• Q fever: the answer is blowing in the wind : Detection of Coxiella burnetii in aerosols

      de Bruin A; van der Plaats R; Janse I; van Rotterdam B; LZO; cib (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2011-10-25)
      Coxiella burnetii is a bacterium that causes Q fever, a zoonosis that affects large numbers of both humans and animals. From 2007 to 2010, large outbreaks of Q fever were observed in a rural area in the Netherlands. In 2009, field studies were started to investigate if C. burnetii DNA can be detected in aerosols on and in the near vicinity of Q fever affected farms. In 2010, these studies were continued in two areas studied in 2009, in the provinces of Noord-Brabant and Zuid-Limburg, to investigate if C. burnetii DNA was still present in aerosols in these areas. In both areas, the C. burnetii DNA content in aerosols obtained in 2010 seemed to have declined in comparison to data of the same locations visited in 2009. These data are in agreement with the observed reduction in the number of reported Q fever cases in 2010 in comparison to 2009. Possible explanations for this decline could be the start of a mandatory vaccination campaign for small ruminants in 2009 and the culling of pregnant animals on Q fever affected farms that started at the end of 2009. This data will be used in future investigations, in which we will combine molecular detection and typing methods for C. burnetii in aerosols with mathematical modelling to get more insight in the transmission of C. burnetii via aerosols and track (individual) sources for C. burnetii infection.
    • (Q)SARs for human toxicological endpoints: a literature search

      Hulzebos E; Schielen P; Masilankiewicz L; CSR; NVIC (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1999-02-01)
      Het doel van dit rapport is het beschrijven van humaan toxicologische SARs (structuur-activiteitsrelaties) die beschikbaar zijn in de literatuur alsmede de SARs die gebruikt worden door de US EPA (Environmental Protection Agency). De implementatie van het gebruik van SARs voor de effect assessment bij CSR is onderzocht. Structuur-activiteitsrelaties (SARs) correleren de moleculaire structuur met biologisch-chemische of fysisch-chemische activiteit. In kwantitatieve structuur-activiteitsrelaties (QSARs) zijn deze correlaties gekwantificeerd. De (Q)SARs worden grofweg verdeeld in "rule-based" SARs en statistische SARs. "Rule-based" SAR gebruikt vergelijkbare stoffen (verzameld in chemische klassen) die hetzelfde werkingsmechanisme hebben. Tevens worden beschrijvers (descriptoren) afgeleid voor dit werkingsmechanisme om het effect van andere vergelijkbare stoffen te voorspellen. De statistische SAR baseert zijn voorspelling op statistisch verkregen beschrijvers van meer heterogene groepen stoffen. De ontwikkeling van de SARs gedurende de jaren hebben beide typen SAR nader tot elkaar gebracht. De gevonden (Q)SARs hebben verder validatie nodig voordat ze gebruikt kunnen worden voor de effect assessment. De onderliggende QSAR methodologie kan geimplementeerd worden. Het voorspellen van het effect van een stof vergelijkbaar met een al eerder gevalueerde stof of een chemische klasse wordt gebruikt op een ad-hoc basis bij CSR. (Q)SAR methodologie, chemische klassen, SAR kenmerken zoals electronische effecten, zouden geimplementeerd moeten worden op een meer systematische manier om de expertise over SARs en om de helderheid van de effect assessment te vergroten.
    • (Q)SARs for human toxicological endpoints: a literature search

      Hulzebos E; Schielen P; Masilankiewicz L; CSR; NVIC (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1999-02-01)
      The goal here was to describe human toxicological SARs (structure-activity relationships) available in the literature and used by the US EPA (Environmental Protection Agency). The CSR laboratory investigated implementation of SARs for the effect assessment. SARs correlate the molecular structure with biological-chemical or physico-chemical activity. These correlations are quantified in quantitative structure-activity relationships (QSARs). The (Q)SARs described are roughly divided into rule-based SARs and statistical SARs. The rule-based SAR uses similar chemicals (collected in chemical categories) having the same mechanism of action and descriptors for this mechanism was to predict the effect of other similar chemicals. The statistical SAR bases its prediction on statistical derived descriptors of more heterogeneous groups of chemicals. The development of SARs during the years has brought the two types of SARs together. The QSARs found need further validation before they can be used for the effect evaluation. QSAR methodology can be implemented. Predicting the effect of a chemical similar to an already assessed chemical or chemical category is used at RIVM/CSR on an ad-hoc basis for effect assessment. (Q)SAR methodology, chemical categories, and SAR features such as electronic effects should be implemented more systemically; this will increase the expertise of using SARs and the transparency of the effect assessment.<br>
    • Q-koorts - ruimingen van besmette bedrijven : Evaluatieonderzoek onder geitenhouders

      van der Velden PG; Dusseldorp A; Drogendijk A; van Overveld A; IMG (Rijksinstituut voor Volksgezondheid en Milieu RIVMInstituut voor Psychotrauma, 2011-06-20)
      In an attempt to halt an outbreak of Q-fever in the Netherlands, many goats had to be killed. The majority of affected farmers judges positively on the procedures followed during the killing of their livestock and how they were treated. However, farmers have serious concerns about the future of their farms. They perceive the current situation as very stressful, for themselves as well as for their partners and children. Compared to non-affected cattle farmers, they more often suffer from serious symptoms of depression. Worries about the future and depression symptoms are strongly correlated. These conclusions are based on research carried out by RIVM and IVP, in order to provide the relevant ministries with information on how to deal with future outbreaks. During and after the crisis, the respondents felt most supported by people close to them (family, colleagues). One out of 5 owners of goat farms indicated to have a need for further support. In consultation with the target group, it could be pointed out which special issues could be improved. Special attention should be paid to financial issues and the barriers met by farmers in order to ask for professional support when needed. The research consisted of 63 interviews by phone of owners of infected farms, and 122 interviews with other cattle farmers. Questions were related to the procedures of the killing, financial situation, social support and (mental) health.
    • QMRAspot: a tool for quantitative microbial risk assessment for drinking water : Manual QMRAspot version 2.0

      Schijven J; Rutjes S; Smeets P; Teunis P; MLU; I&V (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2014-12-18)
      The RIVM has developed a user-friendly computational tool (QMRAspot) to calculate the risk of becoming infected by pathogenic microorganisms in drinking water. This report is a manual in which it is explained how QMRAspot (Quantitative Microbial Risk Assessment from surface water to potable drinking water) can be used, and what the underlying models are. The tool is mainly aimed at pathogenic microorganisms in drinking water produced from surface water. The manual applies to the most recent tool version (2.0, September 2014). The Dutch drinking water companies that produce drinking water from surface water and groundwater are obliged by law to demonstrate that less than one per then thousand persons per year acquire an infection by consumption of unboiled drinking water. QRMAspot was originally developed for the Netherlands, but can be applied worldwide by drinking water companies, researchers and policy makers. This manual describes in detail how data for the risk assessments can be provided, how these data are analysed statistically, and how the risk assessments can be conducted in a consistent and transparent manner. In addition, two frequently occurring applications of QMRAspot are discussed. The first application demonstrates the effect on the infection risk of a high contamination at locations where the drinking water companies abstract surface water. The second application demonstrates to what extent one single sample, in which microorganisms were detected, contributes to the infection risk.
    • Quality and safety of products containing Ephedra Herba on the Dutch market

      Lake OA; Slijkhuis C; Maas WF; Vliet MEA van; Kaste D de; Verdonk-Kleinjan W; Keuringsdienst van Waren, regio Zuid; LGO (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2001-11-26)
      Wij hebben analytisch onderzoek uitgevoerd op Ephedra herba bevattende voedingssupplementen en smartshop producten op de Nederlandse markt. Dergelijke producten worden gepresenteerd als 'natuurlijke, plantaardige' producten en vallen niet onder de Nederlandse wetgeving voor geneesmiddelen. Het grootste deel van de monsters onderzocht in de periode 1993 - 1999 bevatte onaanvaardbaar hoge gehalten aan efedrine (EP) alkaloiden (de actieve bestanddelen van Ephedra herba) in vergelijking met de veiligheidsnormen in de literatuur. Sommige monsters bevatten ook een stof die de werking van de efedrine-alkaloiden potentieert (o.a. coffeine), wat een vergroot veiligheidsrisico betekende. Zowel monsters 'van plantaardige oorsprong' als van synthetische oorsprong werden aangetroffen, en de gehalten aan EP alkaloiden varieerden, zowel van product tot product als van charges binnen 1 product. Momenteel zijn de mogleijkheden om veiligheid en kwaliteit van dergelijke producten op de Nederlandse markt te verbeteren beperkt; de nationale wetgeving biedt hiertoe geen duidelijke mogelijkheden. Niettemin blijkt uit dit onderzoek de noodzaak tot verbetering, ten behoeve van de volksgezondheid.
    • Quality and safety of products containing Ephedra Herba on the Dutch market

      Lake OA; Slijkhuis C; Maas WF; van Vliet MEA; de Kaste D; Verdonk-Kleinjan W; LGO (Rijksinstituut voor Volksgezondheid en Milieu RIVMKeuringsdienst van Warenregio Zuid, 2001-11-26)
      We performed analytical studies on dietary supplements and smart products containing Ephedra herba on the Dutch market. Such products are labelled 'from natural, herbal sources' and do not fall under Dutch Medicines Act. Most of the samples tested from 1993 to 1999 contained unacceptably large amounts of ephedrine (EP) alkaloids (the active substances of Ephedra herba) in relation to the safety criteria in the literature. Some samples also contained an effect-enhancing substance (e.g. coffeine), thus potentiating the risks of adverse events. Samples both 'from herbal sources' and 'not from herbal sources' were encountered, and the contents of EP alkaloids varied from product to product, as well as within a product. This project shows that there is a need to improve the safety and quality of these products in view of public health.<br>
    • Quality and the future. Sustainability outlook. Summary

      Heiligenberg H van den; Netherlands Environmental Assessment Agency = Milieu- en Natuurplanbureau MNP - RIVM; NMD; ECN; GLOBUS; LEI; TELOS; TNS-NIPO; UvA (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2005-03-30)
      Duurzaamheid gaat over de vraag of de huidige ontwikkeling van de wereld kan worden voortgezet. Het antwoord is afhankelijk van maatschappelijke opvattingen over de kwaliteit van leven en de verdeling ervan over de wereld en van wetenschappelijke inzichten in het functioneren van het maatschappelijk en het natuurlijk systeem.
    • Quality and the future. Sustainability outlook. Summary

      Heiligenberg H van den (eds); NMD; ECN; GLOBUS; LEI; TELOS; TNS-NIPO; UvA (Netherlands Environmental Assessment Agency = Milieu- en Natuurplanbureau MNP - RIVM, 2005-03-30)
      The quest for sustainability is about the quality of life and the possibilities for maintaining this quality in the future. The extent to which this quest is fulfilled will depend both on the public opinion with respect to the desired quality of life and the distribution of this quality of life across the globe (reflected in four world views), and the scientific understanding of the functioning of humans and natural systems. The intention of this sustainability outlook then is to contribute to an ensuing public debate on the sustainability issue, through analysis of societal values and scientific insights.
    • Quality and usefulness of (extended) Safety Data Sheets

      Marquart H; Puijk I; Mulder E; Theodori D; NAT; M&V (Rijksinstituut voor Volksgezondheid en Milieu RIVMTNO Triskelion, 2014-08-29)
      The safety data sheet (SDS) is the main instrument for providing information on the safe use of chemical substances and mixtures to professional and industrial users. The REACH legislation is the current legal basis for the SDS in Europe. For registered substances in quantities of 10 tons or more per year per registrant, registrants should also describe the various relevant exposure scenarios ("ES"), and annex them to the SDS. ES are required for all identified uses that can lead to exposure. ES are further required for substances that meet the criteria of article 14 (4) of REACH or are identified as PBT or vPvB. For each ES relevant operational conditions (OC) and risk management measures (RMM) need to be described that are necessary for safe use. Such a requirement does not apply to mixtures of chemicals. However, the information from the exposure scenarios of the substances in the mixture must be somehow incorporated in the SDS of the mixture. The abbreviation "(e)SDS" in this report is used for all types of SDSs with or without exposure scenarios. To verify various field signals of poor quality and because employers use the (e)SDS as a primary source of information to meet their OSH-obligations, the Dutch Labor Inspectorate (I-SZW) commissioned a systematic review of 50 (e)SDS collected during a REACH enforcement project from 2012. These are (e)SDS that the inspectors, based on a quick scan, identified as showing certain shortcomings. The study was conducted by TNO Triskelion BV under the supervision of Bureau REACH and is intended as input into the discussion on possible further actions to improve the quality and usefulness of the (e )SDS. The results for the studied (e) SDS are summarized as follows. For nearly half of the concerned (e)SDS there were strong indications that they were not up to date. The problems identified were related to the use of the Dutch language and incomplete or no specifications on skin protection. In some (e)SDS that reported incompatibility with certain materials, no further specifications were given on how to avoid the associated risk. Inconsistencies were often found between section 7, section 8 and the annexed exposure scenarios and there were indications that the classification listed on the (e)SDS and the harmonized classification did not correspond well with each other, and there were discrepancies between the classification of substances as such or in mixture and the most common self-classification in the C & L Inventory. Likely routes of exposure were often not mentioned. Sometimes there were no ES for substances where we would have expected one. Some (e)SDS didn't even contain a registration number. A reason for this omission may be that the registration deadline is not yet met, but it may also point to a non-compliance. A third of the evaluated (e)SDS did not mention the OELin force and there were no DNELs mentioned. Also, appropriate technical measures were not reported in almost half of the studied (e)SDS. In some cases, these technical measures were mentioned in another section. For about two-thirds of the (e) SDS with exposure scenarios in the appendix, these exposure scenarios had a clear added value. A key notion is that the studied (e) SDS are selected as long as two years ago. The question is whether the conclusions presented here are still representative of the situation in the year 2014. ECHA has already deployed initiatives to improve the quality of the (e)SDS. We refer here to the exchange network for exposure scenarios ENES and the CSR / EV Roadmap that has resulted within the scope of ENES. These initiatives have been established by ECHA and implemented in collaboration with the industry and a number of interested countries. The relevant departments and Social Affairs Inspectorate from the Netherlands and Bureau REACH are involved in ENES and CSR / ES Roadmap. In addition, the Dutch government is carrying out a national project in cooperation with the industry that focuses on identifying and implementing solutions to the problems of SMEs with regard to the (e)SDS. The project runs until early 2015. The specific focus of the Dutch project is to make REACH more effective and more useful, especially for SMEs and in a manner that yields cost savings in the implementation of the REACH obligations. The report concludes with guidance for employers/ DU on how they can independently evaluate the quality and usability of an (e)SDS.
    • Quality Assurance and Quality Control for National Reference Laboraties for Detecting Residues in Biological Samples

      Schothorst RC; Ginkel LA van; Sterk SS; Stephany RW; ARO (1994-05-31)
      The presentation held at the first CRL workshop on Quality Assurance and Quality Control for National Reference Laboratories for Detecting Residues in Biological Samples together with the conclusions and recommendations are collected in this volume.
    • Quality Assurance and Quality Control of veal calf residue control programmes for clenbuterol in the Netherlands

      Bos M; Ginkel LA van; Stephany RW; ARO (1995-11-30)
      Description of the results of a Quality Control programme for the analysis of biological samples for the presence of residues of beta-agonists, focusing on the determination of clenbuterol. Four Dutch Laboratories, three participating in the official National Residue Control Programme and one being the official control laboratory for the Foundation for Quality Guarantee of the Veal Calf Sector (SKV) participate in this programme. From the results it is concluded that this group of laboratories produces results that are qualitatively and quantitatively in good agreement. Both the within laboratory variability and between laboratory variability are acceptable.
    • Quality Assurance by CRL-Salmonella of the serotyping of isolates obtained from the 'Baseline study on the prevalence of Salmonella in slaughter pigs in the EU Member States' (2006-2007)

      Mooijman KA; Veenman C; Maas HME; LZO (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2008-12-31)
      From October 2006 up to October 2007 a 'Baseline study on the prevalence of Salmonella in slaughter pigs' was carried out in all European Member States. A selection of the Salmonella isolates found by the National Reference Laboratories in each Member State was sent to the Community Reference Laboratory for Salmonella (RIVM, Bilthoven, the Netherlands) for quality assurance of the serotyping. This letter report summarises the results of the quality assurance.
    • Quality Assurance Procedures and Good Laboratory Practices (GLP) Guidelines

      Strik JJTWA (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1988-01-31)
      Compilatie van de regels voor kwaliteitsborging en GLP wordt gegeven aan de hand van praktische punten. Definities van deeldoelen van GLP worden beschreven.<br>
    • Quality control of antacid preparations: Up-dating the RIGO-method using standard USP dissolution test apparatus

      van Riet-Nales DA; van Aalst P; de Kaste D; Derks HJGM; LGO (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 1998-10-09)
      In 1976, literature showed that antacid efficacy was dependent on speed of neutralization, maximum pH reached and duration of effect, whereas a pharmacopoeial test procedure which took account of these criteria was missing. Therefore, RIGO developed an in-vitro test procedure for antacid activity (including specifications) which took these criteria into account. The Medicines Evaluation Board in the Netherlands (MEB) decided that the efficacy of an antacid preparation was deemed to be sufficient, if the antacid met the RIGO-specifications using the RIGO-method. This policy is still valid because a pharmacopoeial test procedure which takes these three criteria into account is still not developed. However, the RIGO-method needs to be evaluated in the light of current scientific knowledge and there is a growing need for European support of the policy mentioned because of recently introduced central and decentral registration procedures. Since the RIGO-method uses non- commercially available apparatus, it was investigated whether the RIGO-method could be standardized using the USP dissolution test apparatus. The USP-apparatus appeared to be a good alternative. The newly developed (and validated) test procedure is a good starting point for a European pharmacopoeial test procedure for antacid activity.<br>
    • Quality control parameters of Dutch Down's syndrome screening laboratories 2010

      Schielen PCJI; LIS; cib (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2012-10-29)
      This is the second report on the performance of Dutch screening laboratories pertaining to Down's syndrome screening. Data were kindly provided by the seven screening laboratories, and the evaluation was performed at the RIVM (housing the reference laboratory). The main purpose of this evaluation was to provide the annual (2010) number of screening tests (50,494), the participation rate of the pregnant population (26.8%), the median age of the participating pregnant women (32-33.5 years) and to give an impression of the proportion of high risk results for several regions (AMC-laboratory; 7.6%, RIVM-laboratory; 4.7%, VUMC laboratory; 7.2% and Rijnstate and MUMC laboratory; 5.9%). As was the case in 2009, there was a notable difference in the gestational age at blood sampling (at about 10 weeks in some regions and 12 weeks in others). The analytic performance was analysed by evaluating the concentrations of the serum parameters (pregnancy-associated plasma protein A; PAPP-A), the free ß subunit of human choriongonadotropin (fß hCG) and the nuchal translucency (NT) measurement and secondary parameters, showing that mostly, these parameters were according to quality standards during 2010. As data of two other quality control programmes - that all laboratories participate in - were also according to standards, we conclude that no major problems occurred in 2010. Recommendations based on the conclusions of this report include a thorough evaluation of the settings of risk estimation software and an evaluation of the detection rates and false positive rates for Down syndrome, applying fixed targets for the evaluation. If possible, the evaluation will be performed using the national prenatal screening database, 'Peridos'.
    • Quality control parameters of the Dutch Down syndrome screening laboratories 2009 (2007-2008, when available)

      Schielen PCJI; LIS (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2012-04-02)
      This is the first report on the performance of Dutch screening laboratories with regard to Down's syndrome screening. Data were kindly provided by the seven screening laboratories and the evaluation was performed at the RIVM (housing the reference laboratory). The main achievement of this evaluation was to for the first time give the annual (2009) number of screening tests (48457), the participation of the pregnant population (25.7%), the median age of the participating pregnant women (32-33.5 years) and an impression of the proportion of high risk results for several regions (AMC-laboratory;6.3%, RIVMlaboratory; 4.8%, VUMC laboratory; 7.4% and MUMC laboratory; 5.4%). There were also notable differences in the gestational age at blood sampling (at about 10 weeks in some areas and 12 weeks in others). The analytic performance was analysed by evaluating the concentrations of the serum parameters (pregnancy-associated plasma protein A; PAPP-A), the free ß subunit of human choriongonadotropin (fß-hCG) and the nuchal translucency (NT) measurement and secondary parameters, showing that mostly, these parameters were according to quality standards during 2009. As data of two other quality control programmes that all laboratories participate in were also according to standards, we conclude that no major problems occurred in 2009. For the future, we will try to produce a more complete record of all performance indicators, possibly with the aid of a national database, 'Peridos'. Keywords:
    • Quality of the final rinse water for endoscope washer disinfectors. A literature review

      de Bruijn A; van Drongelen A; BMT (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2010-03-18)
    • Quality of the Gradko passive samplers in the MAN monitoring network

      Noordijk H; Braam M; Stolk AP; van Pul WAJ; Wichink Kruit RJ; MMK; MIL (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-10-16)
      The Ammonia Measurement Network in Nature Reserves (MAN) measures ammonia concentrations in the air at approximately 280 locations in nature areas as part of the Integrated Approach to Nitrogen (PAS). The concentrations are measured using Gradko passive samplers that are exchanged every month. These samplers have a number of important advantages: their compactness, inconspicuousness and simple exchange. In addition, they are also cheaper than other commercially available samplers. A disadvantage, however, is that Gradko samplers are less accurate than other more expensive passive samplers. To overcome this disadvantage, the Gradko samplers in the MAN are calibrated every month to six reference instruments from the National Air Quality Monitoring Network located across the Netherlands in regions with varying pollution levels. In this report, the quality of the Gradko passive samplers is investigated before and after the performed calibration. Without calibration, the measurements of the Gradko samplers are systematically too high, especially in the low concentration range. After calibration, this systematic difference is eliminated. The calibration procedure also corrects the observations for meteorological influences, which reduces noise in the measurements. The accuracy of the calibrated Gradko measurements is very similar to the accuracy of various other low-cost measurement techniques. Because the measurement locations are in public areas and the MAN makes use of the efforts of volunteers and site managers, the simple and robust design of the Gradko samplers is perfectly suited for application in Dutch nature reserves.