The prospects for future public health in the Netherlands are good. Our life expectancy is steadily increasing, and most people feel healthy and do not experience activity limitations. Nevertheless, we face some major future challenges. The seventh Public Health Foresight study describes the societal challenges we will be facing and how we can deal with them.
We have launched the RIVM newsletter. We would like to keep you informed about the developments in public health and the environment in the Netherlands and our institute. Each quarter, we will send you stories and insights.
Tar, nicotine and carbon monoxide (TNCO) levels measured in accordance with the Canadian Intense (CI) method are at least twice as high as the levels measured in accordance with the prescribed ISO method. In some cases, the levels measured with the CI method are even more than 20 times higher than those measured by the ISO method. This is the result of research by RIVM, examining 100 cigarettes using the Canadian Intense method.
On June 14th and 15th, the 6th SAF€RA - Coordination of European Research on Industrial Safety towards Smart and Sustainable Growth - Symposium will take place in the Netherlands. RIVM will host SAF€RA with support from TNO. SAF€RA’s General Assembly will also be held at RIVM.
On the 4th and 5th of June 2018, an expert meeting was held at RIVM to redefine and prioritise the topics for One Health research and integrative activities in Europe. The meeting was aimed at forming the basis for the second round of project proposals based on the necessities of One Health in Europe.RIVM is involved in the One Health EJP, which has started in January 2018 and will run until the end of 2022.
From 1984-2006, employees of the Dutch Ministry of Defence were exposed to chromium-6 during maintenance work. This occurred at five so-called POMS sites (POMS: Prepositioned Organizational Materiel Storage), where principally American NATO equipment was stored and maintained by Defence personnel. The chief source of chromium-6 was the primer coating used to protect the equipment, and maintenance activities could cause the release of this substance. The investigation revealed that the Health & Safety policy at the POMS sites was inadequate, especially in the first operative years. The Ministry of Defence had the responsibility to inform both employees and occupational physicians about the health risks of exposure to chromium-6-based paint and to ensure the use of the appropriate protective equipment. This did not happen adequately.
Healthy ageing and being able to live an independent life until old age is not experienced by everybody. In many Western countries, women live longer than men, but suffer from more disabilities and need more care. It remains largely unknown when these differences between men and women arise in the life course and which modifiable lifestyle factors play a role in these differences. RIVM and VU University recently started research into this.
Microplastics are plastic particles that are smaller than 5 millimetres; through the use of plastic or rubber products these microplastics can end up in the environment (surface water, soil, and air). The uncertainty about the effect of microplastics for humans and ecosystems is still large. Therefore, precautionary measures are considered to reduce the emission of microplastics. RIVM has taken stock of the advantages and disadvantages of potential measures. This study focusses on three sources: abrasion of tyres (the biggest source) and paint, and microplastics added to abrasive cleaning agents (a minor source).
One in six inhabitants of the Caribbean Netherlands is a smoker, one in eight is a heavy drinker and over six in ten are overweight. Half of the population are getting sufficient exercise. Women smoke and drink much less than men, but are more likely to be obese and exercise less. These are some conclusions from the Health Study which was conducted in the Caribbean Netherlands in 2017.
Professor J. (Hans) Brug has been appointed director-general of RIVM per September 10, 2018. The Council of Ministers has approved the nomination on the proposal of Minister Ollongren of the Interior and Kingdom Relations in the Netherlands. Brug succeeds Professor André van der Zande who will leave RIVM by the end of June to enjoy his retirement. Van der Zande has been Director-General since 2011.
Due to developments in modern biotechnology, such as genome editing, synthetic biology and regulation of gene expression, many new applications are expected in the next ten years. For example, new forms of gene therapy, new substances produced by microorganisms and plants that are better adapted for agriculture. The method that is currently used for the assessment of risks for human health and the environment does not seem to be equipped for all future developments. These were the findings of a report by RIVM.
Bacteriophages are viruses that can kill bacteria. The question is whether bacteriophages can be used to treat infections in humans. This may be particularly useful when it comes to infections with antibiotic resistant bacteria. A report from RIVM shows that current scientific evidence is insufficient to determine whether bacteriophages are actually effective in the treatment of human infections. There is also a knowledge gap regarding phage therapy safety. RIVM recently visited the Eliava Institute in Georgia, which has a great deal of experience with bacteriophages.
The Dutch National Action Plan for STI, HIV and sexual health describes the most important goals for the next five years. Good information and comprehensive sexuality education are important for the prevention of STD, HIV, unwanted pregnancy and sexual violence. Efficient cooperation between the most important partners is necessary to achieve this. The National Action Plan defines the concrete objectives and actions for a healthy sexual life.
Despite the growth of the economy, greenhouse gas emissions in the Netherlands in 2017 were1 percent lower than in the previous year. Causes of the decrease are the use of more natural gas and less coal in the electricity production. This is shown by preliminary figures from RIVM / Emission Registration and Statistics Netherlands (CBS).
Heated tobacco products are newly available on the market. An example of such a product is the heatstick which is heated with an iQOS, a device that looks like an e-cigarette. Heating the heatstick leads to the formation of carcinogenic and other harmful substances. The use of heatsticks with the iQOS is harmful to health, but probably less harmful than smoking tobacco cigarettes. This is RIVM’s conclusion, based on its research into heated tobacco products (HTPs).
A recent study by RIVM and AMC shows that the effectiveness of vaccination against Hib is still high. The slight increase in the number of patients with Hib disease in 2016 cannot be explained by a reduced effectiveness of the Hib vaccine. This research was published in The Lancet.
The Dutch National Institute for Public Health and the Environment will leave the NEN/CEN/ISO committees for tobacco and e-cigarettes with immediate effect. The primary reason for this is the considerable influence the tobacco industry exerts within these committees, whereby safeguarding public health receives insufficient emphasis. RIVM will remain active in other NEN, CEN and ISO committees, which focus on subjects other than tobacco.
Today, Elise Hovingh will be awarded a PhD at Utrecht University with a thesis about whooping cough. She studied the interaction between the whooping cough bacteria and our immune system. Whooping cough, also known as pertussis, is a highly contagious disease. Despite vaccination, the disease has become increasingly common in recent years. New vaccines will have to be developed for future control of pertussis. More insight into the functioning of the bacterium that causes whooping cough is important here.
RIVM was asked to give advice to the Human Environment and Transport Inspectorate in the Netherlands after asbestos was found in two make-up products. During the use of these products, the estimated number of asbestos fibres in the air is unacceptably high. The risk of asbestos-related diseases for children who have used these make-up products is probably limited. However, it is important to prevent further exposure as much as possible.
RIVM research reveals that people who eat meat regularly do not carry ESBLs more frequently than vegetarians. ESBL is an enzyme, produced by certain bacteria, which makes these bacteria resistant to antibiotics.
RIVM calculations show that only small steps have been taken to reduce daily salt and energy intake (via sugar) within the National Agreement to Improve Product Composition. Expansion and tightening of the agreements are necessary to achieve a substantially lower salt and sugar intake. The Committee Criteria for Product Improvement recommends a new integrated system to achieve product improvement.
The European Food Safety Authority (EFSA) and RIVM are jointly conducting pilot assessments into the health risks posed to consumers through exposure to multiple pesticides via food. The MCRA model (Monte Carlo Risk Assessment) that was developed by RIVM and Biometris (Wageningen University and Research) is used for this assessments. It is crucial that the required data can be fed into the model in a structured way. This is described in the report “Proposal for a data model for probabilistic cumulative dietary exposure assessments of pesticides in line with the MCRA software”, that was published by EFSA today.
Today Barbara Schimmer will be defending her PhD dissertation entitled The Q fever epidemic in the Netherlands in a One Health context, at Utrecht University. The dissertation describes the epidemiological studies that were carried out during the Q-fever epidemic of 2007-2010. Approximately 4,000 patients with acute Q fever caused by the bacterium Coxiella burnetii, have been reported during this period. Various outbreaks and target groups were investigated in the studies and research was carried out into the source of the infections. In addition to knowledge about risk factors when contracting an infection with the Q fever bacterium in humans and animals, these studies also provide knowledge about prevention measures. For example, Q fever vaccination should be seriously considered for occupational groups who are at high risk of contracting C. burnetii infection because of direct animal contact, such as farmers.
According to a survey by RIVM, 27,000 people were infected with Lyme disease in 2017. In 2014, the last time RIVM reported on the incidence of tick-borne disease, this number was 25,000. The number of patients that have been infected every year has more than quadrupled in the past 20 years.
According to the World Health Organization (WHO), the RIVM Centre for Healthy Living is a prime example of how the national government has taken up its stewardship role within the health promotion landscape for effective health promotion. The WHO has published a news story illustrating the Centre’s work prominently on its Health Systems Response website. Strong features of the Centre include building sustainable capacity for professionals and the alliances with partners.
RIVM was delighted to welcome a delegation from ANSES (French Agency for Food, Environmental and Occupational Health & Safety) in Bilthoven on April 10th. The partnership between ANSES and RIVM is important to both parties. The continuance and reinforcement of the collaboration on topics as infectious diseases, environmental risks and food safety were discussed during the visit.
Ozone layer depletion, air pollution and climate change need to be addressed in connection with each other. This is what RIVM’s professor doctor Guus Velders stressed in his inaugural address as professor of air quality and climate interactions at Utrecht University. “We only have one atmosphere, so we need to treat it carefully.”
Calculations carried out by RIVM indicate that the total intake of Bisphenol A (BPA) via food in the Netherlands is very limited. Even under the most unfavourable circumstances, the exposure would still be a factor of 30 times less than the current tolerable daily intake (TDI). The study also clearly indicates that no single food source contributes largely to the exposure, but that all food sources each make their own ‘small’ contribution. These are the findings of a study conducted by RIVM.
Oncology drugs clearly have become a target for pharmaceutical crime. Although the prevalence of falsified oncology drugs in the legal supply chains appears to be small, these drugs are difficult to detect, particularly in clinical practice. This is shown in a review article by RIVM in the journal The Lancet Oncology.
Publicly accessible locations with amplified music, such as discos, cafes, concert halls and schools, should enforce an average noise level of no more than 102 decibels over fifteen minutes for music activities for people aged 16 years and over. The average noise level should be even lower for children under the age of 16. This advice is the result of RIVM research commissioned by the Ministry of Health, Welfare and Sport.
The Good Practice Brief 'Centre for Healthy Living in the Netherlands: Building sustainable capacity and alliances for effective health promotion' has been published on the World Health Organization website. The RIVM Centre for Healthy Living serves as the national hub for integrated expertise on health promotion in The Netherlands. It is an example of how a national government has taken up its stewardship role for health promotion, shaped by both local government responsibilities and a variety of theme-specific health promotion institutes operating nationally.
The key figures of the National Institute for Public Health and the Environment (RIVM) show that in 2017, the number of TB patients in the Netherlands fell below 800 TB patients for the first time since the first registration in 1950 (787). That is 11 percent less than in 2016. 463 TB patients had pulmonary tuberculosis, 203 of the most contagious form (open tuberculosis). From the remaining 324 patients, TB presented itself extrapulmonary.
RIVM has conducted literature research into the hormone-disrupting effects of the three most commonly used parabens (methyl-, ethyl- and propylparaben) and the exposure of consumers to these substances. Based on the available information from animal studies, it is not possible to draw a conclusion regarding the possible hormone-disrupting effects of these three substances in animals or humans. Consumer exposure to the individual parabens appears to be lower than the level at which a health effect can be expected.
Harmful health effects of dietary supplements with high levels of synephrine, which are used to lose weight or improve sports performance, cannot be excluded. According to RIVM and RIKILT Wageningen University & Research legislation is desired for the maximum permitted amount of synephrine in food supplements.
In the Netherlands, diets with a high environmental impact contain more meat and energy. People with diets causing a relatively high environmental impact can help the environment by reducing their consumption of red and/or processed meat during dinner. This is what RIVM research published in BMC Public Health has shown. The research was based on data from the Dutch National Food Consumption Survey 2007-2010 for adults.
In Europe, strict requirements apply to food safety. Food safety standards are determined at international level. To ensure food safety, standards are set for the maximum permitted concentration of toxic substances in products. However, social and economic consequences that also affect food safety standards are not always taken into account in the same way. RIVM has therefore developed a framework to look broader than just the harmful effects of substances. Transparency and standardisation in decision-making are key for setting food safety standards.
In 2017, RIVM launched a Trend Scenario, as well as three thematic reports about the future demand for health care, technology and wider determinants of health. These are the first products of the Dutch Public Health Foresight study 2018. They show what 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. Both the Trend Scenario as well as the main findings of the thematic reports are now available in English.
RIVM has developed a method to calculate the effects of Sustainable Procurement and applied the method to eight product groups: energy, gas, solar panels, company cars, business trips, workwear, contract transport and transport services. Many purchasing services of the Dutch Government aim to include the effects of products and services on human health and the environment in the procurement process as sustainable procurement (SP) encompasses more than just price and quality considerations.
Commitment lotteries can support overweight adults in their goal to exercise on a regular basis.That is the conclusion of a scientific study by Tilburg University, High Five Health Promotion and RIVM, that was published in Annals of Behavioral Medicine.
RIVM and the Institute for Water Education (IHE) Delft facilitated a workshop on Climate Resilient Water Safety Plans (CR-WSP) on January 22 - 23 2018, in Maputo, Mozambique. In a highly interactive environment, a small group of key players in the Mozambican water sector were brought together: the Water Supply Regulatory CRA, the asset holder AIAS and the operators AdeM and the Mozambican water service supplier Collins.
ESBL is an enzyme, produced by certain bacteria, which makes these bacteria resistant to antibiotics. Researchers from various institutes collaborating in a large consortium discovered that ESBLs occur frequently in livestock, the food chain, the environment and also in humans. However, ESBLs in livestock and meat were found to be genetically different from those in humans. This means that humans acquire ESBLs to a limited extent via livestock and through eating meat. The transmission mainly occurs between humans. These are the most important conclusions of the ESBLAT research consortium, part of the 1Health4Food programme in the area of animal and human health. The results will be presented during the ESBLAT symposium on 9 February.
A new bibliometric analysis method of the University of Leiden shows that the publications of the Strategic Programme of RIVM (SPR) score well worldwide. SPR publications are cited twice as often as average. In addition, one-fifth of these scientific publications belong to the top 10 of the most cited articles in the world. RIVM shares this honour with other institutes, because most SPR publications have been created in collaboration with others.
Active Lyme disease of the central nervous system cannot be detected with an ELISpot test. This was concluded by researchers from RIVM and Diakonessenhuis Utrecht in the Journal of Clinical Microbiology. The study is the first in which the usefulness of a 'cellular test' has been evaluated on an extensive, well-defined population of patients and a control group from the Netherlands. The research shows that positive Borrelia ELISpot results are more common in people who are exposed to the Lyme bacterium, but the ELISpot test cannot distinguish an active central nervous system manifestation of Lyme disease from past Lyme disease.
RIVM has updated the standard for exposure assessment of cleaning products in the ConsExpo Cleaning Products Fact Sheet. RIVM also released a new version of ConsExpo Web, the application for estimating consumer exposure to chemical substances. ConsExpo enables the assessment of consumer exposure to substances from products such as paint, cleaning products and personal care products. ConsExpo is used both within and outside Europe by governments, institutes and industries. The application provides a number of exposure assessment models and a database of default exposure parameters. Together, the models and the database provide a basis for estimating consumer exposure to a specific product in a transparent and standardised way.
Medicinal products may be prescribed for other diseases, or groups of patients, than the ones that they are approved for. This is what we call ‘off-label use’, a practice which is legally permitted under certain conditions. Off-label use fulfils a medical need, but can still be improved in several ways. This has been illustrated in research conducted by RIVM.
A new report by Statistics Netherlands (CBS), the Netherlands Environmental Assessment Agency (PBL) and RIVM outlines a draft monitoring system to measure progress throughout the planned transition towards a circular economy.
With over 1,600 downloads, the scientific article 'Towards a research agenda for water, sanitation and antimicrobial resistance', was one of the most-read articles of IWA Publishing in 2017. The article published in the Journal of Water and Health was a co-publication by RIVM and experts from several countries and WHO.
Often potentially harmful chemical compounds are present in groundwater. RIVM presents a number of options for the revision of the groundwater quality assessment framework. Ensuring the quality of groundwater is currently part of the remit of the Dutch Soil Protection Act but will become part of the Environment and Planning Act in the future. The Environmental and Planning Act compiles standing acts for, among other things, construction, the environment, water, spatial planning and nature conservation.