Suchergebnisse

Human biomonitoring (HBM) monitors levels of environmental pollutants in human samples, which often is a topic of concern for residents near industrially contaminated sites (ICSs). Around an ICS area in Menen (Belgium), including a (former) municipal waste incinerator and a metal recovery plant, increasing environmental concentrations of dioxins and polychlorinated biphenyls (PCBs) were observed, causing growing concern among residents and authorities. The local community succeeded in convincing the responsible authorities to investigate the problem and offer research funding. Persistent organic pollutants (POPs) were measured in two consecutive HBM studies (2002-2006 and 2010-2011), in the context of the Flemish Environment and Health Study (FLEHS), as well as in soil and locally produced food. Meanwhile, local authorities discouraged consumption of locally produced food in a delineated area of higher exposure risk. Ultimately, HBM and environmental data enabled tailored dietary recommendations. This article demonstrates the usefulness of HBM in documenting the body burdens of residents near the ICS, identifying exposure routes, evaluating remediating actions and providing information for tailored policy strategies aiding to further exposure reduction. It also highlights the role of the local stakeholders as an example of community-based participatory research and how such an approach can create societal support for research and policy. ; Funding: The HBM studies were conducted within the framework of the Flemish Center of Expertise on Environment and Health (FLEHS 2002–2006 and 2007–2011), funded by the Flemish Government, Department of Environment & Spatial Development, Flemish Planning Bureau for the Environment and Spatial Development (formally: Department of Environment, Nature & Energy); Department of Economics, Science and Innovation and the Flemish Agency for Care and Health. The scienceto-policy process of the HBM results was funded by the Department of Environment & Spatial Development, Flemish Planning Bureau for the Environment and Spatial Development (formally: Department of Environment, Nature & Energy) and the Flemish Agency for Care and Health. The egg study was funded by the Government of Flanders, Department of Environment & Spatial Development, Flemish Planning Bureau for the Environment and Spatial Development (formally: Department of Environment, Nature & Energy); the Flemish Agency for Care and Health and the Flanders Environment Agency. The views expressed herein are those of the author(s) and are not necessarily endorsed by the Flemish Government. Acknowledgments: The authors wish to express their gratitude to the participants of the studies for their cooperation and to the study nurses and study fieldworkers for their contribution to the study. We also thank the SGS laboratory for collection and analysis of the egg samples and Josworld for designing the leaflet on dietary recommendations for consumption of home-produced eggs.

The data used in this study belong to the individual registries. Requests for case data can be made to the JRC-EUROCAT Central Registry (JRC-EUROCAT@ec.europa.eu), which will ask the individual registries permission to use the data. Aggregate data, updated biannually, are available from the EUROCAT website www.eurocat-network.eu/accessprevalencedata/prevalencetables. Data included in the paper were extracted from the EUROCAT database in April 2014. ; OBJECTIVES: To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies). DESIGN: Questionnaire and population based observational study. SETTING: 24 EUROCAT registries covering 570 000 births annually in 15 countries. PARTICIPANTS: Cases of microcephaly not associated with a genetic condition among live births, fetal deaths from 20 weeks' gestation, and terminations of pregnancy for fetal anomaly at any gestation. MAIN OUTCOME MEASURES: Prevalence of microcephaly (1 Jan 2003-31 Dec 2012) analysed with random effects Poisson regression models to account for heterogeneity across registries. RESULTS: 16 registries responded to the questionnaire, of which 44% (7/16) used the EUROCAT definition of microcephaly (a reduction in the size of the brain with a skull circumference more than 3 SD below the mean for sex, age, and ethnic origin), 19% (3/16) used a 2 SD cut off, 31% (5/16) were reliant on the criteria used by individual clinicians, and one changed criteria between 2003 and 2012. Prevalence of microcephaly in Europe was 1.53 (95% confidence interval 1.16 to 1.96) per 10 000 births, with registries varying from 0.4 (0.2 to 0.7) to 4.3 (3.6 to 5.0) per 10 000 (χ(2)=338, df=23, I(2)=93%). Registries with a 3 SD cut off reported a prevalence of 1.74 per 10 000 (0.86 to 2.93) compared with those with the less stringent 2 SD cut off of 1.21 per 10 000 (0.21 to 2.93). The prevalence of microcephaly would need to increase in one year by over 35% in Europe or by over 300% in a single registry to reach statistical significance (P<0.01). CONCLUSIONS: EUROCAT could detect increases in the prevalence of microcephaly from the Zika virus of a similar magnitude to those observed in Brazil. Because of the rarity of microcephaly and discrepant diagnostic criteria, however, the smaller increases expected in Europe would probably not be detected. Clear diagnostic criteria for microcephaly must be adopted across Europe. ; This study was funded by the European Union in the framework of the Health Programme (2008-13). The funders had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication. Researchers were independent of the funders. ; Peer-reviewed ; Publisher Version