• Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation.

      Suijkerbuijk, Anita Wm; Mangen, Marie-Josee J; Haverkate, Manon R; Luppino, Floriana S; Bantjes, Sabine E; Visser, Leo G; Swaan, Corien M; Ruijs, Wilhelmina Lm; Over, Eelco Ab (2020-09-01)
    • Rabiës PEP na slijmvliescontact.

      van Kessel, R; Schreuder, I; van den Kerkhof, H (2019-10-03)
    • Rabiëscasuïstiek in de GGD-regio Utrecht.

      van Dee, L; Dimmendaal, M; Bantjes, S; Haverkate, M; van Kessel, R (2018-09-18)
    • Radiation Protection for Interventional Fluoroscopy: Results of a Survey Among Dutch Hospitals.

      Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa (2018-06)
      A survey was conducted among 20 Dutch hospitals about radiation protection for interventional fluoroscopy. This was a follow-up of a previous study in 2007 that led to several recommendations for radiation protection for interventional fluoroscopy. The results indicate that most recommendations have been followed. However, radiation-induced complications from interventional procedures are still often not recorded in the appropriate register. Furthermore, even though professionals with appropriate training in radiation protection are usually involved in interventional procedures, this often is not the case when these procedures are carried out outside the radiology department. Although this involvement is not required by Dutch law, it is recommended to have radiation protection professionals present more often at interventional procedures. Further improvements in radiation protection for interventional fluoroscopy may come from a comparison of dose-reducing practices among hospitals, the introduction of diagnostic reference levels for interventional procedures, and a more thorough form of screening and follow-up of patients.

      Smetsers, R C G M; Blaauboer, R O; Dekkers, F; Slaper, H (2018-09-01)
      Radon and thoron progenies in Dutch dwellings cause ~400 cases of lung cancer per year. Some 30% of the risk is due to thoron progeny, which demonstrates that the influence of thoron progeny is much larger than previously anticipated. This was concluded from a national survey in 2500 Dutch dwellings, built since 1930. Radon concentrations (15.6 ± 0.3 Bq m-3 on average) are correlated to type of dwelling, year of construction, ventilation system, location (soil type) and smoking behaviour of inhabitants. The survey data support the establishment of a comparatively low national reference level for radon in dwellings in the Netherlands of 100 Bq m-3, in line with recommendations by WHO and ICRP. Some 24 thousand of the 6.2 million dwellings in the Netherlands (built since 1930) are expected to exceed this level. Around 80% of these are located in the relatively small group of naturally ventilated single-family houses in two designated geographical areas. Radon concentrations above 200 Bq m-3 are rare in the Netherlands and simple and inexpensive measures will be sufficient to reduce enhanced radon concentrations to values below the national reference level. Thoron progeny concentrations (0.64 Bq m-3, on average) show correlations with year of construction and smoking behaviour. In 75 additional dwellings, a pilot study was conducted to determine the relationship between the exhalation of thoron from walls and the concentration of thoron progeny in the room. Thoron exhalation values exceeding the median value of 2.2 × 10-2 Bq m-2 s-1 by a factor 10 or more were found frequently, but enhanced concentrations of thoron progeny were measured only occasionally. Under very unfavourable conditions, however, for instance if phosphogypsum is applied as finishing material on all walls and ceilings in the house, strongly elevated thoron progeny concentrations may occur. This survey yielded a maximum recording of 13.3 Bq m-3. There is no reason to expect that such levels are specific to the Netherlands, indicating that in other regions with low radon levels, thoron may be a more important contributor to the population dose as well.
    • Raising awareness of false positive newborn screening results arising from pivalate-containing creams and antibiotics in Europe when screening for isovaleric acidaemia.

      Bonham, JR; Carling, RS; Lindner, M; Franszon, L; Zetterstrom, R; Boemer, F; Cerone, R; Eyskens, F; Vilarinho, L; Hougaard, M; et al. (2019-03-12)
    • Random effect modelling of patient-related risk factors in orthopaedic procedures: results from the Dutch nosocomial infection surveillance network 'PREZIES'.

      Muilwijk, J; Walenkamp, G H I M; Voss, Andreas; Wille, Jan C; Hof, Susan van den (2006-03-01)
      In the Dutch surveillance for surgical site infections (SSIs), data from 70277 orthopaedic procedures with 1895 SSIs were collected between 1996 and 2003. The aims of this study were: (1) to analyse the trends in SSIs associated with Gram-positive and Gram-negative bacteria; (2) to estimate patient-related risk factors for deep and superficial SSIs after all orthopaedic procedures, with special attention to primary total hip arthroplasty (THA); and (3) to analyse inherent differences in infection risk between hospitals. A random effect model was used to estimate the odds ratios of patient-related risk factors for developing an SSI, and to describe the distribution of the most widespread bacterial species responsible for SSIs among hospitals. Gram-positive organisms, mainly staphylococci, were the main cause of both deep (84.0%) and superficial SSIs (69.1%) after orthopaedic procedures. The percentage of SSIs after THA caused by coagulase-negative staphylococci decreased over the surveillance period, while the contribution of Staphylococcus aureus increased. Temporary elevations in the incidence of the most widespread pathogen species were observed within hospitals. Patient-related factors such as the National Nosocomial Infections Surveillance System risk index or age had little effect on the predictive power of the random effect models. This study underlines the usefulness of a random effect model, which adjusts risk estimates for random variation between hospitals, in a multicentre study on risk factors for SSIs.
    • Ranking Preventive Interventions from Different Policy Domains: What Are the Most Cost-Effective Ways to Improve Public Health?

      van der Vliet, Nina; Suijkerbuijk, Anita W M; de Blaeij, Adriana T; de Wit, G Ardine; van Gils, Paul F; Staatsen, Brigit A M; Maas, Rob; Polder, Johan J (2020-03-24)
    • Ranking uncertainties in atmospheric dispersion modelling following the accidental release of radioactive material.

      Leadbetter, SJ; Andronopoulos, S; Bedwell, P; Chevalier-Jabet, K; Geertsema, G; Gering, F; Hamburger, T; Tomas, JM; Twenhofel, C (2020-11-09)
    • Rapid and Robust On-Scene Detection of Cocaine in Street Samples using a Handheld Near Infrared Spectrometer and Machine Learning Algorithms.

      Kranenburg, Ruben F; Verduin, Joshka; Weesepoel, Yannick; Alewijn, Martin; Heerschop, Marcel; Koomen, Ger; Keizers, Peter; Bakker, Frank; Wallace, Fionn; van Esch, Annette; et al. (2020-07-07)
    • Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, March 2020.

      Reusken, Chantal B; Buiting, Anton; Bleeker-Rovers, Chantal; Diederen, Bram; Hooiveld, Mariëtte; Friesema, Ingrid; Koopmans, Marion; Kortbeek, Titia; Lutgens, Suzanne Pm; Meijer, Adam; et al. (2020-01-01)
    • Rapid Assessment of Stakeholder Concerns about Public Health. An Introduction to a Fast and Inexpensive Approach Applied on Health Concerns about Intensive Animal Production Systems.

      Kraaij-Dirkzwager, Marleen; van der Ree, Joost; Lebret, Erik (2017-12-11)
      To effectively manage environmental health risks, stakeholders often need to act collectively. Stakeholders vary in their desire to act due to many factors, such as knowledge, risk perception, interests, and worldviews. Understanding their perceptions of the issues at stake is crucial to support the risk governance process. Even though concern assessment is a pivotal element of risk governance, few tools for rapid assessment are reported in the literature. We tested a rapid and relatively cheap approach, taking the Dutch debate on Intensive Animal Production Systems (IAPS) and health as an example. Dutch policy-oriented publications on IAPS and health and ten semi-structured in-depth interviews with a variety of stakeholders were analyzed to identify stakeholders and concerns involved in the Dutch debate about IAPS and health. Concerns were mapped and a stakeholder network was derived. Three classes of concerns were recognized in the discussions about IAPS and health: concerns related to health risks, concerns regarding the activity causing the risks (IAPS), and concerns about the process to control the risks. The notions of 'trust' and 'scientific uncertainty' appeared as important themes in the discussions. Argumentation based on concerns directly related to health risks, the activity causing the risk (IAPS), and its risk management can easily become muddled up in a societal debate, limiting the development of effective action perspectives. Acknowledging these multiple stakeholder concerns can clarify the positions taken by stakeholders and allow for more and other action perspectives to develop.
    • Rapid SARS-CoV-2 whole-genome sequencing and analysis for informed public health decision-making in the Netherlands.

      Oude Munnink, Bas B; Nieuwenhuijse, David F; Stein, Mart; O'Toole, Áine; Haverkate, Manon; Mollers, Madelief; Kamga, Sandra K; Schapendonk, Claudia; Pronk, Mark; Lexmond, Pascal; et al. (2020-07-16)
      In late December 2019, a cluster of cases of pneumonia of unknown etiology were reported linked to a market in Wuhan, China1. The causative agent was identified as the species Severe acute respiratory syndrome-related coronavirus and was named SARS-CoV-2 (ref. 2). By 16 April the virus had spread to 185 different countries, infected over 2,000,000 people and resulted in over 130,000 deaths3. In the Netherlands, the first case of SARS-CoV-2 was notified on 27 February. The outbreak started with several different introductory events from Italy, Austria, Germany and France followed by local amplification in, and later also outside, the south of the Netherlands. The combination of near to real-time whole-genome sequence analysis and epidemiology resulted in reliable assessments of the extent of SARS-CoV-2 transmission in the community, facilitating early decision-making to control local transmission of SARS-CoV-2 in the Netherlands. We demonstrate how these data were generated and analyzed, and how SARS-CoV-2 whole-genome sequencing, in combination with epidemiological data, was used to inform public health decision-making in the Netherlands.
    • Rapid water purification using modified graphitic carbon nitride and visible light.

      He, D; Yang, H; Jin, D; Qu, J; Yuan, X; Huo, M; Peijnenburg, WJGM (2021-01-06)
    • Rate constants of hydroxyl radicals reaction with different dissociation species of fluoroquinolones and sulfonamides: Combined experimental and QSAR studies.

      Luo, Xiang; Wei, Xiaoxuan; Chen, Jingwen; Xie, Qing; Yang, Xianhai; Peijnenburg, Willie J G M (2019-09-14)
      Hydroxyl radicals (·OH) initiated degradation is an important process governing fate of aquatic organic micropollutants (OMPs). However, rate constants for aqueous reaction of OMPs with ·OH (kOH) are available only for a limited number of OMPs, which complicates fate assessment of OMPs. Furthermore, molecular structures of many OMPs contain ionizable groups, and the OMPs may dissociate into different anionic/cationic species with different reactivity towards ·OH. Therefore, it is of importance to determine kOH of ionizable OMPs, and to develop quantitative structure-activity relationship (QSAR) models for predicting kOH of OMPs at different ionization forms. Herein kOH values of 9 fluoroquinolones (FQs) and 11 sulfonamides (SAs) at 3 dissociation forms (FQ±/FQ+/FQ-, SA0/SA+/SA-) were determined by competition kinetics experiments. A QSAR model using theoretical molecular structural descriptors was subsequently developed. The QSAR model successfully corroborated previous experimental results, exhibited good statistical performance, and is capable to predict kOH for FQs and SAs with different dissociation forms at environmentally relevant pH conditions. As organic ions have rarely been included in previous QSAR studies, the newly developed model that covers both neutral molecules and ions is of significance for future QSAR development as well as fate assessment of ionizable OMPs.
    • Real-time detection of noroviruses in surface water by use of a broadly reactive nucleic acid sequence-based amplification assay.

      Rutjes, Saskia A; Berg, Harold H J L van den; Lodder, Willemijn J; Roda Husman, Ana Maria de (2006-08-01)
      Noroviruses are the most common agents causing outbreaks of viral gastroenteritis. Outbreaks originating from contaminated drinking water and from recreational waters have been described. Due to a lack of cell culture systems, noroviruses are detected mostly by molecular methods. Molecular detection assays for viruses in water are often repressed by inhibitory factors present in the environment, like humic acids and heavy metals. To study the effect of environmental inhibitors on the performance of nucleic acid sequence-based amplification (NASBA), we developed a real-time norovirus NASBA targeting part of the RNA-dependent RNA polymerase (RdRp) gene. Specificity of the assay was studied with 33 divergent clones that contained part of the targeted RdRp gene of noroviruses from 15 different genogroups. Viral RNA originated from commercial oysters, surface waters, and sewage treatment plants in The Netherlands. Ninety-seven percent of the clones derived from human noroviruses were detected by real-time NASBA. Two clones containing animal noroviruses were not detected by NASBA. We compared the norovirus detection by real-time NASBA with that by conventional reverse transcriptase PCR (RT-PCR) with large-volume river water samples and found that inhibitory factors of RT-PCR had little or no effect on the performance of the norovirus NASBA. This consequently resulted in a higher sensitivity of the NASBA assay than of the RT-PCR. We show that by combining an efficient RNA extraction method with real-time NASBA the sensitivity of norovirus detection in water samples increased at least 100 times, which consequently has implications for the outcome of the infectious risk assessment.
    • Real-time Estimation of Epidemiologic Parameters from Contact Tracing Data During an Emerging Infectious Disease Outbreak.

      Soetens, Loes; Klinkenberg, Don; Swaan, Corien; Hahné, Susan; Wallinga, Jacco (2018-03)
      Contact tracing can provide accurate information on relevant parameters of an ongoing emerging infectious disease outbreak. This is crucial to investigators seeking to control such an outbreak. However, crude contact tracing data are difficult to interpret and methods for analyzing these data are scarce. We present a method to estimate and visualize key outbreak parameters from contact tracing information in real time by taking into account data censoring.