Now showing items 1-20 of 10827

    • Cost-effectiveness of a potential anti-tick vaccine with combined protection against Lyme borreliosis and tick-borne encephalitis in Slovenia.

      Mihajlović, J; Hovius, J W R; Sprong, H; Bogovič, P; Postma, M J; Strle, F (2019-01)
      This study assessed cost-effectiveness of a potential anti-tick vaccine that would protect against both Lyme borreliosis (LB) and tick-borne encephalitis (TBE) in a highly endemic setting of Slovenia. A Markov model was developed to estimate cost-effectiveness of a vaccine with potential combined protection against LB and TBE from the societal perspective. The model expressed time in annual cycles, followed a target population through their lifetime, and applied an annual discounting of 3%. A target population entered the model in a susceptible state, with time dependent probabilities to acquire LB/TBE. Disease manifestations were either resolved within one cycle, or a patient developed LB/TBE sequelae. The vaccination consisted of initial immunization and one revaccination. Estimates of LB/TBE direct and indirect costs, and data on natural course of LB/TBE were obtained from Slovenian databases. Effectiveness of the vaccine with potential combined protection against LB/TBE was derived from studies on existing TBE and LB vaccines, while utility estimates were collected from various literature sources. A vaccine with potential combined protection against LB/TBE was predicted to have an incremental cost of €771,300 per 10,000 vaccinated persons, an incremental utility of 17QALYs and a base-case incremental cost-effectiveness ratio (ICER) of 46,061€/QALY. Vaccine cost, effectiveness and discount rates were identified as the most influential model parameters. A wholesale price for a vaccine shot of €9.13 would lead to cost savings followed by health gains for the vaccination strategy. The base-case ICER was below commonly accepted thresholds of cost-effectiveness, indicating that a combined LB/TBE vaccine might be a cost-effective option in Slovenia. With early Health Technology Assessment becoming increasingly important, this analysis still represents a rare example of cost-effectiveness assessment prior to market authorisation. Although obviously in such a situation some key parameters are unknown, our model sets up a tool to analyse pharmacoeconomic criteria that can help development of a cost-effective health technology, in this case a combined tick-borne diseases vaccine.
    • Fate modelling of nanoparticle releases in LCA: An integrative approach towards “USEtox4Nano”

      Salieri, Beatrice; Hischier, Roland; Quik, Joris T.K.; Jolliet, Olivier (2019-01)
    • The cost-utility of stepped-care algorithms according to depression guideline recommendations - Results of a state-transition model analysis.

      Meeuwissen, Jolanda A C; Feenstra, Talitha L; Smit, Filip; Blankers, Matthijs; Spijker, Jan; Bockting, Claudi L H; van Balkom, Anton J L M; Buskens, Erik (2019-01-01)
      Evidence-based clinical guidelines for major depressive disorder (MDD) recommend stepped-care strategies for sequencing evidence-based treatments conditional on treatment outcomes. This study aims to evaluate the cost-effectiveness of stepped care as recommended by the multidisciplinary clinical guideline vis-à-vis usual care in the Netherlands.
    • Staat van Zoönosen 2017

      Uiterwijk, M; Keur, I; Friesema, I; Rozendaal, H; Holtslag, M; van den Kerkhof, H; Kortbeek, T; Maassen, K (Rijksinstituut voor Volksgezondheid en Milieu, 2018-12-11)
      Zoonotic diseases are infections transmissible between animals and humans. This report is an annual description of zoonotic diseases relevant to the Netherlands. Included are reporting trends of notifiable zoonotic diseases, noteworthy research and case studies. This report also focuses on a specific theme related to zoonotic diseases. This year, the theme is One Health collaboration. Similar to previous years, no noteworthy changes were observed in 2017 with regard to most notifiable zoonotic diseases. Foodborne bacteria (Campylobacter, Listeria monocytogenes, Salmonella and STEC) again make up the largest proportion of zoonotic infections this year. The number of cases of leptospirosis is still high, although last year's decline continues. The number of patients with an orthohantavirus-infection has increased further. In 2016, Brucella canis was observed for the first time in dogs in the Netherlands and again in 2017 several imported dogs tested positive for this bacterium. Besides Chlamydia psittaci, several other zoonotic Chlamydia species exist. From 2013, six Dutch patients were diagnosed with C. caviae pneumonia and in 2017, one with C. felis conjunctivitis. Results from a research project about antibiotic resistance (ESBLAT), show that ESBL-genes are most exchanged between people, instead of between animals and humans. Bacteria containing ESBL-genes are able to produce enzymes that prevent antibiotics from working; the bacteria become resistant. The resistance spreads because the genes can be passed on to other bacteria. The Theme of this year is 'Integrated approach of zoonoses; challenges and applications of One Health collaboration'. To signal, assess and control zoonotic infections, there is a strong need for collaboration between different disciplines, based on the principle of One Health. The central idea of One Health is that humans, animals and the environment are interconnec­ted and influence each other. Described is how the One Health principle has evolved. In addition, two recent outbreaks of zoonoses, Seoul in rats and Brucella canis in dogs, show how One Health cooperation in the Netherlands is organised.
    • Voorbij de brand: Leren van ongevallen bij de brandweer : Resultaten van een pilotonderzoek met Storybuilder

      van Kampen J; Chambon M; ABI; M&V (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-12-10)
      The work of the fire service can lead to dangerous situations and (near) accidents for firefighters themselves, which can result in injuries. This can happen during their work activities in the event of a fire, during preparatory activities or during training activities. For instance working with a (chain) saw, diving or situations in which hazardous substances are released. To improve the safety of employees, the fire service wants to learn from incidents. RIVM has therefore developed, in cooperation with the fire service, an instrument that can be used by all safety regions to collect and analyse data in a consistent manner. This creates a better collaboration between the safety regions to prevent incidents. <br> <br>Currently, incidents involving fire service personnel are registered separately per safety region. In this study, six safety regions systematically gathered information about 140 (near) accidents and dangerous situations at the fire service. They registered which type of accident (almost) occurred, which safety measures may have failed and which instruments were used. The tool developed in this study is based on Storybuilder, an existing tool for national investigation of occupational accidents for which employers are obliged to notify the labour inspectorate. <br> <br>The aim of this pilot study was the development of the instrument. Not all accidents that occurred in the Netherlands have been included, and the reported accidents are therefore not representative but give an impression. To use the instrument at a national scale, it is desirable to develop it further and carry out additional research. The study also demonstrates that Storybuilder can be adapted to analyse incidents within a specific sector. <br>
    • Tuberculose in Nederland 2017 : Surveillancerapport - inclusief rapportage monitoring van interventies

      Slump E; Blijboom L; Bregman IM; Erkens CGM; van Hunen R; Schimmel HJ; van Soolingen D; de Vries G; RES; I&amp;V (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-12-10)
      The number of tuberculosis patients in the Netherlands decreased considerably in 2017, after rises in the two preceding years. There were 787 TB patients reported in 2017, compared to 862 in 2015 and 887 in 2016. Nearly three quarters of the total number of TB patients in the Netherlands come from areas where the incidence of this infectious disease is high, such as Africa and Asia. As in previous years, the largest group of patients came from Eritrea (94), followed by Morocco (73) and Somalia (58). Various factors led to the drop. These include the decreasing influx of immigrants in 2016 and 2017 as well as the falling incidence of tuberculosis in the Dutch population. <br> <br>Tuberculosis is caused by a bacterium and cases must be notified to the Municipal Public Health Services in the patient's place of residence. The majority of patients (eighty per cent) went to the doctor of their own accord; ten per cent were found by screening high-risk groups and eight per cent by examining people in the surroundings of contagious patients. Detecting and treating infected contacts as early as possible can avoid having more people catch tuberculosis. Tuberculosis may be contagious, for example if it is in the lungs, but this is not necessarily the case. Its most infectious form (open tuberculosis) was observed in a quarter of patients in 2017. <br> <br>This is shown by the figures for 2017. RIVM reports these figures annually in order to monitor the progress of measures for tackling tuberculosis in the Netherlands. The National Tuberculosis Control Plan 2016-2020 was drawn up to that end in 2016. This plan states for example that all TB patients must be offered HIV testing because HIV infection increases the risk of tuberculosis. The percentage of TB patients in the Netherlands who have been tested for HIV rose from 28 in 2008 to 75 in 2017. In 2017, 23 TB patients were infected with HIV. <br> <br>Another of the targets of the National Tuberculosis Control Plan 2016-2020 is that 90 per cent of TB patients should complete their medicinal treatment, i.e. not stopping it too early. This is important because successful treatment involves patients taking a number of medicines at the same time for a long period of time (for six months or more). This objective was achieved in 2016 for patients who were not resistant to the key medicine against tuberculosis (rifampicin). The treatment results for 2017 are not yet known. <br> <br>When the TB bacterium is insensitive to rifampicin, this is known as rifampicin-resistant tuberculosis. A complex and lengthier course of treatment is then required. Over the last five years, the number of such patients in the Netherlands has fluctuated between ten and twenty. There were eleven in 2017. <br>
    • Voorbij de brand: Leren van ongevallen bij de brandweer : Resultaten van een pilotonderzoek met Storybuilder

      van Kampen J; Chambon M (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-12-10)
      The work of the fire service can lead to dangerous situations and (near) accidents for firefighters themselves, which can result in injuries. This can happen during their work activities in the event of a fire, during preparatory activities or during training activities. For instance working with a (chain) saw, diving or situations in which hazardous substances are released. To improve the safety of employees, the fire service wants to learn from incidents. RIVM has therefore developed, in cooperation with the fire service, an instrument that can be used by all safety regions to collect and analyse data in a consistent manner. This creates a better collaboration between the safety regions to prevent incidents. Currently, incidents involving fire service personnel are registered separately per safety region. In this study, six safety regions systematically gathered information about 140 (near) accidents and dangerous situations at the fire service. They registered which type of accident (almost) occurred, which safety measures may have failed and which instruments were used. The tool developed in this study is based on Storybuilder, an existing tool for national investigation of occupational accidents for which employers are obliged to notify the labour inspectorate. The aim of this pilot study was the development of the instrument. Not all accidents that occurred in the Netherlands have been included, and the reported accidents are therefore not representative but give an impression. To use the instrument at a national scale, it is desirable to develop it further and carry out additional research. The study also demonstrates that Storybuilder can be adapted to analyse incidents within a specific sector.
    • Tuberculose in Nederland 2017 - Surveillancerapport : inclusief rapportage monitoring van interventies

      Slump E; Blijboom L; Bregman IM; Erkens CGM; van Hunen R; Schimmel HJ; Soolingen D van; de Vries G (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-12-10)
      The number of tuberculosis patients in the Netherlands decreased considerably in 2017, after rises in the two preceding years. There were 787 TB patients reported in 2017, compared to 862 in 2015 and 887 in 2016. Nearly three quarters of the total number of TB patients in the Netherlands come from areas where the incidence of this infectious disease is high, such as Africa and Asia. As in previous years, the largest group of patients came from Eritrea (94), followed by Morocco (73) and Somalia (58). Various factors led to the drop. These include the decreasing influx of immigrants in 2016 and 2017 as well as the falling incidence of tuberculosis in the Dutch population. Tuberculosis is caused by a bacterium and cases must be notified to the Municipal Public Health Services in the patient’s place of residence. The majority of patients (eighty per cent) went to the doctor of their own accord; ten per cent were found by screening high-risk groups and eight per cent by examining people in the surroundings of contagious patients. Detecting and treating infected contacts as early as possible can avoid having more people catch tuberculosis. Tuberculosis may be contagious, for example if it is in the lungs, but this is not necessarily the case. Its most infectious form (open tuberculosis) was observed in a quarter of patients in 2017. This is shown by the figures for 2017. RIVM reports these figures annually in order to monitor the progress of measures for tackling tuberculosis in the Netherlands. The National Tuberculosis Control Plan 2016-2020 was drawn up to that end in 2016. This plan states for example that all TB patients must be offered HIV testing because HIV infection increases the risk of tuberculosis. The percentage of TB patients in the Netherlands who have been tested for HIV rose from 28 in 2008 to 75 in 2017. In 2017, 23 TB patients were infected with HIV. Another of the targets of the National Tuberculosis Control Plan 2016-2020 is that 90 per cent of TB patients should complete their medicinal treatment, i.e. not stopping it too early. This is important because successful treatment involves patients taking a number of medicines at the same time for a long period of time (for six months or more). This objective was achieved in 2016 for patients who were not resistant to the key medicine against tuberculosis (rifampicin). The treatment results for 2017 are not yet known. When the TB bacterium is insensitive to rifampicin, this is known as rifampicin-resistant tuberculosis. A complex and lengthier course of treatment is then required. Over the last five years, the number of such patients in the Netherlands has fluctuated between ten and twenty. There were eleven in 2017.
    • Phytotoxic effects of silver nanoparticles and silver ions to Arabidopsis thaliana as revealed by analysis of molecular responses and of metabolic pathways

      Ke, Mingjing; Qu, Qian; Peijnenburg, W.J.G.M.; Li, Xingxing; Zhang, Meng; Zhang, Zhenyan; Lu, Tao; Pan, Xiangliang; Qian, Haifeng (2018-12)
    • Oral bioaccessibility of silver nanoparticles and ions in natural soils: Importance of soil properties.

      Dang, Fei; Jiang, Yuanyuan; Li, Min; Zhong, Huan; Peijnenburg, WillieJ G M; Shi, Weilin; Zhou, Dongmei (2018-12)
      The abundance of silver nanoparticles (AgNPs) in consumer products has led to their environmental release and therefore to concern about their impact on human health. The ingestion of AgNP-contaminated soil from urban sites is an important exposure pathway, especially for children. Given the limited information on oral bioaccessibility of soil Ag, we used a physiologically based extraction test (PBET) to evaluate the bioaccessibility of AgNPs and AgNO3 from soil digestion. The AgNPs underwent several biochemical transformations, including their simultaneous dissolution and agglomeration in gastric fluid followed by the disintegration in the intestinal fluid of the agglomerates into NPs containing silver and chlorine. Therefore, Ag-containing soil exposed the intestine to nanoparticulate Ag in forms that were structurally different from the original forms. The bioaccessibility of AgNPs (0.5 ± 0.05%-10.9 ± 0.7%) was significantly lower than that of AgNO3 (4.7 ± 0.6%-14.4 ± 0.1%), as a result of the lower adsorption of nanoparticles to soil residues during the digestive process. For the soils tested, the bioaccessibility of AgNPs increased with decreasing clay contents and lower pH. By identifying the soil properties that control AgNP bioaccessibility, a more efficient and accurate screening can be performed of soil types that pose the greatest health risk associated with AgNP exposure.
    • The impact of social capital, land use, air pollution and noise on individual morbidity in Dutch neighbourhoods.

      Zock, Jan-Paul; Verheij, Robert; Helbich, Marco; Volker, Beate; Spreeuwenberg, Peter; Strak, Maciek; Janssen, Nicole A H; Dijst, Martin; Groenewegen, Peter (2018-12)
      Both social and physical neighbourhood factors may affect residents' health, but few studies have considered the combination of several exposures in relation to individual health status.
    • Active commuting through natural environments is associated with better mental health: Results from the PHENOTYPE project.

      Zijlema, Wilma L; Avila-Palencia, Ione; Triguero-Mas, Margarita; Gidlow, Christopher; Maas, Jolanda; Kruize, Hanneke; Andrusaityte, Sandra; Grazuleviciene, Regina; Nieuwenhuijsen, Mark J (2018-12)
      Commuting routes with natural features could promote walking or cycling for commuting. Commuting through natural environments (NE) could have mental health benefits as exposure to NE can reduce stress and improve mental health, but there is little evidence. This study evaluates the association between NE and commuting, whether active or not, and the association between commuting (through NE), whether active or not, and mental health. We also evaluate the moderating effect of NE quality on the association between NE commuting and mental health.
    • Data on child complementary feeding practices, nutrient intake and stunting in Musanze District, Rwanda.

      Uwiringiyimana, Vestine; Ocké, Marga C; Amer, Sherif; Veldkamp, Antonie (2018-12)
      Stunting prevalence in Rwanda is still a major public health issue, and data on stunting is needed to plan relevant interventions. This data, collected in 2015, presents complementary feeding practices, nutrient intake and its association with stunting in infants and young children in Musanze District in Rwanda. A household questionnaire and a 24-h recall questionnaire were used to collect the data. In total 145 children aged 5-30 months participated in the study together with their caregivers. The anthropometric status of children was calculated using WHO Anthro software [1] according to the WHO growth standards [2]. The complementary feeding practices together with households' characteristics are reported per child stunting status. The nutrient intake and food group consumption are presented per age group of children. Also, the percentage contribution of each food groups to energy and nutrient intake in children is reported. The data also shows the association between zinc intake and age groups of children. Using multiple linear regression, a sensitivity analysis was done with height-for-age z-score as the dependent variable and exclusive breastfeeding, deworming table use, BMI of caregiver, dietary zinc intake as independent variables. The original linear regression model and a detailed methodology and analyses conducted are presented in Uwiringiyimana et al. [3].
    • Key criteria for developing ecosystem service indicators to inform decision making

      van Oudenhoven, Alexander P.E.; Schröter, Matthias; Drakou, Evangelia G.; Geijzendorffer, Ilse R.; Jacobs, Sander; van Bodegom, Peter M.; Chazee, Laurent; Czúcz, Bálint; Grunewald, Karsten; Lillebø, Ana I.; Mononen, Laura; Nogueira, António J.A.; Pacheco-Romero, Manuel; Perennou, Christian; Remme, Roy P.; Rova, Silvia; Syrbe, Ralf-Uwe; Tratalos, Jamie A.; Vallejos, María; Albert, Christian (2018-12)
    • Individual variation in temporal relationships between exposure to radiofrequency electromagnetic fields and non-specific physical symptoms: A new approach in studying 'electrosensitivity'.

      Bogers, R P; van Gils, A; Clahsen, S C S; Vercruijsse, W; van Kamp, I; Baliatsas, C; Rosmalen, J G M; Bolte, J F B (2018-12)
      Everyday exposure to radiofrequency electromagnetic fields (RF-EMF) emitted from wireless devices such as mobile phones and base stations, radio and television transmitters is ubiquitous. Some people attribute non-specific physical symptoms (NSPS) such as headache and fatigue to exposure to RF-EMF. Most previous laboratory studies or studies that analyzed populations at a group level did not find evidence of an association between RF-EMF exposure and NSPS.
    • Effects of lomefloxacin on survival, growth and reproduction of Daphnia magna under simulated sunlight radiation

      Luo, Tianlie; Chen, Jingwen; Li, Xuehua; Zhang, Shuying; Yao, Hongye; Peijnenburg, Willie J.G.M. (2018-12)
    • Associations of residential exposure to agricultural pesticides with asthma prevalence in adolescence: The PIAMA birth cohort.

      Bukalasa, Joseph S; Brunekreef, Bert; Brouwer, Maartje; Koppelman, Gerard H; Wijga, Alet H; Huss, Anke; Gehring, Ulrike (2018-12)
      It has been suggested that children who are exposed to agricultural pesticides have an increased risk of asthma, but evidence for associations betweeen residential pesticide exposure and childhood asthma is inconsistent.
    • Chemical composition and source identification of PM 10 in five North Western European cities

      Hama, Sarkawt M.L.; Cordell, Rebecca L.; Staelens, Jeroen; Mooibroek, Dennis; Monks, Paul S. (2018-12)
    • The response of metal leaching from soils to climate change and land management in a temperate lowland catchment

      van der Perk, Marcel; Stergiadi, Maria; de Nijs, Ton C.M.; Comans, Rob N.J.; Bierkens, Marc F.P. (2018-12)
    • Het amnionmembraan : Een verkenning

      de Vries C; Braakhuis HM; EVG; V&amp;Z (Rijksinstituut voor Volksgezondheid en Milieu RIVM, 2018-11-30)
      The National Institute for Public Health and the Environment (RIVM) has carried out an exploratory study into new developments and possible risks associated with the use of the so-called amniotic membrane, both in the Netherlands and elsewhere. For decades, the membrane has been used in ophthalmology as a graft to allow damaged corneas to heal. The amniotic membrane is a very thin membrane that is taken from the placenta. Its use is limited in the Netherlands. <br> <br>New developments concerning the amniotic membrane have mainly been described in the international literature. Research has been carried out into repairing damaged tissues by using stem cells obtained from comparable healthy tissue and growing them on amniotic membrane. The membrane with stem cells can then be placed on the damaged tissue. Another development currently being researched is the possibility of using stem cells from the amniotic membrane to repair damage to other tissues, such as muscles. In the Netherlands, amniotic membrane is mainly used to cover damage to the cornea of the eye. <br> <br>The literature reports only a limited number of risks, such as pain, associated with the use of amniotic membrane. As far as is known, in the Netherlands no complications have been reported concerning treatment with amniotic membrane.<br>