RIVM Publications Repository

Each year the Dutch National Institute for Public Health and the Environment (RIVM) produces numerous reports and publications on all aspects of public health, nutrition and food, health care, disaster management, nature and the environment. 
In addition, RIVM employees publish scientific articles in national and international journals.

Elk jaar brengt het Rijksinstituut voor Volksgezondheid en Milieu (RIVM) talloze rapporten en adviezen uit over volksgezondheid en gezondheidszorg, voeding, natuur en milieu en rampenbestrijding. 
Daarnaast publiceren RIVM-medewerkers wetenschappelijke artikelen in (inter-)nationale tijdschriften.

We are constantly working to improve the Repository. Please contact our administrator if you have any further questions or remarks. 

Recent Submissions

  • PublicationMetadata only
    Soil health indices in disagreement: A systematic review and comparison of soil health assessment methods
    (2026-05-04) Zwaan, RE; Verwijmeren, M; Rutgers, M; Swart, E; Schoffelen, N; Moinet, GYK; Vazquez, C; Creamer, RE
    Soil health is commonly understood as the ability of soils to provide multiple ecosystem services such as primary production, climate mitigation, and water purification without meaningful trade-offs between them. Soil health is increasingly threatened by climate change and land management pressures, stressing the need to adequately assess and monitor it. However, soil health remains a conceptual term, with a wide array of quantification and interpretation approaches that create confusion, misapplication, and barriers to effective policy implementation. This paper identifies different methods of assessing soil health and makes a comparison between six representative assessment methods. To achieve this, we systematically reviewed 199 studies that cover a total of 212 soil health assessments. The methods of these assessments were categorized into a typology based on ten variables, which was subsequently analysed through clustering analysis. This clustering analysis identified four distinct groups of soil health assessments. For the comparison, Six representative assessment methods from three different clusters of soil health assessment were applied to a farm dataset of 87 sites. The analyses of the typology highlighted that soil health assessments conducted at smaller spatial scales typically express soil health as a single combined metric, whereas soil health assessments applied at larger spatial scales studies tend report separate scores for individual soil functions. The comparison of the six representative methods showed low agreement scores and poor correlations between selected soil health assessment methods. We conclude that soil health scores are not interchangeable across methodologies. In other words, different commonly used soil health assessment methods yield strongly contrasting results when applied to the same dataset. Further we noticed that the objective and approach for soil health assessments are often poorly documented. We caution against the use of aggregated soil health or multifunctionality metrics, as these methods obscure important trade-offs between different soil functions. We propose two distinct objectives for soil health assessment: 1. local soil function assessment and 2. broad-scale soil health evaluation and offer practical recommendations for selecting suitable methods aligned with these goals.
  • PublicationMetadata only
    Acute hepatitis B infection escaping vaccination: A case report
    (2026-05-29) Leonhard, Sonja E; Fioole, Daphne N; Benschop, Kimberley SM; Willems, Roel PJ; Petrignani, Mariska; Voordouw, Bettie CG; Smeets, Leonard C; Zaaijer, Hans L
    RATIONALE: Hepatitis B virus (HBV) is an important cause of acute and chronic infectious hepatitis globally. Vaccines against HBV are widely available and generally lead to lifelong protection against chronic infection, disease, and infectivity. Vaccine failure, in which a person fails to form sufficiently high antibody titers, occurs in 5% to 10% of the population. Vaccine failure due to mutations in the virus, enabling vaccine escape, on the other hand, is very rare. PATIENT CONCERNS: A 72-year-old man presented with heartburn complaints. In clinical examination, an enlarged liver was found, and subsequent testing showed abnormal liver function. He was fully vaccinated against HBV. DIAGNOSES: Positive test results for hepatitis B surface antigen, immunoglobulin G and immunoglobulin M antibodies against hepatitis B core antigen, and antibodies against hepatitis B e and surface antigen were found. HBV DNA was positive (14,000 IU/mL). These results indicated an acute HBV infection. INTERVENTIONS: A rare mutation in the S-gene of HBV, D144A, was found. OUTCOMES: The patient recovered without treatment. LESSONS: We describe a case of acute HBV infection in a fully vaccinated person with high post-vaccination titers due to a rare mutation in the S-gene of HBV, which has previously been associated with vaccine escape. We describe the epidemiology of such mutations and the public health consequences of discovering such a strain in the community.
  • PublicationMetadata only
    Decreased chlamydia notifications in six European Union/European Economic Area countries and England, 2024
    (2026-05) Astorga Alsina, Ana Martina; Gomes Dias, Joana; Adlhoch, Cornelia; Nerlander, Lina; Olsen, Anne Olaug; Igoe, Derval; Hiltunen-Back, Eija; Lyons, Fiona; Velicko, Inga; O'Donnell, Kate; Folkard, Kate; Crawford, Katerina; Liitsola, Kirsi; Visser, Maartje; Wessman, Maria; Neary, Martha; Ferguson, Miranda; Puolakkainen, Mirja; Hoffmann, Steen; Pedersen, Thomas Roland; Hannila-Handelberg, Tuula; Mårdh, Otilia
    Over the last decade, bacterial sexually transmitted infection notifications have increased across the European Union/European Economic Area (EU/EEA) and England. However, six EU/EEA countries - Denmark, Finland, Ireland, the Netherlands, Norway and Sweden - and England, reported declines in chlamydia notifications from 2023 to 2024. To explore potential drivers of these decreases, the European Centre for Disease Prevention and Control, together with experts from the seven countries, analysed national surveillance data from 2015 to 2024 and contextualised findings with information on testing practices, policies and public health interventions. Chlamydia notifications in 2024 were compared with expected counts based on trends before the COVID-19 pandemic (2015-2019) using a negative binomial model. Across countries, decreases between 2023 and 2024 ranged from 13% to 19%, primarily affecting 15-24-year-olds. Case numbers fell below the 95% prediction interval in three countries. Five countries reported reduced testing volumes among young people, and all observed lower positivity rates. Some countries implemented online testing and targeted sexual health promotion campaigns. Although reduced testing, changes in behaviour during the COVID-19 pandemic and the risk profile of those accessing testing may have contributed to the declines, further investigation into underlying drivers is necessary to inform sexual health strategies in Europe.
  • PublicationMetadata only
    Host-microbial interactions at the nasal mucosa in young children and adults: A retrospective, cross-sectional study
    (2026-05-21) Reiné, Jesús; King, Lisa A; Singh, Youvika; de Steenhuijsen Piters, Wouter AA; Carniel, Beatriz F; Solórzano, Carla; Mitsi, Elena; Pojar, Sherin; Nikolaou, Elissavet; German, Esther L; Blizard, Annie; Marcon, Fernando; Marques, Alexandre HC; Voskamp, Astrid L; Chu, Mei Ling; Hasrat, Raiza; Hill, Helen; Hales, Caz; Brown, Lynsey; Horsley, Victoria; Hughes, Lisa P; Zaidi, Seher R; Connor, Victoria; Morton, Ben; Collins, Andrea M; Rylance, Jamie; Adler, Hugh; Smits, Hermelijn H; Mahfouz, Ahmed; McNamara, Paul S; Nakaya, Helder I; Bogaert, Debby; Ferreira, Daniela M; Jochems, Simon P
    Young children are at increased risk for respiratory tract infections and are frequently colonized by respiratory pathogens. However, how the mucosal immune system differs between children and adults is relatively unknown. We collected nasal samples from 50 young children (aged 1-5 years) and 318 young adults (aged 18-34 years) to study how the mucosal immune system and host-microbe interactions differ with age. We used multi-omics data integration to combine host (immunophenotyping, transcriptomic, and cytokines) and microbial (16S-rRNA amplicon sequencing, viral PCRs, and pneumococcal culture) datasets. Young children had a paucity of mucosal granulocytes, while B and T cell subsets were increased. Children also had increased immune activation and inflammation, which associated with the presence of Haemophilus spp. and pneumococcus, but not viruses. In adults, Haemophilus spp. associated with T cell and monocyte recruitment, while Dolosigranulum negatively associated with neutrophil degranulation. Thus, nasal immune composition and host-pathogen interactions were clearly age dependent.
  • PublicationMetadata only
    Induction of Salivary IgA and IgG Responses by Parenteral PPV23 Vaccination in Older Adults
    (2026-05-04) Visser, Maxime; Tcherniaeva, Irina; de Rond, Lia; de Zeeuw-Brouwer, Mary-Lène; Verschuren, Monique WM; Picavet, Susan HSJ; de Jonge, Marien I; den Hartog, Gerco; Buisman, Anne-Marie
    Mucosal immunity restricts colonization, thereby reducing the risk of transmission and disease. This is the first study to demonstrate that parenteral 23-valent pneumococcal polysaccharide vaccine (PPV23) vaccination induces salivary IgA and IgG responses in older adults, aged 72-79, an age group at increased risk for pneumococcal disease.
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