Manolis Kogevinas

Εθνική Σχολή Δημόσιας Υγείας, Athínai, Attica, Greece

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Publications (561)3063.59 Total impact

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    ABSTRACT: Bipolar disorder (BD) is a severe and highly heritable neuropsychiatric disorder with a lifetime prevalence of 1%. Molecular genetic studies have identified the first BD susceptibility genes. However, the disease pathways remain largely unknown. Accumulating evidence suggests that microRNAs, a class of small noncoding RNAs, contribute to basic mechanisms underlying brain development and plasticity, suggesting their possible involvement in the pathogenesis of several psychiatric disorders, including BD. In the present study, gene-based analyses were performed for all known autosomal microRNAs using the largest genome-wide association data set of BD to date (9747 patients and 14 278 controls). Associated and brain-expressed microRNAs were then investigated in target gene and pathway analyses. Functional analyses of miR-499 and miR-708 were performed in rat hippocampal neurons. Ninety-eight of the six hundred nine investigated microRNAs showed nominally significant P-values, suggesting that BDassociated microRNAs might be enriched within known microRNA loci. After correction for multiple testing, nine microRNAs showed a significant association with BD. The most promising were miR-499, miR-708 and miR-1908. Target gene and pathway analyses revealed 18 significant canonical pathways, including brain development and neuron projection. For miR-499, four Bonferroni-corrected significant target genes were identified, including the genome-wide risk gene for psychiatric disorder CACNB2. First results of functional analyses in rat hippocampal neurons neither revealed nor excluded a major contribution of miR-499 or miR-708 to dendritic spine morphogenesis. The present results suggest that research is warranted to elucidate the precise involvement of microRNAs and their downstream pathways in BD.
    Translational Psychiatry 11/2015; 5(e678). DOI:10.1038/tp.2015.159 · 5.62 Impact Factor
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    ABSTRACT: The colonic opportunist Streptococcus gallolyticus subspecies gallolyticus (SGG) is potentially associated with colorectal cancer (CRC). Large-scale seroepidemiological data for SGG antibodies and their possible association with CRC is currently missing. Associations between CRC and antibody responses to SGG were examined in 576 CRC cases and 576 controls matched by sex, age and province from a population-based multicase-control project (MCC-Spain). MCC-Spain was conducted between 2008 and 2013 in 12 Spanish provinces. Antibody responses to recombinant affinity-purified SGG pilus proteins Gallo1569, 2039, 2178 and 2179 were analysed by multiplex serology. Polyomavirus (PyV) JC VP1 and PyV 6 VP1 proteins served as disease-specificity controls. In the control population, antibody responses to pilus proteins were mostly weak. Antibody responses to individual pilus proteins Gallo2039 (OR: 1.58, 95% CI: 1.09-2.28), Gallo2178 (OR: 1.58, 95% CI: 1.09-2.30) and Gallo2179 (OR: 1.45, 95% CI: 1.00-2.11) were significantly associated with CRC risk. The association was stronger for positivity to 2 or more pilus proteins of Gallo1569, Gallo2178 and Gallo2179 (OR:1.93, 95% CI: 1.04-3.56) and for double-positivity to Gallo2178 and Gallo2179 (OR: 3.54, 95% CI: 1.49-8.44). The association between SGG infection and CRC risk was stronger among individuals younger than 65 years. For the first time we demonstrated a statistically significant association of exposure to SGG antigens and CRC in a large seroepidemiological study. These results should stimulate further studies on the role of SGG in CRC pathogenesis. This article is protected by copyright. All rights reserved.
    International Journal of Cancer 11/2015; DOI:10.1002/ijc.29914 · 5.09 Impact Factor
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    ABSTRACT: BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children from 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth characteristics with childhood asthma. RESULTS: Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1 but higher FEV1/FVC ratio (P < .05). Greater infant weight gain was associated with higher FEV1 but lower FEV1/FVC ratio and FEF75 in childhood (P < .05). All associations were present across the full range and independent of other early-life growth characteristics. Preterm birth, low birth weight, and greater infant weight gain were associated with an increased risk of childhood asthma (pooled odds ratio, 1.34 [95% CI, 1.15-1.57], 1.32 [95% CI, 1.07-1.62], and 1.27 [95% CI, 1.21-1.34], respectively). Mediation analyses suggested that FEV1, FEV1/FVC ratio, and FEF75 might explain 7% (95% CI, 2% to 10%) to 45% (95% CI, 15% to 81%) of the associations between early growth characteristics and asthma. CONCLUSIONS: Younger gestational age, smaller size for gestational age, and greater infant weight gain were across the full ranges associated with childhood lung function. These associations explain the risk of childhood asthma to a substantial extent.
    Journal of Allergy and Clinical Immunology 11/2015; DOI:10.1016/j.jaci.2015.08.050 · 11.48 Impact Factor
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    ABSTRACT: Few studies have demonstrated gene/environment interactions in cancer research. Using data on high-risk occupations for 2258 case patients and 2410 control patients from two bladder cancer studies, we observed that three of 16 known or candidate bladder cancer susceptibility variants displayed statistically significant and consistent evidence of additive interactions; specifically, the GSTM1 deletion polymorphism (Pinteraction ≤ .001), rs11892031 (UGT1A, Pinteraction = .01), and rs798766 (TMEM129-TACC3-FGFR3, Pinteraction = .03). There was limited evidence for multiplicative interactions. When we examined detailed data on a prevalent occupational exposure associated with increased bladder cancer risk, straight metalworking fluids, we also observed statistically significant additive interaction for rs798766 (TMEM129-TACC3-FGFR3, Pinteraction = .02), with the interaction more apparent in patients with tumors positive for FGFR3 expression. All statistical tests were two-sided. The interaction we observed for rs798766 (TMEM129-TACC3-FGFR3) with specific exposure to straight metalworking fluids illustrates the value of integrating germline genetic variation, environmental exposures, and tumor marker data to provide insight into the mechanisms of bladder carcinogenesis.
    JNCI Journal of the National Cancer Institute 11/2015; 107(11). DOI:10.1093/jnci/djv223 · 12.58 Impact Factor
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    ABSTRACT: Exposure to endocrine disruptors, used as additives, preservatives, plasticisers and solvents in numerous consumer products, might cause adverse health effects. Humans exposed to these chemicals, metabolise and excrete them mostly via urine. Urinary metabolite concentrations are used as biomarkers of exposure. We evaluated the exposure of 4-month pregnant women and their children at 2years of age to phthalates, parabens and bisphenol-A. Concentrations of eight phthalate metabolites, six parabens and bisphenol-A were measured in 239 mother-child pairs of the "Rhea" cohort in Greece. Concentration levels in mother and children were comparable with corresponding concentrations in other countries worldwide. Low Spearman correlation coefficients (CC 0.1-0.2, p-value<0.01) were observed for di-ethyl phthalate (DEP), di-n-butyl phthalate (DnBP), butyl-benzyl phthalate (BBP) and ethyl paraben (EPB) between mothers and their children. We observed higher median daily intake (DIu) for mothers (e.g. di-ethyl phthalate 6.9μgd(-1)kg(-1)) than for their children (1.4μgd(-1)kg(-1)) for all examined compounds, except for di-2-ethylhexyl phthalate (DEHP) and bisphenol-A. Principal component analysis (PCA) indicated two main sources of exposure (plastic related and personal care-hygiene products) for phthalates, parabens and bisphenol-A. Differences in DEHP metabolism were observed among mothers-children and female-male children. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Environment international 10/2015; 83. DOI:10.1016/j.envint.2015.05.014 · 5.56 Impact Factor
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    ABSTRACT: Background: Micronuclei (MN) are biomarkers of early genetic effects that have been used to investigate the association between environmental exposures and cancer. However, few studies have examined the association between environmental exposures during pregnancy and MN in mothers and newborns. Objectives: We examined MN frequency in maternal blood and in cord blood, in relation to maternal air pollution exposure, and the potential interaction with maternal vitamin C intake and maternal smoking. Methods: We used the cytokinesis-block micronucleus assay to assess MN frequency per 1000 bi-nucleated T-lymphocytes from 181 mothers and 183 newborns born in 2007-2008 in Heraklion (Crete, Greece). The ESCAPE land-use regression methods were used to estimate annual mean exposure to outdoor air pollution [particulate matter (PM), black carbon, nitrogen dioxide (NO2) and nitrogen oxides (NOx)] at maternal home addresses. Food frequency questionnaires were used to estimate maternal dietary vitamin C intake during pregnancy. Smoking habits were self-reported using questionnaires which were checked by measuring maternal urinary cotinine levels. Results: Exposure to PM2.5 was associated with increased MN frequencies in pregnant women [rate ratio [RR (95%CI)] per 5µg/m(3)=1.53 (1.02, 2.29)]. This increase was considerably higher among women who did not fulfill the recommended vitamin C dietary allowances [RR=9.35 (2.77, 31.61); n=20]. Exposure to PM2.5-10, PM10, NO2 and NOx were also associated with a higher incidence of MN frequencies in smoker women (n=56). No associations were found for newborns. Conclusions: We found an association between air pollution, particularly PM2.5, and MN frequency in mothers but not in newborns. This association was more pronounced among women with a lower dietary intake of vitamin C during pregnancy and among women who smoked during pregnancy. While results are clear in mothers, the association between maternal carcinogenic exposures during pregnancy and biomarkers of early biologic effect in the newborn remains poorly understood.
    Environmental Research 10/2015; 143(Pt A):170-176. DOI:10.1016/j.envres.2015.10.011 · 4.37 Impact Factor
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    ABSTRACT: BACKGROUND: Studies of related individuals have consistently demonstrated notable familial aggregation of cancer. We aim to estimate the heritability and genetic correlation attributable to the additive effects of common single-nucleotide polymorphisms (SNPs) for cancer at 13 anatomical sites. METHODS: Between 2007 and 2014, the US National Cancer Institute has generated data from genome-wide association studies (GWAS) for 49 492 cancer case patients and 34 131 control patients. We apply novel mixed model methodology (GCTA) to this GWAS data to estimate the heritability of individual cancers, as well as the proportion of heritability attributable to cigarette smoking in smoking-related cancers, and the genetic correlation between pairs of cancers. RESULTS: GWAS heritability was statistically significant at nearly all sites, with the estimates of array-based heritability, hl (2), on the liability threshold (LT) scale ranging from 0.05 to 0.38. Estimating the combined heritability of multiple smoking characteristics, we calculate that at least 24% (95% confidence interval [CI] = 14% to 37%) and 7% (95% CI = 4% to 11%) of the heritability for lung and bladder cancer, respectively, can be attributed to genetic determinants of smoking. Most pairs of cancers studied did not show evidence of strong genetic correlation. We found only four pairs of cancers with marginally statistically significant correlations, specifically kidney and testes (rho = 0.73, SE = 0.28), diffuse large B-cell lymphoma (DLBCL) and pediatric osteosarcoma (rho = 0.53, SE = 0.21), DLBCL and chronic lymphocytic leukemia (CLL) (rho = 0.51, SE =0.18), and bladder and lung (rho = 0.35, SE = 0.14). Correlation analysis also indicates that the genetic architecture of lung cancer differs between a smoking population of European ancestry and a nonsmoking Asian population, allowing for the possibility that the genetic etiology for the same disease can vary by population and environmental exposures. CONCLUSION: Our results provide important insights into the genetic architecture of cancers and suggest new avenues for investigation.
    JNCI Journal of the National Cancer Institute 10/2015; 107(12). DOI:10.1093/jnci/djv279 · 12.58 Impact Factor

  • European Respiratory Journal 09/2015; 46(suppl 59):PA349. DOI:10.1183/13993003.congress-2015.PA349 · 7.64 Impact Factor

  • European Respiratory Journal 09/2015; 46(suppl 59):PA2020. DOI:10.1183/13993003.congress-2015.PA2020 · 7.64 Impact Factor

  • BMJ (online) 08/2015; 351. DOI:10.1136/bmj.h4501 · 17.45 Impact Factor
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    Maria Papadakaki · Eleni Petridou · Manolis Kogevinas · Christos Lionis ·

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    ABSTRACT: This research aimed to assess serum concentrations of a group of persistent organic pollutants (POPs) in a sample of adults recruited in four different regions from Spain and to assess socio-demographic, dietary, and lifestyle predictors of the exposure. The study population comprised 312 healthy adults selected from among controls recruited in the MCC-Spain multicase-control study. Study variables were collected using standardized questionnaires, and pollutants were analyzed by means of gas chromatography with electron capture detection. Multivariable analyses were performed to identify predictors of log-transformed pollutant concentrations, using combined backward and forward stepwise multiple linear regression models. Detection rates ranged from 89.1% (hexachlorobenzene, HCB) to 93.6% (Polychlorinated biphenyl-153 [PCB-153]); p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) showed the highest median concentrations (1.04ng/ml), while HCB showed the lowest (0.24ng/ml). In the multivariable models, age was positively associated with HCB, p,p'-DDE, and PCB-180. BMI was associated positively with p,p'-DDE but negatively with PCB-138. Total accumulated time residing in an urban area was positively associated with PCB-153 concentrations. The women showed higher HCB and lower p,p'-DDE concentrations versus the men. Notably, POP exposure in our study population was inversely associated with the breastfeeding received by participants and with the number of pregnancies of their mothers but was not related to the participants' history of breastfeeding their children or parity. Smoking was negatively associated with HCB and PCB-153 concentrations. Consumption of fatty foods, including blue fish, was in general positively associated with POP levels. Although POP environmental levels are declining worldwide, there is a need for the continuous monitoring of human exposure in the general population. The results of the present study confirm previous findings and point to novel predictors of long-term exposure to persistent organic pollutants. Copyright © 2015 Elsevier B.V. All rights reserved.
    Science of The Total Environment 08/2015; 538:152-161. DOI:10.1016/j.scitotenv.2015.07.162 · 4.10 Impact Factor
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    ABSTRACT: Epidemiologic and animal data indicate that night shift work might increase the risk for breast cancer. We evaluated the association of night work with different clinical types of breast cancer in a population based case-control study (MCC-Spain study) taking into account chronotype, an individual characteristic that may relate to night shift work adaptation. Lifetime occupational history was assessed by face-to-face interviews and shift work information was available for 1708 breast cancer cases and 1778 population controls from 10 Spanish regions, enrolled from 2008 to 2013. We evaluated three shift work domains, including shift work type (permanent vs rotating), lifetime cumulative duration and frequency. We estimated odds ratios (OR) for night work compared to day work using unconditional logistic regression models adjusting for confounders. Having ever worked permanent or rotating night shift was associated with an increased risk for breast cancer compared to day workers [odds ratio (OR) 1.18; 95 % CI 0.97, 1.43]. Chronotype was differentially associated with breast cancer depending on the duration of night shift work. Risk was higher in women with invasive tumors (OR 1.23; 95 % CI 1.00, 1.51) and for estrogen and progestagen positive tumors among premenopausal women (OR 1.44; 95 % CI 1.05, 1.99). Having ever performed night shift was associated with a small increased risk for breast cancer and especially in subgroups of women with particular hormone related characteristics.
    European Journal of Epidemiology 07/2015; DOI:10.1007/s10654-015-0073-y · 5.34 Impact Factor
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    ABSTRACT: To quantify serum concentrations of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and dioxin-like compounds in former phenoxy herbicide production plant workers and firefighters, 20 years after 2,4,5-T production ceased. Of 1025 workers employed any time during 1969-1984, 430 were randomly selected and invited to take part in a morbidity survey and provide a blood sample; 244 (57 %) participated. Firefighters stationed in close proximity of the plant and/or engaged in call-outs to the plant between 1962 and 1987 also participated (39 of 70 invited). Reported here are the serum concentrations of TCDD and other chlorinated dibenzo-dioxins, dibenzofurans, and polychlorinated biphenyls (PCBs). Determinants of the serum concentrations were assessed using linear regression. The 60 men who had worked in the phenoxy/TCP production area had a mean TCDD serum concentration of 19.1 pg/g lipid, three times the mean concentration of the 141 men and 43 women employed in other parts of the plant (6.3 and 6.0 pg/g respectively), and more than 10 times the mean for the firefighters (1.6 pg/g). Duration of employment in phenoxy herbicide synthesis, maintenance work, and work as a boilerman, chemist, and packer were associated with increased serum concentrations of TCDD and 1,2,3,4,7-pentachlorodibenzo-p-dioxin (PeCDD). Employment as a boilerman was also associated with elevated serum concentrations of PCBs. Occupations in the plant associated with phenoxy herbicide synthesis had elevated levels of TCDD and PeCDD. Most other people working within the plant, and the local firefighters, had serum concentrations of dioxin-like compounds comparable to those of the general population.
    International Archives of Occupational and Environmental Health 07/2015; DOI:10.1007/s00420-015-1074-6 · 2.20 Impact Factor
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    ABSTRACT: People are exposed throughout life to a wide range of environmental and occupational pollutants from different sources at home, in the workplace or in the general environment - exposures that normally cannot be directly controlled by the individual. Several chemicals, metals, dusts, fibres, and occupations have been established to be causally associated with an increased risk of specific cancers, such as cancers of the lung, skin and urinary bladder, and mesothelioma. Significant amounts of air pollutants - mainly from road transport and industry - continue to be emitted in the European Union (EU); an increased occurrence of lung cancer has been attributed to air pollution even in areas below the EU limits for daily air pollution. Additionally, a wide range of pesticides as well as industrial and household chemicals may lead to widespread human exposure, mainly through food and water. For most environmental pollutants, the most effective measures are regulations and community actions aimed at reducing and eliminating the exposures. Thus, it is imperative to raise awareness about environmental and occupational carcinogens in order to motivate individuals to be proactive in advocating protection and supporting initiatives aimed at reducing pollution. Regulations are not homogeneous across EU countries, and protective measures in the workplace are not used consistently by all workers all the time; compliance with regulations needs to be continuously monitored and enforced. Therefore, the recommendation on Environment and Occupation of the 4th edition of the European Code against Cancer, focusing on what individuals can do to reduce their cancer risk, reads: "In the workplace, protect yourself against cancer-causing substances by following health and safety instructions." Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.
    07/2015; 103. DOI:10.1016/j.canep.2015.03.017
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    ABSTRACT: Different types of '-omics' data are becoming available in the post-genome era; still a single -omics assessment provides limited insights to understand the biological mechanism of complex diseases. Genomics, epigenomics and transcriptomics data provide insight into the molecular dysregulation of neoplastic diseases, among them urothelial bladder cancer (UBC). Here, we propose a detailed analytical framework necessary to achieve an adequate integration of the three sets of -omics data to ultimately identify previously hidden genetic mechanisms in UBC. We built a multi-staged framework to study possible pair-wise combinations and integrated the data in three-way relationships. SNP genotypes, CpG methylation levels and gene expression levels were determined for a total of 70 individuals with UBC and with fresh tumour tissue available. We suggest two main hypothesis-based scenarios for gene regulation based on the -omics integration analysis, where DNA methylation affects gene expression and genetic variants co-regulate gene expression and DNA methylation. We identified several three-way trans-association 'hotspots' that are found at the molecular level and that deserve further studies. The proposed integrative framework allowed us to identify relationships at the whole-genome level providing some new biological insights and highlighting the importance of integrating -omics data. © 2015 S. Karger AG, Basel.
    Human Heredity 07/2015; 79(3-4):124-36. DOI:10.1159/000381184 · 1.47 Impact Factor
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    ABSTRACT: This study aims to describe time trends in and patterns of use of hormonal contraception and postmenopausal hormone therapy and to identify factors associated with their use among Spanish women. We performed a cross-sectional analysis using data from 1,954 population controls (aged 24-85 y) in 12 provinces of Spain who were enrolled in the Multi Case-Control Spain study (2007-2013). Data were collected from a questionnaire conducted face-to-face by trained personnel. We collected information on sociodemographic factors, lifestyle, sleep patterns, reproductive history, and occupational history. Overall, 48.5% of Spanish women reported ever use of hormonal contraception, and 9.8% of women in the postmenopausal group reported use of postmenopausal hormone therapy. Younger cohorts used hormonal contraception for a longer period, whereas postmenopausal hormone therapy use dramatically dropped in the 2000s. Women with higher education levels (including education of partners) and smoking history were the most probable users of hormonal contraception, whereas inverse associations were observed among housewives, obese women, and nulliparous women. Postmenopausal hormone therapy use was associated with a surgical or therapeutic cause of menopause and with occupational history of rotating shifts. In this Spanish population, several demographic, lifestyle, occupational, and reproductive factors are associated with use of hormonal compounds. Characterizing hormonal users and monitoring trends in the use of these hormonal compounds are essential from a public health perspective.
    Menopause (New York, N.Y.) 06/2015; 72. DOI:10.1097/GME.0000000000000487 · 3.36 Impact Factor
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    ABSTRACT: The determination of dietary patterns in children examines the effects of the overall diet at early ages, instead of looking at individual foods or energy providing nutrients. The present analysis aims to identify the dietary patterns of preschool children and to examine their associations with multiple socio-economic and lifestyle characteristics. Dietary data were collected for 1081 children participating in the Rhea mother-child cohort in Crete, Greece. Diet was assessed using a validated food frequency questionnaire, and dietary patterns were identified with principal component analysis. Multivariable linear regression models were used to examine factors associated with each dietary pattern. Three dietary patterns were identified explaining 45.8% of the total diet variation. The 'Mediterranean' pattern was based on pulses, olive oil, vegetables, fish and fruits; the 'Snacky' pattern included potatoes and other starchy roots, salty snacks, sugar products and eggs; the 'Western' pattern contained cereals, cheese, added lipids, beverages and meat. Preschool attendance and increased time spent with the mother (⩾2 h/day) were positively associated with the 'Mediterranean' pattern, whereas watching TV was inversely associated with this pattern. Lower parental education, maternal age and earlier introduction to solid foods were positively associated with the 'Snacky' pattern. Higher scores on the 'Western' type diet were associated with exposure to passive smoking and watching TV. No variation in energy providing nutrient intake was observed across tertiles of the identified dietary patterns. The results from this analysis indicate the important role of socio-demographic factors on children's dietary preferences in early age.European Journal of Clinical Nutrition advance online publication, 17 June 2015; doi:10.1038/ejcn.2015.93.
    European journal of clinical nutrition 06/2015; DOI:10.1038/ejcn.2015.93 · 2.71 Impact Factor

Publication Stats

15k Citations
3,063.59 Total Impact Points


  • 2009-2015
    • Εθνική Σχολή Δημόσιας Υγείας
      Athínai, Attica, Greece
  • 2008-2015
    • Parc de Salut Mar
      Barcino, Catalonia, Spain
  • 2006-2015
    • CREAL Center for Research in Environmental Epidemiology
      Barcino, Catalonia, Spain
    • Hospital General Universitario de Elche
      Elche, Valencia, Spain
    • University of Verona
      Verona, Veneto, Italy
  • 2001-2015
    • University Pompeu Fabra
      • Department of Experimental and Health Sciences
      Barcino, Catalonia, Spain
  • 1999-2015
    • IMIM Hospital del Mar Medical Research Institute
      Barcino, Catalonia, Spain
    • University of Barcelona
      Barcino, Catalonia, Spain
    • Instituto de Investigación Sanitaria
      Madrid, Madrid, Spain
  • 2014
    • Technological Educational Institute of Crete
      Megalokastro, Crete, Greece
    • Hospital Universitario Ramón y Cajal
      Madrid, Madrid, Spain
    • Centro de Investigación Biomedica En Red del Área de Salud Mental
      Madrid, Madrid, Spain
    • Barcelona Media
      Barcino, Catalonia, Spain
  • 2013-2014
    • Instituto de Salud Carlos III
      Madrid, Madrid, Spain
  • 1998-2013
    • Institut Marqués, Spain, Barcelona
      Barcino, Catalonia, Spain
    • Wageningen University
      Wageningen, Gelderland, Netherlands
  • 2012
    • Cranfield University
      • Cranfield Water Science Institute
      Cranfield, England, United Kingdom
  • 2005-2011
    • University of Crete
      • • Division of Social Medicine
      • • School of Medicine
      Retimo, Crete, Greece
  • 2004-2007
    • National Cancer Institute (USA)
      • • Hormonal and Reproductive Epidemiology
      • • Occupational and Environmental Epidemiology
      • • Division of Cancer Epidemiology and Genetics
      베서스다, Maryland, United States
  • 2002-2006
    • University of Oviedo
      Oviedo, Asturias, Spain
  • 2000-2003
    • Autonomous University of Barcelona
      • Faculty of Medicine
      Cerdanyola del Vallès, Catalonia, Spain
    • Università degli Studi di Torino
      Torino, Piedmont, Italy
  • 1992-1999
    • International Agency for Research on Cancer
      Lyons, Rhône-Alpes, France
  • 1996
    • University of Padova
      Padua, Veneto, Italy
    • Cancer Research Center of Lyon
      Lyons, Rhône-Alpes, France
  • 1995
    • University of British Columbia - Vancouver
      Vancouver, British Columbia, Canada
  • 1994
    • Umeå University
      Umeå, Västerbotten, Sweden
  • 1993
    • Finnish Institute of Occupational Health
      Helsinki, Uusimaa, Finland