RIVM, Wageningen Bioveterinary Research (WBVR) and the Netherlands Centre for One Health (NCOH) are involved in a recently granted One Health European Joint Programme which will start in January 2018. The aim of the One Health EJP is to create a sustainable European One Health framework by integration and alignment of medical, veterinary and food institutes through joint programming of research agendas matching the needs of European and national policy makers and stakeholders. In the Netherlands these organisations are already collaborating closely to counteract the threat of emerging zoonoses and antimicrobial resistance. The Dutch One Health approach can now also be deployed at EU level.
This report provides a broad overview of the health complaints experienced by women with silicone breast implants in the Netherlands. This overview is the result of a survey performed by RIVM, by order and for the account of the Dutch Health and Youth Care Inspectorate (formerly the Dutch Health Care Inspectorate). Based on this survey, it is not possible to indicate whether the implants are the cause of the complaints. However, the results of this survey do provide a basis for follow-up research, which the Dutch Minister of Health, Welfare and Sport will assign to RIVM.
The efficiency and transparency of clinical drug trials in the Netherlands must improve. That concludes Sander van den Bogert in his PhD thesis ‘Trials & Tribulations. Studies on the fate, transparency and efficiency of clinical drug trials’. On October 4th, he will obtain his PhD at Utrecht University.
More outbreaks of food-related infections and food poisoning were reported in 2016 than in 2015. Whether this was caused by a genuine rise in food-related outbreaks in the Netherlands or a higher report rate of outbreaks is not known. Norovirus remains the key pathogen causing food-related outbreaks. This was revealed by the analysis of the reported cases in 2016 for food infections and food poisoning.
Citizen Science is a new approach for the public health field. Wicked public health problems, such as the obesity epidemic, can only be resolved by coordinated action of all stakeholders: municipalities, professionals, companies and citizens. Citizen science may help create a shared knowledge base to underpin such action. However, the promises of citizen science are yet to be realised. Lea Den Broeder has explored possibilities and challenges of citizen science for public health. On September 26th, she will obtain her PhD from Vrije Universiteit Amsterdam with her thesis ‘Citizen Science for Health in All Policies. Engaging communities in knowledge development‘.
During the winter of 2016/2017 the influenza epidemic lasted for 15 weeks. This is longer than the nine-week average epidemic duration in the twenty previous seasons. An estimated 500,000 patients had symptomatic influenza. The influenza vaccine of 2016 was moderate effective against the influenza viruses this winter. These conclusions are presented in RIVM’s annual report on influenza and other respiratory infections 2016/2017.
RIVM proposes water quality standards for perfluoro octanoic acid (PFOA). PFOA is a man-made chemical that is used to protect surfaces. It is used for treatment of carpets and clothes, coatings for cardboard and packaging, fire-fighting foams and the production of non-stick coatings. The substance was used until 2012 at the Dupont-Chemours production plant in Dordrecht, the Netherlands.
How can we strengthen and support health promoting approaches within the broader health and social care system? And how can we best include other sectors in this process? These are the key challenges RIVM will seek to address as task leader within the new EU Joint Action on Chronic Diseases. This CHRODIS+ Joint Action kicks off today and will run for three years.
Policies on magnetic fields from power lines in the Netherlands, Belgium, France, Germany and the United Kingdom are based on different considerations. This concerns the weighing of the scientific evidence for a possibly increased risk of leukaemia in children against social, economic and political considerations. These are the results of research by RIVM.
Nanotechnology is being used for many everyday life products such as in medicine, deodorants, sunscreens or socks. These are only a few examples of consumer products containing nano-sized particles. Nonetheless it is difficult to determine the distribution of nanoparticles in the environment and the risks to human health. RIVM researcher Joris Meesters developed the SimpleBox4nano model to calculate concentrations of nanoparticles in water, soil and air. A major step forward in the environmental risk assessment of nanoparticles. On September 6th, Meesters will graduate on this research and obtain his PhD at Radboud University Nijmegen.
Last January RIVM published a report with facts and figures about the Dutch dietary pattern and an analysis where sustainable, healthy and safe food can strengthen each other. The report ‘What is on our plate? Safe, healthy and sustainable diets in the Netherlands’ is now available in English.
Fourteen Dutch knowledge institutes have joined forces to provide practical, demand-driven policy advice based on climate change adaptation. Today, in Utrecht, the agreement of the establishment of the Netherlands Consortium on Climate Change Adaptation (CCCA) was signed. CCCA aims to provide more effective approaches to the challenges that countries, regions, cities and business communities are facing because of rapid climate change. This consortium will integrate knowledge and expertise from different sectors and integrate disciplines to better match the complex policy issues that trigger rapid warming, also in the light of UN Global Sustainable Development goals.
Substances of very high concern (SVHC) can hamper the safe recycling of waste streams in the Netherlands. These substances occur in a wide range of waste streams. Examples are flame retardants in plastics, dyes in textile or heavy metals in residual streams of agriculture. These are the findings of an exploratory study by RIVM.
European REACH regulation on chemicals can provide benefits to companies that make or import bio-based substances. There are registration exemptions that may be specifically applicable to bio-based manufacturers. This means that if certain conditions are met, the REACH registration obligations will be less of a burden to some of the bio-based manufacturers. REACH also offers all bio-based manufacturers opportunities to develop and market safe and sustainable bio-based alternatives to substances which are currently of very high concern. These are the findings from the RIVM report: ‘REACHing out to the bio-based economy’.
Residues of plant protection products used in greenhouses may enter surface water upon discharge of nutrient solution and affect surface water organisms. Research conducted by RIVM has shown that the Greenhouse Emission Model (GEM) is very well suited for predicting residue concentrations in discharge water from substrate cultivations. These calculations are used for the authorisation of plant protection products.
Each year, RIVM presents an update on the number of illnesses caused by 14 enteric pathogens (such as Salmonella, Campylobacter or Listeria) that can be transmitted by food into the human body. This food-related disease burden is expressed in Disability Adjusted Life Year (DALY), an internationally used measure for the sum of the Years Lost due to Disability (YLD) and the Years of Life Lost (YLL) due to premature mortality in a population. The number of DALYs due to the 14 pathogens is estimated at 4,708 in 2016, which is slightly higher than in 2015 (4,642 DALY's).
Influenza vaccination reduces the number of influenza virus infections but not the overall number of illness.
The most notable infectious disease outbreak in 2016 was the large Zika virus outbreak in Latin America. During this outbreak it was discovered that the Zika virus can cause Guillain-Barré syndrome, and that infection during pregnancy can lead to severe congenital disorders. In the Caribbean Netherlands, the Zika virus is mainly spread by mosquitoes, while in the European Netherlands sexual transmission of the virus occurs via infected travellers. In 2016, Zika virus infection during pregnancy and severe cases of Zika virus disease became notifiable.
In our annual report, we look back at compelling RIVM projects and research in which RIVM was involved in 2016. Our expertise is broader than what we can showcase in this report. Accordingly, we present some of the most notable examples from 2016. For instance, the National Risk Profile, a large-scale study into the health effects of the livestock sector in east Noord Brabant and north Limburg, the new population screening for cervical cancer, and of course, our report on rubber granulate.
On Saba, a Dutch Caribbean island, diseases such as dengue, chikungunya and zika can be reduced by the use of genetically modified mosquitoes. The mosquito is modified in such a way that it can suppress local mosquito populations that transmit these diseases. Potential release of these mosquitoes on Saba is considered to pose negligible risks to human health and the environment.
Our wastewater contains bacteria that are resistant to antibiotics. Residues of antibiotics are also found in wastewater. Current wastewater technology reduces the concentrations of resistant bacteria. Innovative techniques are available which can lead to a further decline. This is shown by a study on antimicrobial resistance in the environment by RIVM in collaboration with other institutes.
If historical trends continue unchanged, dementia will be the leading cause of disease burden in 2040 and the main cause of death. The number of people who die due to dementia will then increase from 14,000 in 2015 to nearly 40,000 in 2040. This is one of the most important findings of the Dutch Public Health Foresight study (PHF) Trend Scenario 2018. The Trend Scenario shows how the health of the Dutch population could look like in 2040 if nothing were to change from now on. Thus, societal challenges for the future can be identified.
The number of bacteria strains resistant to antibiotics in humans has remained stable in the Netherlands over the past year. However, outbreaks of resistant strains of bacteria in healthcare institutions are still reported occasionally. This is expected to happen more often in the future, leaving vulnerable people at an increased risk of getting ill. This is shown in the annual NethMap/MARAN report, which contains information about antibiotic use and antimicrobial resistance in the Netherlands for both humans and animals.
Vaccination coverage for vaccinations in the Dutch National Vaccination Program (NIP) decreased slightly by about half a percent for the third consecutive year. If this trend continues, the risk of future outbreak of measles increases. Compared internationally, vaccination coverage in the Netherlands is still high. This is shown by the Immunisation coverage and annual report National Immunisation Programme in the Netherlands 2016.
Since May 2015, there has been a Zika virus outbreak in South and Central America, including the Caribbean. The Zika virus can cause birth defects, including microcephaly (small head size). Although the WHO has lifted the international emergency situation, alertness about the Zika virus is still needed. Women who are pregnant or may become pregnant still have to take the Zika virus into account when they want to travel. RIVM reiterates the travel advice for regions where Zika virus is present.
An increasing number of clients tested at a Dutch STI clinic for a sexually transmitted infection (STI) is diagnosed with gonorrhoea, syphilis and chlamydia. Gonorrhoea and syphilis are most common in men who have sex with men (MSM). In women and heterosexual men, chlamydia is the most common STI. This emerges from the RIVM report ‘Sexually transmitted infections, including HIV, in the Netherlands in 2016’. GPs have also reported an increase of the number of diagnosed cases of chlamydia and gonorrhoea.
There is a large international outbreak currently of hepatitis A, mostly among gay and bisexual men. In several European countries more than 1,000 patients have been reported. RIVM and Soa Aids Nederland / Man to Man recommend men who have sex with men to vaccinate against hepatitus A. Especially when they visit gay prides or other festivities this summer.
People who live near poultry farms and goat farms suffer from pneumonia more often. In the area surveyed, every year about 1650 people per 100,000 residents get pneumonia. Over 200 of these pneumonia cases are associated with living in the vicinity of poultry farms and goat farms. This has been shown from additional studies in the large-scale survey ‘Livestock farming and the health of local residents’ (VGO) carried out by Utrecht University, Wageningen University and Research, NIVEL and RIVM. The new results confirm earlier findings from the VGO in 2016.
The National Heat Plan became active in the Netherlands on June 19th. This means that it is necessary to take preventive health measures for vulnerable groups. Moreover, everyone should be cautious for sunburn. The heat warning is in effect for the seven provinces in central and southern Netherlands: Utrecht, Overijssel, Gelderland, Zuid-Holland, Noord-Brabant, Zeeland and Limburg, between Monday and Thursday.
The concentrations of the 43 most important greenhouse gases are at unprecedented, record-high levels compared to the last higher than ever in the past 800,000 years. The historical set of data, based on a variety of measurements, has been published in a scientific article to which RIVM contributed.
The employee of a Dutch vaccine manufacturer, who was infected with the polio virus in early April, is no longer carrying the virus. No other people were infected, and the employee can no longer infect others. The Municipal Health Service will now terminate the daily monitoring of the employee and his household contacts. All precautionary measures have been lifted.
The results of blood analysis show that measured blood values correspond well with the calculated values in an earlier study in 2016 on the emission of perfluorooctanoic acid (PFOA) by DuPont/Chemours. These findings support the conclusion of the earlier study that it is likely that residents around Dupont/Chemours have been chronically exposed to high values of PFOA. Long-term exposure to PFOA may have affected the health of people living nearby the DuPont/Chemours factory.
HPV vaccination against cervical cancer also appears to protect against other forms of cancer that can be caused by HPV. These are cancers that increasingly occur in men, such as cancer of the penis, anus, mouth and pharynx. Therefore, at the Minister's request, the Dutch Health Council is looking at whether the advice on vaccination should be adjusted.
More knowledge is required about the extent to which GenX substances accumulate in fish. This information is essential to calculate safe concentrations in water for lifetime fish consumption by humans and wildlife. The fact that the information is unavailable means it is currently not possible to derive an indicative water quality standard for GenX.
Meningococcal disease is a very serious infectious disease that can cause meningitis or blood poisoning. Children are immunised against meningococcal serogroup C at 14 months. Since 2015, however, there has been an increase in meningococcal serogroup W. New vaccines have also become available against meningococcal serogroup B. Because of these developments, the Health Council of the Netherlands is looking at whether and how the immunisation programme against meningococcal disease should be adapted.
Early April, a sealed room at a vaccine manufacturer was the site of an incident. Two employees were exposed to the polio virus. After the incident, the company took immediate actions to contain the virus. Tests have shown that one of the employees is infected with the polio virus. According to the protocol, the Municipal Health Services has documented all household contacts of the infected employee. As a precautionary measure, these persons will be monitored.
The societal costs of Lyme disease have been determined for the Netherlands for the first time. The disease appears to cost nearly EUR 20 million each year. Serious infections and persistent symptoms after treatment of Lyme are responsible for the largest share of these costs. Other costs were caused by tick bites and mild infections. These estimates can be used in the Netherlands and in other countries where the disease is endemic for cost-effectiveness evaluations of preventive measures for tick bites and Lyme disease.
In 2015 slightly more ammonia was emitted in the Netherlands than in 2014 and the ceiling set by the European Union was met (128 kilotons). Both cattle numbers and fertilizer use increased, whereas low emission housing systems for pigs and poultry partly countered this. RIVM and partner institutions draw these conclusions in the Informative Inventory Report 2017.
TIME has named Professor Guus Velders of RIVM as one of the 100 most influential people in the world. Velders was honoured for his work in establishing the basis for the global climate agreement that was signed in October 2016 in Kigali, Rwanda.
One in 5 tick bites occurs in an urban area. Although most tick bites occur in the countryside, many people are bitten in urban areas as well. This is the finding of an analysis of tick bite reports at Tekenradar.nl. Now that the tick season has started, it is important to check for tick bites after any time spent in any areas of greenery, including those in urban areas.
The state of the environment, our health, and levels of social equity are closely interrelated. The role that individual behaviours play in moving to more sustainable societies has been under-emphasised and can be a powerful entry point for change. Many measures to protect the environment also improve our health and at the same time reduce inequalities, but work is needed to fully harness and develop the combined benefits. These are some of the findings presented in the INHERIT Baseline Report launched April 19th.
In the context of authorising plant protection products, the EU currently does not take any account of the use of several different plant protection products for the same crop. RIVM has studied three methods which can be used to take this into account in the future. It has transpired that these methods provide insight into the occurrence of ‘multiple stress’. It is essential to keep developing methods so that they can be actually applied to the process of authorising plant protection products.
The salt content in bread was on average 19 percent lower compared to 2011. In addition, certain types of sauces, soups, canned vegetables and pulses, and crisps had a lower salt content. Reductions vary from 12 to 26 percent. In addition, in a few food groups such as certain types of cold cuts, the saturated fat content was reduced. The sugar content in all studied food groups remained unchanged. This is shown by research on the contents of salt, sugar, and saturated fat in foods compared to 2011, published today by the Dutch National Institute for Public Health and the Environment (RIVM).
Rotavirus can cause severe gastrointestinal infections and is common among infants and young children. There are two vaccines available; both have to be given by mouth (oral vaccines). The Dutch Health Council will advise the Ministry of Health, Welfare and Sport on how childhood vaccination against rotavirus will be made available. The Minister makes a decision on the basis of this advice.
Today RIVM’s Centre for Healthy Living (CGL) welcomes the Bundeszentrale für gesundheitliche Aufklärung. BZgA is the German Federal Centre for Health Education, an institute with whom RIVM collaborates in EuroHealthNet and the Joint Action CHRODIS.
In December 2016, RIVM published in Dutch the results of its research into the health risks of playing sports on synthetic turf pitches with rubber granulate. The scientific background information was published separately on the RIVM website. The English version of the Dutch report from December was published in February 2017. Today sees the publication in English of a compilation of the initial report and all the scientific background documents.
RIVM investigates how the impact of pharmaceutical residues on the environment may be reduced. If certain drugs can be substituted by treatments that are less harmful to the environment, this would be advantageous for the environment . However, this has proved to be difficult.
Off-label use of medicinal products in the European Union is common, both in primary and in secondary care. Off-label use frequently occurs in pharmacotherapy in children and in people with a rare condition, but also oncology, rheumatology and psychiatry are areas with off-label use. This emerges from a study by NIVEL, RIVM and EPHA at the request of the European Commission.
The Global Learning and Observation to Benefit the Environment (GLOBE) program in the Netherlands (GLOBE Netherlands) is organising the annual GLOBE day on 21 March . On this day scientists from KNMI, RIVM and Wageningen UR will show high school students how they can contribute to scientific research. Students will take measurements in their school environment and in this way learn to conduct research themselves and contribute to a better understanding of nature and the environment.
Age plays a role in immune responses after a natural infection with Bordetella pertussis, the bacterium that causes the contagious respiratory infection pertussis (whooping cough). Vaccination against pertussis has dramatically lowered pertussis incidence and mortality rates since the 50s, but this clever bacterium is making a comeback; pertussis is also becoming more common in people who were vaccinated against it.
Current legislation for chemicals insufficiently covers the combined effects of substances on humans and the environment. RIVM discusses one approach to address these combined effects in the environmental risk assessment of substances under the European REACH Regulation.
Although ESBL-producing E. coli-bacteria occur most frequently on raw chicken meat, consumers are probably exposed to a higher number of ESBL-producing bacteria through eating raw or undercooked beef. To date it is unknown if exposure to ESBL-producing bacteria leads to carriage of these bacteria and whether this eventually results in a significant health burden in humans. From calculations in which the different kinds of meat have been investigated, it appears that almost 80% of the exposure to ESBL-producing bacteria is derived from beef. Most ESBL-producing bacteria were found on raw chicken. However, chicken meat is not eaten raw and therefore individuals are less exposed to these bacteria through the consumption of chicken meat.
The Netherlands aims to take the lead in the international ambition for a healthy, sustainable and safe dietary pattern. To achieve this aim an integral policy is required, in which safety, health and sustainability are taken into account. Research by RIVM analyses the opportunities and dilemmas for an integrated food policy.
There has been an ongoing outbreak of Salmonella enteritidis in Europe since 2015. It has also been present in the Netherlands since May 2016. Over 170 Dutch patients were affected by the outbreak. The Netherlands Food and Consumer Product Safety Authority (NVWA), the National Institute for Public Health and the Environment (RIVM), the Netherlands Controlling Authority Eggs (NCAE) and various municipal public health services determined jointly that these cases all derived from infected eggs from a small number of Polish companies with laying hens. No additional new patients have been registered in the Netherlands in recent weeks. This means that the European Salmonella outbreak seems to have been resolved, with a total of nearly 450 recorded cases.
The Suriname Water Company (SWM) recently started the implementation of Water Safety Plans (WSPs). The inception phase included a tailor-made training by Dr. Giuliana Ferrero (UNESCO-IHE) and Mr. Harold van den Berg (RIVM).