• Aan roken toe te schrijven productiviteitskosten voor Nederlandse werkgevers in 1999

      Jacobs-van der Bruggen MAM; Welte RA; Koopmanschap MA; Jager JC; CZO (Rijksinstituut voor Volksgezondheid en Milieu RIVMErasmus Universiteit RotterdamiMTA/BMG, 2002-06-17)
      The productivity costs to Dutch employers attributable to smoking are estimated here for 1999. Included are productivity costs (value of lost production) due to absenteeism, and disability and death of employees due to smoking. Costs associated with smoking breaks during working hours or early retirement were not included due to lacking data. Costs connected with a special organisation of the space in buildings, and garbage or fire due to smoking fall outside the scope of this report. Production loss due to smoking was estimated on the basis of published information on disease-specific relative risks of death applicable to smokers, as compared to non smokers, combined with national disease-specific data on absenteeism, disability and deaths. Considering that employees can be replaced, production loss is restricted to the period from absence to replacement, the friction period. In the primary analysis in this report we estimated productivity costs, assuming a friction period of 6 months. In a comparative analysis we estimated the same costs with a different method, where the estimate was based on direct costs to employers such as salary payment, costs for replacement, death benefits and increased insurance contributions, resulting from employee absence. In 1999, 1.9% absenteeism, 3.3% new disability and 22% deaths among employees could be attributed to smoking. The associated costs were estimated at 305 million Euro or 105 Euro per employed smoker. The estimate based on direct costs to the employer was comparable (both methods estimate the same costs, so the productivity costs and direct costs should not be added up). Considering that health hazards of smoking do not disappear immediately after stopping, the employer saves 27 Euro per year in the short term on an employee who stops smoking. The estimates are conservative because not all smoking-related diseases are included in the calculations. Furthermore, no costs were attributed to passive smoking. Apart from pointing out the advantages to health, employers can also promote a smoking stop for economic reasons.
    • Aanbod en bereikbaarheid van de spoedeisende ziekenhuiszorg in Nederland 2017 : Analyse gevoelige ziekenhuizen 2017

      Kommer GJ; Gijsen R; de Bruin-Kooistra M; Deuning C; KZG; VPZ (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2017-11-09)
      RIVM surveyed the supply and accessibility of hospitals in the Netherlands that provided emergency care in April 2017. This was also done for acute obstetrics. The results show that these hospitals are spread across the Netherlands in such a way that 99.8 percent of the residents can be transported to an emergency medical department (A&E) or hospital with acute obstetrics within 45 minutes, according to the accessibility model. In April 2017, there were 89 A&Es that were open 24/7. That is one less than in 2016 and two less than in 2014. Acute obstetrics was provided 24/7 at 81 hospital locations. That is the same as in 2016 and three less than in 2014. The locations of ambulance stations were also updated in the inventory. Since the last update in 2013, thirteen ambulance stations were added and some stations were relocated. This accessibility analysis looked at the distribution of hospitals throughout the Netherlands. The analysis determines how many hospitals are considered 'sensitive'. There are now ten sensitive hospitals with a 24/7 basic A&E. The accessibility analysis for acute obstetrics results in twelve sensitive hospitals. A hospital is designated as such if, according to the theoretic model, the number of residents that may take more than 45 minutes to be brought to an A&E increases when this hospital closes. The duration of the ride is calculated based on the time the ambulance requires to get from the station via the patient's residence to the hospital. This model-based ride time is then compared with the 45-minute distribution standard. This study also examined the presence and accessibility of, among others, specialists, nurses and facilities to make the diagnoses at the A&Es and start treatment. The collaboration between the A&Es and the out-of-hours GP services was also examined. In 42 cases, the 24/7 A&E and out-of-hours GP services were integrated, with a joint entrance and a procedure for people who report for emergency care with less urgent/complex complaints on their own initiative.
    • Aanbod van interventies gericht op het verbeteren van de voeding van ouderen

      van den Berg SW; de Bruin SR; Rompelberg CJM; Boer JMA; DCZ; V&Z (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2014-08-26)
      The Dutch National Institute for Public Health and the Environment (RIVM) has produced an inventory of interventions offered for example by local health authorities and health care institutions to help elderly people eat healthily. The inventory shows that only a limited range of interventions is available. Furthermore, the interventions do not address the practical problems that elderly people may experience when shopping for groceries or preparing a meal. The interventions are mainly aimed at preventing disease in community-dwelling elderly people, e.g. by educating them about a healthy diet. However, two-thirds of all people aged 65 and older already have one or more chronic diseases. In addition to these dietary interventions, there are other initiatives in place that offer practical support, such as a 'grocery bus' that drives elderly people to a supermarket. Such initiatives were not included in the inventory. There are indications that elderly people, health care providers, informal caregivers and local authorities are not sufficiently familiar with such facilities. RIVM recommends studying, promoting and increasing the visibility of these two types of dietary measures, which appear to be effective in practice. The Ministry of Health, Welfare and Sport may facilitate these efforts. Local authorities, health care providers and elderly people themselves can use the results of this inventory to gain insight into the interventions that are available. A proper diet is important for elderly people as it contributes to their health and ability to function, and thus to their quality of life. An insufficient or unhealthy diet may lead to elderly people becoming malnourished. This can result in diminished fitness and mobility and greater susceptibility to disease. Twelve percent of all community-dwelling elderly people are malnourished. This percentage increases to 35 percent among people receiving homecare. It is important for elderly people to remain self-reliant, in light of the Dutch government's policy to help them live at home for as long as possible.
    • Aandacht voor 'ageing' binnen de chemische industrie : Bedrijven over de risico's als gevolg van het verouderen van chemische installaties

      Geus ECJ; Kieskamp KK; ABI; VLH (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-07-10)
      Bij bedrijven die met chemische stoffen werken, kunnen incidenten ontstaan doordat installaties zijn verouderd. Dit aandachtspunt wordt in Nederland vaak benoemd met de Engelse terminologie: 'ageing of the process industry' of kortweg 'ageing'. Sinds 2015 zijn zogeheten Brzo-bedrijven (Besluit risico's zware ongevallen) verplicht om de veiligheidsrisico's die samenhangen met veroudering en corrosie van hun installaties in kaart te brengen en te beheersen. Vanaf 2017 besteden Brzo-inspectiediensten bij hun inspecties aandacht aan ageing van installaties. Als voorbereiding op de inspectie heeft het RIVM een enquête uitgezet om inzichtelijk te maken hoeveel aandacht Brzo-relevante branches besteden aan ageing. Van de zeventien benaderde brancheorganisaties hebben er negen inhoudelijk gereageerd. Uit de enquête bleek ten eerste dat ageing nog niet bij alle branches expliciet wordt meegenomen bij de beheersing van de risico's. Eind 2016 staan veel bedrijven nog aan het begin om ageing hierin mee te nemen. Bij de meeste brancheorganisaties wordt ageing wel intern besproken. Ten tweede blijken bedrijven verschillende definities van ageing te gebruiken. Bij de 'smallere' definitie gaat ageing alleen over materiaaldegradatie. De 'bredere' gaat niet alleen over het materiaaldegradatie zoals roest en slijtage, maar ook over het verouderden van de gebruikte technieken, procedures en kennis. De helft van de brancheorganisaties gebruikt de bredere. Inmiddels zijn verschillende initiatieven ondernomen om meer aandacht te krijgen voor ageing bij overheid en bedrijven.
    • Aandachtstoffen in het Nederlandse milieubeleid - Overzicht 1994

      Janus JA; Hesse JM; Rikken MGJ; van den Berg R; Canton JH; de Bruijn JH; Deelen A; Denneman CAJ; Diederen HSMA; van Duijvenbooden W; Faasen R; van de Gaag M; de Heer H; Hoube G; Janssens MA; Jonkeres DA; Krijgsheld KR; van Leeuwen FXR; van der Most PFJ; Noordam PC; Robberse JG; Ros JPM; Slooff W; Verweij W; van Zorge JA; ACT (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1994-11-30)
      This report contains an overview of "attention substances", substances placed on a list which is issued each year by the Minister of Housing, Physical Planning and Environment, according to section 22 of the Chemical Substances Act. The substances (or preparations) on that list are requiring special attention because of their possible risk to man or the environment. Attention substances include all priority substances. The main goals of the report are to provide background information for a research plan on these attention substances and to make recommendations for the removal of substances from the attention substances list, primarily on the basis of risk assessment. For each substance the report summarizes key data on emissions, actual environmental concentrations, current environmental quality objectives, and research activities (including national monitoring programmes). The risk assessment for each substance is based on a comparison of exposure levels and toxicological recommended levels (maximum permissible risk levels, "MTR" and negligible risk levels, "VR"). The latter is defined as 1% of the MTR. According to the environmental policy, a substance can be removed from the attention list when the environmental concentrations fall below the negligible risk levels.<br>
    • Aandachtstoffen Wet milieugevaarlijke stoffen (isobutanol, HCN, DBP, DOP en nikkel

      Koning CJM; Poel P van der; Ros JPM (1989-10-31)
      Abstract not available
    • Aandachtstoffen Wet milieugevaarlijke stoffen (koolstofdisulfide, 2- hydroxy-2-methylpropaannitril, dibutylftalaat, di(2-ethylhexyl)ftalaat, hexachloornaftaleen, Direct Red 39, kwik en kwikverbindingen, waterstoffluoride)

      Poel P van der; Ros JPM (1991-04-30)
      This report presents the results of the investigations carried out for 8 substances needing special attention ; in contrast to previous investigations for most substances no extended surveys were carried out. For 2 substances (DBP and DEHP) it concerned a second survey amongst users of these substances. This report presents the results in such a way that no confidential data supplied by the firms can be recognized. It is advized to remove the substances 2-hydroxy-2- methylpropanenitrile, hexachloronaphthalene and Direct Red 39 from the list of substances needing special attention. The other substances can stay on the list and surveys for them can be conducted in respect to the strategy which will be followed after the proposed revision.
    • Aanleg, migratie en proliferatie van primordiale kiemcellen bij de rat

      Kemper CH; Verhoef A; Peters PWJ (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1985-04-30)
      In deze studie wordt het ontstaan, de migratie en de proliferatie van de oerkiemcellen bij de rat bestudeerd. Deze gegevens zijn wel bekend bij de muis en waren tot nu toe niet onderzocht in de rat. Deze oerkiemcellen ontstaan buiten het embryo bij de basis van de allantois en migreren via het endoderm van de darm en het mesenchym naar de genitale plooien waar deze cellen op dag 13 post coitum arriveren, daardoor zijn kwalitatieve en kwantitatieve gegevens per dag verkregen. De primordiale kiemcellen zijn histochemisch aangetoond met een nieuw ontwikkelde methodiek. Deze gegevens zijn van in vivo en in vitro ontwikkelde embryo's.<br>
    • Aanpak van gescheiden rijbanen in SRM-1

      Wesseling J; Beijk R; LVM (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2008-07-31)
      Op verzoek van VROM DGM-LMV heeft het RIVM in de maanden februari tot en met maart een korte analyse gemaakt van de wijze waarop binnen Standaard Reken Methode 1 (SRM-1), ook wel bekend als'CAR-II', met meerdere rijbanen kan worden omgegaan. De technische aspecten van het rekenen met gescheiden rijbanen zijn vastgelegd in een notitie van het RIVM. De notitie, met daarin een globale probleemschets en een voorstel voor een rekenwijze is voor commentaar en bespreking rondgestuurd aan vertegenwoordigers van MNP, TNO, Goudappel-Coffeng en de gemeente Utrecht. Op 7 april 2008 heeft hierover bij het RIVM overleg plaatsgevonden. In verschillende bilaterale contacten is verder gesproken over de praktische uitvoerbaarheid van een mogelijke werkwijze. Het eindresultaat is uiteindelijk een laatste keer voor commentaar aan alle betrokkenen voorgelegd en vervolgens aan VROM doorgegeven. Dit briefrapport bevat de teksten van zowel het eindadvies aan VROM als de onderliggende notitie. Een lijst van betrokkenen is weergegeven in Bijlage A. In Bijlage B wordt een technische analyse van het rekenen met gescheiden rijbanen gegeven.
    • Aanpak van veldonderzoek bij gevallen van lokale bodemverontreiniging

      Duijvenbooden; W.van; Grootens; J.P.A.; Obdam; A.N.M.; Peeters; A.A.; Wever; D. (1985-01-31)
      Abstract not available
    • Aanschaf en introductie van medische technologie in het ziekenhuis

      de Bruijn ACP; van Drongelen AW; GMT; vgc (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2013-03-25)
      Large investment projects for the purchase of medical technology such as scanners, surgical robots, infusion pumps and patient monitors, can be improved. This is the finding of the RIVM evaluation of the purchase procedure for the above-mentioned medical technology in eighteen hospitals. More direction is needed to perform the necessary steps in the procedure, to ensure that a well considered purchase is made and that the medical technology is properly implemented. It was found that as the project progresses, procedural steps are omitted or taken less meticulously. A positive finding was that in all cases a list of criteria was drawn up. Focus points The study shows that less than half of the hospitals performed a risk analysis as part of the purchase procedure. Where a risk analysis was performed, it was not always used for the preparation of the list of criteria, the training of employees and the management of the equipment. A risk analysis identifies the potential risks that are associated with the use of the particular technology and the measures that can be taken to reduce these risks. The assignment of responsibility for the so-called 'release for use' should be improved. Release for use means that the performance of the device is evaluated at its location and that the users are properly trained. In addition to the initial training in the use of medical technology, attention should be paid to the maintenance of people's knowledge and skills. Furthermore, employees should also be sufficiently trained during a trial period. Finally, the purchase project should have a clear endpoint. In many cases, the project was not finalised with a concluding report.
    • Aansluiting MNP-instrumentarium bij de Vogel- en Habitatrichtlijn

      Hinsberg A van; Hoek DCJ van der; Esbroek MLP van; Noordijk H; Knegt B de; Veen MP van; Puijenbroek PJTM van; Knol OM; NLB (2005-02-04)
      The Netherlands Environmental Assessment Agency (MNP-RIVM) has started research aimed at setting up an information system to support the national policy on species and nature areas. Given the political importance, this system was to be focused on information related to the goals set in the European Bird and Habitat Directives (B.H.Ds). At present, the information system contains: 1) specific aims for all individual Dutch Natura 2000 sites protected under the B.H.Ds, 2) spatial information on the presence of B.H.D. species and habitats, measured or derived by statistical models, 3) historical trends (national or site-specific) found in the occurrence of the species, 4) relationships between the occurrence of species and environmental stress or lack of space. The system is based on current ecological instruments used by MNP-RIVM: available monitoring networks, ecological and environmental modelling tools, and ecological indicators. The instruments to evaluate B.H.D. goals were examined for suitability: bottlenecks and their solutions were then identified. The definition of goals for the EU directives related to "favourable conservation status" and the "significance of effects" are still under discussion and thus not yet operational. Until operation, the information system will focus on the occurrence and distribution of the species and habitats under concern as indicated in a recent document of the European Commission, since the decline of these will have to be avoided. The improved tools, together with the current instruments, will form a new information system. Potential applications of such information system are also presented in this report.
    • Aantonen van virussen in water: een vergelijking van de detectiegevoeligheid van de immunoperoxidase methode met de plaque overlay methode

      Theunissen JJH; Krebbers AHW; Medema GJ; MGB (1996-01-31)
      The testing of a method to increase the sensitivity of the current culture method used until now has been described. A sensitivity increase will lead to a better estimation of the virus content of surface water and to a better insight in measurements that should be taken to minimise the infection risk represented by drinking water or bathing water. In six out of 12 naturally contaminated water concentrates the virustiters found by the immunoperoxidase method appeared to be higher, in five out of 12 the titers were comparable and in one out of 12 the titer was lower than that found when the plaque overlay was used. The overall difference was not statistically significant. So the desired increase in sensitivity of the immunoperoxidase assay compared to the plaque overlay assay could not be realised. Due to the minimal increase in sensitivity combined with the smaller sample volume that can be processed, the immunoperoxidase method can only be used when analysing water concentrates with a virus content of at least 1 virus per milliliter.
    • Aanvullend milieutoxicologisch onderzoek aan effluent en ontvangend oppervlaktewater, Lokatie II

      Canton; J.H.; Guchte; C.van de*; Slooff; W.; Beenen; R.*; Oosterloo; W.*; Pols; H.* (1986-08-31)
      Abstract not available
    • Aanvullend onderzoek naar concentraties koper, chroom en arseen in luchtstof, bodem en gras bij houtverduurzamingsbedrijven in Nederland

      Mennen MG; Knol-de Vos T; Fortezza F; van de Beek ACW; Ritsema R; Piso S; Kliest JJG; LAC; IEM (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1998-11-02)
      Supplementary to the study on the emissions and concentrations of copper, arsenic and chromium in air near three wood preservation plants in the Netherlands, we measured concentrations of these elements in coarse dust particles near wood preservation plants. Measurements were taken near a stack of stored impregnated wood in a dry weather period when wind speeds were high. In addition, soil and grass samples, taken in the vicinity of two wood preservation plants, were analysed for copper, arsenic and chromium. Particle mass concentrations varied from 40 to 80 mug m-3, while concentrations of copper, arsenic and chromium were in the range of 5 to 50 ng m-3, which compares well with the results of the measurements in the previous study performed under wet weather and low wind-speed conditions. The concentrations in most of the soil and grass samples compared well with background levels in the Netherlands. This shows that dispersion and deposition of particles from the plants do not lead to detectable copper, arsenic and chromium contamination of the soil and grass near the plants, which is in agreement with the results of model calculations in the previous study. At one location, high copper, arsenic en chromium concentrations were found in the soil however, these appeared to result from earlier plant activity. The results of the additional air, soil and grass measurements confirm the conclusions of the previous study that both the health risks for residents in the surroundings and the contamination of the environment due to emissions from the wood preservation plants are low.
    • Aanvullend radiumonderzoek op twee met woningen bebouwde havenspeciepolders

      Stoop P; Hiemstra YS; Lembrechts JFMM; LSO (1995-02-28)
      This report contains the results of an investigation of radium contents of the soil at the locations Steendijkpolder-zuid, Maassluis (STPZ) and Woudhoek-noord, Schiedam (WH). The aim of this investigation is to determine whether the variation of the radium content within a harbour sludge polder with no topsoil (STPZ) is sufficient to enable quantification of the relation between the radium content of the soil and the radon concentration in dwellings. The second goal is to determine whether it is possible to determine the reduction factor of a topsoil (WH) for radon infiltration. The results show that in the STPZ the variation of the radium content within the polder is large enough to justify the expectation that corresponding variations in radon concentrations will be found. In WH the assess the effect of the topsoil, WH should be compared to another location.
    • Aanvullend serologisch onderzoek naar de immunogeniteit van in het RIVM bereid meningococcen groep A+C polysaccharide vaccin

      Nagel; J.; Beuvery; E.C.; Kanhai; V.; Zee; J.S.van der* (1985-09-30)
      Abstract not available
    • Aanvullende curatieve SOA-bestrijding. INSTRUCTIE GELDEND VANAF 1 JULI 2007. Versie 2, juni 2007

      BBA (Centrum voor Infectieziektebestrijding, 2007-12-07)
      Abstract not available
    • Aanvulling milieurisicogrenzen water voor negen sporenelementen. Afleiding volgens kaderrichtlijn water-methodiek

      van Vlaardingen PLA; Verbruggen EMJ; SEC (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2009-05-07)
    • De aanwezigheid van Legionella species in door drinkwater gevoede watersystemen in Nederland. Deel I. 48 pp. (ook los verkrijgbaar). Idem, Deel II (ADDENDUM) Chemische en bacteriologische analyse resultaten per onderzocht object. Technische informatie van de onderzochte systemen per object. (Alleen samen met deel I verkrijgbaar)

      van Kranen HJ (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1988-06-30)
      Legionella's werden geisoleerd uit warm watervoorzieningen, water van koeltorens, water van luchtbevochtigers en incidenteel uit drinkwater zelf. In 32% van de onderzochte objecten werden, uit water met een temperawtuur varierend van 6 graden C tot en met 59 graden C, legionella's geisoleerd overwegend (75%) in concentraties kleiner dan 10 c.f.u./ml. In deze objecten werden nergens gevallen van legionellose onderkend. De in dit onderzoek voor het eerst geconstateerde besmettingen van luchtbevochtigers met legionellae worden als ongewenst gekwalificeerd.<br>