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Unveiling spatial clusters of systemic sclerosis mortality in Spain: A comprehensive geographical analysis
Lucia Cayuela1, José-Juan Pereyra-Rodríguez2, Paz Collado Ramos3
1Department of Internal Medicine, Hospital Severo Ochoa, Leganés, Spain.
Medicina Clinica
|December 17, 2024
Summary
Systemic sclerosis (SSc) mortality shows significant geographic and sex disparities in Spain, with higher rates in women and clusters in northern regions potentially linked to occupational exposures.
Area of Science:
- Epidemiology
- Environmental Health
- Geographic Health
Background:
- Systemic sclerosis (SSc) is a complex autoimmune disease with poorly understood geographic and sex-specific mortality patterns.
- Understanding these patterns is crucial for identifying potential environmental and occupational risk factors.
Purpose of the Study:
- To analyze spatial patterns of SSc mortality in Spain (2003-2022).
- To identify provincial-level mortality clusters.
- To investigate sex-specific differences in SSc mortality.
Main Methods:
- Utilized national mortality and population data (2003-2022).
- Calculated age-standardized mortality rates.
- Employed spatial analysis techniques including standardized mortality ratios, smoothed relative risks (Besag, York, and Mollié model), and cluster detection (Tango's, Kulldorff's tests).
- Statistical inference performed using Integrated Nested Laplace Approximation (INLA).
Main Results:
- Recorded 2016 SSc deaths, revealing a significant gender disparity with women experiencing rates ~3.4 times higher than men.
- Observed a consistent annual mortality increase of 2.1% for both sexes.
- Identified significant SSc mortality clusters in northwestern Spain (León, Asturias) and surrounding provinces, areas known for silica mining.
- Noted variations in affected provinces between sexes.
Conclusions:
- Significant geographic and sex-based disparities in SSc mortality exist in Spain, with notable clusters in the north.
- Results suggest potential impacts of environmental and occupational exposures on SSc outcomes.
- Highlights the need for targeted public health interventions in high-risk areas.
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