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Wachtlijstontwikkelingen in de verstandelijk gehandicaptenzorg - technische achtergrondrapportage(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2000-09-01)Dit rapport is een vervolg op een eerder verschenen publicatie (nr. 432506002) en gaat in op de technische achtergrond van een model van de wachtlijst voor wonen in de zorg voor verstandelijk gehandicapten. Het rapport beschrijft de modelstructuur, de analyse van de gegevens, het uitvoeren van parameterschattingen en onzekerheidsanalyse en geeft tevens de resultaten in detail. Het model is een recursief niet-lineair model. De bezetting van de wachtlijst en de instellingen, de in- en uitstroom van de wachtlijst en de sterfte en ontslag uit instellingen wordt geslacht-, leeftijd- en handicapspecifiek berekend. Een onzekerheidsanalyse is uitgevoerd in de vorm van parametervariaties met behulp van de Monte Carlo techniek. Het model is gevoelig voor de instroom in de wachtlijst, maar met name voor de uitstroom naar een 'overige' zorgvorm. Om meer betrouwbare modelberekeningen te maken is het noodzakelijk dat er meer volledige en betrouwbare gegevens beschikbaar komen. Het ontbreken van handicapspecifieke getallen in de wachtlijstregistratie en het feit dat realisaties niet adequaat worden teruggekoppeld naar de wachtlijstregistratie heeft de parameterschattingen bemoeilijkt. Het invoeren van een uniek clientennummer in de zorg zou het koppelen van deze registraties en de constructie van een wachtlijst-stroommodel aanzienlijk vereenvoudigen.
Meten van verloren arbeidsjaren door ziekte: Disease-Adjusted Working Years (DAWY). Verkenning van een nieuwe maat(Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2010-04-15)RIVM provides a new model by which it is possible to show the impact of diseases on the productivity of employees. The outcome of the model is health-related loss of working years. This is measured in Disease-Adjusted Working Years (DAWY). Causes of loss of working years are sickness absence, disability and health related productivity loss at work. The new measure enables us to quantify in one figure the consequences of various diseases on loss of working years and in this way to compare them. The ministry of Social Affairs and Employment asked the RIVM to explore the possibilities for a new model. Developing such a model turns out to be possible. The RIVM describes a base model to calculate DAWYs. By means of the example of back complaints it demonstrates the (im)possibilities of calculations of loss of working years caused by disease or unfavourable working conditions. Up till now there has not been a model that combines in one figure the different forms in which working years can get lost. For public health, such a model exists in the form of the burden of disease model, expressed in Disability-Adjusted Life-Years (DALY). The DALY provides insight in the consequences of diseases on health and life expectancy in one figure. The DALY does not provide any insight in the effects of diseases and work-related risk factors on the productivity of employees.
Prognose Milieu-effecten Duurzaam Bouwen(1999-11-30)The Ministry of Housing, Spatial Planning and the Environment commissioned the RIVM to assess the environmental effect of the policy measures for sustainable construction, for the period 1995 - 2020. This study assesses the environmental effects of technical measures for the reduction of energy use, water use and the use of materials in existing and new dwellings and utility buildings. Two models have been developed, one for dwellings and one for utility buildings (only for the sectors health, education, offices and retail trade). With these models technical measures of the National Packet Sustainable Building for the reduction of energy, water use and the use of materials in existing and new dwellings and buildings can be assessed. Behavioral changes have not been included in the models. In order to calculate the effects the measures with regard to sustainable construction have been equipped with penetration scenarios. These penetration scenarios are explicated in consultation with experts (in the fields of policy and construction). For the dwellings in the Netherlands a reduction of energy use for space heating with approximately 15% is calculated. As a result the CO2-emission related to space heating will also decline. In utility buildings the energy use per m2 gross ground area will decline. As a result of the increase in ground area for most of the sectors in utility buildings the energy use (and the resulting CO2-emission) will be stable. The reduction of water use in dwellings is much larger than in utility buildings. This is a result of the much larger possibilities of water reduction in dwellings as compared to utility buildings. The reduction of material use has also been assessed in the prognosis. In the near future environmental profit will be gained in the recycling of materials for buildings, for instance for shingle, gypsum and PVC. In the reduction of harmful emissions, for instance for volatile organic compounds and heavy metals. In the durable use and the reduction in use of non-renewable elements, for instance wood and tar products.
Indicatoren voor succesvolle implementatie van milieumaatregelen: een verkennend onderzoek(1991-05-31)It is the opinion of the Environmental Forecasting Bureau that in aid of the next environmental forecasts (like "Zorgen voor Morgen") more attention should be paid to management aspects. Particularly the implementation and enforcement of environmental policy are aspects that need to be high-lighted. Not paying attention to these qualitative aspects of environmental measures is within the Department of Environmental Quality recognized as a "white spot" which should be coloured in the near future. This report contains an extensive description of a problem exploring survey which examines the possibilities of the integrating management aspects into the scenario- activities of the Department of Environmental Quality. One main result of the survey is that only at a very high (indicative) abstraction level management aspects can be integrated into the scenario-activities. Tackling this issue at a low abstraction level within four months is nearly impossible because of its time-consuming enterprise. The survey also shows that modelling or quantifying behavioral aspects is very difficult. After an extensive description of tackling the issue at a low abstraction level, as a result of this problem exploring exercise, five simple indicators are found which could determine the speed of implementation and effectivity of an environmental measure. These indicators are: Complexity of the Management, Pressure on Management Capacity, Drasticality of the measure ofr the target group, Controlability of the measure and Influence (Power) of the Target group. the report ends with a description of these indicators, their inter- relationship and the possible application of these into the scenario- activities. The results of this problem exploring survey are not absolute results but can be interpreted as material for discussion.
Implementation of QSAR's in ecotoxicological risk assessments(2001-02-28)Quantitative Structure Activity Relationship (QSAR) modelling techniques are overviewed here, along with descriptors which can be used in QSAR equations and the different statistical methods suitable for deriving QSARs. Discussed is the current state of the art on the use of QSAR estimates within the different regulatory assessment frameworks of the Centre for Substances and Risk Assessment at the Dutch National Institute of Public Health and the Environment (RIVM/CSR). Special emphasis has been placed on environmental effect assesssments. Commonly accepted QSAR equations and software programs used in environmental exposure assessments are described. Generally accepted QSAR equations and other QSARs for environmental effects documented in the literature are presented in tabular form; compounds acting by non-polar narcosis, polar narcosis, reactive chemicals and chemicals with a specific mode of action are presented separately. Recently developed computerised QSAR programs are also overviewed. Several recommendations are made for the use of QSARs within RIVM/CSR risk/hazard assessment frameworks, with experiences related to routine application of QSARs in effect assessments to be evaluated and reported on within one year.