• E-cigarette and waterpipe use in two adolescent cohorts: cross-sectional and longitudinal associations with conventional cigarette smoking.

      Treur, Jorien L; Rozema, Andrea D; Mathijssen, Jolanda J P; van Oers, Hans; Vink, Jacqueline M (2017-12-19)
      Alternative tobacco products are increasing in popularity. An important question is whether their use is associated with or even leads to conventional smoking, but large-scale (European) studies are scarce. In two cohorts of Dutch adolescents (Cohort I n = 6819, mean age = 13.8 SD = 1.1, 48.2% female; Cohort II n = 2758, mean age = 17.3 SD = 1.8, 61.3% female), we investigated use of electronic (e)-cigarettes with nicotine, e-cigarettes without nicotine and waterpipe. Generalized estimating equation modelling was conducted with ever conventional smoking as the dependent variable (0 = no, 1 = yes) and ever alternative tobacco use as the independent variable, correcting for clustering within schools, age, sex and education in both cohorts. In a subsample (n = 2100), the association between alternative tobacco use at baseline and conventional smoking 6 months later was tested, taking into account smoking propensity (based on personality, susceptibility to peer pressure and smoking intentions). Ever use prevalence was 13.7% for e-cigarettes with nicotine, 29.4% for e-cigarettes without nicotine and 22.1% for waterpipe in Cohort I and 12.3, 27.6 and 45.3% respectively in Cohort II. Ever smokers had tried alternative tobacco products more often than never smokers. Among never-smoking adolescents at baseline, alternative tobacco use predicted ever smoking 6 months later (e-cigarettes with nicotine OR 11.90 95% CI 3.36-42.11; e-cigarettes without nicotine OR 5.36 95% CI 2.73-10.52; waterpipe OR 5.36 95% CI 2.78-10.31). This association was strongest for adolescents with a low baseline risk of smoking. Experimenting with alternative tobacco products is common among Dutch youth. Alternative tobacco use predicts (future) smoking, especially among adolescents with a low smoking propensity.
    • E-Liquid Flavor Preferences and Individual Factors Related to Vaping: A Survey among Dutch Never-Users, Smokers, Dual Users, and Exclusive Vapers.

      Romijnders, Kim Agj; Krüsemann, Erna Jz; Boesveldt, Sanne; Graaf, Kees de; Vries, Hein de; Talhout, Reinskje (2019-11-22)
      Appealing product characteristics, such as flavors, may stimulate e-cigarette use. While switching to e-cigarettes may reduce harm for smokers, concerns exist about e-cigarette use among never-smokers. The role of flavors in the decision to switch to or refrain from vaping is unclear. This study used a bottom-up approach to investigate the relation between flavor preferences and individual factors related to vaping between various user groups. A cross-sectional survey was conducted among never-users (n = 407), smokers (n = 138), dual users (n = 122), and exclusive vapers (n = 61) in the Netherlands. Demographics, attractiveness of product characteristics, flavor preferences, and individual factors related to vaping (knowledge, trust, perceived susceptibility, attitude, social influence, deliberation, and intention) were assessed. The availability of different flavors was the most attractive characteristic of e-cigarettes. Dual users and exclusive vapers had most often used tobacco and menthol/mint flavors when they first started vaping. Compared to dual users, exclusive vapers currently used more fruit and sweet flavors. Never-users who were interested in trying an e-liquid flavor had more knowledge about and a more positive attitude towards e-cigarettes. Smokers who were interested in trying a flavor had a more positive attitude towards e-cigarettes and experienced the social influence towards not using e-cigarettes as less strong than those who did not want to try any flavor. Hence, individual factors related to vaping differed depending on whether never-users and smokers wanted to try an e-liquid flavor. This means that flavors may moderate differences found in individual factors related to vaping, or vice versa.
    • An E-liquid Flavor Wheel: A Shared Vocabulary based on Systematically Reviewing E-liquid Flavor Classifications in Literature.

      Krüsemann, Erna Johanna Zegerina; Boesveldt, Sanne; de Graaf, Kees; Talhout, Reinskje (2018-05-18)
      E-liquids are available in a high variety of flavors. A systematic classification of e-liquid flavors is necessary to increase comparability of research results. In the food, alcohol and fragrance industry, flavors are classified using flavor wheels. We systematically reviewed literature on flavors related to e-cigarette use, to investigate how e-liquid flavors have been classified in research, and propose an e-liquid flavor wheel to classify e-liquids based on marketing descriptions.
    • Early childhood infections and body mass index in adolescence.

      Prins-van Ginkel, Annemarijn C; Wijga, Alet H; Bruijning-Verhagen, Patricia C J; Brunekreef, Bert; Gehring, Ulrike; van der Hoek, Wim; Koppelman, Gerard H; van Rossem, Lenie; van der Sande, Marianne A B; Smit, Henriëtte A (2021-03-26)
    • Early environmental quality and life-course mental health effects: The Equal-Life project

      van Kamp, I; Waye, KP; Kanninen, K; Gulliver, J; Bozzon, A; Psyllidis, A; Boshuizen, H; et al. (2022-01-18)
    • Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study.

      Pluymen, Linda P M; Wijga, Alet H; Gehring, Ulrike; Koppelman, Gerard H; Smit, Henriëtte A; van Rossem, L (2018-02-22)
      To investigate whether early introduction of complementary foods (CF) is associated with an increased risk of overweight during childhood, and whether this association differs between formula-fed and breastfed infants.
    • Early Life Microbiota and Respiratory Tract Infections.

      de Steenhuijsen Piters, Wouter A A; Binkowska, Justyna; Bogaert, Debby (2020-08-12)
    • Early measles vaccination during an outbreak in The Netherlands: reduced short and long-term antibody responses in children vaccinated before 12 months of age.

      Brinkman, Iris D; de Wit, Jelle; Smits, Gaby P; Ten Hulscher, Hinke I; Jongerius, Maria C; Abreu, Taymara C; van der Klis, Fiona R M; Hahné, Susan J M; Koopmans, M P G; Rots, Nynke Y; et al. (2019-04-11)
      The majority of infants will not be protected by maternal antibodies until their first measles vaccination between 12-15 months of age. This provides incentive to reduce the age of measles vaccination, but immunological consequences are insufficiently understood and long-term effects are largely unknown. Infants who received early measles vaccination between 6-12 months and a second dose at 14 months of age (n=79) were compared with a control group who received one dose at 14 months of age (n=44). Measles-neutralizing antibody concentrations and avidity were determined up to 4 years of age. Infants with a first measles vaccination administered before 12 months of age show long-term reduced measles-neutralizing antibody concentrations and avidity compared to the control group. For 11.1% of children with a first dose before 9 months of age, antibody levels had dropped below the cutoff for clinical protection at 4 years of age. Early measles vaccination provides immediate protection in the majority of infants, but long-term neutralizing antibody responses are reduced compared to infants vaccinated at a later age. Additional vaccination at 14 months of age does not improve this. Long-term, this may result in an increasing number of children susceptible to measles.
    • Early origins of lung disease: towards an interdisciplinary approach.

      Ubags, Niki D J; Alejandre Alcazar, Miguel A; Kallapur, Suhas G; Knapp, Sylvia; Lanone, Sophie; Lloyd, Clare M; Morty, Rory E; Pattaroni, Céline; Reynaert, Niki L; Rottier, Robbert J; et al. (2020-09-30)
    • Early prevention of pertussis is key - Author's reply.

      Barug, Daantje; Pronk, Inge; van Houten, Marlies; Versteegh, Florens; Knol, Mirjam; Berbers, Guy; Sanders, Elisabeth; Rots, Nynke (2019-07-01)
    • Ebola in the Netherlands, 2014-2015: costs of preparedness and response.

      Suijkerbuijk, Anita W M; Swaan, Corien M; Mangen, Marie-Josee J; Polder, Johan J; Timen, Aura; Ruijs, Wilhelmina L M (2017-11-17)
      The recent epidemic of Ebola virus disease (EVD) resulted in countries worldwide to prepare for the possibility of having an EVD patient. In this study, we estimate the costs of Ebola preparedness and response borne by the Dutch health system. An activity-based costing method was used, in which the cost of staff time spent in preparedness and response activities was calculated based on a time-recording system and interviews with key professionals at the healthcare organizations involved. In addition, the organizations provided cost information on patient days of hospitalization, laboratory tests, personal protective equipment (PPE), as well as the additional cleaning and disinfection required. The estimated total costs averaged €12.6 million, ranging from €6.7 to €22.5 million. The main cost drivers were PPE expenditures and preparedness activities of personnel, especially those associated with ambulance services and hospitals. There were 13 possible cases clinically evaluated and one confirmed case admitted to hospital. The estimated total cost of EVD preparedness and response in the Netherlands was substantial. Future costs might be reduced and efficiency increased by designating one ambulance service for transportation and fewer hospitals for the assessment of possible patients with a highly infectious disease of high consequences.
    • Ebola Preparedness in the Netherlands: The Need for Coordination Between the Public Health and the Curative Sector.

      Swaan, Corien M; Öry, Alexander V; Schol, Lianne G C; Jacobi, André; Richardus, Jan Hendrik; Timen, Aura (2018-02-07)
      During the Ebola outbreak in West Africa in 2014-2015, close cooperation between the curative sector and the public health sector in the Netherlands was necessary for timely identification, referral, and investigation of patients with suspected Ebola virus disease (EVD).
    • ECDC Round Table Report and ProMed-mail most useful international information sources for the Netherlands Early Warning Committee.

      Bijkerk, Paul; Monnier, Annelie A; Fanoy, Ewout B; Kardamanidis, Katina; Friesema, Ingrid Hm; Knol, Mirjam J (2017-04-06)
      The Netherlands Early Warning Committee (NEWC) aims to identify infectious diseases causing a potential threat to Dutch public health. Threats are assessed and published as (information) alerts for public health experts. To identify threats from abroad, the NEWC screens 10 sources reporting disease outbreaks each week. To identify the sources essential for complete and timely reporting, we retrospectively analysed 178 international alerts published between 31 January 2013 and 30 January 2014. In addition, we asked the four NEWC coordinators about the required time to scan the information sources. We documented the date and source in which the signal was detected. The ECDC Round Table (RT) Report and ProMED-mail were the most complete and timely sources, reporting 140 of 178 (79%) and 121 of 178 (68%) threats respectively. The combination of both sources reported 169 (95%) of all threats in a timely manner. Adding any of the other sources resulted in minor increases in the total threats found, but considerable additional time investment per additional threat. Only three potential relevant threats (2%) would have been missed by only using the ECDC RT Report and ProMed-mail. We concluded that using only the ECDC RT Report and ProMed-mail to identify threats from abroad maintains a sensitive Early Warning System.
    • Echovirus type 6 transmission clusters and the role of environmental surveillance in early warning, the Netherlands, 2007 to 2016.

      Monge, Susana; Benschop, Kimberley; Soetens, Loes; Pijnacker, Roan; Hahné, Susan; Wallinga, Jacco; Duizer, Erwin (2018-11-01)
      BackgroundIn the Netherlands, echovirus type 6 (E6) is identified through clinical and environmental enterovirus surveillance (CEVS and EEVS). AimWe aimed to identify E6 transmission clusters and to assess the role of EEVS in surveillance and early warning of E6. MethodsWe included all E6 strains from CEVS and EEVS from 2007 through 2016. CEVS samples were from patients with enterovirus illness. EEVS samples came from sewage water at pre-specified sampling points. E6 strains were defined by partial VP1 sequence, month and 4-digit postcode. Phylogenetic E6 clusters were detected using pairwise genetic distances. We identified transmission clusters using a combined pairwise distance in time, place and phylogeny dimensions. ResultsE6 was identified in 157 of 3,506 CEVS clinical episodes and 92 of 1,067 EEVS samples. Increased E6 circulation was observed in 2009 and from 2014 onwards. Eight phylogenetic clusters were identified; five included both CEVS and EEVS strains. Among these, identification in EEVS did not consistently precede CEVS. One phylogenetic cluster was dominant until 2014, but genetic diversity increased thereafter. Of 14 identified transmission clusters, six included both EEVS and CEVS; in two of them, EEVS identification preceded CEVS identification. Transmission clusters were consistent with phylogenetic clusters, and with previous outbreak reports. ConclusionAlgorithms using combined time-place-phylogeny data allowed identification of clusters not detected by any of these variables alone. EEVS identified strains circulating in the population, but EEVS samples did not systematically precede clinical case surveillance, limiting EEVS usefulness for early warning in a context where E6 is endemic.
    • Eco-epidemiology of Novel Bartonella Genotypes from Parasitic Flies of Insectivorous Bats.

      Sándor, Attila D; Földvári, Mihály; Krawczyk, Aleksandra I; Sprong, Hein; Corduneanu, Alexandra; Barti, Levente; Görföl, Tamás; Estók, Péter; Kováts, Dávid; Szekeres, Sándor; et al. (2018-04-29)
      Bats are important zoonotic reservoirs for many pathogens worldwide. Although their highly specialized ectoparasites, bat flies (Diptera: Hippoboscoidea), can transmit Bartonella bacteria including human pathogens, their eco-epidemiology is unexplored. Here, we analyzed the prevalence and diversity of Bartonella strains sampled from 10 bat fly species from 14 European bat species. We found high prevalence of Bartonella spp. in most bat fly species with wide geographical distribution. Bat species explained most of the variance in Bartonella distribution with the highest prevalence of infected flies recorded in species living in dense groups exclusively in caves. Bat gender but not bat fly gender was also an important factor with the more mobile male bats giving more opportunity for the ectoparasites to access several host individuals. We detected high diversity of Bartonella strains (18 sequences, 7 genotypes, in 9 bat fly species) comparable with tropical assemblages of bat-bat fly association. Most genotypes are novel (15 out of 18 recorded strains have a similarity of 92-99%, with three sequences having 100% similarity to Bartonella spp. sequences deposited in GenBank) with currently unknown pathogenicity; however, 4 of these sequences are similar (up to 92% sequence similarity) to Bartonella spp. with known zoonotic potential. The high prevalence and diversity of Bartonella spp. suggests a long shared evolution of these bacteria with bat flies and bats providing excellent study targets for the eco-epidemiology of host-vector-pathogen cycles.
    • Ecological momentary assessment study of exposure to radiofrequency electromagnetic fields and non-specific physical symptoms with self-declared electrosensitives.

      Bolte, John F B; Clahsen, Sander; Vercruijsse, Wendy; Houtveen, Jan H; Schipper, C Maarten A; van Kamp, Irene; Bogers, Rik (2019-10-01)
    • An ecological perspective on a river's rights: a recipe for more effective water quality.governance?

      Wuijts, S; Beekman, J; van der Wal, B; Suykens, C; Driessen, PPJ; van Rijswick, HFMW (2019-01-02)
    • Ecologische risico's van cytostatica in Nederlandse oppervlaktewateren

      van Dijk, J; Venhuis, B; van Vlaardingen, P; Moermond, C; Marinkovic, M (2019-02-06)