RIVM Publications Repository

Each year the Dutch National Institute for Public Health and the Environment (RIVM) produces numerous reports and publications on all aspects of public health, nutrition and food, health care, disaster management, nature and the environment. 
In addition, RIVM employees publish scientific articles in national and international journals.

Elk jaar brengt het Rijksinstituut voor Volksgezondheid en Milieu (RIVM) talloze rapporten en adviezen uit over volksgezondheid en gezondheidszorg, voeding, natuur en milieu en rampenbestrijding. 
Daarnaast publiceren RIVM-medewerkers wetenschappelijke artikelen in (inter-)nationale tijdschriften.

We are constantly working to improve the Repository. Please contact our administrator if you have any further questions or remarks. 

Recent Submissions

  • PublicationOpen Access
    Adviesnotitie met aanbevelingen voor multidisciplinaire zorg voor vliegend personeel met gezondheidsklachten en vermoeden van 'aerotoxisch syndroom'
    (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2026-07-10) Hendriks, H

    Dit is de derde adviesnotitie van de Nationale Adviesgroep Cabinelucht (NAC). In deze adviesnotitie wordt een concreet advies gegeven met een aanbeveling om vliegend personeel met gezondheidsklachten en vermoeden van 'aerotoxisch syndroom' voor multidisciplinaire zorg. Het doel van deze adviesnotitie is passende zorg gaan bieden met de mogelijkheid om onderzoek te doen naar een al dan niet causaal verband tussen blootstelling aan chemische stoffen via cabinelucht en gezondheidsklachten bij vliegend personeel.

    De NAC is in 2015 door het ministerie van Infrastructuur en Waterstaat (IenW) opgericht naar aanleiding van internationale discussies over de oorzaak van de gezondheidsklachten bij piloten en cabinepersoneel van vliegtuigen. Het RIVM voert sinds 2020 het secretariaat van de NAC. De adviesgroep informeert alle betrokken partijen over internationale onderzoeken naar de kwaliteit van cabinelucht in vliegtuigen. Deze adviesnotitie is opgesteld door leden van de NAC en zal namens IenW worden aangeboden aan de minister en de Tweede Kamer.

  • PublicationOpen Access
    Rapportage 2025 Nationale Adviesgroep Cabinelucht
    (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2026-07-10) Hendriks, HS

    Piloten en cabinepersoneel in vliegtuigen kunnen gezondheidsklachten hebben, zoals duizeligheid, misselijkheid, desoriëntatie en trillende ledematen. Ondanks veel onderzoek is de oorzaak van de klachten nog steeds niet duidelijk. Ook is onduidelijk hoe vaak de klachten voorkomen.

    Naar aanleiding van de internationale discussie hierover heeft het ministerie van Infrastructuur en Waterstaat (IenW) in 2015 de Nationale Adviesgroep Cabinelucht (NAC) opgericht. De adviesgroep adviseert de minister van IenW over dit onderwerp. Ook informeert de NAC alle betrokken partijen over internationale onderzoeken naar de kwaliteit van cabinelucht in vliegtuigen. De NAC rapporteert elk jaar de voortgang en resultaten van bijeenkomsten en onderzoeken.

    Zo heeft de NAC in 2025 verder gewerkt aan een adviesnotitie. Daarin adviseert de NAC één centrale plek op te richten met verschillende deskundigen waar personeel met gezondheidsklachten terecht kan. Op deze plek is de best mogelijke zorg beschikbaar en worden klachten vanuit verschillende vakgebieden onderzocht. Ook kunnen de deskundigen daar veel informatie verzamelen en voor onderzoek gebruiken. Het gaat bijvoorbeeld om personeel met klachten na een fume event, waarbij chemische stoffen de cabine in lekken.

    In de NAC zitten vertegenwoordigers van werkgevers: KLM en Corendon, van werknemers: VNV, NVLT, VNC en FNV Cabine en onderzoeksinstituten: RIVM (Rijksinstituut voor Volksgezondheid en Milieu), NLR (Nederlands Lucht- en Ruimtevaartcentrum) en TNO (Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek). Vertegenwoordigers vanuit de ministeries van IenW en Sociale Zaken en Werkgelegenheid (SZW) zijn waarnemend lid. Het RIVM voert sinds 2020 het secretariaat.

  • PublicationMetadata only
    Community participation in Health Impact Assessment
    (Cheltenham : Edward Elgar, 2026, 2026-05-12) Staatsen, Brigit; Elberse, Janneke; den Broeder, Lea
    Introduction The COVID pandemic, extreme weather events related to climate change, and geopolitical turmoil, have shown that impactful events have grave consequences for the health and well-being of people across society. Given these developments, the future might seem more insecure than before these recent developments. However, although what lies ahead of us is never certain, the future is also not ‘empty’. Our future, including the future of our health, is connected with past and current developments, and today's actions are meaningful in shaping it. With this apparent insecurity, however, the need to address linkages between public health and other societal dimensions becomes more urgent. Navigating through and between these dimensions requires knowledge about where they meet, where they clash and what the implications are of trade-offs that policy- and decision-makers choose. Health Impact Assessment (HIA) is one of the tools that help us unravel the interconnectedness of health and other societal dimensions in a very concrete way, namely at the level of proposed developments or even policies. As such, it is a key tool that helps put Health in All Policies into practice. Health in All Policies (HiAP) is an approach in public policies that takes the implications for health of all policy domains into account. However, recognising these implications does not mean that all other priorities need to be set aside for health. Instead, transparency about choices made and about the considerations leading to these choices is core (Leppo et al., 2013). It is important to be aware that putting health first may create barriers rather than support co-operation. Here again, this was demonstrated during the pandemic when many societal sectors faced the necessity to adapt to a health crisis, but also had to deal with societal discomfort. Bit by bit, therefore, a Health FOR All Policies approach is gaining attention. This means that the benefits of promoting and protecting the health of the population for other societal goals, for example, sustaining the workforce or improving the population's educational level, should also become more clearly articulated (Jansen-van Eijndt et al., 2023). In addition, policymaking is only one aspect of societal development. If health promotion and protection are to thrive, it also needs to focus on the role and influence of societal organisations and the private sector as well. This is reflected by concepts such as the ‘economy of well-being’ (EuroHealthNet, 2022) and, inversely, the ‘commercial determinants of health’ (Gilmore et al., 2023). This development also calls for broader participation in HiAP, of both people and communities, as well as other stakeholders. According to the Adelaide Statement on Health in All Policies, the active engagement of communities is a core ingredient of HiAP (World Health Organization, 2017). Stakeholder participation, in particular of affected populations, is also one of the key principles of HIA. However, as demonstrated by McDermott et al. (2024), this principle is not reflected well in every HIA guidance document; this means there is room for improvement. Therefore, this chapter focuses on the participation of citizens and professionals working in local communities as an important stakeholder group. We discuss, first, the benefits of such community participation in HIA. Second, we discuss the importance of levels of participation and the criteria for participation. We provide several examples of community participation in HIA for project and policy development. The cases described are located in the Netherlands. As Dutch native speakers, we have access to local knowledge about these examples, allowing a deeper understanding of both the complexity of issues and developments at stake, as well as what features and aspects link up to the broader body of knowledge about community participation in HIA. Finally, we summarise which steps need to be taken to meaningfully develop community participation in HIA for the future. This chapter is underpinned by two of the Best Practice Principles for HIA (Winkler et al., 2021). First of all, the ethical use of evidence. We will argue that this should also include the knowledge of citizens and local professionals. Second, stakeholder participation as a democratic value. Elsewhere in this Handbook, the argument is made that HIA is different for projects and for policies. In this chapter, however, we do not explicitly differentiate between the two as far as community participation is concerned. Indeed, while recognising the differences, engaging communities on a project level without understanding how those projects relate to broader policy processes may mean missing out on important background about the situation and related current or past policies affecting people's health and well-being.
  • PublicationMetadata only
    Landscape wetness and beaver wetlands enhance environmental prevalence of Francisella spp.
    (2026-06-20) Hökby, Lovisa; Khalil, Hussein; Bylund, Helena; Forsman, Mats; Lidberg, William; Norman, Anita; Spörndly-Nees, Ellinor; Ågren, Anneli; Maas, Miriam; Ecke, Frauke
    Identifying the contributions of biotic and abiotic factors in pathogen transmission is essential to mitigate vector-borne and zoonotic disease risk. Francisella tularensis is the etiological agent of the infectious disease tularemia in wildlife and humans. Environmental factors driving transmission in wildlife, including the role of hares and beavers, are largely unknown, as are causes of increasing human incidence of tularemia in Europe. We tested whether the degree of wetness in the landscape is related to tularemia status in hares, found dead in 2016–2021 (n = 428), and whether the occurrence of F. tularensis in water varies between beaver wetlands (n = 14) and non-beaver wetlands (n = 14). Latitude, landscape coverage of lakes, streams, and open wetlands, as well as soil moisture, contributed to explaining infection in hares. Notably, F. tularensis and/or Francisella spp. was polymerase chain reaction (PCR)-detected in water of three beaver wetlands, but not in non-beaver wetlands. Our results suggest that wetlands, especially beaver wetlands, play an important role in the transmission cycle of F. tularensis. This finding raises concern regarding the potential role of wetland rewetting and beaver wetlands in amplifying tularemia transmission in wildlife and humans.
  • PublicationMetadata only
    Combined threats of land use, climate change and nitrogen deposition to global vascular plant diversity
    (2026-06-19) Moreira, Hadassa; Janssen, Sharon D; Kuipers, Koen JJ; Posthuma, Leo; Hauck, Mara; Huijbregts, Mark AJ; Schipper, Aafke M
    Vascular plants are threatened by multiple anthropogenic pressures. While the local effects of these pressures on plants are relatively well studied, much less is known about the implications for global plant diversity. Here, we quantify the combined threats of land use, climate change and nitrogen deposition to global vascular plant diversity by upscaling the impacts of these pressures from the local to the global scale. First, we assessed losses of local plant species richness due to contemporary land use, climate change and nitrogen deposition at a spatial resolution of 10 arc-seconds, combining pressure-response relationships based on empirical data with the global distribution of these pressures. Next, we upscaled local species loss to ecoregion-level extinction threat with a multi-pressure species-area relationship model. Finally, we upscaled regional to global extinction threats based on regional endemism richness. We estimate that 23.3% of the vascular plant species are threatened with global extinction, with 57% of the total global extinction threat concentrated in 148 of the 816 ecoregions in the biomes Tropical and subtropical moist broadleaf forests, Temperate broadleaf and mixed forests, Mediterranean forests, woodlands and scrub, and Tropical and subtropical grasslands, savannas and shrub. Land use contributed the most to the global extinction threat (46%) followed by climate change (33%) and nitrogen deposition (21%). Our modelling approach identifies hotspots of extinction threat resulting from combined human pressures and distinguishes the contribution of each individual pressure. Our findings may inform decision-making concerned with the mitigation of pressures and the conservation of vascular plant diversity.
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