• Quantitative Assessment of the Health Risk for Livestock When Animal Viruses Are Applied in Human Oncolytic Therapy: A Case Study for Seneca Valley Virus.

      Schijven, Jack; Brizee, Sabrina; Teunis, Peter; de Vos, Clazien; Eblé, Phaedra; Rutjes, Saskia (2018-11-05)
      Some viruses cause tumor regression and can be used to treat cancer patients; these viruses are called oncolytic viruses. To assess whether oncolytic viruses from animal origin excreted by patients pose a health risk for livestock, a quantitative risk assessment (QRA) was performed to estimate the risk for the Dutch pig industry after environmental release of Seneca Valley virus (SVV). The QRA assumed SVV excretion in stool by one cancer patient on Day 1 in the Netherlands, discharge of SVV with treated wastewater into the river Meuse, downstream intake of river water for drinking water production, and consumption of this drinking water by pigs. Dose-response curves for SVV infection and clinical disease in pigs were constructed from experimental data. In the worst scenario (four log
    • A quantitative comparison of anti-Müllerian hormone measurement and its shifting boundaries between two assays.

      de Kat, A C; Broekmans, F J M; van Westing, A C; Lentjes, E; Verschuren, W M M; van der Schouw, Y T (2017-07)
      Anti-Müllerian hormone (AMH), a quantitative marker of ovarian reserve, is used for both clinical and research purposes in the field of reproductive medicine. Numerous AMH assays have been developed. Among other factors, the lack of large-scale comparisons of the various assays hinders the universal interpretation of AMH levels. Moreover, little is known of the practical performance of highly sensitive assays compared with conventional assays with regard to the very low AMH levels found in women nearing menopause. This study aimed to compare the measurements of the Gen II (Beckman Coulter) assay with those of the highly sensitive picoAMH (AnshLabs) assay.
    • Quantitative health impact assessment methodology for societal initiatives: a scoping review.

      Reumers, LM; Bekker, MPM; Jansen, MWJ; Hilderink, HBM; Ruwaard, D (2020-03-31)
    • Quantitative human health risk assessment along the lifecycle of nano-scale copper-based wood preservatives.

      Hristozov, Danail; Pizzol, Lisa; Basei, Gianpietro; Zabeo, Alex; Mackevica, Aiga; Hansen, Steffen Foss; Gosens, Ilse; Cassee, Flemming R; de Jong, Wim; Koivisto, Antti Joonas; et al. (2018-06-12)
      The use of nano-scale copper oxide (CuO) and basic copper carbonate (Cu2(OH)2CO3) in both ionic and micronized wood preservatives has raised concerns about the potential of these substances to cause adverse humans health effects. To address these concerns, we performed quantitative (probabilistic) human health risk assessment (HHRA) along the lifecycles of these formulations used in antibacterial and antifungal wood coatings and impregnations by means of the EU FP7 SUN project's Decision Support System (SUNDS, www.sunds.gd). The results from the risk analysis revealed inhalation risks from CuO in exposure scenarios involving workers handling dry powders and performing sanding operations as well as potential ingestion risks for children exposed to nano Cu2(OH)2CO3 in a scenario involving hand-to-mouth transfer of the substance released from impregnated wood. There are, however, substantial uncertainties in these results, so some of the identified risks may stem from the safety margin of extrapolation to fill data gaps and might be resolved by additional testing. Our stochastic approach successfully communicated the contribution of different sources of uncertainty in the risk assessment. The main source of uncertainty was the extrapolation from short to long-term exposure, which was necessary due to the lack of (sub)chronic in vivo studies with CuO and Cu2(OH)2CO3. Considerable uncertainties also stemmed from the use of default inter- and intra-species extrapolation factors.
    • Quantitative Microbial Risk Assessment for Airborne Transmission of SARS-CoV-2 via Breathing, Speaking, Singing, Coughing, and Sneezing.

      Schijven, Jack; Vermeulen, Lucie C; Swart, Arno; Meijer, Adam; Duizer, Erwin; de Roda Husman, Ana Maria (2021-04-01)
      A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol droplets was developed. Previously published data on droplets expelled by breathing, speaking, singing, coughing, and sneezing by an infected person were used as inputs. Scenarios encompassed virus concentration, exposure time, and ventilation. Newly collected data of virus RNA copies in mucus from patients are presented.
    • A quantitative risk assessment for human Taenia solium exposure from home slaughtered pigs in European countries.

      Meester, Marina; Swart, Arno; Deng, Huifang; van Roon, Annika; Trevisan, Chiara; Dorny, Pierre; Gabriël, Sarah; Vieira-Pinto, Madalena; Johansen, Maria Vang; Van Der Giessen, Joke (2019-02-12)
      Taenia solium, a zoonotic tapeworm, is responsible for about a third of all preventable epilepsy human cases in endemic regions. In Europe, adequate biosecurity of pig housing and meat inspection practices have decreased the incidence of T. solium taeniosis and cysticercosis. Pigs slaughtered at home may have been raised in suboptimal biosecurity conditions and slaughtered without meat inspection. As a result, consumption of undercooked pork from home slaughtered pigs could pose a risk for exposure to T. solium. The aim of this study was to quantify the risk of human T. solium exposure from meat of home slaughtered pigs, in comparison to controlled slaughtered pigs, in European countries. A quantitative microbial risk assessment model (QMRA) was developed and porcine cysticercosis prevalence data, the percentage of home slaughtered pigs, meat inspection sensitivity, the cyst distribution in pork and pork consumption in five European countries, Bulgaria, Germany, Poland, Romania and Spain, were included as variables in the model. This was combined with literature about cooking habits to estimate the number of infected pork portions eaten per year in a country. The results of the model showed a 13.83 times higher prevalence of contaminated pork portions from home slaughtered pigs than controlled slaughtered pigs. This difference is brought about by the higher prevalence of cysticercosis in pigs that are home raised and slaughtered. Meat inspection did not affect the higher exposure from pork that is home slaughtered. Cooking meat effectively lowered the risk of exposure to T. solium-infected pork. This QMRA showed that there is still a risk of obtaining an infection with T. solium due to consumption of pork, especially when pigs are reared and slaughtered at home, using data of five European countries that reported porcine cysticercosis cases. We propose systematic reporting of cysticercosis cases in slaughterhouses, and in addition molecularly confirming suspected cases to gain more insight into the presence of T. solium in pigs and the risk for humans in Europe. When more data become available, this QMRA model could be used to evaluate human exposure to T. solium in Europe and beyond.
    • Quantitative risk assessment of meat-borne Toxoplasma gondii infection in the mainland of China.

      Deng, H; Swart, A; Wu, Y; Li, X; Li, J; Liu, M; Opsteegh, M; van der Giessen, Jwb (2012-12-21)
    • Quantitative structure-activity relationships for green algae growth inhibition by polymer particles.

      Nolte, Tom M; Peijnenburg, Willie J G M; Hendriks, A Jan; van de Meent, Dik (2017-07)
      After use and disposal of chemical products, many types of polymer particles end up in the aquatic environment with potential toxic effects to primary producers like green algae. In this study, we have developed Quantitative Structure-Activity Relationships (QSARs) for a set of highly structural diverse polymers which are capable to estimate green algae growth inhibition (EC50). The model (N = 43, R2 = 0.73, RMSE = 0.28) is a regression-based decision tree using one structural descriptor for each of three polymer classes separated based on charge. The QSAR is applicable to linear homo polymers as well as copolymers and does not require information on the size of the polymer particle or underlying core material. Highly branched polymers, non-nitrogen cationic polymers and polymeric surfactants are not included in the model and thus cannot be evaluated. The model works best for cationic and non-ionic polymers for which cellular adsorption, disruption of the cell wall and photosynthesis inhibition were the mechanisms of action. For anionic polymers, specific properties of the polymer and test characteristics need to be known for detailed assessment. The data and QSAR results for anionic polymers, when combined with molecular dynamics simulations indicated that nutrient depletion is likely the dominant mode of toxicity. Nutrient depletion in turn, is determined by the non-linear interplay between polymer charge density and backbone flexibility.
    • Rabies risk behaviour in a cohort of Dutch travel clinic visitors: A retrospective analysis.

      Croughs, Mieke; van den Hoogen, Godelief A L; van Jaarsveld, Cornelia H M; Bantjes, Sabine E; Pijtak-Radersma, Atie H; Haverkate, Manon R; Swaan, Corien M; Ruijs, Wilhelmina L M (2021-06-11)
    • 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)