• 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.
    • 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 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.
    • 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.
    • 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; László, Zoltán; Hornok, Sándor; Földvári, Gábor (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.
    • Ecosystem quality in LCIA: status quo, harmonization, and suggestions for the way forward

      Woods, John S.; Damiani, Mattia; Fantke, Peter; Henderson, Andrew D.; Johnston, John M.; Bare, Jane; Sala, Serenella; Maia de Souza, Danielle; Pfister, Stephan; Posthuma, Leo; Rosenbaum, Ralph K.; Verones, Francesca (2017-11-27)
    • Editorial for the Special Issue of JPH-Autumn 2017.

      Rushmer, Rosemary; van Oers, Hans; Kothari, Anita (2018-03-01)
    • Editorial to “Use of non-human primate disease models”

      Vermeire, Theo; Badin, Romina Aron; Langermans, Jan; Prescott, Mark J. (2018-09)
    • Editorial: dose-dependent ZnO particle-induced acute phase response in humans warrants re-evaluation of occupational exposure limits for metal oxides.

      Vogel, Ulla; Cassee, Flemming R (2018-02-12)
      Epidemiological studies link inhalation of particles to increased risk of cardiovascular disease. Inhaled particles may induce cardiovascular disease by several different mechanisms including translocation of particles to systemic circulation, activation of airway sensory nerves resulting in autonomic imbalance and particle-induced pulmonary inflammation and acute phase response.The acute phase response is the systemic response to acute and chronic inflammatory states caused by for example bacterial infection, virus infection, trauma and infarction. It is characterized by differential expression of ca. 50 different acute phase proteins including C-reactive protein and Serum amyloid A, which are the most differentially up-regulated acute phase response proteins. Blood levels of these two acute phase proteins are closely associated with risk of cardiovascular disease in epidemiological studies and SAA has been causally related to the formation of plaques in the aorta in animal studies.In a recent paper in Particle and Fibre Toxicology, Christian Monsé et al. provide evidence that inhalation of ZnO nanoparticles induces dose-dependent acute phase response in humans at dose levels well below the current mass-based occupational exposure limits in a number of countries including Germany, The Netherlands, UK, Sweden, Denmark and the US.Given the evidence suggesting a causal relationship between increased levels of serum amyloid A and atherosclerosis, the current results call for a re-evaluation of occupational exposure limits for a number of particle exposures including ZnO taking induction of acute phase response into account. Furthermore, it underscores cardiovascular disease as an occupational disease.
    • Een virtuele zombie-epidemie tijdens Lowlands

      Klinkenberg D; Tieben R; Rijswijk J van; Bhulai S; Luigies R; Wallinga J (2018-03)
    • Effect of Adding Sugar to Burley Tobacco on the Emission of Aldehydes in Mainstream Tobacco Smoke

      Cheah, Nuan Ping; Borst, Simon; Hendrickx, Loes; Cremers, Hans; Jansen, Eugene; Opperhuizen, Antoon; Talhout, Reinskje (2018-03-01)
    • Effect of Antibiotic-Mediated Microbiome Modulation on Rotavirus Vaccine Immunogenicity: A Human, Randomized-Control Proof-of-Concept Trial.

      Harris, Vanessa C; Haak, Bastiaan W; Handley, Scott A; Jiang, Baoming; Velasquez, Daniel E; Hykes, Barry L; Droit, Lindsay; Berbers, Guy A M; Kemper, Elles Marleen; van Leeuwen, Ester M M; Boele van Hensbroek, Michael; Wiersinga, Willem Joost (2018-08-08)
      Rotavirus vaccines (RVV) protect against childhood gastroenteritis caused by rotavirus (RV) but have decreased effectiveness in low- and middle-income settings. This proof-of-concept, randomized-controlled, open-label trial tested if microbiome modulation can improve RVV immunogenicity. Healthy adults were randomized and administered broad-spectrum (oral vancomycin, ciprofloxacin, metronidazole), narrow-spectrum (vancomycin), or no antibiotics and then vaccinated with RVV, 21 per group per protocol. Baseline anti-RV IgA was high in all subjects. Although antibiotics did not alter absolute anti-RV IgA titers, RVV immunogenicity was boosted at 7 days in the narrow-spectrum group. Further, antibiotics increased fecal shedding of RV while also rapidly altering gut bacterial beta diversity. Beta diversity associated with RVV immunogenicity boosting at day 7 and specific bacterial taxa that distinguish RVV boosters and RV shedders were identified. Despite the negative primary endpoint, this study demonstrates that microbiota modification alters the immune response to RVV and supports further exploration of microbiome manipulation to improve RVV immunogenicity.
    • Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination.

      Hanquet, Germaine; Krizova, Pavla; Valentiner-Branth, Palle; Ladhani, Shamez N; Nuorti, J Pekka; Lepoutre, Agnes; Mereckiene, Jolita; Knol, Mirjam; Winje, Brita A; Ciruela, Pilar; Ordobas, Maria; Guevara, Marcela; McDonald, Eisin; Morfeldt, Eva; Kozakova, Jana; Slotved, Hans-Christian; Fry, Norman K; Rinta-Kokko, Hanna; Varon, Emmanuelle; Corcoran, Mary; van der Ende, Arie; Vestrheim, Didrik F; Munoz-Almagro, Carmen; Latasa, Pello; Castilla, Jesus; Smith, Andrew; Henriques-Normark, Birgitta; Whittaker, Robert; Pastore Celentano, Lucia; Savulescu, Camelia (2018-10-24)
      Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies.
    • The Effect of Chronic NO Synthase Inhibition on the Vasoactive and Structural Properties of Thoracic Aorta, NO Synthase Activity, and Oxidative Stress Biomarkers in Young SHR.

      Berenyiova, Andrea; Dovinova, Ima; Kvandova, Miroslava; Kristek, Frantisek; Jansen, Eugene; Majzunova, Miroslava; Cacanyiova, Sona (2018)
      Although the role of nitric oxide (NO) in essential hypertension is still unclear, the effects of long-term NO deficiency have not yet been investigated during the critical juvenile period in spontaneously hypertensive rats (SHR). We aimed to analyze the effects of chronic NO synthase (NOS) inhibition on systolic blood pressure (sBP), vasoactivity, morphological changes and superoxide level in the thoracic aorta (TA), NOS activity in different tissues, and general biomarkers of oxidative stress in plasma of young SHR. Four-week-old SHR were treated with NG-nitro-L-arginine methyl ester (L-NAME, 50 mg/kg/day, p.o.) for 4-5 weeks. L-NAME treatment induced a transient sBP increase only, and surprisingly, slightly inhibited endothelium-dependent relaxation of TA. Hereby, the inhibition of NOS activity varied from tissue to tissue, ranging from the lowest in the TA and the kidney to the highest in the brain stem. In spite of an increased sensitivity of adrenergic receptors, the maximal adrenergic contraction of TA was unchanged, which was associated with changes in elastin arrangement and an increase in wall thickness. The production of reactive oxygen species in the TA was increased; however, the level of selected biomarkers of oxidative stress did not change. Our findings proved that the TA of young SHR responded to chronic NO deficiency by the development of adaptive mechanisms on the functional (preserved NO-derived vasorelaxation, unincreased contraction) and molecular (preserved NOS activity) level.
    • Effect of diet with or without exercise on abdominal fat in postmenopausal women - a randomised trial.

      van Gemert, Willemijn A; Peeters, Petra H; May, Anne M; Doornbos, Adriaan J H; Elias, Sjoerd G; van der Palen, Job; Veldhuis, Wouter; Stapper, Maaike; Schuit, Jantine A; Monninkhof, Evelyn M (2019-02-11)
      We assessed the effect of equivalent weight loss with or without exercise on (intra-) abdominal fat in postmenopausal women in the SHAPE-2 study. The SHAPE-2 study is a three-armed randomised controlled trial conducted in 2012-2013 in the Netherlands. Postmenopausal overweight women were randomized to a diet (n = 97), exercise plus diet (n = 98) or control group (n = 48). Both intervention groups aimed for equivalent weight loss (6-7%) following a calorie-restricted diet (diet group) or a partly supervised intensive exercise programme (4 h per week) combined with a small caloric restriction (exercise plus diet group). Outcomes after 16 weeks are amount and distribution of abdominal fat, measured by magnetic resonance imaging (MRI) with the use of the three-point IDEAL Dixon method. The diet and exercise plus diet group lost 6.1 and 6.9% body weight, respectively. Compared to controls, subcutaneous and intra-abdominal fat reduced significantly with both diet (- 12.5% and - 12.0%) and exercise plus diet (- 16.0% and - 14.6%). Direct comparison between both interventions revealed that the reduction in subcutaneous fat was statistically significantly larger in the group that combined exercise with diet: an additional 10.6 cm We conclude that weight loss of 6-7% with diet or with exercise plus diet reduced both subcutaneous and intra-abdominal fat. Only subcutaneous fat statistically significantly reduced to a larger extent when exercise is combined with a small caloric restriction.
    • Effect of incident hepatitis C infection on CD4 count and HIV RNA trajectories based on a multinational HIV seroconversion cohort.

      van Santen, Daniela K; van der Helm, Jannie J; Touloumi, Giota; Pantazis, Nikos; Muga, Roberto; Gunsenheimer-Bartmeyer, Barbara; Gill, M John; Sanders, Eduard; Kelleher, Anthony; Zangerle, Robert; Porter, Kholoud; Prins, Maria; Geskus, Ronald B (2018-10-15)
      Most studies on hepatitis C virus (HCV)/HIV co-infection do not account for the order and duration of these two infections. We aimed to assess the effect of incident HCV infection, and its timing relative to HIV seroconversion (HIVsc) in HIV-positive men who have sex with men (MSM) on their subsequent CD4 T-cell count (CD4) and HIV-RNA viral load (VL) trajectories.