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Citizens’ opinions on (non-)essential uses of persistent chemicals: A survey in seven European countries
No full textA prospective ecological risk assessment of high-efficiency III-V/silicon tandem solar cells.
No full textScope and Incentives for Risk Selection in Health Insurance Markets With Regulated Competition: A Conceptual Framework and International Comparison.
No full textDisentangling Population Health Management Initiatives in Diabetes Care: A Scoping Review.
No full textLong-term exposure to air pollution and incidence of gastric and the upper aerodigestive tract cancers in a pooled European cohort: The ELAPSE project.
No full textAir pollution has been shown to significantly impact human health including cancer. Gastric and upper aerodigestive tract (UADT) cancers are common and increased risk has been associated with smoking and occupational exposures. However, the association with air pollution remains unclear. We pooled European subcohorts (N = 287,576 participants for gastric and N = 297,406 for UADT analyses) and investigated the association between residential exposure to fine particles (PM2.5 ), nitrogen dioxide (NO2 ), black carbon (BC) and ozone in the warm season (O3w ) with gastric and UADT cancer. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. During 5,305,133 and 5,434,843 person-years, 872 gastric and 1139 UADT incident cancer cases were observed, respectively. For gastric cancer, we found no association with PM2.5 , NO2 and BC while for UADT the hazard ratios (95% confidence interval) were 1.15 (95% CI: 1.00-1.33) per 5 μg/m3 increase in PM2.5 , 1.19 (1.08-1.30) per 10 μg/m3 increase in NO2 , 1.14 (1.04-1.26) per 0.5 × 10-5 m-1 increase in BC and 0.81 (0.72-0.92) per 10 μg/m3 increase in O3w . We found no association between long-term ambient air pollution exposure and incidence of gastric cancer, while for long-term exposure to PM2.5 , NO2 and BC increased incidence of UADT cancer was observed
A cross-sectional analysis of factors associated with the teachable moment concept and health behaviors during pregnancy.
No full textEpidemiology of reported cases of leptospirosis in the EU/EEA, 2010 to 2021.
No full textBackgroundLeptospirosis is a zoonotic disease caused by bacteria of the genus Leptospira. Humans are infected by exposure to animal urine or urine-contaminated environments. Although disease incidence is lower in Europe compared with tropical regions, there have been reports of an increase in leptospirosis cases since the 2000s in some European countries.AimWe aimed to describe the epidemiology of reported cases of leptospirosis in the European Union/European Economic Area (EU/EEA) during 2010-2021 and to identify potential changes in epidemiological patterns.MethodsWe ran a descriptive analysis of leptospirosis cases reported by EU/EEA countries to the European Centre for Disease Prevention and Control with disease during 2010-2021. We also analysed trends at EU/EEA and national level.ResultsDuring 2010-2021, 23 countries reported 12,180 confirmed leptospirosis cases corresponding to a mean annual notification rate of 0.24 cases per 100,000 population. Five countries (France, Germany, the Netherlands, Portugal and Romania) accounted for 79% of all reported cases. The highest notification rate was observed in Slovenia with 0.82 cases per 100,000 population. Overall, the notification rate increased by 5.0% per year from 2010 to 2021 (95% CI: 1.2-8.8%), although trends differed across countries.ConclusionThe notification rate of leptospirosis at EU/EEA level increased during 2010-2021 despite including the first 2 years of the COVID-19 pandemic and associated changes in population behaviours. Studies at (sub)national level would help broaden the understanding of differences at country-level and specificities in terms of exposure to Leptospira, as well as biases in diagnosis and reporting
Ex ante analyse Nationaal Programma Landelijk Gebied: provinciale programma's en rijksmaatregelen
No full textRisicobeoordeling van kruidenpreparaten met Huperzia serrata
No full textHerbal preparations (food supplements) containing extracts of the herb Huperzia serrata are sold in the Netherlands. These herbal preparations are mainly available online. According to the manufacturers, Huperzia serrata can support memory and improve concentration. Herbal preparations containing this herb turn out to be harmful to human health. RIVM advises consumers not to use herbal preparations with Huperzia serrata, especially during pregnancy. The number of people using such products is not known. People can experience acute undesirable effects on the cholinergic system. Examples include increased salivation, muscles weakness, abdominal cramps, diarrhoea, blurred vision, lacrimation and paralysis. There are also indications that Huperzia serrata is harmful to the unborn child during pregnancy. These health effects can already occur when people take the advised dose. The effects are caused by constituents of Huperzia serrrata, of which huperzine A is most studied. People using herbal preparations with Huperzia serrata extract ingest enough huperzine A to experience the harmful effects. No information is available on other constituents in Huperzia serrata, apart from an indication that eight compounds, other than huperzine A, may also inhibit the enzyme acetylcholinesterase. It is therefore possible that these eight compounds can enhance the effect of huperzine A.In Nederland worden kruidenpreparaten (voedingssupplementen) met extracten van het kruid Huperzia serrata verkocht. Deze kruidenpreparaten zijn vooral online verkrijgbaar. Volgens fabrikanten kan Huperzia serrata het geheugen ondersteunen en de concentratie verbeteren. Kruidenpreparaten met dit kruid blijken schadelijk te zijn voor de gezondheid. Het RIVM adviseert consumenten daarom geen kruidenpreparaten met Huperzia serrata te gebruiken, vooral niet tijdens de zwangerschap. Het is niet bekend hoeveel mensen dit product gebruiken. Mensen kunnen last krijgen van wat we noemen acute ongewenste effecten op het cholinergische systeem. Voorbeelden daarvan zijn meer speekselproductie, zwakke spieren, buikkrampen, diarree, wazig zicht, tranende ogen en verlamming. Er zijn ook aanwijzingen dat Huperzia serrata schadelijk is voor het ongeboren kind tijdens de zwangerschap. Deze gezondheidseffecten kunnen al ontstaan als mensen de aanbevolen hoeveelheid gebruiken. De effecten worden veroorzaakt door de stoffen in het kruid; huperzine A is daarvan de meest onderzochte stof. Mensen die kruidenpreparaten met Huperzia serrata gebruiken, krijgen genoeg huperzine A binnen om schadelijke effecten te kunnen ervaren. Over andere stoffen in Huperzia serrata is geen informatie bekend, behalve een aanwijzing dat acht stoffen, net als huperzine A, de werking van het enzym acetylcholinesterase remmen. Daarom is het mogelijk dat deze acht stoffen het effect van huperzine A kunnen versterken
Effectiveness and considerations of legionella control methods applied in premise plumbing systems
No full textIn leidingwaterinstallaties kunnen legionellabacteriën zitten. Mensen kunnen een longontsteking krijgen als ze deze bacteriën inademen, vooral boven de 60 jaar en rokers. In Nederland worden daarom verschillende technieken gebruikt om mensen zo min mogelijk aan deze bacteriën bloot te stellen. Het RIVM heeft op een rij gezet welke technieken dat zijn, hoe effectief ze zijn in de praktijk en welke aandachtspunten ze hebben. Dit is een vervolg op onderzoek uit 2012. Het onderzoek bevestigt de conclusies uit 2012 dat de effectiviteit van de techniek per locatie kan verschillen. Alle technieken werken in principe, maar of dat in de praktijk zo is hangt van verschillende omstandigheden af. Bijvoorbeeld van de manier waarop de leidingwaterinstallatie is aangelegd en wordt onderhouden. Ook moet de techniek zelf goed worden gebruikt en onderhouden. Voorbeelden van technieken in Nederland zijn: automatische spoelsystemen (thermisch beheer), membraanfilters en UV-lampen (fysisch beheer) en koper/zilver-ionisatie (elektrochemisch beheer). Nieuw ten opzichte van 2012 is dat in Nederland chloor aan het leidingwater mag worden toegevoegd (chemisch beheer). Het voordeel van chloor is dat het Legionella in de hele leidingwaterinstallatie kan doden. Regelmatig spoelen is belangrijk om voldoende chloor in alle leidingen te hebben. Nadeel is dat legionellabacteriën er resistent tegen kunnen worden als het lang wordt gebruikt. De techniek werkt dan minder goed. Ook kunnen bij het gebruik van chloor schadelijke stoffen in het water ontstaan. Vanwege de nadelen van het gebruik van biociden adviseert het RIVM om in de regelgeving duidelijker aan te geven onder welke voorwaarden chemisch en elektrochemisch beheer mag worden gebruikt. Het RIVM adviseert om deze technieken alleen in prioritaire locaties toe te staan, zoals sauna's en ziekenhuizen. Ook zouden adviseurs die de beheersplannen maken duidelijker moeten aangeven waarom het aantal legionellabacteriën niet op een andere manier kan worden beperkt. De Inspectie Leefomgeving en Transport (ILT) kan dan beter toetsen of de (elektro)chemische techniek terecht mag worden gebruikt.Premise plumbing systems may contain Legionella bacteria. People can get pneumonia if they inhale these bacteria, especially people aged 60 years or older and smokers. In order to prevent exposure to these bacteria several control methods are used in the Netherlands. RIVM (National Institute for Public Health and the Environment) listed which methods are used, how effective they are in practice and which points should be taken into account when applying them. This is a follow-up to research from 2012. This study confirms the conclusions from the 2012 report that the effectiveness of the method can differ per location. All methods work in principle, but this does depend on various circumstances. For example, the way in which the premise plumbing system is constructed and maintained can be crucial. The technique itself must also be applied and maintained properly. Examples of methods applied in the Netherlands are: automatic flushing systems (thermal control), membrane filters and UV lamps (physical control) and copper/silver ionization (electrochemical control). New compared to 2012 is that chlorine is now allowed to be added to the premise plumbing system in the Netherlands (chemical control). The advantage of chlorine is that it can kill Legionella throughout the entire plumbing system. It is important to flush regularly to ensure there is sufficient chlorine in every part of the plumbing system. However, the Legionella bacteria may become resistant to chlorine over time, resulting in loss of effectiveness. The use of chlorine can also produce harmful substances in the water. RIVM recommends that regulations indicate more clearly under which conditions chemical and electrochemical control techniques may be used. RIVM advises to only allow these techniques to be used in priority locations, such as saunas and hospitals. Certified advisors who draw up management plans should also substantiate more clearly why the number of Legionella bacteria can only be limited if a (electro)chemical technique is used. This allows the Human Environment and Transport Inspectorate (ILT; competent authority) to better assess whether these control technologies can be installed