• Immunoglobulin A deficiency in children, an undervalued clinical issue.

      Koenen, M H Mischa; van Montfrans, J M Joris; Sanders, E A M Elisabeth; Bogaert, D Debby; Verhagen, L M Lilly (2019-12-01)
    • The immunomodulatory effects of measles-mumps-rubella (MMR) vaccination on persistence of heterologous vaccine responses.

      Zimmermann, Petra; Perrett, Kirsten P; van der Klis, Fiona R M; Curtis, Nigel (2019-02-21)
      It is proposed that measles-containing vaccines (MCV) have immunomodulatory effects which include a reduction in all-cause childhood mortality. The antibody response to heterologous vaccines provides a means to explore these immunomodulatory effects. This is the first study to investigate the influence of measles-mumps-rubella (MMR) vaccine on the persistence of antibodies to a broad range of heterologous infant vaccinations given in the first year of life. In total, 319 children were included in the study. All infants received routine vaccinations at 6 weeks, 4 and 6 months of age. At 12 months of age, 212 children were vaccinated with measles-mumps-rubella (MMR) and Haemophilus influenzae type b-meningococcus C (Hib-MenC) vaccine while the remaining 99 children had not yet received this vaccine. In the MMR/Hib-MenC-vaccinated group, blood was taken 28 ± 14 days after receiving these vaccines. Antibodies against diphtheria, tetanus, pertussis (pertussis toxin, filamentous haemagglutinin, pertactin), poliomyelitis (type 1, 2, 3) and 13 pneumococcal serotypes were measured. Geometric mean antibody concentrations (GMC) and seroprotection rates were compared between MMR/MenC-Hib-vaccinated and MMR/MenC-Hib-naïve participants. In the final analysis, 311 children were included. Seroprotection rates were lower in MMR/Hib-MenC-vaccinated children against pertussis toxin and pneumococcus serotype 19A. After adjustment for pre-specified factors, MMR/Hib-MenC-vaccinated infants had significantly higher antibody concentrations against tetanus (likely explained by a boosting effect of the carrier protein, a tetanus toxoid), while for the other vaccine antigens there was no difference in antibody concentrations between the two groups. This article is protected by copyright. All rights reserved.
    • Immunotoxic effects of chemicals: A matrix for occupational and environmental epidemiological studies.

      Veraldi, Angela; Costantini, Adele Seniori; Bolejack, Vanessa; Miligi, Lucia; Vineis, Paolo; Loveren, Henk van (2006-12-01)
      BACKGROUND: Many biological and chemical agents have the capacity to alter the way the immune system functions in human and animals. This study evaluates the immunotoxicity of 20 substances used widely in work environments. METHODS: A systematic literature search on the immunotoxicity of 20 chemicals was performed. The first step was to review literature on immunotoxicity testing and testing schemes adopted for establishing immunotoxicity in humans. The second step consisted of providing a documentation on immunotoxicity of substances that are widely used in work environment, by building tables for each chemical of interest (benzene, trichloroethylene, PAHs, crystalline silica, diesel exhausts, welding fumes, asbestos, styrene, formaldehyde, toluene, vinyl chloride monomer, tetrachloroethylene, chlorophenols, 1,3-butadiene, mineral oils, P-dichlorobenzene, dichloromethane, xylene, 1,1,1-trichloroethane, ethylene oxide). The third step was the classification of substances; an index (strong, intermediate, weak, nil) was assigned on the basis of the evidence of toxicity and type of immunotoxic effects (immunosuppression, autoimmunity, hypersensitivity) on the basis of the immune responses. Finally substances were assigned a score of immunotoxic power. RESULTS: Tables have been produced that include information for the 20 substances of interest, based on 227 animal studies and 94 human studies. Each substance was assigned an index of immunotoxic evidence, a score of immunotoxic power and type of immunotoxic effect. CONCLUSIONS: This matrix can represent a tool to identify chemicals with similar properties concerning the toxicity for the immune system, and to interpret epidemiological studies on immune-related diseases.
    • Immunotoxicity Testing of Nanomedicinal Products: Possible Pitfalls in Endotoxin Determination

      Giannakou, Christina; E. Geertsma, Robert; H. de Jong, Wim; van Loveren, Henk; J. Vandebriel, Rob; VDZ Park, Margriet (2017-01-05)
    • Immunotoxicology: A brief history, current status and strategies for future immunotoxicity assessment.

      Germolec, Dori; Luebke, Robert; Rooney, Andrew; Shipkowski, Kelly; Vandebriel, Rob; van Loveren, Henk (2017-08)
    • Impact and cost-effectiveness of different vaccination strategies to reduce the burden of pneumococcal disease among elderly in the Netherlands.

      Thorrington, Dominic; van Rossum, Leo; Knol, Mirjam; de Melker, Hester; Rümke, Hans; Hak, Eelko; van Hoek, Albert Jan (2018)
      Streptococcus pneumoniae causes morbidity and mortality among all ages in The Netherlands. To reduce this burden, infants in The Netherlands receive the 10-valent pneumococcal conjugated vaccine (PCV10), but older persons are not targeted. We assessed the impact and cost-effectiveness of vaccination with 23-valent pneumococcal polysaccharide vaccine (PPV23) or 13-valent PCV (PCV13) among all those aged 60, 65 or 70 and/or in combination with replacing PCV10 with PCV13 in the infant vaccination programme.
    • Impact of a proposed revision of the IESTI equation on the acute risk assessment conducted when setting maximum residue levels (MRLs) in the European Union (EU): A case study.

      Breysse, Nicolas; Vial, Gaelle; Pattingre, Lauriane; Ossendorp, Bernadette C; Mahieu, Karin; Reich, Hermine; Rietveld, Anton; Sieke, Christian; van der Velde-Koerts, Trijntje; Sarda, Xavier (2018-06-03)
      Proposals to update the methodology for the international estimated short-term intake (IESTI) equations were made during an international workshop held in Geneva in 2015. Changes to several parameters of the current four IESTI equations (cases 1, 2a, 2b, and 3) were proposed. In this study, the overall impact of these proposed changes on estimates of short-term exposure was studied using the large portion data available in the European Food Safety Authority PRIMo model and the residue data submitted in the framework of the European Maximum Residue Levels (MRL) review under Article 12 of Regulation (EC) No 396/2005. Evaluation of consumer exposure using the current and proposed equations resulted in substantial differences in the exposure estimates; however, there were no significant changes regarding the number of accepted MRLs. For the different IESTI cases, the median ratio of the new versus the current equation is 1.1 for case 1, 1.4 for case 2a, 0.75 for case 2b, and 1 for case 3. The impact, expressed as a shift in the IESTI distribution profile, indicated that the 95th percentile IESTI shifted from 50% of the acute reference dose (ARfD) with the current equations to 65% of the ARfD with the proposed equations. This IESTI increase resulted in the loss of 1.2% of the MRLs (37 out of 3110) tested within this study. At the same time, the proposed equations would have allowed 0.4% of the MRLs (14 out of 3110) that were rejected with the current equations to be accepted. The commodity groups that were most impacted by these modifications are solanacea (e.g., potato, eggplant), lettuces, pulses (dry), leafy brassica (e.g., kale, Chinese cabbage), and pome fruits. The active substances that were most affected were fluazifop-p-butyl, deltamethrin, and lambda-cyhalothrin.
    • The impact of ambient air pollution on the human blood metabolome.

      Vlaanderen, J J; Janssen, N A; Hoek, G; Keski-Rahkonen, P; Barupal, D K; Cassee, F R; Gosens, I; Strak, M; Steenhof, M; Lan, Q; et al. (2017-07)
      Biological perturbations caused by air pollution might be reflected in the compounds present in blood originating from air pollutants and endogenous metabolites influenced by air pollution (defined here as part of the blood metabolome). We aimed to assess the perturbation of the blood metabolome in response to short term exposure to air pollution.
    • Impact of an Outdoor Smoking Ban at Secondary Schools on Cigarettes, E-Cigarettes and Water Pipe Use among Adolescents: An 18-Month Follow-Up.

      Rozema, Andrea D; Hiemstra, Marieke; Mathijssen, Jolanda J P; Jansen, Maria W J; van Oers, Hans J A M (2018-01-25)
      Abstract: The effectiveness of outdoor smoking bans on smoking behavior among adolescents remains inconclusive. This study evaluates the long-term impact of outdoor school ground smoking bans among adolescents at secondary schools on the use of conventional cigarettes, e-cigarettes (with/without nicotine) and water pipes. Outdoor smoking bans at 19 Dutch secondary schools were evaluated using a quasi-experimental design. Data on 7733 adolescents were obtained at baseline, and at 6 and 18-month follow-up. The impact of outdoor smoking bans on 'ever use of conventional cigarettes', 'smoking onset', 'ever use of e-cigarette with nicotine', 'e-cigarette without nicotine', and 'water pipe' was measured. Multilevel logistic regression analysis was used. At schools with a ban, implementation fidelity was checked. At schools where a ban was implemented, at 18-month follow-up more adolescents had started smoking compared to the control condition. No effect of implementation of the ban was found for smoking prevalence, e-cigarettes with/without nicotine, and water pipe use. Implementation fidelity was sufficient. No long-term effects were found of an outdoor smoking ban, except for smoking onset. The ban might cause a reversal effect when schools encounter difficulties with its enforcement or when adolescents still see others smoking. Additional research is required with a longer follow-up than 18 months.
    • Impact of copper nanoparticles and ionic copper exposure on wheat (Triticum aestivum L.) root morphology and antioxidant response.

      Zhang, Zhenyan; Ke, Mingjing; Qu, Qian; Peijnenburg, W J G M; Lu, Tao; Zhang, Qi; Ye, Yizhi; Xu, Pengfei; Du, Benben; Sun, Liwei; et al. (2018-04-28)
      Copper nanoparticles (nCu) are widely used in industry and in daily life, due to their unique physical, chemical, and biological properties. Few studies have focused on nCu phytotoxicity, especially with regard to toxicity mechanisms in crop plants. The present study examined the effect of 15.6 μM nCu exposure on the root morphology, physiology, and gene transcription levels of wheat (Triticum aestivum L.), a major crop cultivated worldwide. The results obtained were compared with the effects of exposing wheat to an equivalent molar concentration of ionic Cu (Cu2+ released from CuSO4) and to control plants. The relative growth rate of roots decreased to approximately 60% and the formation of lateral roots was stimulated under nCu exposure, possibly due to the enhancement of nitrogen uptake and accumulation of auxin in lateral roots. The expression of four of the genes involved in the positive regulation of cell proliferation and negative regulation of programmed cell death decreased to 50% in the Cu2+ treatment compared to that of the control, while only one gene was down-regulated to about half of the control in nCu treatment. This explained the decreased root cell proliferation and higher extent of induced cell death in Cu2+- than in nCu-exposed plants. The increased methane dicarboxylic aldehyde accumulation (2.17-fold increase compared with the control) and decreased antioxidant enzyme activities (more than 50% decrease compared with the control) observed in the Cu2+ treatment in relation to the nCu treatment indicated higher oxidative stress in Cu2+- than in nCu-exposed plants. Antioxidant (e.g., proline) synthesis was pronouncedly induced by nCu to scavenge excess reactive oxygen species, alleviating phytotoxicity to wheat exposed to this form of Cu. Overall, oxidative stress and root growth inhibition were the main causes of nCu toxicity.
    • Impact of delivery mode-associated gut microbiota dynamics on health in the first year of life.

      Reyman, Marta; van Houten, Marlies A; van Baarle, Debbie; Bosch, Astrid A T M; Man, Wing Ho; Chu, Mei Ling J N; Arp, Kayleigh; Watson, Rebecca L; Sanders, Elisabeth A M; Fuentes, Susana; et al. (2019-11-01)
    • Impact of excess NO x emissions from diesel cars on air quality, public health and eutrophication in Europe

      Jonson, J E; Borken-Kleefeld, J; Simpson, D; Nyíri, A; Posch, M; Heyes, C (2017-09-01)
    • Impact of food and water-borne diseases on European population health

      Cassini, A; Colzani, E; Kramarz, P; Kretzschmar, ME; Takkinen, J (2016-12)
    • The impact of frying aerosol on human brain activity.

      Naseri, Motahareh; Jouzizadeh, Mojtaba; Tabesh, Mahsa; Malekipirbazari, Milad; Gabdrashova, Raikhangul; Nurzhan, Sholpan; Farrokhi, Hamta; Khanbabaie, Reza; Mehri-Dehnavi, Hossein; Bekezhankyzy, Zhibek; et al. (2019-09-01)
      Knowledge on the impact of the exposure to indoor ultrafine particles (UFPs) on the human brain is restricted. Twelve non-atopic, non-smoking, and healthy adults (10 female and 7 male, in average 22 years old) were monitored for brain physiological responses via electroencephalographs (EEGs) during cooking. Frying ground beef meat in sunflower oil using electric stove without ventilation was conducted. UFPs, particulate matter (PM) (PM1, PM2.5, PM4, PM10), CO2, indoor temperature, RH, oil and meat temperatures were monitored continuously throughout the experiments. The UFP peak concentration was recorded to be approximately 2.0 × 105 particles/cm3. EEGs were recorded before exposure, at end of cooking when PM peak concentrations were observed, and 30 min after the end of the cooking session (post-exposure). Brain electrical activity statistically significantly changed during post-exposure compared to the before exposure, suggesting the translocation of UFPs to the brain, occurring solely in the frontal and temporal lobes of the brain. Study participants older than 25 were more susceptible to UFPs compared to those younger than 25. Also, the brain abnormality was mainly driven by male rather than female study participants. The brain slow-wave band (delta) decreased while the fast-wave band (Beta3) increased similar to the pattern found in the literature for the exposure to smoking fumes and diesel exhaust.
    • Impact of infant pneumococcal conjugate vaccination on community acquired pneumonia hospitalization in all ages in the Netherlands.

      van Deursen, A M M; Schurink-Van't Klooster, T M; Man, W H; van de Kassteele, J; van Gageldonk-Lafeber, A B; Bruijning-Verhagen, P C J L; de Melker, H E; Sanders, E A M; Knol, M J (2017)
      The long-term impact of pneumococcal conjugate vaccines on pneumonia hospitalizations in all age-groups varies between countries. In the Netherlands, the 7-valent pneumococcal conjugate vaccine (PCV7) was implemented for newborns in 2006 and replaced by PCV10 in 2011. We assessed the impact of PCVs on community-acquired pneumonia (CAP) hospitalization rates in all age-groups.
    • Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013.

      Cassini, Alessandro; Colzani, Edoardo; Pini, Alessandro; Mangen, Marie-Josee J; Plass, Dietrich; McDonald, Scott A; Maringhini, Guido; van Lier, Alies; Haagsma, Juanita A; Havelaar, Arie H; et al. (2018-04)
      Background and aimsThe Burden of Communicable Diseases in Europe (BCoDE) study aimed to calculate disability-adjusted life years (DALYs) for 31 selected diseases in the European Union (EU) and European Economic Area (EEA). Methods: DALYs were estimated using an incidence-based and pathogen-based approach. Incidence was estimated through assessment of data availability and quality, and a correction was applied for under-estimation. Calculation of DALYs was performed with the BCoDE software toolkit without applying time discounting and age-weighting. Results: We estimated that one in 14 inhabitants experienced an infectious disease episode for a total burden of 1.38 million DALYs (95% uncertainty interval (UI): 1.25-1.5) between 2009 and 2013; 76% of which was related to the acute phase of the infection and its short-term complications. Influenza had the highest burden (30% of the total burden), followed by tuberculosis, human immunodeficiency virus (HIV) infection/AIDS and invasive pneumococcal disease (IPD). Men had the highest burden measured in DALYs (60% of the total), adults 65 years of age and over had 24% and children less than 5 years of age had 11%. Age group-specific burden showed that infants (less than 1 year of age) and elderly people (80 years of age and over) experienced the highest burden. Conclusions: These results provide baseline estimates for evaluating infectious disease prevention and control strategies. The study promotes an evidence-based approach to describing population health and assessing surveillance data availability and quality, and provides information for the planning and prioritisation of limited resources in infectious disease prevention and control.
    • The impact of influenza vaccination on infection, hospitalisation and mortality in the Netherlands between 2003 and 2015.

      Backer, J A; Wallinga, J; Meijer, A; Donker, G A; van der Hoek, W; van Boven, M (2018-10-11)
      Influenza epidemics annually cause substantial morbidity and mortality. For this reason, vaccination is offered yearly to persons with an elevated risk for complications. Assessments of the impact of vaccination are, however, hampered by year-to-year variation in epidemic size and vaccine effectiveness. We estimate the impact of the current vaccination programme comparing simulations with vaccination to counterfactual simulations without vaccination. The simulations rely on an age- and risk-structured transmission model that tracks the build-up and loss of immunity over successive seasons, and that allows the vaccine match to vary between seasons. The model parameters are estimated with a particle Monte Carlo method and approximate Bayesian computation, using epidemiological data on vaccine effectiveness and epidemic size in the Netherlands over a period of 11 years. The number of infections, hospitalisations and deaths vary greatly between years because waning of immunity and vaccine match may differ every season, which is in line with observed variation in influenza epidemic sizes. At an overall coverage of 21%, vaccination has averted on average 13% (7.2-19%, 95% range) of infections, 24% (16-36%) of hospitalisations, and 35% (16-50%) of deaths. This suggests that vaccination is mainly effective in protecting vaccinees from infection rather than reducing transmission. As the Dutch population continues to grow and age, the vaccination programme is projected (up to 2025) to gain in impact, despite a decreasing infection attack rate.
    • Impact of influenza vaccination programmes among the elderly population on primary care, Portugal, Spain and the Netherlands: 2015/16 to 2017/18 influenza seasons.

      Machado, Ausenda; Mazagatos, Clara; Dijkstra, Frederika; Kislaya, Irina; Gherasim, Alin; McDonald, Scott A; Kissling, Esther; Valenciano, Marta; Meijer, Adam; Hooiveld, Mariëtte; et al. (2019-11-01)
    • Impact of informal electronic waste recycling on metal concentrations in soils and dusts.

      Ohajinwa, Chimere May; van Bodegom, Peter M; Vijver, Martina G; Peijnenburg, Willie J G M (2018-03-20)
      Electronic and electrical equipment contains over 1000 different substances, including metals. During informal e-waste recycling some of these substances such as metals, are released into the environment causing environmental pollution. This study assessed the impact of different informal e-waste recycling activities (burning, dismantling, and repairing) on metal concentrations in top soils and various dust. A comparative cross-sectional study design was adopted to assess metal concentrations in top soils and in various dust samples from multiple e-waste recycling sites. Metal concentrations at e-waste recycling sites were compared to the concentrations at control sites in three study locations in Nigeria (Lagos, Ibadan, and Aba). In the three study locations, mean metal concentrations at the e-waste recycling sites exceeded the concentrations at the control sites and the Nigerian standard guideline values by 100 s to 1000 s times. Burning sites showed the highest pollution level, followed by dismantling sites, then repair sites. Our findings show serious environmental and public health concerns. The metal concentrations were also higher than levels reported in other studies at the same locations in Nigeria, indicating that the situation is worsening. This study provides scientific evidence for an urgent need to develop effective strategies to strengthen enforcement of existing e-waste regulations in Nigeria.
    • The impact of knowledge of HPV positivity on cytology triage in primary high-risk HPV screening.

      Aitken, Clare A; Holtzer-Goor, Kim M; Uyterlinde, Anne; van den Brule, Adriaan Jc; van der Linden, Hans C; Huijsmans, Cornelis J; de Kok, Inge McM; van Kemenade, Folkert J (2019-07-25)