• Risk assessment and risk management

      Landsiedel, Robert; Sauer, Ursula G.; de Jong, Wim H. (2018-01-10)
    • Risk assessment frameworks for nanomaterials: Scope, link to regulations, applicability, and outline for future directions in view of needed increase in efficiency

      Oomen, Agnes G.; Steinhäuser, Klaus Günter; Bleeker, Eric A.J.; van Broekhuizen, Fleur; Sips, Adriënne; Dekkers, Susan; Wijnhoven, Susan W.P.; Sayre, Philip G. (2018-01)
    • Risk assessment of aflatoxins in food.

      Schrenk, Dieter; Bignami, Margherita; Bodin, Laurent; Chipman, James Kevin; Del Mazo, Jesús; Grasl-Kraupp, Bettina; Hogstrand, Christer; Hoogenboom, Laurentius Ron; Leblanc, Jean-Charles; Nebbia, Carlo Stefano; et al. (2020-03-09)
      EFSA was asked to deliver a scientific opinion on the risks to public health related to the presence of aflatoxins in food. The risk assessment was confined to aflatoxin B1 (AFB1), AFB2, AFG1, AFG2 and AFM1. More than 200,000 analytical results on the occurrence of aflatoxins were used in the evaluation. Grains and grain-based products made the largest contribution to the mean chronic dietary exposure to AFB1 in all age classes, while 'liquid milk' and 'fermented milk products' were the main contributors to the AFM1 mean exposure. Aflatoxins are genotoxic and AFB1 can cause hepatocellular carcinomas (HCCs) in humans. The CONTAM Panel selected a benchmark dose lower confidence limit (BMDL) for a benchmark response of 10% of 0.4 μg/kg body weight (bw) per day for the incidence of HCC in male rats following AFB1 exposure to be used in a margin of exposure (MOE) approach. The calculation of a BMDL from the human data was not appropriate; instead, the cancer potencies estimated by the Joint FAO/WHO Expert Committee on Food Additives in 2016 were used. For AFM1, a potency factor of 0.1 relative to AFB1 was used. For AFG1, AFB2 and AFG2, the in vivo data are not sufficient to derive potency factors and equal potency to AFB1 was assumed as in previous assessments. MOE values for AFB1 exposure ranged from 5,000 to 29 and for AFM1 from 100,000 to 508. The calculated MOEs are below 10,000 for AFB1 and also for AFM1 where some surveys, particularly for the younger age groups, have an MOE below 10,000. This raises a health concern. The estimated cancer risks in humans following exposure to AFB1 and AFM1 are in-line with the conclusion drawn from the MOEs. The conclusions also apply to the combined exposure to all five aflatoxins.
    • Risk assessment of components in tobacco smoke and e-cigarette aerosols: a pragmatic choice of dose metrics.

      Bos, Peter M J; Soeteman-Hernández, Lya G; Talhout, Reinskje (2021-04-20)
    • Risk Assessment of Per- and Polyfluoroalkyl Substances (PFASs) Mixtures: A Relative Potency Factor Approach.

      Bil, Wieneke; Zeilmaker, Marco; Fragki, Styliani; Lijzen, Johannes; Verbruggen, Eric; Bokkers, Bas (2020-07-30)
    • Risk Assessment of Processes and Products in Industrial Biotechnology.

      Chen, Chao; Reniers, Genserik (2018-09-23)
      Risk assessment has been used extensively as the main approach to prevent accidents in the chemical and process industry. Industrial biotechnology has many of the same hazards as chemical technology, but also encounters biological hazards related to biological agents. Employees in the biotechnology industry are susceptible to health risks because of different types of exposure to harmful agents. The external environment may also be affected by these agents in cases of accidental release. This chapter first presents several traditional risk assessment methods that may be used in industrial biotechnology after comparing differences between industrial biotechnology and chemical technology. Hazard identification in industrial biotechnology is then discussed, for biological as well as traditional hazards. Furthermore, risk assessment of occupational health and safety related to biological hazards is examined using exposure analysis and risk characterization. A two-stage risk assessment method is recommended to assess environmental and ecological risks in industrial biotechnology. Risk analysis of traditional accidents (fire, explosions, and toxic releases) in industrial biotechnology is also described. Graphical Abstract.
    • Risk assessment of substances that are both genotoxic and carcinogenic report of an International Conference organized by EFSA and WHO with support of ILSI Europe.

      Barlow, S; Renwick, A G; Kleiner, J; Bridges, J W; Busk, L; Dybing, Erik; Edler, L; Eisenbrand, G; Fink-Gremmels, J; Knaap, A G A C; et al. (2006-10-01)
      The European Food Safety Authority (EFSA) and the World Health Organization (WHO), with the support of the International Life Sciences Institute, European Branch (ILSI Europe), organized an international conference on 16-18 November 2005 to discuss how regulatory and advisory bodies evaluate the potential risks of the presence in food of substances that are both genotoxic and carcinogenic. The objectives of the conference were to discuss the possible approaches for risk assessment of such substances, how the approaches may be interpreted and whether they meet the needs of risk managers. ALARA (as low as reasonably achievable) provides advice based solely on hazard identification and does not take into account either potency or human exposure. The use of quantitative low-dose extrapolation of dose-response data from an animal bioassay raises numerous scientific uncertainties related to the selection of mathematical models and extrapolation down to levels of human exposure. There was consensus that the margin of exposure (MOE) was the preferred approach because it is based on the available animal dose-response data, without extrapolation, and on human exposures. The MOE can be used for prioritisation of risk management actions but the conference recognised that it is difficult to interpret it in terms of health risk.
    • A risk based sampling design including exposure assessment linked to disease burden, uncertainty and costs

      Pielaat, Annemarie; Chardon, Jurgen E.; Wijnands, Lucas M.; Evers, Eric G. (2018-02)
    • Risk Benefit Assessment of foods: Key findings from an international workshop

      Pires, Sara M.; Boué, Géraldine; Boobis, Alan; Eneroth, Hanna; Hoekstra, Jeljer; Membré, Jeanne-Marie; Persson, Inez Maria; Poulsen, Morten; Ruzante, Juliana; van Klaveren, Jacob; et al. (2018-09)
    • Risk factors associated with sustained circulation of six zoonotic arboviruses: a systematic review for selection of surveillance sites in non-endemic areas.

      Esser, Helen J; Mögling, Ramona; Cleton, Natalie B; van der Jeugd, Henk; Sprong, Hein; Stroo, Arjan; Koopmans, Marion P G; de Boer, Willem F; Reusken, Chantal B E M (2019-05-27)
    • Risk factors associated with the incidence of self-reported COVID-19-like illness: data from a web-based syndromic surveillance system in the Netherlands.

      McDonald, Scott A; van den Wijngaard, Cees C; Wielders, Cornelia C H; Friesema, Ingrid H M; Soetens, Loes; Paolotti, Daniela; van den Hof, Susan; van Hoek, Albert Jan (2021-05-19)
    • Risk factors for antimicrobial resistance in turkey farms: a cross-sectional study in three European countries.

      Horie, M; Yang, D; Joosten, P; Munk, P; Wadepohl, K; Schmitt, H; et al. (2021-08-02)
    • Risk factors for developing acute gastrointestinal, skin or respiratory infections following obstacle and mud run participation, the Netherlands, 2017.

      den Boogert, Elisabeth M; Oorsprong, Danielle M; Fanoy, Ewout B; Leenders, Alexander Cap; Tostmann, Alma; van Dam, Adriana Sg (2019-10-01)
    • Risk factors for gastroenteritis associated with canal swimming in two cities in the Netherlands during the summer of 2015: A prospective study.

      Joosten, Rosa; Sonder, Gerard; Parkkali, Saara; Brandwagt, Diederik; Fanoy, Ewout; Mughini-Gras, Lapo; Lodder, Willemijn; Ruland, Erik; Siedenburg, Evelien; Kliffen, Suzanne; et al. (2017)
      Urban canal swimming events are popular in the Netherlands. In 2015, two city canal swimming events took place, in Utrecht (Utrecht Singel Swim, USS) and in Amsterdam (Amsterdam City Swim, ACS). This prospective study characterizes the health risks associated with swimming in urban waters. Online questionnaires were sent to 160 (USS) and 2,692 (ACS) participants, with relatives of participants who did not swim completing the questionnaire as a control. Swimming water specimens and stool specimens of diarrheic participants in the ACS group were analysed. A total of 49% of USS and 51% of ACS swimmers returned their questionnaires. Nine percent of USS swimmers and 4% of non-swimmers reported gastrointestinal complaints (aRR 2.1; 95% CI: 0.3-16), while a total of 31% of ACS swimmers and 5% of non-swimmers reported gastrointestinal complaints (aRR 6.3; 95% CI: 4.1-9.5). AGI risk among ACS participants was directly related to increasing number of mouthfuls of water swallowed. Various norovirus genotypes were detected in five out of seven stool specimens taken from ACS participants and in all three tested ACS water samples. We conclude that the AGI risk among open-water swimmers in urban areas depends on the circumstances around the event. The epidemiological curve, the statistical association between swimming and AGI, and the microbiological evidence for norovirus in stool and water specimens suggest that AGI outbreak after the ACS event was due to water contamination by multiple norovirus strains, which is possibly linked to sewage overflow due to prior heavy rainfall. There is need for more targeted preventive measurements and recommendations for organizers, municipal authorities and participants to prevent this reoccurring in the future.
    • Risk factors for hepatitis E virus seropositivity in Dutch blood donors

      Mooij, Sofie H.; Hogema, Boris M.; Tulen, Anna D.; van Pelt, Wilfrid; Franz, Eelco; Zaaijer, Hans L.; Molier, Michel; Hofhuis, Agnetha (2018-04-13)
    • Risk factors for persisting measles susceptibility: a case-control study among unvaccinated orthodox Protestants.

      de Munter, Anne C; Tostmann, Alma; Hahné, Susan J M; Spaan, D Henri; van Ginkel, Rijk; Ruijs, Wilhelmina L M (2018-04-30)
      Measles is an infectious disease providing lifelong immunity. Epidemics periodically occur among unvaccinated orthodox Protestants in the Netherlands. During the 2013/2014 epidemic, 17% of the reported patients was over 14 years old. Apparently, they did not catch measles during the previous 1999/2000 epidemic and remained susceptible. We wanted to identify risk factors for this so-called persisting measles susceptibility, and thus risk factors for acquiring measles at older age with increased risk of complications.
    • Risk factors for sporadic campylobacteriosis: A systematic review and meta-analysis.

      Fravalo, P; Kooh, P; Mughini-Gras, L; David, J; Thebault, A; Cadavez, V; Gonzales-Barron, U (2020-07-06)
    • Risk factors for sporadic cryptosporidiosis in the Netherlands: Analysis of a three-year population based case-control study coupled with genotyping, 2013-2016.

      Nic Lochlainn, Laura M; Sane, Jussi; Schimmer, Barbara; Mooij, Sofie; Roelfsema, Jeroen; Van Pelt, Wilfrid; Kortbeek, Titia (2018-11-03)
      In 2012, cryptosporidiosis cases increased in the Netherlands, but no single source was identified. In April 2013, we began a three year population based case-control study, coupled with genotyping, to identify risk factors for sporadic cryptosporidiosis. Cryptosporidium cases were laboratory confirmed (microscopy or PCR), followed by C. hominis and C. parvum species determination testing. We analysed data by study year, combined and by species. We performed single variable analysis and variables with a P-value ≤0.10 were included in a multivariable logistic regression model adjusting for age, sex and season. The study included 609 cases and 1,548 frequency-matched controls. C. parvum was the predominant species in the first two study years, shifting to C. hominis in the third year. Household person-to-person transmission and eating barbequed food were strongly associated with being a case. Eating tomatoes was negatively associated. By study year, person-to-person transmission was an independent risk factor. Analysis by species identified different risk factors for C. parvum and C. hominis cases. This was the first case-control study examining risk factors for sporadic cryptosporidiosis in the Netherlands. Providing information about Cryptosporidium exposure during outdoor activities and improvements in hygiene within households could prevent future sporadic infections.
    • Risk factors for sporadic infections caused by Shiga toxin-producing Escherichia coli: a systematic review and meta-analysis.

      Augustin, JC; Kooh, P; Mughini-Gras, L; Guillier, L; Thebault, A; Audiat-Perrin, F; Cadavez, V; Gonzales-Brron, U; Sanaa, M (2020-06-22)
    • Risk for Heart Failure: The Opportunity for Prevention With the American Heart Association's Life's Simple 7.

      Uijl, Alicia; Koudstaal, Stefan; Vaartjes, Ilonca; Boer, Jolanda M A; Verschuren, W M Monique; van der Schouw, Yvonne T; Asselbergs, Folkert W; Hoes, Arno W; Sluijs, Ivonne (2019-08-01)