbatical period at the University of Paris at that time) and Prof. Weiland attended, together with groups from Cartagena, Bilbao, Castellón, Pamplona, Valladolid, Barcelona and Huelva.

Phase One.

This phase was carried out in Cartagena during autumn and winter 1993 and all schools within the city district were invited to participate: only one of them declined entering. The two age groups (6-7 and 13-14 years) were surveyed and participation rate was very high in the older group; however, it was not so high in the younger one but fortunately still enough to be included in the international analyses. As no funding for fieldworkers was possible at that time the research team, composed by Drs. García-Marcos, Dr. Guillén Pérez, Dr. Ñíguez Carbonell, Dr. Guillén Marco, Mrs. Martínez-Torres, Mrs. Gomez-Segado, Mrs Sánchez de Val. Mrs. Saura Robles and Mr. Amoraga Bernal, dedicated part of their own time to the survey and was very excited with the results: data on the epidemiology on asthma, rhinitis and eczema was available for the first time in the area after a never ending process of double entry of the data.

Phase Two.

Cartagena was lucky to raise some funds from the Spanish Government in order to implement four centres of this Phase in Spain. However, that meant to be a central organizer for the four centres and to train fieldworkers not only locally but also for the rest of centres in the country. Phase Two was in itself a nightmare and was even worse because of the responsibilities of having additional centres to coordinate. The positive part was having funds enough for carrying out the project during 2000-2001. Also fortunate was the fact of having European funds for training and coordinating purposes at the University of Munster (Germany) and later at the University of Ulm (Germany). Prof. Garcia-Marcos attended to several of those training and coordination meetings during the late 90’s an early 2000’s and together with Mrs. Martínez Torres was responsible for performing the study in Cartagena for coordinating and training the other centres. The study was slow to perform as it included very extensive questionnaires and procedures, including prick test and blood extraction. Unfortunately, participation rate was slightly below 70% what meant some problems for prevalence publications; however more than 1500 children were surveyed and most of them had all modules completed. Cartagena did the test of bronchial hyperresponsiveness and the dust collection modules in a sub-sample of 100 healthy and 100 asthmatic children. The funniest part was sending the dust samples to the University of Utrecht in carbon dioxide snow inside a huge coffin-like polyurethane box which was given to us by a fish factory which used them to send frozen big tuna fishes to Japan!

Phase Three.

After Phase One and Two, phase Three was an easy task. Again Cartagena performed their own survey, in the same area as in Phase One, and coordinated all Spanish centres. As some new funds arrived for the project, some fieldworkers were hired and the process was smooth and quick, mainly occupying the spring of 2000. A new system of questionnaire scanning was also implemented which made the process even easier, making possible for the principal investigator to concentrate in publishing the results of both Phases Two and Three. Almost the same schools as in Phase One were surveyed and again participation rate was very high among adolescents and not so good among school-children. Anyway, for the first time Cartagena had data on the change of prevalence of asthma and allergies. Good.