The Strategic Programme RIVM (SPR Strategic Programme RIVM (Strategic Programme RIVM )) is our programme for our own research, innovation and knowledge development. With this programme, we focus on topics that deserve extra attention because they may have an impact on public health and the environment in the future.

New problems in the field of public health and the environment need answers. Technological innovations create new opportunities to find these answers. We innovate and we gather new knowledge. The SPR Strategic Programme RIVM (Strategic Programme RIVM ) topics make it possible for us to study things that we believe are or will be of great social importance. We want to use this research to help improve public health and the environment in the Netherlands – not just now, but also in the future.

Every four years, RIVM chooses new topics (spearheads) to make sure that we keep our finger on the pulse of trends in society and science. RIVM employees can submit project proposals about these topics.

SPR 2023–2026: new methods and techniques

All the research we do at RIVM generates a lot of data. These data form the basis for our publications, advice and information provision. At the same time, the amounts of data are growing bigger and the data themselves are becoming more complex and varied. We need new research methods and techniques.
We also need new methods and techniques to collect, process, analyse and unlock data. In the period from 2023 until 2026, SPR (Strategic Programme RIVM) will focus on developing and using these new methods and techniques.

There are five categories of methods and techniques that we will innovate, use and develop further:

  1. Methods and techniques to measure and monitor data collected through fieldwork, laboratory research and/or epidemiology.
  2. Methods and techniques to analyse large and combined data files, integrate data streams (local to global) and bring information together in real time.
  3. Methods, models and techniques to be able to make integral considerations. These will also improve process and outcome indicators that are used to calculate social benefits and make them visible.
  4. Methods to let citizens help with data collection, make it easier to unlock data and explain the effects of interventions to citizens and policymakers.
  5. Methods and techniques to integrate social and behavioural science aspects in RIVM research in order to improve public health, safety and sustainability.

In total, we will carry out about 30 projects in this SPR round. We will add the project plans to this web page in the course of 2023. The following projects will start in early 2023:

24/7 physical behaviours (24/7 PB)

What?
The aim is to develop a set of new characteristics of 24/7 PB patterns for which the following applies: (1) it represents the relevant 24/7PB characteristics from sensor information, (2) they are simple and attractive to communicate, e.g. in activity guidelines, and (3) they can be derived from the most commonly used sensor protocols. Also we will give estimates of the prevalence of those 24/7 PB-characteristics in the Dutch population, and whether they are associated with health. 

Why?
Being physically active is a key component of a healthy lifestyle. Sensor-based measurements to analyse 24/7 physical behaviours are increasingly used in cohort and monitoring studies. The sensor-based data expands the information on physical activity on intensity -also sleep and sedentary behaviour- and provide information on timing of behaviour over the day or week. The question is which characteristics of 24/7 physical behaviour that arise from the technological possibilities of the sensors, describe physical behaviour well, are associated with health and are suitable for communication in guidelines. 

How?
We will combine up-to-date literature, expert discussion groups, and data from a number of different longitudinal cohort- and monitoring studies for which sensor-based measuring of PB is part of the protocol, to identify new characteristics of 24/7 PB patterns. 
Cooperation 
Our team combines expertise from the field of epidemiology, public health, human movement science, data science, sensor technology from inside and outside RIVM. In particular, we will collaborate with CBS, and experts from several international collaborating projects (i.e., Eupasmos, LABDA).
 

Involvement of citizens in RIVM research (Project 5B)

Objectives and research questions
This project concerns the involvement of citizens in RIVM research. As part of this project, we will develop guidance for the use of methods to involve citizens in research and modelling. Furthermore, we will gain experience with the incorporation of insights from citizens into the modelling of the effects of policy measures. Moreover, we will gain experience with working together with citizens as co-researchers.

Motivation
There is limited experience at RIVM with citizen involvement, especially when it comes to working together with citizens on research and incorporating citizens’ perspectives into the modelling of the effects of policy measures. Furthermore, it is often unclear which level and method of citizen involvement are most suitable for each RIVM project.

Deliverables

  • Decision tool for citizen involvement
  • Improved alcohol consumption model
  • RIVM-wide Community of Practice
  • Six scientific articles
  • PhD thesis

Study design/action plan
This project will see us develop an interactive, easily accessible, web-based decision tool that will help RIVM researchers decide on the most suitable level and method of citizen involvement for each type of project. Subsequently, we will apply three citizen involvement methods to the case of policy measures to reduce alcohol consumption. Next, we will incorporate the information obtained into an existing model on the societal costs and benefits of policy measures to reduce alcohol consumption, so that we can improve this model. We will also organise a Community of Practice on citizen involvement.

Project team

  • V&Z/VPZ:
    • Adriënne Rotteveel: project leader, co-supervisor, coordination of Work Package 2
    • Mattijs Lambooij: co-supervisor, coordination of WP4
    • Eelco Over: execution of WP3
    • Ardine de Wit: supervisor, coordination of WP 3
    • PhD candidate: execution of WP1, WP2 and WP4
  • BDV/C&D:
    • Simone Raaijmakers: adviser
  • External:
    • Esther de Weger (Athena Institute, Vrije Universiteit Amsterdam): PhD supervisor, coordination of WP1
    • Three citizens as co-researchers: project members

Understanding the effect of policy on dietary behaviour (BEDOELD)

Objectives and research questions
This project aims to generate knowledge that will empower policymakers to develop more effective policies by taking account of the capacity to act (Doenvermogen) of the target population. Two behaviours will be examined: eating a more plant-based diet and making the home more sustainable. We will be using a complex systems approach to gain insights into the multi-level mechanisms that influence the target behaviours. We will also develop methods to integrate behavioural knowledge into complex quantitative models.

Motivation
The effect of policies is the result of technical effects and uptake. Uptake refers to the amount of people actually doing what the policy in question aims to achieve and the technical effect refers to, for instance, the (bio)mechanical and/or medical mechanism related to the desired behaviours. Examples are a plant-based diet and more efficient energy use in the home. The food pattern that results in optimal health may not be the pattern people are most likely to adhere to, and the most effective technical measures to improve energy use in the home may not be the most feasible or attractive ones for the people who live there. If policymakers want to find an optimal balance between technical efficiency and uptake of the target behaviours, they need an integral assessment. This project aims, in close cooperation with the CHANGE project, to learn more about what is needed and how this assessment can be realised.

The focal point of this research is the Doenvermogen concept: ‘non-cognitive abilities, such as setting a goal and making a plan, taking action, persevering and being able to deal with temptations and setbacks’ (WRR 2017). This influences the extent to which citizens are able to achieve the behaviours set out in the policy goals, thereby increasing the uptake and making the policy more effective.

Deliverables

  • A PhD thesis with four scientific articles about Doenvermogen in policymaking to promote a more plant-based diet
  • Two articles about Doenvermogen in policymaking to make the home more sustainable
  • Methodological innovation in complex systems analysis
  • Dissemination of knowledge among policymakers
  • Input for the agent-based model of the SPR Strategic Programme RIVM (Strategic Programme RIVM ) project CHANGE

Study design/action plan
We will answer the research questions in six steps. The first step is to collect policymakers’ insights and questions about Doenvermogen. Next, we will visualise the psychological, social and contextual mechanisms in causal loop diagrams. We will then use literature and meta-regression analysis to (partially) fill these diagrams with parameter estimates. We will fill any remaining empty parts by conducting additional experiments. Finally, we will extend existing agent-based models with behavioural insights from the complex system to evaluate which combinations of policy interventions are most effective.

Project team

  • VPZ will contribute expertise on nutrition, behaviour and agent-based modelling and also supervise the PhD student
  • DMG will contribute expertise on sustainability and behaviour, the energy transition and agent-based modelling
  • G&M/Radboud University will contribute expertise on meta-regression analysis in behaviour models
  • Erasmus University (ESPHM) will contribute expertise on choice behaviour in healthy lifestyle research
  • University of Amsterdam will contribute knowledge on empirical applications of complex networks
     

BEHAVioural sciences Integrated into infectious disease modelliNG: upgrading policy advice (BEHAVING)

Objectives and research questions
In this project, we aim to better project and understand the impact of policy changes on the transmission of infectious diseases. We do this by (objective 1) collecting and using pre-existing real-life data to study the heterogeneity in components of behaviour and their influence on future behaviour and (objective 2) building and analysing infectious disease transmission models that incorporate the studied heterogeneity in behaviour and behaviour change.

Motivation
Mathematical models are often an important basis for public health decisions. Heterogeneity in behaviour and in response to control measures creates differences in infection risk. These are relevant to the effectiveness of monitoring. Current infectious disease models take this insufficiently into account when it comes to policy advice, as shown during the COVID-19 pandemic. The aim of this project is to assess whether extending models with a dynamic description of this heterogeneity in components of behaviour increases the quality of policy advice.

Deliverables

  • A framework consisting of questionnaires that facilitates the collection of behavioural data and a better estimation of future behaviour, which can be used for epidemic modelling
  • A set of mathematical models that incorporate components of behaviour and behaviour change
  • Estimates of the impact of future policy changes on the transmission of infectious diseases

Study design/action plan
We will apply the two objectives to three types of infectious diseases: COVID-19 as an example of an emerging infectious disease, chlamydia as an example of a sexually transmitted infection (STI), and measles as an example of a vaccine-preventable disease from the national immunisation programme (NIP). We collected behavioural data on COVID-19 during the pandemic. We will collect data on chlamydia and measles through a framework yet to be developed. This framework will serve as a guideline to structured questionnaires about current and future behaviour (intentions and actual behaviour) related to potential policy changes, linked to explanatory components of behaviour from behaviour change theories. We will then use the behavioural data and pre-existing data to build mathematical models that incorporate heterogeneity in components of behaviour related to the transmission of infectious diseases. We will use these models to project the impact of policy changes aimed at behaviour change with regard to disease transmission. For COVID-19, we will do this retrospectively and compare the outcome with projections made at the time. For chlamydia, we will explore the potentially adverse consequences of a planned policy change. For measles, we will develop and analyse the effectiveness of scenarios for strategies to reach low-coverage subgroups. For both chlamydia and measles, an important focus will be on characterising subgroups based on components of behaviour to determine which subpopulations are at higher risk of infection and how these subpopulations may be targeted.
Project team

  • EPI: Janneke Heijne, project leader, STI epidemiologist and infectious disease modeller; Daphne van Wees, behavioural scientist and STI epidemiologist; Don Klinkenberg, infectious disease modeller (COVID-19 & measles); Jantien Backer, infectious disease modeller (COVID-19 & contacts); NIP epidemiologist, to be selected; Hester de Melker, head of the NIP department; Jacco Wallinga, head of the modelling department
  • ODD: Ka Yin Leung, data scientist and infectious disease modeller
  • G&M: Marijn de Bruin, behavioural scientist, member of the Corona Behavioural Unit and professor  of Behavioural Medicine & Health Psychology at Radboudumc/Radboud University
  • LCI: Marion de Vries, senior researcher (vaccination, risk and crisis communication)
  • Erasmus MC Rotterdam: Luc Coffeng, infectious disease modeller and behavioural scientist
  • University of Amsterdam (Uva): Frenk van Harreveld, professor of Social Psychology
  • An advisory board that will be formed at the start of the project
     

BIGFOOD: Using data to advance the protein transition

Research aim
For people, nature and the environment it is necessary to use less animal proteins and more vegetable proteins. We call that change the protein transition. In the BIGFOOD project we investigate the effects of the protein transition on public health, food safety and the environment. We also identify and study promising measures to advance the protein transition. 

Motivation
If we want our food production chain and ourselves to remain healthy, we must switch from a diet high in animal proteins to a diet high in vegetable proteins. With the research in this project we will find out what the best strategies for the protein transition are and we can calculate their (potential) effects. 

Deliverables

The results of our research will be:

  • a 'data platform', a central place where we collect our data.
  • a 'BIGFOOD toolbox', with useful example scripts to analyze the data in the platform.
  • a dissertation with four scientific articles
  • a teaching module about using the data platform

Design
We use data from various parts of the food chain, such as agriculture, food industry, food points of sale, and the consumer. We make this data available, combine and analyze it. We follow FAIR principles, which means that our data is findable, accessible, interoperable and reusable. We analyze large data sets using artificial intelligence. 

Project team

  • RIVM: PLG, GZB, DMG, MIL, Z&O, IV Organisation
  • Partners: WUR (WU, WFBR, WFSR), Statistics Netherlands (CBS), Netherlands Food and Consumer Product Safety Authority (NVWA)

 

BIOTICHS: Bending the curve

BIOTICHS: Biodiversity Indication Opportunities for Transition to Circular, Healthy and Sustainable societies

Objectives and research questions
To increase knowledge for the transition to a sustainable living environment, the restoration of nature and biodiversity and the sustainable use of ecosystem services.

We want to 1) characterise and analyse the causes of loss of biodiversity and ecosystem services by developing innovative methods, 2) map the values of nature, biodiversity and ecosystem services and 3) include them in an assessment framework for sustainable, nature-inclusive land use. We pay specific attention to diagnostic approaches (Work Package 1), soil biodiversity and its provision of ecosystem services to support sustainable land use (WP2), operational decision frameworks (WP3) and practical testing (WP4), with a focus not only on pressure-response relationships for nature but also the potential to characterise possible relationships between biodiversity and human health.

Motivation
‘Bending the curve'’ of biodiversity loss is key for man-made negative impacts on biodiversity and ecosystem services. Nature and biodiversity are threatened by e.g. nutrient oversupply (such as nitrogen or phosphorus), toxic substances, desiccation, mismanagement, and loss of habitat, often in spatially variable combinations of pressures and pressure intensities. For the transition to a sustainable living environment, it is essential to characterise current biodiversity patterns, diagnose the dominant causes of impacts, and develop optimised strategies for sustainable societal uses of ecosystems and their services, with an eventual relationship to human health. Sustainable management strategies that optimise biodiversity will increase vital ecosystem services, such as water regulation, pollination, natural attenuation and nutrient cycling, and promote resilient performance. In order to improve knowledge-based decision-making on this subject, it is necessary to achieve a better understanding of the relationships between these pressures and their effects on biodiversity, the provision of ecosystem services and human health. The project involves collating and curating the available (bio)monitoring data and developing data-driven insights into pressures and impacts on structural and functional impact metrics, with contemporary ‘big data’ analysis methodologies tailored to the subject (details explained below). Previous work in aquatic systems has yielded basic methodologies to derive a site-specific diagnosis of the probable causes of observed biological impacts, which will be developed further and expanded to cover terrestrial ecosystems and the relation between these impacts and human health. These methods also bridge the gap between applied ecology and ecotoxicology. These are currently separate disciplines, which hampers diagnosis and management practices. The next step is to use the acquired diagnostic insights for region-specific sustainable management, with an emphasis on soil ecosystem services and sustainable soil use. Given the unique combination of knowledge on environmental and human health issues at RIVM, the project will involve linking the human health epidemiology and the aquatic/terrestrial ‘ecological epidemiology’ and exploring potential cause-effect chains of impacts on human health by reviewing the literature on this, developing working hypotheses, and potentially developing this novel and likely important field further.

Study design/action plan
This research will consist of four work packages as shown in Figure 1 below, with an emphasis on different aspects regarding aquatic and terrestrial ecosystems and human health and with a close (design) link between scientific developments and operational utility for environmental management in the context of sustainable development. Given the central role of (bio)monitoring data sets in the planned studies, the project team will collectively define how to work on a BIOTICHS ‘data lake’, in which place-time-parameters-values-units information is collated, curated, stored and sub-selected for the various purposes in WP1–WP4. At the start of the project, there will be various databases available (see Appendix 1). In the course of the project, the ‘data lake’ will be expanded on the basis of identified (additional) data sources, as part of which those data will be curated, harmonised (in terms of units) etc.

Deliverables
The deliverables of the project are scientific manuscripts, two PhD theses, an extensive (bio)monitoring database as well as pertinent statistical models that are both suited for broader use beyond the project duration, and capacity building at RIVM and with network partners.
 

CASSIS: - From Complex Adaptive Systems towards the SImulation of actionS

What?
CASSIS generates knowledge on how to intervene in a system that causes a high level of burnout among workers, and chronic stress among residents caused by urban densification. The results are disseminated through scientific articles and presentations given to various target groups.

Why?
The mental health of the Dutch population is under pressure. Examples include the increase in burnout among workers and the occurrence of chronic stress among residents caused by urban densification. Qualitative system models provide insight into the underlying mechanisms of these complex societal problems. In order to take preventive measures, it is important to translate this knowledge into systems actions and study their potential impact.

How?
Two innovative methods based on systems thinking are applied in CASSIS: 
1)    The Action Scales Model (ASM) to identify, together with stakeholders, systems actions to intervene in the system. 
2)    System Dynamic Simulation Models (SDSM) to simulate the impact of the systems actions in a quantitative model. 

Cooperation

  • Amsterdam UMC
  • Erasmus MC
  • Trimbos Institute
  • TNO

Is the project a continuation of another project?
CASSIS is a continuation of the SPR Strategic Programme RIVM (Strategic Programme RIVM ) projects COLLABORATE and INCLUSIVE.

Cells4Thought: Human cell models for healthy brains

What?
This project will use human-relevant cell models to investigate whether and how chemical substances can influence brain development. The objective is to better predict better whether a chemical substance is harmful, than can at present be achieved using the models currently in use.

Why?
Chemical substances may contribute to the disruption of brain development. The current means to evaluate this, in particular tests involving laboratory animals, do not appear to be a good predictor for effects in humans. For this reason, new models should be developed that can better mimic human brain development.

How?
The project will use human stem cells to test how certain substances affect brain development. In addition, mutations will be engineered in the cells’ DNA to study whether people with a specific genetic makeup are more sensitive to chemical substances than others.

Cooperation

  • Amsterdam University Medical Center – Knowledge centre for developmental disorders
  • Erasmus Medical Center – Developmental Biology / iPS facility

CHANGE: – aCtionable Hotspot identificAtion and impact iNteGration for the Energy transition

Summary

Objectives and research questions

The main objective is developing an integrated model framework to assess the impact of technologies used in the energy transition, while considering the social dynamics that influence the transition. We have formulated two main research questions:

  1. How can models for assessing the safety of substances, sustainability and noise be combined with energy transition models?
  2. How can Agent Based Modelling (ABM) be used to include behaviour in energy transition models, so that social dynamics can be taken into account?

Motivation
Reaching our climate goals is a matter of great importance. So far, predominantly techno-economic factors have been included in energy scenarios. This focus on minimising one impact – climate change – can lead to unintended effects in other areas, such as biodiversity or health. This should be avoided. Furthermore, social dynamics can greatly influence the speed and effectiveness of the energy transition and its impact. These behavioural factors have been absent from energy scenarios until now.

Deliverables
Modules that combine assessment of the safety of substances, health and sustainability with energy transition models

  • Complex model analysis methods to determine the main drivers of the impact of energy transition technologies
  • Agent Based Models to include behaviour in scenarios for the uptake of key energy transition technologies
  • A valid behavioural modelling framework for policy advice

Study design/action plan
Integration of models

  1. Literature research on the major effects of energy transition technologies
  2. Combination of existing impact models with energy transition models
  3. Creation of metamodels to combine impact models with Agent Based Models and performance of a global sensitivity analysis to add robustness to the models and their interpretation
  4. Testing and analysis of the combined models for behaviour, energy transition and impact

Application of ABM

  1. Literature research on behavioural determinants that are relevant for the energy transition
  2. Development of conceptual behavioural model and formalisation in an ABM for a case study on home sustainability improvements
  3. Gathering of behavioural data for calibration and validation of the ABM
  4. Creation of an ABM framework and test for a second case study

Project team
RIVM centres involved:

  • Sustainability, Environment and Health
  • Environmental Safety and Security
  • Safety of Substances and Products
  • Health and Society
  • Nutrition, Prevention and Health Services
  • Environmental Quality

External partners are Leiden University and Delft University of Technology, each of which will help supervise PhD students working on the integration of impact models and on the application of ABM, respectively.

CRADLE: Consented RAre Disease screening early in LifE

What?
How can genetic testing add value to newborn blood spot screening (NBS) in the Netherlands? The aim of this project is to investigate the potential applications and challenges of genetic testing for serious, treatable conditions in the screening of newborns. The ultimate objective is to establish the technological, ethical, legal and societal questions raised by these tests. Which conditions should these tests meet when applied? What are the views of the various stakeholders? How does the general population regard these applications, and what do parents of newborns consider important?

Why?
Worldwide, we see rapid developments in the application of genome-wide DNA testing in NBS. In this research project we will study the potential applications and challenges of these technologies for NBS in the Netherlands. This will allow RIVM to adequately respond to these future developments, and address questions from society.

How?
The project is a combination of technical and social sciences. The study will ascertain both practical and technical aspects of DNA technology and data storage. It will also identify the consequences of genetic testing on the laboratory logistics of current screening. The performance of genetic testing will be compared with current testing methods for several conditions included in the current Dutch NBS panel. Through interviews and focus groups, this project will investigate the perspective of stakeholders and the public on important ethical, legal and societal issues.  Information requirements of the public and parents of newborns will be established using specific questionnaires.

The findings and conclusions of this study will be compiled into an implementation framework for genetic testing in newborn blood spot screening.

Cooperation

  • Amsterdam UMC, Department of Human Genetics, Community Genetics research group
  • Leiden UMC, Department of Paediatrics, Laboratory for Primary Immune Deficiencies

 

DEbugging MIsclassification: STatistical methods for correction of InFormation bias in epidemiologY (DEMISTIFY)

What?
We study the validity and applicability of various statistical methods for correcting information bias. The objective is to apply the knowledge gained in future RIVM research projects and surveillance programmes. This means that misclassification issues are recognised and that outcome bias is corrected through appropriate statistical methods.

Why?
Misclassification of exposure or outcome status is common in surveillance and epidemiological studies, which leads to information bias. This complicates the interpretation of results and can lead to wrong conclusions being taken. There are statistical methods that reduce information bias. However, these are poorly implemented due to factors including unfamiliarity and inexperience.

How?
We select three to five representative cases within RIVM where information bias and misclassification play a role. We first determine the appropriate statistical methods for each case. We then validate the methods using simulation studies and by applying the methods to the surveillance data or the study data. Finally, we convert the findings into a guideline document. 

Cooperation

  • LUMC

 

ENABLE - ENergietrAnsitie en BinnenmiLiEu: Ontwikkeling risicobeoordelingsmethodiek voor gecombineerde blootstelling

Summary

Objectives and research questions

The ENABLE project (ENergietrAnsitie en BinnenmiLiEu: Ontwikkeling risicobeoordelingsmethodiek voor gecombineerde blootstelling) aims to determine the health impact of energy retrofitting measures in homes. To this end, we will carry out measurements and develop models for exposure to airborne chemical, microbiological and radiological agents that will be used to develop integrated risk assessment methods, while considering behaviour.

Motivation
Energy transition measures, although primarily aimed at mitigating climate change, can affect the quality of the indoor environment, leading to effects on health and well-being. These effects can be positive as well as negative. Their net effect on the indoor environment is currently unknown. Determining this net effect is relevant for public health as well as for public acceptance of measures. ENABLE will contribute to understanding the integral effects on health of the energy transition in homes.

Deliverables
ENABLE will deliver results from a case study on air quality and the effects of behaviour on the impact of technological measures in homes that have undergone energy retrofitting measures, models, risk assessment tools, a fact sheet for stakeholders and scientific papers.

Study design/action plan
The ENABLE project will involve the development of tools to characterise human exposure to agents in the indoor environment. To this end, we will examine a case study to assess changes in indoor air quality before and after energy retrofitting measures. In the case study, we will also examine how to investigate and harness the influence of behaviour on sustainability practices. In addition, ENABLE will contribute to integrating risk assessment methods from different fields (chemical, [micro]biological, radiological) into one comprehensive toolset. Unique for ENABLE is that all this information on measurements, risk assessment, perception and behaviour can be translated into knowledge that is important and pertinent for policy advice provided by ministries, Municipal Public Health Services (GGDs) and other actors/stakeholders.

Project team
The project team consists of members from the RIVM centres VLH, VSP, GZB, ZNO and DMG as well as external experts.

ENCOURAGE

Summary

Objectives and research questions

The objectives are:
a) to explore how existing health data can be combined and analysed in a smart way in order to investigate the positive and negative impacts on health of interventions in the living environment; 

b) to study the health impact of selected interventions in the living environment that have taken place in the (recent) past.

Research questions
What is the magnitude, spatial scale and time window of changes in environmental stressors (air pollution and noise) or other aspects of the built environment (green and blue space) caused by interventions that change the infrastructure or other aspects of the physical environment?

  • How can the Dutch infrastructure of health data, including cohort studies, be used for evaluation research into the health impacts of interventions in the living environment?
  • What are the most effective study designs that can be used to investigate the health impacts of selected interventions by means of data from health registries or specific Dutch cohorts?
  • What are the impacts of selected interventions on physical and/or mental health?
  • How can we use the results of our study to derive criteria for the evaluation of future interventions in the living environment?

Motivation
To overcome the various societal and public health challenges, we need innovative and integral solutions that can have a direct or indirect effect on public health. While many interventions in the living environment have been implemented in the past, evidence on the health impact of these interventions is still lacking.

Deliverables

  • A guidance document guiding the study design and statistical analysis of interventions in the living environment, using existing data in general.
  • Four scientific publications for peer-reviewed international journals.
  • One PhD thesis.
  • One report on the evaluation of future changes and/or interventions in the living environment.

Study design/action plan
We will prepare an inventory of selected interventions in the living environment. The idea is that the selected interventions change the infrastructure and/or physical environment in one or more areas in the Netherlands. We will assess the impact of these changes on environmental exposures and/or other factors of the built environment. Specifically, we will focus on changes in air pollution, noise and access to green and blue spaces. We will then link the estimated exposures and/or factors of the built environment before and after the change in infrastructure and/or physical environment to all relevant residential addresses of subjects in the different health registries and specific cohort studies. Next, we will investigate the impact on cardiometabolic and mental health in selected case studies. In addition, we will conduct a specific case study on physical activity behaviour and perception of the environment to explore the association between changes in the environment and health. However, there are many methodological challenges when it comes to investigating the impacts of changes and interventions. We will overcome these challenges by means of designs and statistical techniques specifically developed for the evaluation of the selected interventions on the basis of the available health data.

Project team
The following RIVM centres are involved: Sustainability, Environment and Health, Environmental Quality, Nutrition, Prevention and Health Services, and the department of Statistics, Informatics and Modelling. External partners are Utrecht University’s Institute for Risk Assessment Sciences (IRAS) and the Netherlands Institute for Health Services Research (NIVEL).

EFFICIENT: novel data mining methodologies

Efficient

Novel data mining methodologies for extracting and discovering determinants of behaviour, needs and suggestions of professionals and the public from existing data sources and social media to improve RIVM research, policy advice and communication.

Summary

Objectives and research questions

The aim of the Efficient project is to apply and evaluate novel and established data mining methodologies to make efficient use of existing RIVM data registries, social media and fora, and to improve RIVM research, policy advice and communication. The research question to be answered is: what are the most accurate text mining methodologies to detect and extract perceptions, attitudes, beliefs, sentiments, needs, suggestions and experiences of professionals and the public regarding the COVID-19 pandemic, HPV vaccination, cervical cancer screening and the nitrogen crisis? Comparing different types of data and determining the most user-friendly output will allow us to develop a proof-of-concept dashboard.

Motivation
Every day, RIVM receives hundreds of questions, comments and suggestions of professionals and the public about the various topics that it deals with. These offer an important opportunity to provide RIVM with relevant societal feedback loops to better adapt its work to societal needs. Largely automated analyses of rich data sources can be an important addition to methods such as interviews and surveys, as these sources are continuously updated with – among others – suggestions, needs and experiences from professionals and the public.

Deliverables

  • A generic tool to anonymise large amounts of text automatically in accordance with the GDPR
  • A user-friendly proof-of-concept text-mining dashboard for RIVM staff and a training course on text mining, opportunities and pitfalls
  • Knowledge on determinants of behaviour, needs, suggestions and experiences of professionals and the public concerning  topics that are relevant to RIVM

Study design/action plan
Using four use cases and with the close involvement of subject matter experts, we will identify and use novel and established text-mining methodologies. We will evaluate how accurate and feasible these methods are. Next, we will identify by means of a participatory design process which indicators are required and how these should be visualised. Based on a literature review, user stories and pre-prototypes, we will develop a sustainable and user-friendly proof-of-concept dashboard as well as a text-mining course to secure text-mining expertise for RIVM.

Project team

  • Core team: M. Stein (PI – LCI/CIb), M. de Vries (LCI/CIb), text-mining postdoc (LCI/CIb-VU), Florian Kunneman (VU AI), Jurriaan Biesheuvel (SIM/IV).
  • Subject matter experts and technical advisers from LCI/CIb, EPI/CIb, G&M/V&Z, VPZ/V&Z, Communication M&V, Communication CvB and Communication CIb, DVP, and information managers and data scientists from the IV Organisation.
  • External partners: Faculty of Science (Artificial intelligence) of Vrije Universiteit Amsterdam for its expertise in AI and text mining, as well as other leading AI experts.

Evanement Objectives and research questions

Summary

Objectives and research questions

This project aims to develop expertise and simulation models for policy support regarding the prevention of poor mental health. Main research questions are: What are the links between determinants, poor mental health and the incidence of mental disorders and how can these be quantified to support policy evaluations? What outcomes and integration methods work best to evaluate prevention policies in this field?

Motivation
Young people increasingly experience stress, pressure and poor mental health. Timely prevention may avoid severe mental health problems at a later age and increase mental resilience, while reducing healthcare costs. Many different options for prevention exist.
To support decision-makers with the implementation of the Dutch national action plan for mental health, proper information is required. RIVM is seen as a partner for monitoring and evaluation. Under the current proposal, RIVM will fulfil this role by creating methods for novel decision models, as not all known methods for public health models regarding somatic disease can be translated one by one.

Deliverables

  • Expertise on policy evaluation for better mental health.
  • Expertise on participatory modelling in health economics in the Netherlands.
  • Health impact model and economic module for policy evaluations in ‘public mental health’.
  • Strengthening of RIVM’s network and  expertise in the field of mental health.

Study design/action plan
We will follow the modelling cycle, combining quantitative and qualitative research methods. First, we will develop a conceptual model using participatory modelling and then implement it by estimating model parameters and code writing. In parallel, we will develop a suitable method for integration of a broad range of outcomes and costs. Next, we will validate the model and apply it to a case study, using the Groningen pilot, which encourages all stakeholders to exchange best practices and work towards more prevention for better mental health.

Project team

  • IVO-ODD (Anoukh van Giessen, modeller, PhD student): project coordination, modelling and data analysis.
  • V&Z-VPZ (Ardine de Wit, Talitha Feenstra, PhD student): project coordination, outcomes and integration.
  • VSP-ICM (Silke Gabbert, Arianne de Blaeij): integrated economic evaluation.
  • Trimbos (Ben Wijnen, Laura Shields-Zeeman): modelling, outcomes and data analysis.
  • MIND (Dwayne Meijnckens, Paul Ulrich): stakeholder involvement, outcomes and modelling.
  • VU (Judith Bosmans; Ardine de Wit): outcomes and integration.
  • RUG (Frederike Jörg; Talitha Feenstra, PD): data analysis, modelling and case study.

Project advisers

  • IVO-ODD (Jeljer Hoekstra): modelling
  • DGM (Hanneke Kruize): economic evaluation
  • G&M (Carolien van den Brink, Ronald Gijsen, Guus Luijben, Djoeke van Dale): mental health policy, group-based model building
  • Trimbos (Silvia Evers): economic evaluation of mental health policy
  • MIND (Cisca Goedhart): stakeholder involvement
  • Netherlands Youth Institute (Germie van den Berg): national and international youth sector network

content Future Air

Name of research project: Future Air

What?
What effect does climate change have on air quality in the Netherlands? In this project we study how climate change changes the concentrations and exposure of air pollutants over time. These include nitrogen dioxide, fine particles, ozone and pollen. The outcome is described in scientific articles and used in air quality-related future scenarios.

Why?
Our climate is changing and this already has visible impact on weather patterns and will to continue to have an impact for the next decades. Apart from direct impact, climate change also has an effect on exposure to air pollutants, impacting public health. How do these effects relate to the effects of current and future air quality policy in the Netherlands and Europe?

How?
To study this issue, we link the outcome of climate models to air quality models. Various climate change and air quality scenarios are assessed for their effect on concentrations of air pollutants and pollen in the Netherlands. Health effects are also being assessed.

Cooperation

  • KNMI
  • UK Centre for Ecology & Hydrology
  • Finnish Meteorological Institute
  • Swiss Tropical and Public Health Institute

GLOW: Towards a Green and healthy Living environment: an Opportunity for health and Well-being

Summary

Objectives and research questions
Available knowledge about promoting health through the physical environment is often focused on individual topics, and environmental intervention studies are still rare. As a result, it is difficult to put together a package of impactful environmental measures to promote health and reduce overweight that is supported by stakeholders.

Motivation
GLOW’s ambition for 2026 is to gain more insight into how the design of the physical environment as a whole affects our health, with a focus on the role of behaviour. We will focus on the interactions between design, behaviour and the topics of exercise-friendly environment, green space and food environment. As an end point, we will focus on overweight.

In order to make optimal use of the possibilities of the physical environment to promote behavioural change and health, we need more knowledge about effective interventions in the living environment, how to combine data in the evaluation of effectiveness, and important determinants of behavioural choices in different contexts and groups.

Deliverables

  • Literature review report
  • Living labs reports
  • System dynamic model
  • Agent-based model
  • Action perspective in practice
  • Four publications

Study design/action plan
Throughout the project, stakeholders (the public, policymakers, professionals) will be actively involved in project choices, modelling and the evaluation of results (in the form of a living lab). The project will start with a literature study. After that, we will develop a system dynamic model that describes the paths and interrelationships between design, behaviour and the chosen topics. In addition, we will develop an agent-based model (ABM) that will allow us to visualise the effects of changes in the environment and to which we can add ‘live’ data on people’s behaviour. We will collect these data in two or three living labs, in which we will implement, monitor and evaluate promising interventions for physical activity, green space and food environment. Next, we will perform a synthesis of the lessons learned from literature, modelling and the living labs.

Project team
A PhD candidate appointed at RIVM and supervised by Wageningen University & Research will work together with two RIVM postdocs and other PhD students working on ABM within SPR Strategic Programme RIVM (Strategic Programme RIVM ). The work will partly be carried out by an RIVM team and students of HU University of Applied Sciences Utrecht and Amsterdam University of Applied Sciences. The RIVM team will consist of experts in the fields of environmental epidemiology, behaviour, health, spatial planning and mathematical modelling, among others. Other SPR project activities and results, such as ENCOURAGE, CONCOCT and BELEEF, will be used and build on insights from RIVM projects such as INHERIT, LEGO and the Ministry of Health, Welfare and Sport project ‘Physical living environment and health promotion’.

HAI NL: Harmonized Automated Surveillance of Hospital Infections on a National Level

What?
We study the usability and conditions for a federative system for automating national surveillance of hospital-acquired infections (e.g. surgical site infections after surgery). This allows RIVM to develop a system enabling hospitals to use data from the electronic health record for surveillance purposes, without the need to share these source data with RIVM.

Why?
Surveillance of infections is important to be able to take preventive measures. As the current, manual surveillance is not sustainable, a federative system would facilitate the implementation of automated surveillance of various types of infections, without personal data being shared. This would make it easier for hospitals to prepare for a future with possible new infections or more complicated analysis techniques.

How?
Through interviews and discussion groups with experts and stakeholders, we  inventory the requirements for federative, automated surveillance. Together with hospitals, we evaluate the possibility of receiving data and whether the results are accurate. We also compare current analyses methods with new methods for epidemiological analyses to evaluate usability.

Cooperation

A scientific advisory body comprised of international experts from reputable scientific institutions.

INDIGO: - Innovative methods for Diversity in public health programmes (INnovatieve methoden voor DIversiteit in volksGezondheidsprogramma’s en Onder

What?
The objective of this project is to develop and evaluate innovative methods to reach and involve people in vulnerable positions in public health programmes and scientific research. The end product is the INDIGO strategy: a combination of social network interventions, interactive audiovisual techniques and communication technologies.

Why?
Various groups in our society are underrepresented in public health programmes, and as a result also in scientific research, thus contributing to health inequalities. Due to lower participation in health programmes, these groups miss out on health benefits. We furthermore lack knowledge of whether research results also apply to them.
The knowledge of how suitable channels can be used, how to build trust, and how timing and relevance of public health programmes and scientific research can be improved upon is limited among policymakers, implementers and researchers.

How?
Promising methods are selected from scientific and other literature and refined and integrated in collaboration (cocreation) with citizens, researchers and other stakeholders. We use the population cancer screening as case study. Tests are conducted in small-scale feasibility studies to see how the INDIGO strategy can be implemented in practice in population screenings and in relevant scientific research.

Cooperation

  • Amsterdam UMC, Public and Occupational Health.
  • Maastricht University, Health Promotion.
  • This team is supplemented by stakeholder representatives.

INnovation in FOresight Methods (INFORM)

What?
The main goal of INFORM  is to identify, apply and evaluate innovative methods for exploring the future (foresight) of public health. These are methods that have not yet been applied by the RIVM in foresight studies. In this way we create future-proof and scientifically up-to-date methods and processes. In addition we also ensure that the insights gained are  applied in future Public Health Foresight Studies (PHF) within the RIVM. 
INFORM’s results are varied and include scientific publications on the use of the selected innovative methods. In addition active dissemination of knowledge gained through the RIVM foresight website and foresight study community.

Why?
RIVM uses PHF to study the future of public health and health care every four years. The future of public health and health services faces a number of ‘wicked problems’. One of these is the relationship between public health and health services, which involves many interdependencies. Currently the foresight methods used within RIVM are not sufficient to unravel such complex issues. 

How?
We will start with an inventory of qualitative, quantitative and mixed methods that we can add to our PHF methodology toolbox. Based on a  selection of these, we will apply these methods in two work packages. In the process, we are likely to become competent in horizon scanning using AI or machine learning. We will use a complex system analysis method to map out the dependencies within the nexus. Furthermore, in collaboration with citizens, we will apply narrative foresight methods, such as storytelling to make the outlined scenarios relatable and bring them to life. In the last work package, we will evaluate and secure the lessons learned to ensure that they are well incorporated into future PHFs and the broader area of expertise foresight. 

Integrated in vitro Toxicokinetics and Toxicodynamics to Advance Multi-organ Toxicity Testing (INTACT).

Name of research project: Integrated in vitro Toxicokinetics and Toxicodynamics to Advance Multi-organ Toxicity Testing (INTACT).

What?
INTACT focuses on developing new methods that do not involve animal testing to test the toxicity of chemical substances. The object is to make a more accurate assessment of such substances using in vitro and computer models, resulting in better risk assessments and less use of animal testing.

Why?
This research is important because of the ethical objections to animal testing and the limited translatability of animal experiments to humans.  New methods that do not involve animal testing do not always yield the information needed for risk assessment. INTACT aims to find reliable and human-oriented research methods for substance safety, developed in partnership by in vitro researchers, modellers and risk assessors.

How?
INTACT uses sophisticated in vitro models and integrates them with computer models to form an ‘intact’ model of the human body. INTACT combines the evaluation of routes of exposure of chemical substances with the reactions in multiple organs. This is how INTACT develops an integrated predictive model for risk assessment.

Cooperation:

  • Institute for Risk Assessment Sciences (IRAS) of Utrecht University (UU)

MODIVIERS

Name of research project: Modifiers of temperature related MOrtality and Disease: Identification of Vulnerable individuals, buildings and neighbourhoods and Improvement of EaRly warning Systems (MODIVIERS)

What?
We study the relationship between temperature and mortality, hospitalisation and mental health, taking into account vulnerable groups and locations. This knowledge will help to improve temperature warning systems and adapt the built environment to a changing climate. 

Why?
Climate scenarios show that temperatures will rise in the next years, along with the number of heatwaves. Exposure to both high and low temperatures impact health. To better prepare the Netherlands for future climate scenarios, it is important to understand the relationship between temperature and health, and to identify vulnerable groups and locations.   

How?
We use daily temperature data supplied by the Royal Netherlands Meteorological Institute (KNMI). We link these data to health data and information on socioeconomic status, housing characteristics and the built environment. To study the relationships between temperature and health, we use case time series analyses. 

Cooperation

  • KNMI
  • Statistics Netherlands (CBS)
  • VU Amsterdam
     

PINPOINT

What?
The objective of this project is to develop a new computer model that can be used to identify possible endocrine disruptors. The predictions that this model makes can be used as a basis for further evaluation through assessment frameworks and Safe and Sustainable by Design processes.

Why?
There is mounting concern about the harmful effects of endocrine disruptors. For many of these substances, experimental data about their possible endocrine-disrupting effects is currently lacking. Computer-modelled predictions may enrich the currently available data and play a role in the early identification of possible endocrine disruptors.

How?
This project will involve the development and use of two types of methods: a ligand-based method (based on a substance’s ‘functional’ data) and a structure-based method (based on substance-protein interactions). These two methods will then be incorporated into a single model for the purpose of generating reliable and robust predictions.

Cooperation

This project is a partnership between:

  • RIVM (Centre for Safety of Substances and Products and Centre for Health Protection).
  • Leiden University (Leiden Academic Centre for Drug Research).

SEquencing Wastewater for Epidemiological Research (SEWER)

Name of research project: SEquencing Wastewater for Epidemiological Research (SEWER)

What?
In addition to SARS-CoV-2, there are other respiratory pathogens, including influenza virus and RSV that cause seasonal increases in infections.The possible result is a higher burden on the Dutch health care system. A wastewater-based surveillance program that includes these pathogens could yield useful information supplementing the current surveillance landscape. Such a programme would focus on pandemic preparedness.

Why?
This SPR Strategic Programme RIVM (Strategic Programme RIVM ) project studies how the wastewater surveillance can be expanded to contribute to solving relevant questions concerning public health protection.

How?
Can innovative molecular and sequencing-based analysis techniques be applied? What insights do they provide? Can data analysis and modelling be developed based on the data from this project and other data sources, in order to provide customize data for end-users and ultimately for policymakers?

Cooperation

  • Public Health Service of Amsterdam
  • NIVEL

TOOLBOX Respiratory

Summary

Objectives and research questions
The aim of this project is to develop and validate an innovative toolset that will allow future research on the development of the immune system in the first years of life (ages 0–3). Secondary aims are 1) to develop and validate the performance of multiple analyses (microorganisms, immune markers, antibodies) in a single low-volume upper airway sample; and 2) to produce respiratory syncytial  viruses (RSV) and proteins and influenza proteins in-house for addition to existing in-house antibody assays.

Motivation
Despite being subjected to the same vaccination programme, children are not equally protected against infectious diseases. In the first years of life, the immune system is still developing. In the meantime children, are being exposed to micro-organisms and other inhaled agents. To what extent and how the developing immune system is affected by these exposures is largely unknown. Insight into these external factors will help us understand what the exposure risks for children are and which infections may need to be prevented through e.g. vaccination. To be able to investigate the development of the respiratory immune system in young children, we need approaches to collect nasal samples more frequently and in a non-invasive manner. Typically, such nasal samples will have low sample volumes. Currently, no integrated set of tools is available for the performance of multiple measurements in such low-volume samples.

Deliverables

  1. Validated protocols for the simultaneous detection of micro-organisms, immune markers and antibodies in a single low-volume nasal sample
  2. A laboratory protocol for the simultaneous sequencing and production of RSV from clinical samples
  3. A laboratory protocol for the in-house production of RSV and influenza proteins, which are not or insufficiently available commercially
  4. Adapted laboratory protocols for existing antibody assays to incorporate viruses and proteins produced in-house
  5. Several manuscripts and one PhD thesis about the development of the tools mentioned above and their use with previously collected nasal samples from children

Study design/action plan
Part A. Tool development
We will perform an adult volunteer pilot study to collect nose, throat and saliva samples. By using these samples we will compare microbial detection and immune profiling techniques between the sampling methods. For the molecular detection of microorganisms PCR, we will compare nanopore sequencing and shotgun metagenomics to evaluate the amount of microorganisms detected using the different techniques. This will involve evaluating the sensitivity, in addition to evaluating the possibility of performing microbial detection with immune assays in the same low-volume sample. In addition, we will detect immune markers using commercial assays. The samples will also serve as a template to produce recombinant RSV. Finally, we will set up a protein production facility at RIVM for the detection of antibodies to various infectious agents, especially cross-reactive antibodies to the influenza stem of the protein Haemagglutinin.

Part B. Tool validation
We will validate the developed tools using existing cohorts with non-invasively collected samples from adults, healthy children and children with recurrent respiratory infections to detect a) viruses and bacteria, b) immune markers and c) pathogen-specific antibodies. We can use the nationwide PIENTER3 cohort (cross-sectional population cohort), the VIOOL study (healthy children) and the DIMER study (children with recurrent respiratory infections) for this purpose.
We will then use data on microbial composition, immune marker profiles, antibodies and respiratory complaints to evaluate the applicability of the toolbox in future scenarios.

Project team
RIVM

  • Gerco den Hartog, IIV/IMS: sampling and immune marker measurements
  • Jorgen de Jonge, IIV/IMM: protein production and antibody measurements
  • Puck van Kasteren, IIV/IMM: reverse genetics and functional assays
  • Adam Meijer, IDS: respiratory virus diagnostics/surveillance
  • Dirk Eggink, IDS: protein production, virus diagnostics and whole genome sequencing
  • Rob Mariman, IDS: molecular detection of micro-organisms
  • Nicoline van der Maas, LCI: clinical consultation
  • Susana Fuentes, IIV: adviser on microbial analyses

External

  • Lilly Verhagen, Radboud UMC: paediatrician, infectious diseases & immunology subspecialist, mucosal immunology in infectious diseases
  • Marien de Jonge, Radboud UMC: mucosal immunology and diagnosticsDimitri Diavatopoulos: sampling, mucosal sampling and immunity
  • Ronald Dijkman, University of Bern: adviser on molecular virology
  • Patricia Bruijning-Verhagen, UMCU Utrecht: paediatrician and epidemiologist, advice and samples

TOXDOWN

Summary

Objectives and research questions

  1. Development of meaningful indicators related to the presence of toxic chemicals (or mixtures thereof) in the living environment that are indicative for environmental and human health effects and meet the information needs of the various stakeholder groups: the public, industry, authorities and scientists.
  • Development of the indicators for the environment will build upon the eco-toxic pressure approach in water and can be extended and integrated to cover the various compartments (air, soil and water). For the development of an indicator on human health, there are a number of scientific issues to be addressed and, consequentially, choices to be made. Discussions amongst scientists from different fields and input from the stakeholders on their information needs will therefore serve as a basis for the development of the indicators.
  • Extension of these rational indicators with an indicator related to the perceptions of stakeholder groups on the presence of chemicals in the living environment.
  1. Quantification of the developed indicators using existing databases and models and presentation in easily understandable geographic maps.
  2. Detailed use of the indicators and approaches in a suitable case study. In a participative process with stakeholders, if appropriate, we will develop an action plan elaborating interventions to reduce and/or manage the toxic chemicals in that living environment. For this plan, we will explore the solution space at the local, regional and (inter)national levels.
  3. Development of a generic approach to gain insights into the presence of toxic chemicals in the local living environment with respect to their effects and work towards reducing the amount of those chemicals. This approach will rely on rational elements as a basis for the indicators, but we will also use other elements, like perceptions and values of the stakeholder groups, to shape the process.

Motivation

  • Chemicals are essential in daily life and form the basis of many economic activities. However, these chemicals can affect environmental and human health as well as sustainability.
  • The EU European Union (European Union ) is aiming for zero pollution. This ambition still needs to be put into practice, not least at the local level, where the concerns of citizen groups can be high and the knowledge that local/regional authorities and industry partners need to assess situations and develop interventions is often insufficient. 
  • Information tailored to the needs of stakeholders is essential to assess the local situation and develop interventions to reduce and/or manage the toxic chemicals.

Deliverables

  • Major contribution to two PhD theses to be prepared by candidates that are also RIVM employees, thereby ensuring that the experience and insights gained are properly embedded within the organisation.
  • At least eight scientific publications from the ToxDown project and an expected three or more additional publications in cooperation with other projects.
  • Capacity building on and lessons learned from experience with reducing the presence of toxic chemicals (or mixtures thereof) in the living environment, in partnership with stakeholders (the public, industry, regional/local authorities), as well as prevention of and/or addressing societal unrest.
  • Cooperation with SPR Strategic Programme RIVM (Strategic Programme RIVM )-BIOTICHS: information on the indicator for environmental effects (eco-toxic pressure) as input for biodiversity impacts (BIOTICHS), and information on biodiversity for consideration in discussions with stakeholders in ToxDown.

Study design/action plan
The work will be organised into different work packages.

WP1 will provide the basis for developing indicators on the presence of toxic chemicals (or mixtures thereof) in the local living environment that are relevant to the stakeholders. We will gain insights into the perspectives and information needs of the public, authorities and enterprises with respect to the assessment of and decision-making on toxic chemicals. WP1 also aims to achieve a mutual understanding of scientific perspectives from different fields that can be used to develop the indicators.
WP2 is about developing meaningful indicators relating to the presence of toxic chemicals (or mixtures thereof) in the living environment. This comprises indicators relevant to the environment and human health. With respect to the development of an indicator related to human health, WP2 depends heavily on the outcome of WP1. The reason for this is that there are a number of scientific issues to be addressed and, consequentially, choices to be made. One issue to be considered is how to address the exposure of chemicals from other routes like food, smoking and consumer products. Another is the question of how to address mixtures of chemicals in the indicator. Using the results of WP1, we will develop and integrate the existing eco-toxic pressure approach for the aquatic environment further into a method that will provide (an) indicator(s) for eco-toxic pressure from the environment due to mixtures of chemicals in air, soil, and water. We will present the results in geographical maps for the Netherlands.
WP3 is about gaining insights into the perceptions (e.g. evaluations of severity) of stakeholder groups of the presence of toxic chemicals (or mixtures thereof) in the living environment and its socio-psychological determinants. We will use a theoretical framework derived from literature. On the basis of the results, we will construct indicators related to stakeholders’ perceptions of the presence of toxic chemicals.
In WP4, we will apply the indicators and approaches developed in WP1, 2 and 3 to a case study in a local residential area. We will collect the data needed to quantify the indicators with the help of the stakeholders. We will then discuss the resulting information with the stakeholders. The results will provide insights into the toxic chemicals (or mixtures thereof) in their living environment and the perceptions of the stakeholders. Once an agreement has been reached, this process will lead to the co-creation if interventions and actions to be included in an action plan to manage or reduce the chemicals in the living environment. The interventions and actions can be directed at the regional/local level, but also at the EU/national level. Lastly, we will evaluate the approach used in the case study with the stakeholders in order to set up a generic approach for future projects.
WP5 is about managing, coordinating and facilitating the work. We will monitor and stimulate the quality of the work being done. The communication plan and its implementation, the data management plan and integrating activities into WP1 to WP4 will form part of this WP.

Project team
An interdisciplinary project team will be put together, with expertise covering ecotoxicology, epidemiology, human toxicology, medical environmental sciences, mixture toxicity, data science, social psychology and change management. A major part of the work will be performed by two RIVM employees that will use this project, and other projects, to achieve their PhD degree. A core team of project members with different expertise will be strongly involved in the various activities. Additional expertise and information on existing databases and approaches will be obtained from a larger group of experts within and outside RIVM.

VITAL4ALL

Summary

Objective
This project aspires to contribute to a society in which people remain healthy and vital for as long as possible.

Research questions
How do inflammation (‘inflammageing’), functional ability and vitality develop over the course of a life? How do older persons themselves perceive vitality? What are leverage points for a public health approach that improves vitality in our ageing population?

Motivation
Given the ageing of the population, the public health mission of ensuring that people remain vital into old age is more urgent than ever. Understanding drivers of vitality and healthy ageing is crucial.

Deliverables

  • Identification of actionable determinants to ensure that more people reach older ages in good health, remaining vital for as long as possible.
  • Publication of the results in scientific papers and a PhD thesis.
  • Dissemination of the results to stakeholders and the general public through infographics and websites.

Study design/action plan
We will build on two key (WHO) concepts, intrinsic capacity (IC) and functional ability (FA), as stepping stones towards vitality. In essence, vitality is about ‘being able to live life to its fullest’.

We will combine a molecular (1), individual (2) and societal perspective (3). Ad1. We will explore how the immune system and chronic inflammation change and affect IC as people age. Ad2. We will study FA as it develops over the course of a life, its determinants and its contribution to vitality. Ad3. We will probe the perceptions of vitality among middle-aged/older persons and study the potential of the concept of vitality in public health. We will combine innovative quantitative and qualitative methods by performing a longitudinal analysis of the contribution of inflammation to ageing in a unique richly phenotyped cohort, including positive health outcomes, and involving older persons through a participative approach.

Project team
Our team will combine expertise from the fields of immunology, epidemiology, public health, ageing, socio-economic differences and participatory research methods from within and outside RIVM.