Sonia Namorado

• PhD
• Researcher at National Institute of Health Dr. Ricardo Jorge

Background Oral diseases are a global public health challenge and remain among the most prevalent non-communicable diseases. This study aims to characterize the self-assessment of oral health state, degree of edentulism, oral rehabilitation and the quality of life, namely chewing capacity, and the associated psychological and social aspects in the...

In 2023, a second wave of the global mpox epidemic, which is mainly affecting men who have sex with men (MSM), was observed in some countries. Herein, we benefited from a large viral sequence sampling (76/121; 63%) and vast epidemiological data to characterise the re-emergence and circulation of the Monkeypox virus (MPXV) in Portugal during 2023. W...

Cardiovascular diseases are the leading cause of death globally. The objective of this study was to estimate the 10-year cardiovascular risk in the Portuguese population using the new Systematic Coronary Risk Evaluation 2. Data from the first National Health Examination Survey from 2015 were used. Inclusion criteria were age between 40 and 69 years...

Background: Firefighters are subject to a variety of stressors, hence the importance of equipping them with resources that contribute to the management of these stressors. Aims: Considering that a healthy lifestyle is one of these resources, this study aimed to characterize the lifestyle of a Portuguese firefighters sample, rate their general lifes...

O Conselho Nacional de Secretários de Saúde (Conass) e o Instituto de Higiene e Medicina Tropical da Universidade Nova de Lisboa (IHMT), de Portugal, lançaram hoje, durante a Assembleia do Conselho, o mais recente volume da Série Linha Editorial Internacional de Apoio aos Sistemas de Saúde (Leiass). Esta obra, resultado de uma colaboração sem prece...

O Conselho Nacional de Secretários de Saúde (Conass) e o Instituto de Higiene e Medicina Tropical da Universidade Nova de Lisboa (IHMT), de Portugal, lançaram hoje, durante a Assembleia do Conselho, o mais recente volume da Série Linha Editorial Internacional de Apoio aos Sistemas de Saúde (Leiass). Esta obra, resultado de uma colaboração sem prece...

Little is known about exposure determinants of acrylamide (AA), a genotoxic food-processing contaminant, in Europe. We assessed determinants of AA exposure, measured by urinary mercapturic acids of AA (AAMA) and glycidamide (GAMA), its main metabolite, in 3157 children/adolescents and 1297 adults in the European Human Biomonitoring Initiative. Harm...

We reflect on epidemiological modeling conducted throughout the COVID-19 pandemic in Western Europe, specifically in Belgium, France, Italy, the Netherlands, Portugal, Switzerland, and the United Kingdom. Western Europe was initially one of the worst-hit regions during the COVID-19 pandemic. Western European countries deployed a range of policy res...

Human biomonitoring (HBM) data in Europe are often fragmented and collected in different EU countries and sampling periods. Exposure levels for children and adult women in Europe were evaluated over time. For the period 2000–2010, literature and aggregated data were collected in a harmonized way across studies. Between 2011–2012, biobanked samples...

Background Despite effective prevention and control strategies, in countries of the Balkan region, cancers are the second leading cause of mortality, closely following circulatory system diseases. Objective To describe trends in the burden of breast, cervical, and colon and rectum cancer in the Balkan region and per country between 1990 and 2019,...

Background: Seafood is a major source of vital nutrients for optimal fetal growth, but at the same time is the main source of exposure to methylmercury (MeHg), an established neurodevelopmental toxicant. Pregnant women must be provided with dietary advice so as to include safely fish in their diet for nutrition and mercury control. The aim of this...

Objectives: Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature re...

Most countries have acknowledged the importance of assessing and quantifying their population's internal exposure from chemicals in air, water, soil, food and other consumer products due to the potential health and economic impact. Human biomonitoring (HBM) is a valuable tool which can be used to quantify such exposures and effects. Results from HB...

Introduction Work-family conflict is a public health concern due to the effects it has on the health of family members and on the work life and performance. During the COVID-19 pandemic work-family boundary management was a challenge for workers, with important consequences to the conflict between both domains, and was crucial for well-being at wor...

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Ali...

Current approaches for the assessment of environmental and human health risks due to exposure to chemical substances have served their purpose reasonably well. Nevertheless, the systems in place for different uses of chemicals are faced with various challenges, ranging from a growing number of chemicals to changes in the types of chemicals and mate...

In the scope of the European Human Biomonitoring Initiative, a survey directed to all the European citizens was launched to collect information on their opinions and perceptions on exposure to chemicals and human biomonitoring (HBM). In Portugal, 669 individuals have answered the survey, the majority being female, with high educational level and ha...

Mycotoxins are natural metabolites produced by fungi that contaminate food and feed worldwide. They can pose a threat to human and animal health, mainly causing chronic effects, e.g., immunotoxic and carcinogenic. Due to climate change, an increase in European population exposure to mycotoxins is expected to occur, raising public health concerns. T...

Vaccination strategies to control COVID-19 have been ongoing worldwide since the end of 2020. Understanding their possible effect is key to prevent future disease spread. Using a modelling approach, this study intends to measure the impact of the COVID-19 Portuguese vaccination strategy on the effective reproduction number and explore three scenari...

Firefighters are an occupational group exposed to multiple agents, such as heat, fatigue, noise and chemical substances. Exposure to these agents can have a severe impact on their health. In addition, lifestyle behaviors may also affect their health and well-being. As such, the aim of this study was to assess health-related lifestyle behaviors in P...

The objectives of the study were to estimate the current exposure to cadmium (Cd) in Europe, potential differences between the countries and geographic regions, determinants of exposure and to derive European exposure levels. The basis for this work was provided by the European Human Biomonitoring Initiative (HBM4EU) which established a framework f...

Background Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other...

A study was conducted within the European Human Biomonitoring Initiative (HBM4EU) to characterize occupational exposure to Cr(VI). Herein we present the results of biomarkers of genotoxicity and oxidative stress, including micronucleus analysis in lymphocytes and reticulocytes, the comet assay in whole blood, and malondialdehyde and 8-oxo-2′-deoxyg...

More than 20 years ago, acrylamide was added to the list of potential carcinogens found in many common dietary products and tobacco smoke. Consequently, human biomonitoring studies investigating exposure to acrylamide in the form of adducts in blood and metabolites in urine have been performed to obtain data on the actual burden in different popula...

Pyrethroids are a major insecticide class, suitable for biomonitoring in humans. Due to similarities in structure and metabolic pathways, urinary metabolites are common to various active substances. A tiered approach is proposed for risk assessment. Tier I was a conservative screening for overall pyrethroid exposure, based on phenoxybenzoic acid me...

Acrylamide, a substance potentially carcinogenic in humans, represents a very prevalent contaminant in food and is also contained in tobacco smoke. Occupational exposure to higher concentrations of acrylamide was shown to induce neurotoxicity in humans. To minimize related risks for public health, it is vital to obtain data on the actual level of e...

Early-life exposure occurs during gestation through transfer to the fetus and later, during lactation. Recent monitoring data revealed that the Portuguese population is exposed to mycotoxins, including young children. This study aimed to develop a pilot study to assess the early-life exposure to mycotoxins through a mother-child cohort, and to iden...

Human biomonitoring has become a pivotal tool for supporting chemicals’ policies. It provides information on real-life human exposures and is increasingly used to prioritize chemicals of health concern and to evaluate the success of chemical policies. Europe has launched the ambitious REACH program in 2007 to improve the protection of human health...

O período entre 2018 e 2022 mostrou-nos que o problema dos incêndios à escala global não está a diminuir, antes pelo contrário. Parece que as consequências das alterações climáticas já estão a afectar a ocorrência de incêndios florestais em várias partes do Mundo, de uma forma que só esperaríamos que acontecesse vários anos mais tarde. Em muitos pa...

Vaccination strategies to control COVID-19 have been ongoing worldwide since the end of 2020. Understanding their possible effect is key to prevent future disease spread. Using a modelling approach, this study intends to measure the impact of the COVID-19 Portuguese vaccination strategy on the effective reproduction number and explore three scenari...

Background Previous studies show high chronic physical disease/depression comorbidity and higher healthcare use in these patients. Most studies focus on a single physical disease and do not consider number of diseases or depression severity. We aimed to characterise the chronic physical disease/depression relation in the Portuguese and analyse its...

Introduction Although research on leadership has privileged its effect on performance, there is also some empirical evidence that leadership can have a beneficial effect on the well-being of subordinates. The analysis of this effect in professions with high demands that can affect stress and well-being, as is the case with firefighters, is especial...

Objective The aim of this study was to identify the effects of severe wildfires on the population’s mental health in the long term and the role of perceived health status, health vulnerability, resiliency and sense of coherence. Methods A longitudinal survey with 3 waves (9, 19 and 24 months after the wildfire) was carried out in a representative...

Mercury (Hg) is one of the HBM4EU priority substances. The main source of human exposure to Hg is through the consumption of seafood contaminated with methylmercury. Considering the toxicity of Hg on the developing central nervous system, it is important to characterize MeHg exposure levels in pregnant women in European countries where seafood cons...

BACKGROUND AND AIM: Mercury and its compounds are toxic and are among the substances of higher concern globally. Toxicity depends on mercury compounds, route of exposure and duration. The European population is mostly exposed to organic mercury (methylmercury) due to fish consumption; while exposure to inorganic and elemental mercury is largely ass...

BACKGROUND AND AIM: The development of Human Biomonitoring (HBM) surveys is highly dependent on the cooperation and engagement of the individuals being sampled. As such, in the context of the European Human Biomonitoring Initiative (HBM4EU) an online citizen survey was conducted in Europe to gain insights into the perceptions of the population abo...

Background Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other...

Background Participation rates in health surveys, recognized as an important quality dimension, have been declining over the years, which may affect representativeness and confidence in results. The Portuguese national health examination survey INSEF (2015) achieved a participation rate of 43.9%, which is in line with participation rates from other...

Purpose Sunlight exposure is responsible for a large number of dermatological diseases. The purpose of this study was to estimate the prevalence of hazardous sun exposure and adherence to sun protective behaviours and its associated factors in adults from the Portuguese population. Methods A total of 4,797 participants aged between 25 and 74 years...

Introduction: Health surveys constitute a relevant information source to access the population’s health status. Given that survey errors can significantly influence estimates and invalidate study findings, it is crucial that the fieldwork progress is closely monitored to ensure data quality. The objective of this study was to describe the fieldwork...

Background Disability is not just a health problem. It is a wider phenomenon that reflects the gap between a person’s capacities and their ability to fully perform the role demanded by society. Both personal and environmental factors are major contributors to disability. Objective: We aimed to estimate the prevalence of self-reported disability, ov...

Introduction: Cardiovascular disease is the leading cause of morbidity and mortality in Portugal and globally. Cardiovascular risk algorithms, namely the SCORE (Systematic Coronary Risk Evaluation), are recommended in the context of cardiovascular disease prevention. Our aim is to estimate and characterize the cardiovascular risk of the Portuguese...

Introduction: Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portugue...

Background In many European countries, parallel to health examination surveys (HES), human biomonitoring (HBM) studies are conducted to monitor chemical exposures of the population. HES and HBM studies use survey based data collection with similarities in sample selection and recruitment, ethics and data protection, collection of data by questionna...

Introduction Cardiovascular disease is an important cause of death and disability worldwide, and hypertension is responsible for at least 45% of all deaths due to heart disease and 51% of deaths due to stroke. This study aimed to estimate and describe the distribution of prevalence, awareness, treatment and control of hypertension in the Portuguese...

Oral health is a determinant for quality of life and preventive behaviours such as regular tooth brushing can reduce the risk of a wide spectrum of oral diseases. Adopting preventive behaviours increases the likelihood of being healthy and can be conditioned by demographic and socio-economic factors. Objective: This study aims to describe preventiv...

Background: This study aimed to compare self-reported and examination-based prevalence of hypertension and hypercholesterolemia in Portugal in 2015 and to identify factors associated with the measurement error in self-reports. Methods: We used data from the Portuguese National Health Examination Survey (n = 4911), that combines personal intervie...

Background In Health Examination Surveys interview information is complemented with objective information, providing more accurate indicators than self-reported data. We report the study design, planning and implementation of the first Portuguese Health Examination Survey (INSEF). Methods INSEF was a cross-sectional population-based study represen...

Annual influenza vaccination is recommended to people with chronic conditions. This study aimed to estimate the proportion of chronically ill adults vaccinated against influenza in consecutive seasons and to identify associated factors. We used data from the first National Health Examination Survey (INSEF), a cross-sectional study conducted in 2015...

Aims: Diabetes Mellitus is a major public health threat worldwide and continues to increase in numbers and significance. Estimates of diabetes prevalence, awareness, treatment and control are essential to effectively monitor its trends, plan and evaluate interventions. Methods: We conducted a nationwide health examination survey in the populatio...

Obesity is recognised as a serious public health issue, due to its associated morbidity and mortality. This study aimed at estimating the prevalence of overweight and obesity in the Portuguese population through direct measurements obtained by the 1st National Health Examination Survey (INSEF 2015) and to identify its associated sociodemographic fa...

This study compares self-reported and examination-based prevalence of hypertension and hypercholesterolemia using data from the Portuguese National Health Examination Survey (n=4911), that combines personal interview and clinical measurements. Sensitivity and specificity of self-reported hypertension and hypercholesterolemia were calculated, logist...

A Diabetes Mellitus é uma grande ameaça para a saúde pública em todo o mundo, continuando a aumentar em prevalência e significado. As estimativas da sua prevalência, conhecimento e controlo são essenciais para monitorizar as suas tendências de forma efetiva. Neste contexto, foi realizado o primeiro Inquérito Nacional de Saúde com Exame Físico (INSE...

O estudo teve como objetivo estimar a distribuição da prevalência de hipertensão, seu conhecimento (awareness), tratamento e controlo na população portuguesa em 2015. Realizou-se um inquérito nacional com uma amostra representativa de 4911 indivíduos, com idade compreendida entre 25 e 74 anos e residentes em Portugal há mais de 12 meses. O inquérit...

The Portuguese National Health Examination Survey is developed as a part of the project “Improvement of epidemiological health information to support public health decision and management in Portugal. Towards reduced inequalities, improved health, and bilateral cooperation”, that benefits from a 1.500.000€ Grant from Iceland, Liechtenstein and Norw...

The first Portuguese National Health Examination Survey (2015): design, planning and implementation Background Health Examination Surveys (HES) were interview data is complemented with objective information from physical examination and laboratory analysis, provide more accurate health indicators than self-reported data. Here we report the study de...

Profile of the Portuguese Health Examination Survey Biospecimen Collection

This work addresses practices related to quality assurance in the first Portuguese National Health Examination Survey (INSEF). INSEF is a cross-sectional population-based study that combines face-to-face interview, physical examination and blood collection and aims to obtain data on 4200 participants from all 7 regions of Portugal. To ensure accura...

Recruitment of participants in health surveys is recognised as the most challenging step of fieldwork. This work presents preliminary results of recruitment in the first Portuguese National Health Examination Survey (INSEF) comparing participants and non participants. INSEF is a cross-sectional prevalence study targeting 4200 individuals aged 25–74...

The participation of fieldwork teams is key to successful surveys implementation. Thus, the Portuguese National Health Examination Survey (INSEF) is involving fieldwork teams in survey quality control processes. The aim of this presentation is to report a midterm evaluation's results of the internal quality control concerning participants' recruitm...

The metal cadmium (Cd) is a widespread environmental pollutant with documented adverse effects on the kidneys and bones from long-term environmental exposure, but with insufficiently elucidated public health consequences such as risk of cardiovascular disease, hormone-related cancer in adults and developmental effects in children. This study is the...

Abstract A communication strategy was developed by The Consortium to Perform Human Biomonitoring on a European Scale (COPHES), as part of its objectives to develop a framework and protocols to enable the collection of comparable human biomonitoring data throughout Europe. The framework and protocols were tested in the pilot study DEMOCOPHES (Demons...

Abstract The toxicity of methylmercury (MeHg) in humans is well established and the main source of exposure is via the consumption of large marine fish and mammals. Of particular concern are the potential neurodevelopmental effects of early life exposure to low-levels of MeHg. Therefore, it is important that pregnant women, children and women of ch...

This communication addresses problems arose and solutions adopted in sample design and sample selection for the first Portuguese National Health Examination Survey, a cross-sectional study that aims to obtain epidemiological data for the Portuguese population at regional and national level.

This paper focuses on development and testing of the questionnaire used in the first Portuguese National Health Examination Survey (INSEF), a cross-sectional prevalence study conducted by the National Health Institute Doutor Ricardo Jorge (INSA) in cooperation with the Norwegian Institute of Public Health, five Regional Health Administrations and t...

Background: For Europe as a whole, data on internal exposure to environmental chemicals do not yet exist. Characterization of the internal individual chemical environment is expected to enhance understanding of the environmental threats to health. Objectives: We developed and applied a harmonized protocol to collect comparable human biomonitoring d...

Environmental Health Perspectives (Impact Factor: 7.26). 12/2014; DOI: 10.1289/ehp.1408616

Background In 2008, the Portuguese smoke-free law came into effect including partial bans in the leisure-hospitality (LH) sector. The objective of the study is to assess the prevalence of smoking control policies (total ban, smoking permission and designated smoking areas) adopted by the LH sector in Portugal. The levels of noncompliance with each...