Dr. Els van Schie has been appointed RIVM Director of Environment and Safety as from 1 February 2015. She will succeed Dr. Marcel van Raaij and interim director Dr. Jan Roels, and brings to RIVM valuable knowledge and experience on environment and safety.
RIVM has developed a new version of QMRAspot (2.0), a user-friendly computational tool to calculate the risk of becoming infected by pathogenic microorganisms in drinking water. In addition, RIVM has published a user’s manual that also explains the underlying models for the tool.
At least 20 million adults in Europe are annoyed by transportation noise in agglomerations, from motorways, airports or railways. The majority of the noise annoyance and 90 percent of the burden of disease of environmental noise are related to the exposure to road traffic noise. This is the outcome of a RIVM report compiled for the European Commission.
The Statistical Program to Assess Dietary Exposure (SPADE), developed by RIVM, is now available. SPADE estimates the habitual intake distribution for foods or dietary components based on information of intake, measured on a limited number of days.
The patient, who was admitted in the Radboud univerisity medical center over the past few days because of a suspected Ebola infection, was proven not to be infected. This has been demonstrated by the definitive results from the specific tests.
In November 2014 avian ‘flu has been detected on poultry farms in the Netherlands. It is the highly pathogenic variant of avian influenza A (H5N8), which is very dangerous for poultry (chickens, ducks and turkeys).
There are many possible biobased alternatives to substances of very high concern (SVHC). Some are even ready to be deployed right away. This is the outcome of a study by Wageningen UR Food & Biobased Research commissioned by the Dutch National Institute for Public Health and the Environment (RIVM) and the Dutch Ministry of Infrastructure and the Environment.
Combining strengths in drug discovery and development by partnering with a medium- or large-sized pharmaceutical company increases the likelihood of success in bringing new products to the market for small companies. The drugs of small companies taken over by a medium or large pharmaceutical company, were more often approved by the European Medicines Agency (EMA) for marketing approval than the proprietary drugs from small companies. This was the outcome of a study conducted by Utrecht University, RIVM and the Central Committee on Research Involving Human Subjects (CCMO).
Tuesday 18 November is European Antibiotic Awareness Day. On this day, throughout Europe, attention is focused on the responsible use of antibiotics for people and animals. Using antibiotics incorrectly or too frequently causes bacteria to become increasingly resistant (insusceptible) to the effects of antibiotics. The risk is that illnesses such as pneumonia or bladder infections could become more difficult to treat, or even untreatable. In addition to responsible use of antibiotics, we also focus on the prevention of the spread of resistant bacteria in the Netherlands.
Dr. ZhiChao Dang of the National Institute of Public Health and Environment (RIVM) was appointed honory professor at the highly renowned Nanjing Institute of Geography and Limnology, Chinese Academy of Sciences (NIGLAS). RIVM aims to enhance cooperation with China on important research topics such as endocrine disrupting chemicals.
Every year, RIVM supplies an overview of surveillance and developments in the National Immunisation Programme (NIP). One striking event in 2013 was the measles epidemic that ran until February 2014 and was particularly widespread in areas where vaccination uptake was low. Vaccination schedules were also altered: the pneumococcal vaccination changed from four to three injections and the HPV vaccination from three to two injections. Participation in the NIP in the Netherlands remains at a high level. Continuous monitoring is still necessary to maintain this effective and safe vaccination programme.
In personalised medicine, patients are treated with medicinal products according to their individual characteristics, such as genetic background, instead of a traditional one-size-fits-all approach. Genetic screening of patients for effective and safe treatment with medicinal products is performed using in vitro diagnostic devices (IVDs), including genetic tests. Therefore, in personalised medicine, medicinal products and IVDs are linked. However, different regulatory frameworks exist for these two components of personalised medicine. The current RIVM report states that in order to adequately control the risks of personalised medicine, the legislation of medicinal products and that of IVDs should be linked. Also, RIVM research reveals that the training of healthcare professionals in the use of personalised medicine techniques needs to be improved.
RIVM has conducted an explorative study on the use of point-of-care (POC) tests in nursing homes. The study shows that many quality and safety aspects related to the use of POC tests are managed well in most of the nursing homes. This includes aspects such as hygienic measures, patient identification, maintenance of POC test meters and the handling of samples. Yet, for some other aspects, more attention is needed.
Measurements by thousands of citizen scientists in the Netherlands using their smartphones and the iSPEX add-on are delivering accurate data on fine air particles in the atmosphere that add valuable information to professional measurements. The scientific article that presents these first results of the iSPEX project is being published today in Geophysical Research Letters.
In safeguarding the quality, safety and efficacy of medicinal products, the present EU regulatory system has become a time consuming and highly regulated process. This raises questions about the sustainability of the system. Today RIVM published the report entitled Minds Open: sustainability of the European regulatory system for medicinal products, which deals with the four key issues of safety and efficacy, cost, innovation, and availability.
As 21 days have passed since the two aid workers evacuated from Sierra Leone had unprotected contact with Ebola patients, active monitoring of their health status by the Community Health Service has ended.
The average annual disease burden for the total Dutch population was highest for invasive pneumococcal disease and influenza. This is based on data on 32 infectious diseases published by RIVM in the annual ‘State of Infectious Diseases in the Netherlands’. This disease burden is the number of healthy years lost due to infectious diseases. These and other findings in the report are used by policy makers in public health to assess preventive measures.
The Medicines Evaluation Board (MEB), the Netherlands Pharmacovigilance Centre (Lareb), the National Institute for Public Health and the Environment (RIVM), and the National Health Care Institute will work even closer together to make reliable information about medicines more easily accessible to the user.
On the first day of the 17th European Health Forum Gastein (EHFG), the Dutch National Institute for Public Health and the Environment (RIVM) organises a workshop on ‘Our health in 2040’. The workshop is based on the sixth edition of the Public Health Status and Foresight Report (PHSF): A healthier Netherlands. Annemiek van Bolhuis en Nancy Hoeymans (RIVM) will share their working experience with different future scenarios for public health. Together with a panel and the audience, they will discuss how foresight and scenarios can support policy-making in Europe.
The two patients, who have been admitted to the hospital under suspicion of an Ebola infection, are not infected with the virus. Further investigations revealed that in both cases the symptoms were caused by malaria. Both patients are being treated for malaria.
On 22 September, following the request of the General Practitioner, a patient was transported to the Radboudumc in order to undergo further medical assessment. The patient had visited an area where according to the WHO Ebola virus transmission occurs and developed disease symptoms upon return to the Netherlands. This assessment is not unique. Over the past weeks a few other patients who developed disease symptoms after returning from an Ebola risk area have been assessed. Such patients are examined in an specially equipped isolation room.
Two repatriated Dutch aid workers were discharged Monday 15 September from Leiden University Medical Center (LUMC) after a 24-hour observation period. They were admitted Sunday 14 September as a precaution after having had unprotected contact with patients who turned out to be infected with the Ebola virus in Sierra Leone. Fortunately, the care providers are not showing any disease symptoms at the moment and are thus not contagious, even if they would prove to develop Ebola at a later stage. They have decided to spend the time in which they might develop disease symptoms at a secluded location. During this period, the Municipal Health Service in their region will meticulously monitor their health on a daily basis, such as body temperature and disease symptoms which include diarrhoea, vomiting and muscular pain.
On September 12, 2014, RIVM organised the symposium ‘Acceptation of and communication about the National Immunisation Programme’. During this symposium, various experts discussed the results of the doctoral research conducted by Irene Harmsen of RIVM in cooperation with Maastricht University and TNO Healthy Living Leiden. The most important outcome is that from now onwards RIVM is able to listen more closely to the views on the National Immunisation Programme of the public, including parents and children’s health clinic personnel.
Two Dutch doctors working for an NGO (the Lion Heart Foundation) will be evacuated from Sierra Leone. They had direct contact with Ebola infected patients in Sierra Leone while their protective equipment was not fully adequate. The doctors have shown no symptoms of the infection so far. The two doctors will be evacuated and their condition will be assessed by doctors upon arrival.
Every four years, RIVM assesses the quality, accessibility and affordability of the Dutch healthcare system. The Dutch Health Care Performance Report 2014 highlights numerous positive developments, as well as a some issues for consideration.
RIVM has created an overview of the possible risks of bisphenol A (BPA) for humans and the environment. BPA is a component of many different products and affects the endocrine system. Based on scientific studies, it is as yet unclear whether the current levels of exposure to BPA are harmful for humans and the environment.
RIVM has sent a message to Community Health Services containing information about how issues concerning Ebola are arranged in the Netherlands. The Community Health Service can use this information to inform General Practitioners and after-hours clinics about Ebola and refer to the information available at the NHG (Dutch College of General Practitioners) and LHV (National Association of General Practitioners). GPs are advised to inquire about the travelling history of potentially suspect patients by telephone. If a GP believes this might concern an Ebola infection, consultation with the relevant Community Health Service will take place immediately.
In recent years the Netherlands has witnessed an increase in the number of cases of gastroenteritis caused by the Campylobacter bacterium. It appears that the use of a certain type of antacid (proton pump inhibitor) is involved in this. According to an article by RIVM researchers published today in the Eurosurveillance scientific magazine, most Campylobacter infections seem to be related to the use of proton pump inhibitors among the elderly in particular.
In our annual report, we look back at compelling RIVM projects and research in 2013. For instance, our role in the measles epidemic, the health risks of alternative tobacco products like the e-cigarette, the introduction of a new bowel cancer screening programme and our involvement in the Knowledge Centre Healthy Urban Living for healthy and sustainable cities.
August 8th the World Health Organization declared the Ebola outbreak in West Africa an international health emergency and appealed for global aid to help afflicted countries. "A coordinated international response is deemed essential to stop and reverse the international spread of Ebola," the WHO said in a statement after a two-day meeting of its emergency committee on Ebola. The risk of the virus entering the Netherlands remains small but cannot be ruled out. Vigilance is required with returning visitors from effected countries.
RIVM proposes water quality standards for three drugs in surface water: carbamazepine (epilepsy), metoprolol (heart disease) and metformin (diabetes). The proposed values are currently not exceeded in major rivers in The Netherlands.
Uncertainty still remains over the safety of the nanomaterial SAS in food. Food additive E551 consists of ‘synthetic amorphous silica’ (SAS) and is applied as an anti-caking agent. It is present in products such as coffee creamer, soup and sauce powders and seasoning mixes.
The Central Government Real Estate Agency has awarded the contract to build new premises for two knowledge institutes - the National Institute for Public Health and the Environment (RIVM) and the Medicines Evaluation Board (MEB) - to StruktonHurks. Both these institutes are part of the Ministry of Health, Welfare and Sport. This is the first Private Public Partnership project in the Netherlands for a government building with laboratories. The building will be constructed between 2015 and the end of 2018, at the Wentgebouw location in Utrecht Science Park in Utrecht. The parties will sign the contract on 17 July 2014.
Almost two months ago, two Dutch people were diagnosed with the MERS coronavirus. After repeated tests, experts of RIVM, Erasmus Medical Centre, Haaglanden Medical Centre, Haaglanden Municipal Health Service, the Isala hospital in Zwolle, and IJsselland Municipal Health Service have concluded that no new cases have since been found in the Netherlands. They recently joined forces to deal with the examination, diagnostics and policy concerning the two MERS patients in the Netherlands. Six other Municipal Health Services contributed substantially in the monitoring of the patients’ contacts.
Statement of PAN Europe regarding the contents of her report ‘A Poisonous Injection’ June 26, 2014.
From the RIVM report 'Vaccination level of the National Immunisation Programme of the Netherlands' (report year 2014) the strong commitment of Community Health Services (GGD’s) and child welfare centres once again becomes clear. Hence the average participation per vaccination for children lies between 92 and 99%. Ninety-five percent (95%) of infants born on or after 1 August, 2011, have been vaccinated against hepatitis B.
If patients with acute Q fever are re-examined for antibodies one year after their infection, 98% of the patients with chronic Q fever can be detected. In her PhD research Lieke Wielders, epidemiologist at RIVM and the Jeroen Bosch Ziekenhuis, argues in favour of such an additional check for Q fever patients.
Dutch people are reaching an increasingly advanced age: in 2030, the life expectancy of men will be 82 years, and of women, 85. In 2030, partly as a result of population ageing, approximately 7 million people in the Netherlands will be living with a chronic disease: this is roughly 40% of the population, versus 32% today. This increase does not imply that more people will be excluded from society: most people with a chronic disease between the ages of 20-65 work as many hours as people who are not chronically ill. The percentage of overweight adults (48%) is not expected to increase. These are some of the results from ‘Een gezonder Nederland’ (A Healthier Netherlands), the 2014 Public Health Forecasting Report ‘(Volksgezondheid Toekomst Verkenning’ or VTV in short) by RIVM, which on 24 June was presented to Minister for Health Schippers.
Many countries in Europe and Central Asia have a need for reliable data on ammonia emissions. These data include ammonia emissions inventories and monitoring of abatement measures. This has become evident in the RIVM/SZNIIMESH proceedings of a workshop with experts from 14 countries on measures to reduce ammonia emissions.
After continuing to rise for many years, in 2013 the prevalence of resistance to antibiotics levelled out somewhat in both hospitals and primary care. The sales of antibiotics for animal use have also fallen once again, indicating a reduction in use and, consequently, a lower risk of resistance. This has been shown by the annual NethMap/MARAN report. In order to control the increase and spread of antibiotic resistance it is necessary that trends in the use of and resistance to antibiotics be carefully followed by means of monitoring and checks. In order to continue and optimise the current package of measures, intensive collaboration between professionals in both the public and private domains is essential, both in human and in veterinary health care.
On 25 and 26 June, an international conference about resistance to antibiotics - an increasing worldwide problem - will take place in The Hague. As a result of the improper and excessive use of antibiotics, a growing number of bacteria varieties have become resistant against their effects. Ministers from various countries worldwide will discuss the safe use of antibiotics in both human healthcare and veterinary medicine.
RIVM monitors and informs the government about potential national health threats with regard to antibiotic resistance. Based on a national AMR surveillance system trends are monitored. RIVM is also involved in international surveillance networks. The animation 'Antibiotic resistance: why do some antibiotics fail' illustrates antibiotic resistance and the need to carefully consider whether antibiotics really need to be used.
The second European Polio Conference takes place in Amsterdam from 25 - 27 June 2014, with the theme of the ‘Post-Polio Syndrome, A Condition without Boundaries’.
RIVM has investigated the effect of paracetamol on the immune system of adolescents. If paracetamol was taken before vaccination, the amount of antibodies was lower than when no paracetamol was taken. This is because paracetamol has a negative effect on the immune system, the body's natural defence system. If paracetamol is taken after the vaccination, the vaccine would be as effective as when no paracetamol had been taken.
RIVM again received authorisation to use the quality mark ‘drempelvrij.nl’ on their website in 2014.
Dromedary camels contaminated with the MERS coronavirus are presumed to excrete this in their milk, and consuming this raw milk may thus pose a risk to public health. These findings are the result of an ongoing international study coordinated by the Erasmus MC in collaboration with RIVM and were published on 12 June 2014 in a Eurosurveillance article.
There is no reason to believe that the limited addition of two types of biodiesel to petroleum diesel accounts for an additional increase in harmful emissions from road traffic. This has become clear from an inventory of available data drawn up by RIVM and TNO.
In 2012, in the Netherlands the number of TB patients remained under 1,000 (958) for the first time. This was demonstrated by the ‘Tuberculosis in the Netherlands in 2012’ surveillance report by RIVM in collaboration with KNCV Tuberculosefonds.
Today is World Environment Day (WED). Every year on June 5, the United Nations Environment Programme UNEP encourages worldwide awareness and action for the environment. In the Netherlands RIVM monitors the quality of air, water and soil, and assesses the risks to health and the environment. We support the transition to a sustainable and green economy so that future generations can live in a healthy environment.
RIVM-experts from the Environmental Assessment Unit (EAU) have undertaken two missions involving an emergency situation in the Solomon Islands and an environmental assessment in Georgia. These missions are coordinated respectively by the United Nations (UN) and by a joint action from the UN and European Union (EU).
The two patients who were diagnosed last week with the MERS coronavirus are now on the mend. The results of the tests that have been carried out on persons in the vicinity of the patients were negative. In the coming weeks, these tests will be repeated to establish with certainty, whether or not these persons have been infected with the virus MERS. Currently, this means that there is no evidence for a MERS infection.
As of 13 May 2014, RIVM and Erasmus MC have diagnosed the MERS coronavirus in two Dutch people. The patients are related and were infected during a joint journey to Saudi Arabia. Both have been hospitalised and are being cared for in strict isolation. Their health status is stable. The man and woman involved shared a hotel room for two weeks and both suffer from underlying conditions that probably made them more susceptible to this virus.
RIVM and ECN have developed an innovative assessment framework for testing the environmental effects on soil and groundwater of leachate water from sustainable landfill sites. The Netherlands is the first country to attempt sustainable landfill management on such a large scale in three pilot projects.
Hydrofluorocarbons (HFCs) are potent greenhouse gases used in refrigerators and air conditioners and are released primarily at the end of the life-span of these products. The result is an accumulation of substances in these applications which forms a previously unrecognized additional risk for climate change.
The coming year RIVM is going to be collecting good examples of interventions for the prevention of chronic diseases such as cardiovascular disease and type 2 diabetes. RIVM is undertaking this within the framework of a large EU-funded collaborative project – the Joint Action on CHROnic DISeases and promoting healthy ageing across the life cycle (CHRODIS-JA).
RIVM aims to improve the collaboration between the human and veterinary health sectors. This makes it possible to intervene quickly and efficiently in case of a zoonotic disease outbreak. This approach is explained in our new film on zoonoses.
In 2014 the number of girls who were immunised against the human papilloma virus (HPV) rose. This virus can cause cervical cancer later in life. By 1 January, 60.7% of girls born in 1999 have had all three HPV injections. On comparison with the group of girls born in 1998, this is an increase of 0.8%. This gradually increasing trend has been seen from 2010 when the HPV vaccination was first included in the Dutch national vaccination programme.
RIVM proposes that the water quality standard for the insecticide imidacloprid be reduced by a factor of eight. New research has shown that the harmful effects of imidacloprid on aquatic organisms occur at lower concentrations than expected.
At the request of State Secretary Martin van Rijn (VWS, the Dutch Ministry of Health), RIVM is carrying out an investigation into the safety of e-cigarettes. This concerns an investigation into the harmful substances in the e-liquids and the vapour from e-cigarettes. The use of e-cigarettes is also being investigated. Based on this information, RIVM is assessing the risks of direct exposure of the user to the vapour. In addition, it is determined whether replacing a cigarette with an e-cigarette is less harmful for the individual users.
Today, April 8th, RIVM welcomes education professionals for the annual GLOBE day. Brand new ambassador of GLOBE in The Netherlands and Director-General of RIVM, André van der Zande will perform the opening ceremony.
Today is World Health Day, which focuses on diseases that are passed on by creatures such as mosquitoes and ticks. These include malaria, dengue fever and Lyme disease. In the tropics in particular, these diseases involve many cases of illness and death, which is why the general advice to travellers is to take the correct precautions against mosquitoes. The best-known disease passed on by these creatures is Lyme disease, which can be obtained from a tick bite.
This week, a delegation of RIVM gave a training course in Brazil about policy relevant to soil. We shared experiences with Brazilian associates and explained innovations in Dutch policies pertaining to soil. The course was concluded on Wednesday with a closing conference that was opened by State Secretary Mansveld of Infrastructure and the Environment.
RIVM contributes to the safe use of nanomaterials through research, alerts and policy consultations, and this work is demonstrated in a short informative film.
RIVM is in a state of readiness to assist and support the fire brigade, the Dutch National Police Service (KLPD) and the Regional Emergency Health Organisation (GHOR) in the event of any disasters with hazardous or unknown substances or any food-related incidents during the NSS. RIVM has a team on standby in The Hague for this purpose, with a mobile laboratory and a radiation measurement vehicle. A number of fixed measurement points for radiation have also been installed in The Hague.
The measles epidemic, the first case of which occurred in the Netherlands in May 2013, is coming to an end. So far, over 2600 patients with measles have been reported, but over the last few weeks the number of new reports has decreased. Because hardly any reports are coming in from the municipalities with a low vaccination rate against measles (under 90 percent), providing complementary vaccination for children aged six months is no longer required in these municipalities. Based on advice provided by the National Institute for Public Health and the Environment, Minister Edith Schippers of Health, Welfare and Sports has decided to cease the provision of complementary vaccinations as per 1 March 2014. The regular vaccination policy for measles will be maintained.
In the Netherlands, many different pesticides are detected in surface waters. Some of these compounds exceed the water quality standards. An inventory of RIVM and Rijkswaterstaat (Dutch Ministry for Infrastructure and the Environment) on how other countries deal with pesticides and water quality shows that other countries face similar problems, but the substances may differ depending on the finding location.
RIVM will be working alongside a consortium of 23 international partners on a safe design for ‘new’ nanoparticles. The FutureNanoNeeds project starts with research into nanotechnology that can help to increase the efficiency of solar cells and improve the energy storage capacity of batteries. RIVM will research the safety of the particles used in this technology.
The 6th worldwide study into Persistent Organic Pollutants (POPs) in breast milk is about to commence. The study will reveal the extent to which governments are succeeding in banning the use of these substances, and thus in reducing exposure to them. Worldwide, the United Nations (UNEP) and the World Health Organization (WHO) will coordinate the study; RIVM organises the Netherlands participation.
Annually RIVM provides an overview of key events and developments in the National Immunisation Programme (NIP). Remarkably, a measles epidemic occurred in 2013, starting in May, mainly in areas with low vaccination coverage. In 2012 it was a whooping cough epidemic, which especially struck children of 0-2 years, children aged 8 years and adults. The pneumococcal vaccine also proved to be effective against pneumococcal disease in reduced doses. The participation level in the NIP has been high for many years, resulting in low incidences of most target diseases. For an optimal programme, continuous monitoring of effectiveness and safety remains necessary.
Nanotechnology offers improved options for the diagnosis and treatment of cancer. Today, in the lead up to World Cancer Day on 4 February 2014, 13 countries in Europe are giving special attention to nanotechnology in the fight against cancer.
'I want to know the story behind an epidemic'. Interview with Jaap van Dissel, Director of RIVM Centre for Infectious Disease Control.
January 19 - 25 European Cervical Cancer Prevention Week. The European Cervical Cancer Association (ECCA) launched this week 8 years ago to increase public awareness of cervical cancer, and of ways of preventing this disease. Each year, cervical cancer kills 250,000 women throughout the world. Yet this disease can usually be prevented by effective screening and vaccination. Nevertheless, many women are poorly informed about this disease, and many European countries have inadequate prevention programmes.
January 2014 RIVM launches a new bowel cancer screening programme. In the long term, this screening programme can help prevent 2,400 deaths from bowel cancer each year. In the course of 2014, all men and women born in 1938, 1939, 1947, 1949 and 1951 will receive an invitation to participate, followed two weeks later by a self-screening kit.
RIVM report 'State of Infectious Diseases 2012' provides insight into the development of infectious diseases in The Netherlands. In addition, developments in other countries that are relevant for the Netherlands are described. The theme for this State of Infectious diseases report is vaccination and its relevance for the Dutch public. The annual report is compiled for policymakers at the Dutch Ministry of Health, Welfare and Sport (VWS).