• Het influenzaseizoen 2015/2016 in Nederland: beheerst door influenza A(H1N1)pdm09- en B/Victoria/2/87-lijn-virussen.

      Jong JC de; Meijer A; Broek I van den; Broek I van den; Lange MMA de; Broek I van den; Dam-Deisz WDC (2016-12)
    • Influenzavaccinatie gezondheidswerknemers

      Groeneveld, GH; van Dissel, JT; van der Geest, N; de Vries, M; Meerstad-Rombach, F (2019-09-09)
    • Informed decision making in the context of childhood immunization.

      Lehmann, Birthe A; de Melker, Hester E; Timmermans, Daniëlle R M; Mollema, Liesbeth (2017-12)
      We aimed to assess informed decision making about childhood immunization by measuring knowledge, deliberation and value-consistency. Additionally, we investigated whether informed decision making is different for parents who accept and parents who decline vaccination.
    • Ingestion and Chronic Effects of Car Tire Tread Particles on Freshwater Benthic Macroinvertebrates.

      Redondo-Hasselerharm, Paula E; de Ruijter, Vera N; Mintenig, Svenja M; Verschoor, Anja; Koelmans, Albert A (2018-11-20)
      Micronized particles released from car tires have been found to contribute substantially to microplastic pollution, triggering the need to evaluate their effects on biota. In the present study, four freshwater benthic macroinvertebrates were exposed for 28 days to tread particles (TP; 10-586 μm) made from used car tires at concentrations of 0, 0.1, 0.3, 1, 3, and 10% sediment dry weight. No adverse effects were found on the survival, growth, and feeding rate of Gammarus pulex and Asellus aquaticus, the survival and growth of Tubifex spp., and the number of worms and growth of Lumbriculus variegatus. A method to quantify TP numbers inside biota was developed and here applied to G. pulex. In bodies and faces of G. pulex exposed to 10% car tire TP, averages of 2.5 and 4 tread particles per organism were found, respectively. Chemical analysis showed that, although car tire TP had a high intrinsic zinc content, only small fractions of the heavy metals present were bioavailable. PAHs in the TP-sediment mixtures also remained below existing toxicity thresholds. This combination of results suggests that real in situ effects of TP and TP-associated contaminants when dispersed in sediments are probably lower than those reported after forced leaching of contaminants from car tire particles.
    • Inhalation toxicity profiles of particulate matter: a comparison between brake wear with other sources of emission.

      Gerlofs-Nijland, M E; Bokkers, B G H; Sachse, H; Reijnders, J J E; Gustafsson, M; Boere, A J F; Fokkens, P F H; Leseman, D L A C; Augsburg, K; Cassee, F R (2019-02-01)
      Objective: There is substantial evidence that exposure to airborne particulate matter (PM) from road traffic is associated with adverse health outcomes. Although it is often assumed to be caused by vehicle exhaust emissions such as soot, other components may also contribute to detrimental effects. The toxicity of fine PM (PM2.5; <2.5 µm mass median aerodynamic diameter) released from brake pads was compared to PM from other sources. Materials and methods: PM2.5 of different types of brake pads (low-metallic, semi-metallic, NAO and ECE-NAO hybrid), tires and road pavement, poultry as well as the combustion of diesel fuel and wood (modern and old-fashioned stove technologies) were collected as suspensions in water. These were subsequently aerosolized for inhalation exposures. Female BALB/cOlaHsd mice were exposed for 1.5, 3, or 6 hours by nose-only inhalation up to 9 mg/m3. Results: Neither cytotoxicity nor oxidative stress was observed after exposure to any of the re-aerosolized PM2.5 samples. Though, at similar PM mass concentrations the potency to induce inflammatory responses was strongly dependent on the emission source. Exposure to most examined PM2.5 sources provoked inflammation including those derived from the poultry farm, wear emissions of the NAO and ECE-NAO hybrid brake pads as well as diesel and wood combustion, as indicated by neutrophil chemoattractant, KC and MIP-2 and lung neutrophil influx. Discussion and conclusions: Our study revealed considerable variability in the toxic potency of brake wear particles. Understanding of sources that are most harmful to health can provide valuable information for risk management strategies and could help decision-makers to develop more targeted air pollution regulation.
    • Inhaled Nanoparticles Accumulate at Sites of Vascular Disease.

      Miller, Mark R; Raftis, Jennifer B; Langrish, Jeremy P; McLean, Steven G; Samutrtai, Pawitrabhorn; Connell, Shea P; Wilson, Simon; Vesey, Alex T; Fokkens, Paul H B; Boere, A John F; et al. (2017-05-23)
      The development of engineered nanomaterials is growing exponentially, despite concerns over their potential similarities to environmental nanoparticles that are associated with significant cardiorespiratory morbidity and mortality. The mechanisms through which inhalation of nanoparticles could trigger acute cardiovascular events are emerging, but a fundamental unanswered question remains: Do inhaled nanoparticles translocate from the lung in man and directly contribute to the pathogenesis of cardiovascular disease? In complementary clinical and experimental studies, we used gold nanoparticles to evaluate particle translocation, permitting detection by high-resolution inductively coupled mass spectrometry and Raman microscopy. Healthy volunteers were exposed to nanoparticles by acute inhalation, followed by repeated sampling of blood and urine. Gold was detected in the blood and urine within 15 min to 24 h after exposure, and was still present 3 months after exposure. Levels were greater following inhalation of 5 nm (primary diameter) particles compared to 30 nm particles. Studies in mice demonstrated the accumulation in the blood and liver following pulmonary exposure to a broader size range of gold nanoparticles (2-200 nm primary diameter), with translocation markedly greater for particles <10 nm diameter. Gold nanoparticles preferentially accumulated in inflammation-rich vascular lesions of fat-fed apolipoproteinE-deficient mice. Furthermore, following inhalation, gold particles could be detected in surgical specimens of carotid artery disease from patients at risk of stroke. Translocation of inhaled nanoparticles into the systemic circulation and accumulation at sites of vascular inflammation provides a direct mechanism that can explain the link between environmental nanoparticles and cardiovascular disease and has major implications for risk management in the use of engineered nanomaterials.
    • The INHERIT Model: A Tool to Jointly Improve Health, Environmental Sustainability and Health Equity through Behavior and Lifestyle Change.

      van der Vliet, Nina; Staatsen, Brigit; Kruize, Hanneke; Morris, George; Costongs, Caroline; Bell, Ruth; Marques, Sibila; Taylor, Timothy; Quiroga, Sonia; Martinez Juarez, Pablo; et al. (2018-07-07)
      The need for analysis and action across the interrelated domains of human behaviors and lifestyles, environmental sustainability, health and inequality is increasingly apparent. Currently, these areas are often not considered in conjunction when developing policies or interventions, introducing the potential for suboptimal or conflicting outcomes. The INHERIT model has been developed within the EU-funded project INHERIT as a tool to guide thinking and intersectoral action towards changing the behaviors and lifestyles that play such an important role in today’s multidisciplinary challenges. The model integrates ecological public health and behavioral change models, emphasizing inequalities and those parts of the causal process that are influenced by human behaviors and lifestyles. The model was developed through web-based and live discussions with experts and policy stakeholders. To test the model’s usability, the model was applied to aspects of food consumption. This paper shows that the INHERIT model can serve as a tool to identify opportunities for change in important −food-related behaviors and lifestyles and to examine how they impact on health, health inequalities, and the environment in Europe and beyond. The INHERIT model helps clarify these interrelated domains, creating new opportunities to improve environmental health and health inequality, while taking our planetary boundaries into consideration.
    • Inhibiting ex-vivo Th17 responses in Ankylosing Spondylitis by targeting Janus kinases.

      Hammitzsch, Ariane; Chen, Liye; de Wit, Jelle; Al-Mossawi, M Hussein; Ridley, Anna; Sekine, Takuya; Simone, Davide; Doig, Karen; Skapenko, Alla; Bowness, Paul (2018-10-23)
      Treatment options for Ankylosing Spondylitis (AS) are still limited. The T helper cell 17 (Th17) pathway has emerged as a major driver of disease pathogenesis and a good treatment target. Janus kinases (JAK) are key transducers of cytokine signals in Th17 cells and therefore promising targets for the treatment of AS. Here we investigate the therapeutic potential of four different JAK inhibitors on cells derived from AS patients and healthy controls, cultured in-vitro under Th17-promoting conditions. Levels of IL-17A, IL-17F, IL-22, GM-CSF and IFNγ were assessed by ELISA and inhibitory effects were investigated with Phosphoflow. JAK1/2/3 and TYK2 were silenced in CD4+ T cells with siRNA and effects analyzed by ELISA (IL-17A, IL-17F and IL-22), Western Blot, qPCR and Phosphoflow. In-vitro inhibition of CD4+ T lymphocyte production of multiple Th17 cytokines (IL-17A, IL-17F and IL-22) was achieved with JAK inhibitors of differing specificity, as well as by silencing of JAK1-3 and Tyk2, without impacting on cell viability or proliferation. Our preclinical data suggest JAK inhibitors as promising candidates for therapeutic trials in AS, since they can inhibit multiple Th17 cytokines simultaneously. Improved targeting of TYK2 or other JAK isoforms may confer tailored effects on Th17 responses in AS.
    • Initiation of anti-retroviral therapy before pregnancy reduces the risk of infection-related hospitalization in HIV-exposed uninfected infants born in a high-income country.

      Goetghebuer, Tessa; Smolen, Kinga K; Adler, Catherine; Das, Jishnu; McBride, Trevor; Smits, Gaby; Lecomte, Sandra; Haelterman, Edwige; Barlow, Patricia; Piedra, Pedro A; et al. (2018-09-12)
      Epidemiological studies conducted in low and high-income countries showed that infants exposed to maternal HIV but not infected themselves by the virus have a high risk of severe infections. Immune alterations during fetal life have been proposed as a possible mechanism.
    • INNO-LiPA DNA line probe assay misidentification of M. smegmatis as Mycobacterium fortuitum complex.

      van den Broek, Theo; Janssen, Nard G; Hetem, David J; Bekers, Wouter; Kamst, Miranda; Fluit, Ad C; van Ingen, Jakko; Kusters, Johannes G; Rentenaar, Rob J (2019-06-24)
    • Innovating dementia care; implementing characteristics of green care farms in other long-term care settings.

      Buist, Yvette; Verbeek, Hilde; de Boer, Bram; de Bruin, Simone R (2018-01-16)
      People with dementia at green care farms (GCFs) are physically more active, have more social interactions, are involved in a larger variety of activities, and come outdoors more often than those in other long-term dementia care settings. These aspects may positively affect health and well-being. This study explored which and how characteristics of GCFs could be implemented in other long-term dementia care settings, taking into account possible facilitators and barriers.
    • Innovative organotypic in vitro models for safety assessment: aligning with regulatory requirements and understanding models of the heart, skin, and liver as paradigms.

      Pridgeon, Chris S; Schlott, Constanze; Wong, Min Wei; Heringa, Minne B; Heckel, Tobias; Leedale, Joe; Launay, Laurence; Gryshkova, Vitalina; Przyborski, Stefan; Bearon, Rachel N; et al. (2018-01-23)
      The development of improved, innovative models for the detection of toxicity of drugs, chemicals, or chemicals in cosmetics is crucial to efficiently bring new products safely to market in a cost-effective and timely manner. In addition, improvement in models to detect toxicity may reduce the incidence of unexpected post-marketing toxicity and reduce or eliminate the need for animal testing. The safety of novel products of the pharmaceutical, chemical, or cosmetics industry must be assured; therefore, toxicological properties need to be assessed. Accepted methods for gathering the information required by law for approval of substances are often animal methods. To reduce, refine, and replace animal testing, innovative organotypic in vitro models have emerged. Such models appear at different levels of complexity ranging from simpler, self-organized three-dimensional (3D) cell cultures up to more advanced scaffold-based co-cultures consisting of multiple cell types. This review provides an overview of recent developments in the field of toxicity testing with in vitro models for three major organ types: heart, skin, and liver. This review also examines regulatory aspects of such models in Europe and the UK, and summarizes best practices to facilitate the acceptance and appropriate use of advanced in vitro models.
    • Inschatting gezondheidsrisico's grafietregen Wijk aan Zee

      Geraets, L; Schulpen, S (Rijksinstituut voor Volksgezondheid en Milieu, 2019-06-04)
      De afgelopen jaren is er bij het slakverwerkingsproces bij Tata Steel en Harsco verschillende keren een uitstoot geweest waarbij grafietregen in de omgeving terecht kwam. De bewoners van Wijk aan Zee willen inzicht hebben in de samenstelling van deze grafietregen en de mogelijke risico’s voor hun gezondheid. De provincie Noord-Holland heeft het RIVM gevraagd te kijken naar de mogelijkheden tot onderzoek. Hiervoor zijn vragen van de bewoners over de uitstoot van grafietregen in kaart gebracht en, waar mogelijk, beantwoord. Ook is een inschatting gemaakt van de gezondheidsrisico’s als gevolg van blootstelling aan stoffen in grafietregen.
    • Insights into Livestock-Related Microbial Concentrations in Air at Residential Level in a Livestock Dense Area.

      de Rooij, Myrna M T; Hoek, Gerard; Schmitt, Heike; Janse, Ingmar; Swart, Arno; Maassen, Catharina B M; Schalk, Marjolijn; Heederik, Dick J J; Wouters, Inge M (2019-07-02)
    • Insights into possibilities for grouping and read-across for nanomaterials in EU chemicals legislation.

      Mech, A; Rasmussen, K; Jantunen, P; Aicher, L; Alessandrelli, M; Bernauer, U; Bleeker, E A J; Bouillard, J; Di Prospero Fanghella, P; Draisci, R; et al. (2018-09-05)
      This paper presents a comprehensive review of European Union (EU) legislation addressing the safety of chemical substances, and possibilities within each piece of legislation for applying grouping and read-across approaches for the assessment of nanomaterials (NMs). Hence, this review considers both the overarching regulation of chemical substances under REACH (Regulation (EC) No 1907/2006 on registration, evaluation, authorization, and restriction of chemicals) and CLP (Regulation (EC) No 1272/2008 on classification, labeling and packaging of substances and mixtures) and the sector-specific pieces of legislation for cosmetic, plant protection and biocidal products, and legislation addressing food, novel food, and food contact materials. The relevant supporting documents (e.g. guidance documents) regarding each piece of legislation were identified and reviewed, considering the relevant technical and scientific literature. Prospective regulatory needs for implementing grouping in the assessment of NMs were identified, and the question whether each particular piece of legislation permits the use of grouping and read-across to address information gaps was answered.
    • Intake of dietary saturated fatty acids and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort: associations by types, sources of fatty acids and substitution by macronutrients.

      Liu, Shengxin; van der Schouw, Yvonne T; Soedamah-Muthu, Sabita S; Spijkerman, Annemieke M W; Sluijs, Ivonne (2018-03-09)
      The association between dietary saturated fatty acids (SFA) intake and type 2 diabetes (T2D) remains unclear. This study aimed at investigating the association between SFA intake and T2D risk based on (1) individual SFA (differing in carbon chain length), (2) food sources of SFA and (3) the substituting macronutrients.
    • Intake of Fat-Soluble Vitamins in the Belgian Population: Adequacy and Contribution of Foods, Fortified Foods and Supplements.

      Moyersoen, Isabelle; Devleesschauwer, Brecht; Dekkers, Arnold; de Ridder, Karin; Tafforeau, Jean; van Camp, John; van Oyen, Herman; Lachat, Carl (2017-08-11)
      A key challenge of public health nutrition is to provide the majority of the population with a sufficient level of micronutrients while preventing high-consumers from exceeding the tolerable upper intake level. Data of the 2014 Belgian food consumption survey (n = 3200) were used to assess fat-soluble vitamin (vitamins A, D, E and K) intake from the consumption of foods, fortified foods and supplements. This study revealed inadequate intakes for vitamin A, from all sources, in the entire Belgian population and possible inadequacies for vitamin D. The prevalence of inadequate intake of vitamin A was lowest in children aged 3-6 (6-7%) and highest in adolescents (girls, 26%; boys, 34-37%). Except for women aged 60-64 years, more than 95% of the subjects had vitamin D intake from all sources below the adequate intake (AI) of 15 μg/day. The risk for inadequate intake of vitamins K and E was low (median > AI). Belgian fortification and supplementation practices are currently inadequate to eradicate suboptimal intakes of vitamins A and D, but increase median vitamin E intake close to the adequate intake. For vitamin A, a small proportion (1-4%) of young children were at risk of exceeding the upper intake level (UL), while for vitamin D, inclusion of supplements slightly increased the risk for excessive intakes (% > UL) in adult women and young children. The results may guide health authorities when developing population health interventions and regulations to ensure adequate intake of fat-soluble vitamins in Belgium.
    • Intake of individual fatty acids and risk of prostate cancer in the European prospective investigation into cancer and nutrition.

      Perez-Cornago, Aurora; Huybrechts, Inge; Appleby, Paul N; Schmidt, Julie A; Crowe, Francesca L; Overvad, Kim; Tjønneland, Anne; Kühn, Tilman; Katzke, Verena; Trichopoulou, Antonia; et al. (2019-02-26)
      The associations of individual dietary fatty acids with prostate cancer risk have not been examined comprehensively. We examined the prospective association of individual dietary fatty acids with prostate cancer risk overall, by tumor subtypes, and prostate cancer death. 142,239 men from the European Prospective Investigation into Cancer and Nutrition who were free from cancer at recruitment were included. Dietary intakes of individual fatty acids were estimated using center-specific validated dietary questionnaires at baseline and calibrated with 24-h recalls. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). After an average follow-up of 13.9 years, 7,036 prostate cancer cases and 936 prostate cancer deaths were ascertained. Intakes of individual fatty acids were not related to overall prostate cancer risk. There was evidence of heterogeneity in the association of some short chain saturated fatty acids with prostate cancer risk by tumor stage (p
    • Intakes of 4 dietary lignans and cause-specific and all-cause mortality in the Zutphen Elderly Study.

      Milder, Ivon E J; Feskens, Edith J M; Arts, Ilja C W; Bueno-de-Mesquita, H Bas; Hollman, Peter C H; Kromhout, Daan (2006-08-01)
      BACKGROUND: Plant lignans are converted to enterolignans that have antioxidant and weak estrogen-like activities, and therefore they may lower cardiovascular disease and cancer risks. OBJECTIVE: We investigated whether the intakes of 4 plant lignans (lariciresinol, pinoresinol, secoisolariciresinol, and matairesinol) were inversely associated with coronary heart disease (CHD), cardiovascular diseases (CVD), cancer, and all-cause mortality. DESIGN: The Zutphen Elderly Study is a prospective cohort study in which 570 men aged 64-84 y were followed for 15 y. We recently developed a database and used it to estimate the dietary intakes of 4 plant lignans. Lignan intake was related to mortality with the use of Cox proportional hazards analysis. RESULTS: The median total lignan intake in 1985 was 977 microg/d. Tea, vegetables, bread, coffee, fruit, and wine were the major sources of lignan. The total lignan intake was not related to mortality. However, the intake of matairesinol was inversely associated with CHD, CVD, and all-cause mortality (P