TY - JOUR T1 - Daily allergy burden and heart rate characteristics in adults with allergic rhinitis based on a wearable telemonitoring system JF - Clinical and Translational Allergy Y1 - 2023 A1 - Joren Buekers A1 - Michiel Stas A1 - Raf Aerts A1 - Nicolas Bruffaerts A1 - Sebastien Dujardin A1 - An Van Nieuwenhuyse A1 - Jos Van Orshoven A1 - Guillaume Chevance A1 - Ben Somers A1 - Jean‐Marie Aerts A1 - Judith Garcia‐Aymerich KW - Allergy KW - heart rate monitoring KW - rhinitis KW - stress AB -

Background

Allergic rhinitis includes a certain degree of autonomic imbalance. However, no information is available on how daily changes in allergy burden affect autonomic imbalance. We aimed to estimate associations between daily allergy burden (allergy symptoms and mood) and daily heart rate characteristics (resting heart rate and sample entropy, both biomarkers of autonomic balance) of adults with allergic rhinitis, based on real-world measurements with a wearable telemonitoring system.

Methods

Adults with a tree pollen allergy used a smartphone application to self-report daily allergy symptoms (score 0–44) and mood (score 0–4), and a Mio Alpha 2 wristwatch to collect heart rate characteristics during two pollen seasons of hazel, alder and birch in Belgium. Associations between daily allergy burden and heart rate characteristics were estimated using linear mixed effects distributed lag models with a random intercept for individuals and adjusted for potential confounders.

Results

Analyses included 2497 participant-days of 72 participants. A one-point increase in allergy symptom score was associated with an increase in next-day resting heart rate of 0.08 (95% CI: 0.02–0.15) beats per minute. A one-point increase in mood score was associated with an increase in same-day sample entropy of 0.80 (95% CI: 0.34–1.26) × 10−2. No associations were found between allergy symptoms and heart rate sample entropy, nor between mood and resting heart rate.

Conclusion

Daily repeated measurements with a wearable telemonitoring system revealed that the daily allergy burden of adults with allergic rhinitis has systemic effects beyond merely the respiratory system.

VL - 13 CP - 4 M3 - 10.1002/clt2.12242 ER - TY - Generic T1 - Daily heart rate characteristics, allergy symptom severity and mood in adults with allergic rhinitis Y1 - 2022 A1 - J Buekers A1 - M Stas A1 - Raf Aerts A1 - Nicolas Bruffaerts A1 - S Dujardin A1 - An Van Nieuwenhuyse A1 - J Van Orshoven A1 - G Chevance A1 - B Somers A1 - Aerts A1 - Garcia-Aymerich, J AB -

Background: Adults with allergic rhinitis experience elevated resting heart rates and altered heart rate variability in comparison to healthy peers. However, no information is available on acute, daily changing factors that could underlie these cardiac alterations.

Aim: To estimate associations between daily heart rate characteristics (i.e. resting heart rate, autocorrelation and sample entropy) and allergy symptom severity and mood in adults with allergic rhinitis.

Methods: Adults with a tree pollen allergy (n=82) self-reported daily symptom severity (score: 0-44) and mood (score: 0-4) in a mobile health application during two pollen seasons of hazel, alder and birch trees. Heart rate characteristics were extracted from daytime heart rate measurements (Mio Alpha 2 wristwatch; 1 Hz; >6 hours/day). Associations between heart rate characteristics and allergy symptom severity or mood (lag 0-2) were estimated using linear mixed effects regressions, adjusted for potential confounders with a random intercept for individuals.

Results: The analyses included 3800 participant-days. A one-point increase in symptom severity was associated with an increase in resting heart rate of 0.07 (0.02 to 0.13) beats per minute on the next day. A one-point improvement in mood was associated with a decrease in autocorrelation of -0.00027 (-0.00052 to -0.00001) and an increase in sample entropy of 0.0087 (0.0049 to 0.0125) on the same day.

Conclusion: Results suggest that a higher symptom burden provokes the cardiovascular system (higher resting heart rate on the next day), while a better mood might be related to a healthier, more adaptable cardiovascular system (more irregular heart rate on the same day).

JF - ERS International Congress 2022 PB - European Respiratory Journal VL - 60: Suppl. 66, 2487 UR - https://erj.ersjournals.com/content/60/suppl_66/2487 CP - European Respiratory Journal M3 - 10.1183/13993003.congress-2022.2487 ER - TY - JOUR T1 - Mapping abundance distributions of allergenic tree species in urbanized landscapes: A nation-wide study for Belgium using forest inventory and citizen science data JF - Landscape and Urban Planning Y1 - 2022 A1 - Sébastien Dujardin A1 - Michiel Stas A1 - Camille Van Eupen A1 - Raf Aerts A1 - Marijke Hendrickx A1 - Andy W. Delcloo A1 - François Duchêne A1 - Rafiq Hamdi A1 - Tim S. Nawrot A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers A1 - Catherine Linard A1 - Nicolas Dendoncker KW - Allergenic trees KW - Citizen science KW - Forest mapping KW - respiratory health KW - Species distribution modelling KW - Urban vegetation AB -

Mapping the distribution of allergenic plants in urbanized landscapes is of high importance to evaluate its impact on human health. However, data is not always available for the allergy-relevant species such as alder, birch, hazel, especially within cities where systematic inventories are often missing or not readily available. This research presents an approach to produce high-resolution abundance maps of allergenic tree species using existing forest inventories and opportunistic open-access citizen science data. Following a two-step approach, we first built species distribution models (SDMs) to predict species habitat suitability, using environmental characteristics as predictors. Second, we used statistical regressions to model the relationships between abundance, the habitat suitability predicted by the SDMs, and additional vegetation cover covariates. The combination of forest inventory data with citizen science data improves the accuracy of abundance distribution models of allergenic tree species. This produces a continuous, 1-hectare resolution map of alder, birch, and hazel showing spatial variations of abundance distributions both within the urban fabric and along the urban–rural gradient. Species abundance modelling can offer a better understanding of the existing and potential future allergy risk posed by green spaces and pave the way for a wide variety of applications at fine-scale, which is indispensable for evidence-based urban green space policy and planning in support of public health.

VL - 218 M3 - 10.1016/j.landurbplan.2021.104286 ER - TY - JOUR T1 - Residential Exposure to Urban Trees and Medication Sales for Mood Disorders and Cardiovascular Disease in Brussels, Belgium: An Ecological Study JF - Environmental Health Perspectives Y1 - 2022 A1 - Dengkai, Chi A1 - Raf Aerts A1 - An Van Nieuwenhuyse A1 - Mariska, Bauwelinck A1 - Claire Demoury A1 - Michelle, Plusquin A1 - Tim S., Nawrot A1 - Lidia, Casas A1 - Ben, Somers AB -

Background:

The available evidence for positive associations between urban trees and human health is mixed, partly because the assessment of exposure to trees is often imprecise because of, for instance, exclusion of trees in private areas and the lack of three-dimensional (3D) exposure indicators (e.g., crown volume).

Objectives:

We aimed to quantify all trees and relevant 3D structural traits in Brussels (Belgium) and to investigate associations between the number of trees, tree traits, and sales of medication commonly prescribed for mood disorders and cardiovascular disease.

Methods:

We developed a workflow to automatically isolate all individual trees from airborne light detection and ranging (LiDAR) data collected in 2012. Trait data were subsequently extracted for 309,757 trees in 604 census tracts. We used the average annual age-standardized rate of medication sales in Brussels for the period 2006 to 2014, calculated from reimbursement information on medication prescribed to adults (19–64 years of age). The medication sales data were provided by sex at the census tract level. Generalized log-linear models were used to investigate associations between the number of trees, the crown volume, tree structural variation, and medication sales. Models were run separately for mood disorder and cardiovascular medication and for men and women. All models were adjusted for indicators of area-level socioeconomic status.

Results:

Single-factor models showed that higher stem densities and higher crown volumes are both associated with lower medication sales, but opposing associations emerged in multifactor models. Higher crown volume [an increase by one interquartile range (IQR) of 1.4×104 m³/hainterquartile range (IQR) of 1.4×104 m³/ha] was associated with 34% lower mood disorder medication sales [women, β=−0.341β=−0.341 (95% CI: −0.379−0.379, −0.303−0.303); men, β=−0.340β=−0.340 (95% CI: −0.378−0.378, −0.303−0.303)] and with 21–25% lower cardiovascular medication sales [women, β=−0.214β=−0.214 (95% CI: −0.246−0.246, −0.182−0.182); men, β=−0.252β=−0.252 (95% CI: −0.285−0.285, −0.219−0.219)]. Conversely, a higher stem density (an increase by one IQR of 21.8 trees/haIQR of 21.8 trees/ha) was associated with 28–32% higher mood disorder medication sales [women, β=0.322β=0.322 (95% CI: 0.284, 0.361); men, β=0.281β=0.281 (95% CI: 0.243, 0.319)] and with 20–24% higher cardiovascular medication sales [women, β=0.202β=0.202 (95% CI: 0.169, 0.236); men, β=0.240β=0.240 (95% CI: 0.206, 0.273)].

Discussion:

We found a trade-off between the number of trees and the crown volumes of those trees for human health benefits in an urban environment. Our results demonstrate that conserving large trees in urban environments may not only support conservation of biodiversity but also human health. https://doi.org/10.1289/EHP9924

VL - 130 CP - 5 M3 - 10.1289/EHP9924 ER - TY - JOUR T1 - Residential green space and mental health-related prescription medication sales: An ecological study in Belgium. JF - Environmental Research Y1 - 2022 A1 - Raf Aerts A1 - Naomi Vanlessen A1 - Sébastien Dujardin A1 - Nemery, Benoit A1 - An Van Nieuwenhuyse A1 - Mariska Bauwelinck A1 - Casas, Lidia A1 - Claire Demoury A1 - Michelle Plusquin A1 - Nawrot, Tim S KW - Environmental epidemiology KW - medication sales KW - Mental health KW - mood disorders KW - Residential green space AB -

BACKGROUND: Residential green space has been associated with mental health benefits, but how such associations vary with green space types is insufficiently known.

OBJECTIVE: We aimed to investigate associations between types and quantities of green space and sales of mood disorder medication in Belgium.

METHODS: We used aggregated sales data of psycholeptics and psychoanaleptics prescribed to adults from 2006 to 2014. Generalized mixed effects models were used to investigate associations between relative covers of woodland, low-green, grassland, and garden, and average annual medication sales. Models were adjusted for socio-economic background variables, urban-rural differences, and administrative region, and included random effects of latitude and longitude.

RESULTS: Urban census tracts were associated with 9-10% higher medication sales. In nationwide models, a 10% increase in relative cover of woodland, garden, and grass was associated with a 1-2% decrease in medication sales. The same association was found for low green but only for men. In stratified models, a 10% increase in relative cover of any green space type in urban census tracts was associated with a decrease of medication sales by 1-3%. In rural census tracts, no protective associations between green space and mood disorder medication sales were observed, with the exception of relative woodland cover for women (-1%), and low green was associated with higher medication sales (+6-7%).

CONCLUSIONS: Taken together, these results suggest that living in green environments may be beneficial for adult mental health. Woodland exposure seemed the most beneficial, but the amount of green space was more important than the type. Results underline the importance of conserving green space in our living environment, for the conservation of biodiversity and for human health.

VL - 211 M3 - 10.1016/j.envres.2022.113056 ER - TY - JOUR T1 - Residential green space in association with the methylation status in a CpG site within the promoter region of the placental serotonin receptor HTR2A JF - Epigenetics Y1 - 2022 A1 - Yinthe Dockx A1 - Esmée, Bijnens A1 - Nelly, Saenen A1 - Raf Aerts A1 - Jean-Marie, Aerts A1 - Lidia, Casas A1 - Andy, Delcloo A1 - Nicolas, Dendoncker A1 - Catherine, Linard A1 - Michelle, Plusquin A1 - Michiel, Stas A1 - An Van Nieuwenhuyse A1 - Jos, Van Orshoven A1 - Ben, Somers A1 - Tim, Nawrot KW - Aserotonin KW - DNA Methylation KW - epigenetic KW - Green space KW - HTR2 KW - Placenta AB -

Green space could influence adult cognition and childhood neurodevelopment , and is hypothesized to be partly driven by epigenetic modifications. However, it remains unknown whether some of these associations are already evident during foetal development. Similar biological signals shape the developmental processes in the foetal brain and placenta.Therefore, we hypothesize that green space can modify epigenetic processes of cognition-related pathways in placental tissue, such as DNA-methylation of the serotonin receptor HTR2A. HTR2A-methylation was determined within 327 placentas from the ENVIRONAGE (ENVIRonmental influence ON early AGEing) birth cohort using bisulphite-PCR-pyrosequencing. Total green space exposure was calculated using high-resolution land cover data derived from the Green Map of Flanders in seven buffers (50 m-3 km) and stratified into low (<3 m) and high (≥3 m) vegetation. Residential nature was calculated using the Land use Map of Flanders. We performed multivariate regression models adjusted for several a priori chosen covariables. For an IQR increment in total green space within a 1,000 m, 2,000 m and 3,000 m buffer the methylation of HTR2A increased with 1.47% (95%CI:0.17;2.78), 1.52% (95%CI:0.21;2.83) and 1.42% (95%CI:0.15;2.69), respectively. Additionally,, we found 3.00% (95%CI:1.09;4.91) and 1.98% (95%CI:0.28;3.68) higher HTR2A-methylation when comparing residences with and without the presence of nature in a 50 m and 100 m buffer, respectively. The methylation status of HTR2A in placental tissue is positively associated with maternal green space exposure. Future research is needed to understand better how these epigenetic changes are related to functional modifications in the placenta and the consequent implications for foetal development.

M3 - 10.1080/15592294.2022.2088464 ER - TY - JOUR T1 - Variability in the association between long-term exposure to ambient air pollution and mortality by exposure assessment method and covariate adjustment: A census-based country-wide cohort study JF - Science of The Total Environment Y1 - 2022 A1 - Mariska Bauwelinck A1 - Chen, Jie A1 - Kees de Hoogh A1 - Klea Katsouyanni A1 - Sophia Rodopoulou A1 - Evangelia Samoli A1 - Zorana J. Andersen A1 - Richard Atkinson A1 - Casas, Lidia A1 - Deboosere, Patrick A1 - Claire Demoury A1 - Nicole Janssen A1 - Jochem O. Klompmaker A1 - Wouter Lefebvre A1 - Amar Jayant Mehta A1 - Tim S. Nawrot A1 - Bente Oftedal A1 - Matteo Renzi A1 - Massimo Stafoggia A1 - Maciek Strak A1 - Vandenheede, Hadewijch A1 - Charlotte Vanpoucke A1 - An Van Nieuwenhuyse A1 - Danielle Vienneau A1 - Bert Brunekreef A1 - Gerard Hoek KW - cause-specific mortality KW - Environmental hazard KW - exposure assessment KW - health effects KW - population-based KW - Survival Analysis AB -

Background

Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions.

Methods

We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43).

Results

We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 μg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 μg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3].

Conclusion

Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method.

VL - 804 M3 - 10.1016/j.scitotenv.2021.150091 ER - TY - JOUR T1 - Association between local airborne tree pollen composition and surrounding land cover across different spatial scales in Northern Belgium JF - Urban Forestry & Urban Greening Y1 - 2021 A1 - Michiel Stas A1 - Raf Aerts A1 - Marijke Hendrickx A1 - Nicolas Bruffaerts A1 - Nicolas Dendoncker A1 - Lucie Hoebeke A1 - Catherine Linard A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers KW - Aerobiology KW - Allergy KW - NMDS KW - Passive sampling KW - Urban green areas AB -

Airborne pollen are important aeroallergens affecting human health. Local airborne pollen compositions can pose health-risks for the sensitized population, but at present little is known about fine-scale pollen composition patterns.

The overall objective of this study is to determine local variations in tree pollen composition with passive samplers and to identify the surrounding landscape characteristics that drive them. In February–May 2017, during the tree pollen season, airborne tree pollen were measured by passive sampling at 2 m height above ground-level in 14 sites in the Flanders and Brussels-Capital region (Belgium). Non-metric multidimensional scaling was used to investigate environmental gradients that determine the pollen composition and amounts. Land cover types were identified across spatial scales ranging between 20 m and 5 km.

The passive samplers detected the same pollen taxa during the same time windows as the validated volumetric Burkard samplers. Using passive samplers, we were able to measure local airborne pollen compositions. Corylus and Platanus pollen were associated to urban areas; Populus, Juglans and Fraxinus pollen to agricultural areas; forests and wetlands were sources of Alnus and Quercus pollen. Salix, Populus and Betula pollen were also mainly associated to wetlands. The landscape context drives the airborne tree pollen composition at a meso-scale (1−5 km) rather than at finer scale (20−500 m). Thus, land cover types (e.g. forest, bush land, agricultural lands and wetlands) surrounding urban areas may increase exposure to allergenic pollen in the urban area, potentially affecting the health of a large proportion of the population.

VL - 61 M3 - 10.1016/j.ufug.2021.127082 ER - TY - JOUR T1 - Childhood leukemia near nuclear sites in Belgium: An ecological study at small geographical level JF - Cancer Epidemiology Y1 - 2021 A1 - Claire Demoury A1 - Faes, Christel A1 - De Schutter, Harlinde A1 - Sylviane Carbonnelle A1 - Michael Rosskamp A1 - Francart, Julie A1 - Van Damme, Nancy A1 - Van Bladel, Lodewijk A1 - An Van Nieuwenhuyse A1 - Eva M De Clercq VL - 72 M3 - 10.1016/j.canep.2021.101910 ER - TY - JOUR T1 - Childhood leukemia near nuclear sites in Belgium: An ecological study at small geographical level. JF - Cancer Epidemiol Y1 - 2021 A1 - Claire Demoury A1 - Faes, Christel A1 - De Schutter, Harlinde A1 - Sylviane Carbonnelle A1 - Michael Rosskamp A1 - Francart, Julie A1 - Van Damme, Nancy A1 - Van Bladel, Lodewijk A1 - An Van Nieuwenhuyse A1 - Eva M De Clercq KW - ADOLESCENT KW - Belgium KW - Child KW - Child, Preschool KW - Female KW - Humans KW - incidence KW - Leukemia KW - Male KW - Nuclear Power Plants KW - REGISTRIES KW - Small-Area Analysis AB -

BACKGROUND: A previous investigation of the occurrence of childhood acute leukemia around the Belgian nuclear sites has shown positive associations around one nuclear site (Mol-Dessel). In the following years, the Belgian Cancer Registry has made data available at the smallest administrative unit for which demographic information exists in Belgium, i.e. the statistical sector. This offers the advantage to reduce the potential misclassification due to large geographical scales.

METHODS: The current study performed for the period 2006-2016 uses Poisson models to investigate (i) the incidence of childhood acute leukemia within 20 km around the four Belgian nuclear sites, (ii) exposure-response relationships between cancer incidence and surrogate exposures from the nuclear sites (distance, wind direction frequency and exposure by hypothetical radioactive discharges taking into account historical meteorological conditions). All analyses are carried out at statistical sector level.

RESULTS: Higher incidence rate ratios were found for children <15 years (7 cases, RR = 3.01, 95% CI: 1.43;6.35) and children <5 years (< 5 cases, RR = 3.62, 95% CI: 1.35;9.74) living less than 5 km from the site of Mol-Dessel. In addition, there was an indication for positive exposure-response relationships with the different types of surrogate exposures.

CONCLUSION: Results confirm an increased incidence of acute childhood leukemia around Mol-Dessel, but the number of cases remains very small. Random variation cannot be excluded and the ecological design does not allow concluding on causality. These findings emphasize the need for more in-depth research into the risk factors of childhood leukemia, for a better understanding of the etiology of this disease.

VL - 72 M3 - 10.1016/j.canep.2021.101910 ER - TY - JOUR T1 - Exposure to green space and pollen allergy symptom severity: A case-crossover study in Belgium JF - Science of The Total Environment Y1 - 2021 A1 - Michiel Stas A1 - Raf Aerts A1 - Marijke Hendrickx A1 - Delcloo, Andy A1 - Nicolas Dendoncker A1 - Sébastien Dujardin A1 - Catherine Linard A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers KW - Air pollution; Allergic rhinitis; Biodiversity; Birch pollen allergy; Personal exposure AB -

Background: The prevalence of pollen allergy has increased due to urbanization, climate change and air pollution. The effects of green space and air pollution on respiratory health of pollen allergy patients are complex and best studied in spatio-temporal detail.

Methods: We tracked 144 adults sensitized to Betulaceae pollen during the tree pollen season (January-May) of 2017 and 2018 and assessed their spatio-temporal exposure to green space, allergenic trees, air pollutants and birch pollen. Participants reported daily symptom severity scores. We extracted 404 case days with high symptom severity scores and matched these to 404 control days. The data were analyzed using conditional logistic regression with a 1:1 case-crossover design.

Results: Case days were associated with exposure to birch pollen concentration (100 grains/m3) [adjusted odds ratio 1.045 and 95% confidence interval (1.014-1.078)], O3 concentration (10 μg/m3) [1.504 (1.281-1.766)] and PM10 concentration (10 μg/m3) [1.255 (1.007-1.565)] on the day of the severe allergy event and with the cumulative exposure of one and two days before. Exposure to grass cover (10% area fraction) [0.655 (0.446-0.960)], forest cover (10% area fraction) [0.543 (0.303-0.973)] and density of Alnus (10%) [0.622 (0.411-0.942)] were protective for severe allergy, but only on the day of the severe allergy event. Increased densities of Betula trees (10%) were a risk factor [unadjusted OR: 2.014 (1.162-3.490)].

Conclusion: Exposure to green space may mitigate tree pollen allergy symptom severity but only when the density of allergenic trees is low. Air pollutants contribute to more severe allergy symptoms. Spatio-temporal tracking allows for a more realistic exposure assessment.

VL - 781 M3 - 10.1016/j.scitotenv.2021.146682 ER - TY - JOUR T1 - Lessons learned from Chernobyl and Fukushima on thyroid cancer screening and recommendations in case of a future nuclear accident. JF - Environ Int Y1 - 2021 A1 - Enora Cléro A1 - Evgenia Ostroumova A1 - Claire Demoury A1 - Bernd Grosche A1 - Ausrele Kesminiene A1 - Liudmila Liutsko A1 - Yvon Motreff A1 - Deborah Oughton A1 - Philippe Pirard A1 - Agnès Rogel A1 - An Van Nieuwenhuyse A1 - Dominique Laurier A1 - Elisabeth Cardis KW - Chernobyl Nuclear Accident KW - Child KW - Early Detection of Cancer KW - Fukushima Nuclear Accident KW - Humans KW - Japan KW - Quality of Life KW - Republic of Korea KW - Thyroid Neoplasms AB -

Exposure of the thyroid gland to ionizing radiation at a young age is the main recognized risk factor for differentiated thyroid cancer. After the Chernobyl and Fukushima nuclear accidents, thyroid cancer screening was implemented mainly for children, leading to case over-diagnosis as seen in South Korea after the implementation of opportunistic screening (where subjects are recruited at healthcare sites). The aim of cancer screening is to reduce morbidity and mortality, but screening can also cause negative effects on health (with unnecessary treatment if over-diagnosis) and on quality of life. This paper from the SHAMISEN special issue (Nuclear Emergency Situations - Improvement of Medical And Health Surveillance) presents the principles of cancer screening, the lessons learned from thyroid cancer screening, as well as the knowledge on thyroid cancer incidence after exposure to iodine-131. The SHAMISEN Consortium recommends to envisage systematic health screening after a nuclear accident, only when appropriately justified, i.e. ensuring that screening will do more good than harm. Based on the experience of the Fukushima screening, the consortium does not recommend mass or population-based thyroid cancer screening, as the negative psychological and physical effects are likely to outweigh any possible benefit in affected populations; thyroid health monitoring should however be made available to persons who request it (regardless of whether they are at increased risk or not), accompanied with appropriate information and support.

VL - 146 M3 - 10.1016/j.envint.2020.106230 ER - TY - JOUR T1 - Residential green space types, allergy symptoms and mental health in a cohort of tree pollen allergy patients JF - Landscape and Urban Planning Y1 - 2021 A1 - Michiel Stas A1 - Raf Aerts A1 - Marijke Hendrickx A1 - Nicolas Dendoncker A1 - Sébastien Dujardin A1 - Catherine Linard A1 - Tim S. Nawrot A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers AB -

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VL - 210 M3 - 10.1016/j.landurbplan.2021.104070 ER - TY - JOUR T1 - Residing in urban areas with higher green space is associated with lower mortality risk: A census-based cohort study with ten years of follow-up JF - Environment International Y1 - 2021 A1 - Mariska Bauwelinck A1 - Casas, Lidia A1 - Tim S. Nawrot A1 - Nemery, Benoit A1 - Sonia Trabelsi A1 - Isabelle Thomas A1 - Raf Aerts A1 - Wouter Lefebvre A1 - Charlotte Vanpoucke A1 - An Van Nieuwenhuyse A1 - Deboosere, Patrick A1 - Vandenheede, Hadewijch KW - COPD KW - Greenness KW - Greenspace KW - Ischemic heart disease KW - Perception KW - population-based AB -

Background

Epidemiological studies suggest that residing close to green space reduce mortality rates. We investigated the relationship between long-term exposure to residential green space and non-accidental and cardio-respiratory mortality.

Methods

We linked the Belgian 2001 census to population and mortality register follow-up data (2001–2011) among adults aged 30 years and older residing in the five largest urban areas in Belgium (n = 2,185,170 and mean follow-up time 9.4 years). Residential addresses were available at baseline. Exposure to green space was defined as 1) surrounding greenness (2006) [normalized difference vegetation index (NDVI) and modified soil-adjusted vegetation index (MSAVI2)] within buffers of 300 m, 500 m, and 1000 m; 2) surrounding green space (2006) [Urban Atlas (UA) and CORINE Land Cover (CLC)] within buffers of 300 m, 500 m, and 1000 m; and 3) perceived neighborhood green space (2001). Cox proportional hazards models with age as the underlying time scale were used to probe into cause-specific mortality (non-accidental, respiratory, COPD, cardiovascular, ischemic heart disease (IHD), and cerebrovascular). Models were adjusted for several sociodemographic variables (age, sex, marital status, country of birth, education level, employment status, and area mean income). We further adjusted our main models for annual mean (2010) values of ambient air pollution (PM2.5, PM10, NO2 and BC, one at a time), and we additionally explored potential mediation with the aforementioned pollutants.

Results

Higher degrees of residential green space were associated with lower rates of non-accidental and respiratory mortality. In fully adjusted models, hazard ratios (HR) per interquartile range (IQR) increase in NDVI 500 m buffer (IQR: 0.24) and UA 500 m buffer (IQR: 0.31) were 0.97 (95%CI 0.96–0.98) and 0.99 (95%CI 0.98–0.99) for non-accidental mortality, and 0.95 (95%CI 0.93–0.98) and 0.97 (95%CI 0.96–0.99) for respiratory mortality. For perceived neighborhood green space, HRs were 0.93 (95%CI 0.92–0.94) and 0.94 (95%CI 0.91–0.98) for non-accidental and respiratory mortality, respectively. The observed lower mortality risks associated with residential exposure to green space were largely independent from exposure to ambient air pollutants.

Conclusion

We observed evidence for lower mortality risk in associations with long-term residential exposure to green space in most but not all studied causes of death in a large representative cohort for the five largest urban areas in Belgium. These findings support the importance of the availability of residential green space in urban areas.

VL - 148 M3 - 10.1016/j.envint.2020.106365 ER - TY - JOUR T1 - An evaluation of species distribution models to estimate tree diversity at genus level in a heterogeneous urban-rural landscape JF - Landscape and Urban Planning Y1 - 2020 A1 - Michiel Stas A1 - Raf Aerts A1 - Marijke Hendrickx A1 - Nicolas Dendoncker A1 - Dujardin,S. A1 - Catherine Linard A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers AB -

Trees provide ecosystem services that improve the environment and human health. The magnitude of these improvements may be related to tree diversity within green spaces, yet spatially explicit diversity data necessary to investigate such associations are often missing. Here, we evaluate two methods to model tree diversity at genus level based on environmental covariates and presence point data. We aimed to identify the drivers and suitable methods for urban and rural tree diversity models in the heterogeneous region of Flanders, Belgium.

We stratified our research area into dominantly rural and dominantly urban areas and developed distribution models for 13 tree genera for both strata as well as for the area as a whole. Occurrence data were obtained from an open-access presence-only database of validated observations of vascular plants. These occurrence data were combined with environmental covariates in MaxEnt models. Tree diversity was modelled by adding up the individual species distribution models.

Models in the dominantly rural areas were driven by soil characteristics (soil texture and drainage class). Models in the dominantly urban areas were driven by environmental covariates explaining urban heterogeneity. Nevertheless, the stratification into urban and rural did not contribute to a higher model quality. Generic tree diversity estimates were better when presences derived from distribution models were simply added up (binary stacking, True Positive Rate of 0.903). The application of macro-ecological constraints resulted in an underestimation of generic tree diversity (probability stacking, True Positive Rate of 0.533). We conclude that summing presences derived from species distribution models (binary stacking) is a suitable approach to increase knowledge on regional diversity.

VL - 198 M3 - 10.1016/j.landurbplan.2020.103770 ER - TY - JOUR T1 - An evaluation of species distribution models to estimate tree diversity at genus level in a heterogeneous urban-rural landscape JF - Landscape and Urban Planning Y1 - 2020 A1 - Michiel Stas A1 - Raf Aerts A1 - Marijke Hendrickx A1 - Nicolas Dendoncker A1 - Sébastien Dujardin A1 - Catherine Linard A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers KW - allergenic tree species KW - Belgium KW - Maxent KW - species distribution models KW - stacking AB -

Trees provide ecosystem services that improve the environment and human health. The magnitude of these improvements may be related to tree diversity within green spaces, yet spatially explicit diversity data necessary to investigate such associations are often missing. Here, we evaluate two methods to model tree diversity at genus level based on environmental covariates and presence point data. We aimed to identify the drivers and suitable methods for urban and rural tree diversity models in the heterogeneous region of Flanders, Belgium.

We stratified our research area into dominantly rural and dominantly urban areas and developed distribution models for 13 tree genera for both strata as well as for the area as a whole. Occurrence data were obtained from an open-access presence-only database of validated observations of vascular plants. These occurrence data were combined with environmental covariates in MaxEnt models. Tree diversity was modelled by adding up the individual species distribution models.

Models in the dominantly rural areas were driven by soil characteristics (soil texture and drainage class). Models in the dominantly urban areas were driven by environmental covariates explaining urban heterogeneity. Nevertheless, the stratification into urban and rural did not contribute to a higher model quality. Generic tree diversity estimates were better when presences derived from distribution models were simply added up (binary stacking, True Positive Rate of 0.903). The application of macro-ecological constraints resulted in an underestimation of generic tree diversity (probability stacking, True Positive Rate of 0.533). We conclude that summing presences derived from species distribution models (binary stacking) is a suitable approach to increase knowledge on regional diversity.

VL - 198 M3 - https://doi.org/10.1016/j.landurbplan.2020.103770 ER - TY - JOUR T1 - Heat related mortality in the two largest Belgian urban areas: A time series analysis JF - Environmental Research Y1 - 2020 A1 - Katrien De Troeyer A1 - Mariska Bauwelinck A1 - Raf Aerts A1 - Dimitrios Profer A1 - Julie Berckmans A1 - Delcloo, Andy A1 - Rafiq Hamdi A1 - Bert Van Schaeybroeck A1 - Hans Hooyberghs A1 - Dirk Lauwaet A1 - Claire Demoury A1 - An Van Nieuwenhuyse KW - Ambient temperature KW - Belgium KW - mortality KW - Short-term effect KW - Urban heat island AB -

Background

Summer temperatures are expected to increase and heat waves will occur more frequently, be longer, and be more intense as a result of global warming. A growing body of evidence indicates that increasing temperature and heatwaves are associated with excess mortality and therefore global heating may become a major public health threat. However, the heat-mortality relationship has been shown to be location-specific and differences could largely be explained by the most frequent temperature. So far, in Belgium there is little known regarding the heat-mortality relationship in the different urban areas.

Objectives

The objective of this study is to assess the heat-mortality relationship in the two largest urban areas in Belgium, i.e. Antwerp and Brussels for the warm seasons from 2002 until 2011 taking into account the effect of air pollution.

Methods

The threshold in temperature above which mortality increases was determined using segmented regressions for both urban areas. The relationship between daily temperature and mortality above the threshold was investigated using a generalized estimated equation with Poisson distribution to finally determine the percentage of deaths attributable to the effect of heat.

Results

Although only 50 km apart, the heat-mortality curves for the two urban areas are different. More specifically, an increase in mortality occurs above a maximum temperature of 25.2 °C in Antwerp and 22.8 °C in Brussels. We estimated that above these thresholds, there is an increase in mortality of 4.9% per 1 °C in Antwerp and of 3.1% in Brussels. During the study period, 1.5% of the deaths in Antwerp and 3.5% of the deaths in Brussels can be attributed to the effect of heat. The thresholds differed considerably from the most frequent temperature, particularly in Antwerp. Adjustment for air pollution attenuated the effect of temperature on mortality and this attenuation was more pronounced when adjusting for ambient ozone.

Conclusion

Our results show a significant effect of temperature on mortality above a city-specific threshold, both in Antwerp and in Brussels. These findings are important given the ongoing global warming. Recurrent, intense and longer episodes of high temperature and expected changes in air pollutant levels will have an important impact on health in urban areas.

VL - 188 M3 - 10.1016/j.envres.2020.109848 ER - TY - JOUR T1 - Residential green space, air pollution, socioeconomic deprivation and cardiovascular medication sales in Belgium: A nationwide ecological study JF - Science of The Total Environment Y1 - 2020 A1 - Raf Aerts A1 - Nemery, Benoit A1 - Mariska Bauwelinck A1 - Sonia Trabelsi A1 - Deboosere, Patrick A1 - An Van Nieuwenhuyse A1 - Tim S. Nawrot A1 - Casas, Lidia KW - Cardiovascular disease KW - environment KW - epidemiology KW - exposure KW - medication sales KW - public health KW - Structural equation model AB -

Green space may improve cardiovascular (CV) health, for example by promoting physical activity and by reducing air pollution, noise and heat.  Socioeconomic and environmental factors may modify the health effects of green space. We examined the association between residential green space and reimbursed CV medication sales in Belgium between 2006 and 2014, adjusting for socioeconomic deprivation and air pollution.  We analyzed data for 11,575 census tracts using structural equation models for the entire country and for the administrative regions.  Latent variables for green space, air pollution and socioeconomic deprivation were used as predictors of CV medication sales and were estimated from the number of patches of forest, census tract relative forest cover and relative forest cover within a 600 m buffer around the census tract; annual mean concentrations of PM2.5, BC and NO2; and percentages of inhabitants that were foreign-born from lower- and mid-income countries, unemployed or had no higher education. A direct association between socioeconomic deprivation and CV medication sales [parameter estimate (95% CI): 0.26 (0.25; 0.28)] and inverse associations between CV medication sales and green space [–0.71 (–0.80; –0.61)] and air pollution [–1.62 (–1.69; –0.61)] were observed.  In the regional models, the association between green space and CV medication sales was stronger in the region with relatively low green space cover (Flemish Region, standardized estimate –0.16) than in the region with high green space cover (Walloon Region, –0.10).  In the highly urbanized Brussels Capital Region the association tended towards the null. In all regions, the associations between CV medication sales and socioeconomic deprivation were direct and more prominent. Our results suggest that there may be an inverse association between green space and CV medication sales, but socioeconomic deprivation was always the strongest predictor of CV medication sales.

VL - 712 M3 - https://doi.org/10.1016/j.scitotenv.2019.136426 ER - TY - JOUR T1 - Residential green space and medication sales for childhood asthma: A longitudinal ecological study in Belgium JF - Environmental Research Y1 - 2020 A1 - Raf Aerts A1 - Sébastien Dujardin A1 - Nemery, Benoit A1 - An Van Nieuwenhuyse A1 - Jos Van Orshoven A1 - Jean-Marie Aerts A1 - Ben Somers A1 - Marijke Hendrickx A1 - Nicolas Bruffaerts A1 - Mariska Bauwelinck A1 - Casas, Lidia A1 - Claire Demoury A1 - Michelle Plusquin A1 - Tim S. Nawrot KW - Environmental epidemiology KW - medication sales KW - Pediatric asthma KW - Residential green space KW - respiratory health AB -

Background: Living in green environments has been associated with various health benefits, but the evidence for positive effects on respiratory health in children is ambiguous.

Objective: To investigate if residential exposure to different types of green space is associated with childhood asthma prevalence in Belgium.

Methods: Asthma prevalence was estimated from sales data of reimbursed medication for obstructive airway disease (OAD) prescribed to children between 2010 and 2014, aggregated at census tract level (n = 1872) by sex and age group (6–12 and 13–18 years). Generalized log-linear mixed effects models with repeated measures were used to estimate effects of relative covers of forest, grassland and garden in the census tract of the residence on OAD medication sales. Models were adjusted for air pollution (PM10), housing quality and administrative region.

Results: Consistent associations between OAD medication sales and relative covers of grassland and garden were observed (unadjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, β = 0.15–0.17; garden, β = 0.13–0.17).  The associations remained significant after adjusting for housing quality and chronic air pollution (adjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, β = 0.10–0.14; garden, β = 0.07–0.09). There was no association between OAD medication sales and forest cover.

Conclusions: Based on aggregated data, we found that living in close proximity to areas with high grass cover (grasslands, but also residential gardens) may negatively impact child respiratory health. Potential allergic and non-allergic mechanisms that underlie this association include elevated exposure to grass pollen and fungi and reduced exposure to environmental biodiversity. Reducing the dominance of grass in public and private green space might be beneficial to reduce the childhood asthma burden and may simultaneously improve the ecological value of urban green space.

VL - 189 M3 - https://doi.org/10.1016/j.envres.2020.109914 ER - TY - JOUR T1 - Residential green space and seasonal distress in a cohort of tree pollen allergy patients JF - International Journal of Hygiene and Environmental Health Y1 - 2020 A1 - Raf Aerts A1 - Michiel Stas A1 - Naomi Vanlessen A1 - Marijke Hendrickx A1 - Nicolas Bruffaerts A1 - Lucie Hoebeke A1 - Nicolas Dendoncker A1 - Sébastien Dujardin A1 - Nelly D. Saenen A1 - An Van Nieuwenhuyse A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Tim S. Nawrot A1 - Ben Somers KW - Emotional distress KW - GHQ-12 KW - Mental health KW - Residential green space KW - Respiratory Hypersensitivity KW - Tree pollen allergy AB -

Background

Residential green space may improve human health, for example by promoting physical activity and by reducing stress. Conversely, residential green space may increase stress by emitting aeroallergens and exacerbating allergic disease. Here we examine impacts of exposure to residential green space on distress in the susceptible subpopulation of adults sensitized to tree pollen allergens.

Methods

In a panel study of 88 tree pollen allergy patients we analyzed self-reported mental health (GHQ-12), perceived presence of allergenic trees (hazel, alder, birch) near the residence and residential green space area within 1 km distance [high (≥3 m) and low (<3 m) green]. Results were adjusted for patients’ background data (gender, age, BMI, smoking status, physical activity, commuting distance, education level, allergy medication use and chronic respiratory problems) and compared with distress in the general population (N = 2467).

Results

Short-term distress [mean GHQ-12 score 2.1 (95% confidence interval 1.5–2.7)] was higher in the study population than in the general population [1.5 (1.4–1.7)]. Residential green space had protective effects against short-term distress [high green, per combined surface area of 10 ha: adjusted odds ratio OR = 0.94 (95% confidence interval 0.90–0.99); low green, per 10 ha: OR = 0.85 (0.78–0.93)]. However, distress was higher in patients who reported perceived presence of allergenic trees near their residence [present vs. absent: OR = 2.04 (1.36–3.07)].

Conclusions

Perceived presence of allergenic tree species in the neighbourhood of the residence of tree pollen allergy patients modulates the protective effect of residential green space against distress during the airborne tree pollen season.

VL - 223 CP - 1 M3 - 10.1016/j.ijheh.2019.10.004 ER - TY - JOUR T1 - Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level. JF - Int J Cancer Y1 - 2020 A1 - Claire Demoury A1 - De Schutter, Harlinde A1 - Faes, Christel A1 - Sylviane Carbonnelle A1 - Sébastien Fierens A1 - Molenberghs, Geert A1 - Van Damme, Nancy A1 - Van Bladel, Lodewijk A1 - An Van Nieuwenhuyse A1 - Christiane Vleminckx KW - ADOLESCENT KW - Adult KW - Aged KW - Aged, 80 and over KW - Belgium KW - Child KW - Child, Preschool KW - environmental exposure KW - Female KW - Geography KW - Humans KW - incidence KW - Infant KW - Infant, Newborn KW - Iodine Radioisotopes KW - Male KW - middle aged KW - Neoplasms, Radiation-Induced KW - Nuclear Power Plants KW - Radiation, Ionizing KW - Radioactive Hazard Release KW - Thyroid Neoplasms KW - Weather KW - Young adult AB -

In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol-Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine-131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure-response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual level.

VL - 146 CP - 11 M3 - 10.1002/ijc.32796 ER - TY - JOUR T1 - Urban environment and mental health: the NAMED project, protocol for a mixed-method study. JF - BMJ Open Y1 - 2020 A1 - Laura Lauwers A1 - Sonia Trabelsi A1 - Ingrid Pelgrims A1 - Hilde Bastiaens A1 - Eva M De Clercq A1 - Ariane Guilbert A1 - Madeleine Guyot A1 - Michael Leone A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Roy Remmen A1 - Nelly Saenen A1 - Isabelle Thomas A1 - Keune, Hans KW - air pollution KW - Belgium KW - Cities KW - Environment Design KW - Humans KW - Mental health KW - noise KW - Research Design KW - Residence Characteristics KW - social class KW - Social Environment KW - Urban Health KW - Urban Population AB -

INTRODUCTION: Mental health issues appear as a growing problem in modern societies and tend to be more frequent in big cities. Where increased evidence exists for positive links between nature and mental health, associations between urban environment characteristics and mental health are still not well understood. These associations are highly complex and require an interdisciplinary and integrated research approach to cover the broad range of mitigating factors. This article presents the study protocol of a project called Nature Impact on Mental Health Distribution that aims to generate a comprehensive understanding of associations between mental health and the urban residential environment.

METHODS AND ANALYSIS: Following a mixed-method approach, this project combines quantitative and qualitative research. In the quantitative part, we analyse among the Brussels urban population associations between the urban residential environment and mental health, taking respondents' socioeconomic status and physical health into account. Mental health is determined by the mental health indicators in the national Health Interview Survey (HIS). The urban residential environment is described by subjective indicators for the participant's dwelling and neighbourhood present in the HIS and objective indicators for buildings, network infrastructure and green environment developed for the purpose of this project. We assess the mediating role of physical activity, social life, noise and air pollution. In the qualitative part, we conduct walking interviews with Brussels residents to record their subjective well-being in association with their neighbourhood. In the validation part, results from these two approaches are triangulated and evaluated through interviews and focus groups with stakeholders of healthcare and urban planning sectors.

ETHICS AND DISSEMINATION: The Privacy Commission of Belgium and ethical committee from University Hospital of Antwerp respectively approved quantitative database merging and qualitative interviewing. We will share project results with a wide audience including the scientific community, policy authorities and civil society through scientific and non-expert communication.

VL - 10 CP - 2 M3 - 10.1136/bmjopen-2019-031963 ER - TY - JOUR T1 - Urban environment and mental health: the NAMED project, protocol for a mixed-method study JF - BMJ Open Y1 - 2020 A1 - Laura Lauwers A1 - Sonia Trabelsi A1 - Ingrid Pelgrims A1 - Hilde Bastiaens A1 - Eva M De Clercq A1 - Ariane Guilbert A1 - Madeleine Guyot A1 - Michael Leone A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Roy Remmen A1 - Nelly Saenen A1 - Isabelle Thomas A1 - Keune, Hans AB -

Introduction Mental health issues appear as a growing problem in modern societies and tend to be more frequent in big cities. Where increased evidence exists for positive links between nature and mental health, associations between urban environment characteristics and mental health are still not well understood. These associations are highly complex and require an interdisciplinary and integrated research approach to cover the broad range of mitigating factors. This article presents the study protocol of a project called Nature Impact on Mental Health Distribution that aims to generate a comprehensive understanding of associations between mental health and the urban residential environment.

Methods and analysis Following a mixed-method approach, this project combines quantitative and qualitative research. In the quantitative part, we analyse among the Brussels urban population associations between the urban residential environment and mental health, taking respondents’ socioeconomic status and physical health into account. Mental health is determined by the mental health indicators in the national Health Interview Survey (HIS). The urban residential environment is described by subjective indicators for the participant’s dwelling and neighbourhood present in the HIS and objective indicators for buildings, network infrastructure and green environment developed for the purpose of this project. We assess the mediating role of physical activity, social life, noise and air pollution. In the qualitative part, we conduct walking interviews with Brussels residents to record their subjective well-being in association with their neighbourhood. In the validation part, results from these two approaches are triangulated and evaluated through interviews and focus groups with stakeholders of healthcare and urban planning sectors.

Ethics and dissemination The Privacy Commission of Belgium and ethical committee from University Hospital of Antwerp respectively approved quantitative database merging and qualitative interviewing. We will share project results with a wide audience including the scientific community, policy authorities and civil society through scientific and non-expert communication.

VL - 10 CP - 2 M3 - 10.1136/bmjopen-2019-031963 ER - TY - JOUR T1 - Determinants of persistent organic pollutant (POP) concentrations in human breast milk of a cross-sectional sample of primiparous mothers in Belgium JF - Environment International Y1 - 2019 A1 - Raf Aerts A1 - Ilse Van Overmeire A1 - Ann Colles A1 - Mirjana Andjelkovic A1 - Govindan Malarvannan A1 - Giulia Poma A1 - Elly Den Hond A1 - Els Van de Mieroop A1 - Marie-Christine Dewolf A1 - François Charlet A1 - An Van Nieuwenhuyse A1 - Joris Van Loco A1 - Adrian Covaci AB -

Background: Bio-accumulation of persistent organic pollutants (POPs) in the environment and in the food chain

can lead to high pollutant concentrations in human fat-containing tissues and breast milk.

Objectives: We aimed to identify the maternal characteristics that determined POP concentrations in breast milk

of primiparous mothers in Belgium.

Methods: Breast milk samples were obtained from a cross-sectional sample of 206 primiparous mothers in 2014.

POP concentrations in breast milk samples were determined by GC-ECNI-MS and GC-EI-MS/MS depending on

the analytes' sensitivity. Associations between POP concentrations in breast milk and potential determinants

were investigated using two-way contingency tables and multivariable generalized linear models.

Results: Fifteen of the 23 screened POPs were detected in the breast milk samples. Four organochlorine compounds

(p,p′-DDT, p,p′-DDE, HCB and β-HCH) and two brominated flame retardant congeners (BDE-47, BDE-

153) were detected at concentrations above the limit of quantification in>50% of the breast milk samples.

Maternal age and BMI were usually associated with higher POP concentrations. Rural residency and consumption

of home-produced eggs, fatty fish and fish oil supplements were associated with higher concentrations

of DDT and DDE. Consumption of fatty fish and being breastfed during childhood were associated with higher

concentrations of HCB and β-HCH. Fish oil supplements and home-produced eggs were associated with higher

concentrations of BDEs, but for BDE congeners exposure routes other than diet require further investigation.

Conclusions: Dietary and non-dietary determinants predict individual POP concentrations in breast milk.

VL - 131 ER - TY - JOUR T1 - Determinants of persistent organic pollutant (POP) concentrations in human breast milk of a cross-sectional sample of primiparous mothers in Belgium JF - Environment International Y1 - 2019 A1 - Raf Aerts A1 - Ilse Van Overmeire A1 - Ann Colles A1 - Mirjana Andjelkovic A1 - Malarvannan, Govindan A1 - Poma, Giulia A1 - Den Hond, Elly A1 - Van De Mieroop, Els A1 - Dewolf, Marie-Christine A1 - François Charlet A1 - An Van Nieuwenhuyse A1 - Joris Van Loco A1 - Covaci, Adrian KW - brominated flame retardants KW - Human biomonitoring KW - Human breast milk KW - Organochlorine pesticides KW - PERSISTENT ORGANIC POLLUTANTS KW - Primipara mothers AB -

Background

Bio-accumulation of persistent organic pollutants (POPs) in the environment and in the food chain can lead to high pollutant concentrations in human fat-containing tissues and breast milk.

Objectives

We aimed to identify the maternal characteristics that determined POP concentrations in breast milk of primiparous mothers in Belgium.

Methods

Breast milk samples were obtained from a cross-sectional sample of 206 primiparous mothers in 2014. POP concentrations in breast milk samples were determined by GC-ECNI-MS and GC-EI-MS/MS depending on the analytes' sensitivity. Associations between POP concentrations in breast milk and potential determinants were investigated using two-way contingency tables and multivariable generalized linear models.

Results

Fifteen of the 23 screened POPs were detected in the breast milk samples. Four organochlorine compounds (p,p′-DDT, p,p′-DDE, HCB and β-HCH) and two brominated flame retardant congeners (BDE-47, BDE-153) were detected at concentrations above the limit of quantification in >50% of the breast milk samples. Maternal age and BMI were usually associated with higher POP concentrations. Rural residency and consumption of home-produced eggs, fatty fish and fish oil supplements were associated with higher concentrations of DDT and DDE. Consumption of fatty fish and being breastfed during childhood were associated with higher concentrations of HCB and β-HCH. Fish oil supplements and home-produced eggs were associated with higher concentrations of BDEs, but for BDE congeners exposure routes other than diet require further investigation.

Conclusions

Dietary and non-dietary determinants predict individual POP concentrations in breast milk.

VL - 131 M3 - 10.1016/j.envint.2019.104979 ER - TY - Generic T1 - Evaluation de l’exposition humaine aux résidus de pesticides à l’aide de bracelets en silicone Y1 - 2019 A1 - Laure Joly A1 - Raf Aerts A1 - Philippe Szternfeld A1 - K Tsilikas A1 - Koen De Cremer A1 - Philippe Castelain A1 - M Aerts A1 - J Van Orshoven A1 - B Somers A1 - M Ghendrickx A1 - Mirjana Andjelkovic A1 - An Van Nieuwenhuyse JF - 49e congrès du Groupe Français de recherche sur les Pesticides ER - TY - JOUR T1 - Personal exposure to traffic-related air pollutants and relationships with respiratory symptoms and oxidative stress: A pilot cross-sectional study among urban green space workers. JF - Sci Total Environ Y1 - 2019 A1 - Ariane Guilbert A1 - Koen De Cremer A1 - Billie Heene A1 - Claire Demoury A1 - Raf Aerts A1 - Declerck, Priscilla A1 - Brasseur, Olivier A1 - An Van Nieuwenhuyse KW - Air Pollutants KW - Belgium KW - benzene KW - Cities KW - cross-sectional studies KW - environmental exposure KW - Environmental Monitoring KW - Humans KW - Inflammation KW - Oxidative Stress KW - Pilot Projects KW - Polycyclic Aromatic Hydrocarbons KW - Respiratory System KW - Soot KW - Urban Population KW - Vehicle Emissions AB -

Exposure to ambient air pollution has been associated with various adverse health effects including respiratory, cardiovascular and neurological diseases. Exposure data for some specific pollutants and settings are however still insufficient and mechanisms underlying negative health outcomes are not fully elucidated. This pilot study aimed to assess individual exposure to three traffic-related air pollutants, black carbon (BC), polycyclic aromatic hydrocarbons (PAHs) and benzene, and the relationship with respiratory and oxidative stress outcomes in a cross-sectional sample of 48 green space workers in Brussels, Belgium. Participants were followed during four consecutive working days in 2016-2017 during which their individual exposure to BC, PAHs, benzene and more generally air pollution was measured using aethalometers, urinary biomarkers (1-hydroxypyrene, 1-naphthol, 2-naphthol, S-phenylmercapturic acid) and questionnaires. Data on respiratory health and oxidative stress were collected using questionnaires and respiratory/urinary biomarkers (exhaled nitric oxide [NO], 8-hydroxydeoxyguanosine [8-OHdG]). Associations between exposure and health outcomes were investigated using comparison tests and linear regression models, after stratification by present-day smoking status. Spatial variation in BC exposure was high, with concentrations varying between 0.26 and 5.69 μg/m. The highest levels were recorded during transport and, to a lesser extent, in green spaces located in the vicinity of roads with high traffic intensity. Concentrations of PAHs and benzene biomarkers did not systematically exceed the limits of detection. Among smokers, respiratory inflammation increased linearly with exposure to BC measured over the four days of follow-up (β = 8.73, 95% CI: 4.04, 13.41). Among non-smokers, oxidative stress increased linearly with BC measured on the fourth day (β = 2.88, 95% CI: 1.52, 4.24). Despite some limitations, this work supports the hypothesis that BC induces respiratory inflammation and oxidative stress. It also highlights the value of this compound as well as exhaled NO and urinary 8-OHdG biomarkers to detect early/mild effects of air pollution.

VL - 649 M3 - 10.1016/j.scitotenv.2018.08.338 ER - TY - JOUR T1 - Personal exposure to traffic-related air pollutants and relationships with respiratory symptoms and oxidative stress: A pilot cross-sectional study among urban green space workers JF - Science of The Total Environment Y1 - 2019 A1 - Ariane Guilbert A1 - Koen De Cremer A1 - Billie Heene A1 - Claire Demoury A1 - Raf Aerts A1 - Declerck, Priscilla A1 - Brasseur, Olivier A1 - An Van Nieuwenhuyse KW - Belgium KW - Black carbon KW - Health outcomes KW - Human biomonitoring KW - Polycyclic Aromatic Hydrocarbons AB -

Exposure to ambient air pollution has been associated with various adverse health effects including respiratory, cardiovascular and neurological diseases. Exposure data for some specific pollutants and settings are however still insufficient and mechanisms underlying negative health outcomes are not fully elucidated. This pilot study aimed to assess individual exposure to three traffic-related air pollutants, black carbon (BC), polycyclic aromatic hydrocarbons (PAHs) and benzene, and the relationship with respiratory and oxidative stress outcomes in a cross-sectional sample of 48 green space workers in Brussels, Belgium. Participants were followed during four consecutive working days in 2016–2017 during which their individual exposure to BC, PAHs, benzene and more generally air pollution was measured using aethalometers, urinary biomarkers (1-hydroxypyrene, 1-naphthol, 2-naphthol, S-phenylmercapturic acid) and questionnaires. Data on respiratory health and oxidative stress were collected using questionnaires and respiratory/urinary biomarkers (exhaled nitric oxide [NO], 8-hydroxydeoxyguanosine [8-OHdG]). Associations between exposure and health outcomes were investigated using comparison tests and linear regression models, after stratification by present-day smoking status. Spatial variation in BC exposure was high, with concentrations varying between 0.26 and 5.69 μg/m3. The highest levels were recorded during transport and, to a lesser extent, in green spaces located in the vicinity of roads with high traffic intensity. Concentrations of PAHs and benzene biomarkers did not systematically exceed the limits of detection. Among smokers, respiratory inflammation increased linearly with exposure to BC measured over the four days of follow-up (β = 8.73, 95% CI: 4.04, 13.41). Among non-smokers, oxidative stress increased linearly with BC measured on the fourth day (β = 2.88, 95% CI: 1.52, 4.24). Despite some limitations, this work supports the hypothesis that BC induces respiratory inflammation and oxidative stress. It also highlights the value of this compound as well as exhaled NO and urinary 8-OHdG biomarkers to detect early/mild effects of air pollution.

VL - 649 M3 - 10.1016/j.scitotenv.2018.08.338 ER - TY - JOUR T1 - Simultaneous determination of parabens, bisphenols and alkylphenols in human placenta by ultra-high performance liquid chromatography-tandem mass spectrometry JF - Journal of Chromatography B Y1 - 2019 A1 - Ilse Van Overmeire A1 - Karen Vrijens A1 - Nawrot, Tim A1 - An Van Nieuwenhuyse A1 - Joris Van Loco A1 - Tim Reyns KW - Alkylphenol KW - Bisphenol KW - endocrine disruptor KW - Paraben KW - Placenta KW - UHPLC-MS/MS AB -

This study presents de development and validation of an ultra- high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous determination of four parabens (methyl-, ethyl-, propyl-, and butyl-paraben (MeP, EtP, PrP, BuP), four bisphenols (BP) (BPA, BPB, BPF, and BPS) and two alkylphenols (nonyl phenol (NP) and tert-octylphenol (OP) in human placenta samples. After a short sample preparation time the extracts are analysed by UHPLC-MS/MS using negative electrospray ionization. Labeled internal standards and matrix-matched calibration are used for quantification of the compounds. The method was validated according FDA guideline for bio analytical methods using spiked samples at three concentration levels (0.5–5 and 25 ng g−1). The parameters accuracy and precision fulfill the criteria. Calibration curves are linear between 0.5 and 50 ng −1. The limits of detection and quantification are in the range of 0.1–0.3 ng g−1 and 0.2–0.7 ng g−1, respectively. The applicability of the method was demonstrated on 71 human placenta samples from a Belgian cohort. The detection frequency was highest for OP (95%), EtP (86%), BPA (49%) and BPS (44%). Among the quantified compounds the highest quantification frequency was observed for OP (85%), EtP (65%) and BPA (25%). The concentrations of parabens ranged from 0.5 to 7.1 ng g−1 for MeP, from 0.5 to 4.5 ng g−1 for EtP and from 0.5 to 9.1 ng g−1 for PrP. The levels of bisphenols ranged from 0.5 to 3.9 ng g−1 for BPA, from 0.6 to 2.1 ng g−1 for BPF and from 0.8 to 1.3 ng g−1 for BPS. BPB and NP were not detected and OP levels ranged from 0.5 to 3.7 ng g g−1. The results demonstrate that the developed analytical method is very sensitive and that levels of several compounds with known /suspected endocrine disrupting properties could be detected or quantified in human placenta samples. The results therefore suggest that fetal exposure to these compounds occurs. The method will be useful for studies to evaluate the health effects associated with this prenatal exposure.

VL - 1121 M3 - 10.1016/j.jchromb.2019.05.012 ER - TY - JOUR T1 - Simultaneous determination of parabens, bisphenols and alkylphenols in human placenta by ultra-high performance liquid chromatography - tandem mass spectrometry JF - Journal of Chromatography B Y1 - 2019 A1 - Ilse Van Overmeire A1 - K. Vrijens A1 - Nawrot, T. A1 - An Van Nieuwenhuyse A1 - Joris Van Loco A1 - Tim Reyns KW - Alkylphenol KW - Bisphenol KW - endocrine disruptor KW - Paraben KW - Placenta KW - UHPLC-MS/MS AB -

This study presents de development and validation of an ultra- high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous determination of four parabens (methyl-, ethyl-, propyl-, and butyl-paraben (MeP, EtP, PrP, BuP), four bisphenols (BP) (BPA, BPB, BPF, and BPS) and two  alkylphenols (nonyl phenol (NP) and tert-octylphenol (OP) in human placenta samples.  After a short sample preparation time the extracts are analysed by UHPLC-MS/MS using negative electrospray ionization.  Labeled internal standards and matrix-matched calibration are used for quantification of the compounds. The method was validated according FDA guideline for bio analytical methods using spiked samples at three concentration levels (0.5-5 and 25 ng g−1). The parameters accuracy and precision fulfill the criteria. Calibration curves are linear between 0.5 and 50 ng −1. The limits of detection and quantification are in the range of 0.1-0.3 ng g−1 and 0.2 -0.7 ng g−1, respectively. The applicability of the method was demonstrated on  71 human placenta samples from a Belgian cohort. The detection frequency was highest for OP (95%), EtP (86%), BPA (49%) and BPS (44%). Among the quantified compounds the highest quantification frequency was observed for OP (85%), EtP (65%) and BPA (25%). The concentrations of parabens ranged from 0.5-7.1 ng g−1 for MeP, from 0.5-4.5 ng g−1 for EtP and from 0.5-9.1 ng g−1 for PrP. The levels of bisphenols ranged from 0.5-3.9 ng g−1 for BPA, from 0.6-2.1 ng g−1 for BPF and from 0.8-1.3 ng g−1 for BPS. BPB and NP were not detected and OP levels ranged from 0.5-3.7 ng g−1. The results demonstrate that the developed analytical method is very sensitive and that levels of several compounds with known /suspected endocrine disrupting properties could be detected or quantified in human placenta samples. The results therefore suggest that fetal exposure to these compounds occurs. The method will be useful for studies to evaluate the health effects associated with this prenatal exposure.

VL - 1121 ER - TY - JOUR T1 - Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level JF - International Journal of Cancer Y1 - 2019 A1 - Claire Demoury A1 - De Schutter, Harlinde A1 - Faes, Christel A1 - Sylviane Carbonnelle A1 - Sébastien Fierens A1 - Molenberghs, Geert A1 - Van Damme, Nancy A1 - Van Bladel, Lodewijk A1 - An Van Nieuwenhuyse A1 - Christiane Vleminckx KW - ecological study KW - incidence KW - Nuclear sites KW - statistical sector KW - thyroid cancer AB -

In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol‐Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine‐131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure–response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual level.

M3 - 10.1002/ijc.32796 ER - TY - JOUR T1 - Biodiversity and human health: mechanisms and evidence of the positive health effects of diversity in nature and green spaces. JF - Br Med Bull Y1 - 2018 A1 - Raf Aerts A1 - Olivier Honnay A1 - An Van Nieuwenhuyse AB -

Introduction: Natural environments and green spaces provide ecosystem services that enhance human health and well-being. They improve mental health, mitigate allergies and reduce all-cause, respiratory, cardiovascular and cancer mortality. The presence, accessibility, proximity and greenness of green spaces determine the magnitude of their positive health effects, but the role of biodiversity (including species and ecosystem diversity) within green spaces remains underexplored. This review describes mechanisms and evidence of effects of biodiversity in nature and green spaces on human health.

Sources of data: We identified studies listed in PubMed and Web of Science using combinations of keywords including 'biodiversity', 'diversity', 'species richness', 'human health', 'mental health' and 'well-being' with no restrictions on the year of publication. Papers were considered for detailed evaluation if they were written in English and reported data on levels of biodiversity and health outcomes.

Areas of agreement: There is evidence for positive associations between species diversity and well-being (psychological and physical) and between ecosystem diversity and immune system regulation.

Areas of concern: There is a very limited number of studies that relate measured biodiversity to human health. There is more evidence for self-reported psychological well-being than for well-defined clinical outcomes. High species diversity has been associated with both reduced and increased vector-borne disease risk.

Growing points: Biodiversity supports ecosystem services mitigating heat, noise and air pollution, which all mediate the positive health effects of green spaces, but direct and long-term health outcomes of species diversity have been insufficiently studied so far.

Areas timely for research: Additional research and newly developed methods are needed to quantify short- and long-term health effects of exposure to perceived and objectively measured species diversity, including health effects of nature-based solutions and exposure to microbiota.

VL - 127 CP - 1 M3 - 10.1093/bmb/ldy021 ER - TY - JOUR T1 - Childhood leukaemia near nuclear sites in Belgium, 2002–2008 JF - European Journal of Cancer Prevention Y1 - 2018 A1 - Bollaerts, Kaatje A1 - Simons, Koen A1 - Van Bladel, Lodewijk A1 - De Smedt, Tom A1 - Sonck, Michel A1 - Sébastien Fierens A1 - E Poffijn A1 - Geraets, David A1 - Gosselin, Pol A1 - Herman Van Oyen A1 - Francart, Julie A1 - An Van Nieuwenhuyse KW - Child KW - data interpretation KW - incidence KW - leukaemia KW - nuclear reactors KW - radioactive pollutants KW - Statistical analysis AB -

This paper describes an ecological study investigating whether there is an excess incidence of acute leukaemia among children aged 0-14 years living in the vicinity of the nuclear sites in Belgium. Poisson regression modelling was carried out for proximity areas of varying sizes. In addition, the hypothesis of a gradient in leukaemia incidence with increasing levels of surrogate exposures was explored by means of focused hypothesis tests and generalized additive models. For the surrogate exposures, three proxies were used, that is, residential proximity to the nuclear site, prevailing winds and simulated radioactive discharges, on the basis of mathematical dispersion modelling. No excess incidence of acute leukaemia was observed around the nuclear power plants of Doel or Tihange nor around the nuclear site of Fleurus, which is a major manufacturer of radioactive isotopes in Europe. Around the site of Mol-Dessel, however, two- to three-fold increased leukaemia incidence rates were found in children aged 0-14 years living in the 0-5, 0-10 and the 0-15 km proximity areas. For this site, there was evidence for a gradient in leukaemia incidence with increased proximity, prevailing winds and simulated radioactive discharges, suggesting a potential link with the site that needs further investigation. An increased incidence of acute leukaemia in children aged 0-14 years was observed around one nuclear site that hosted reprocessing activities in the past and where nuclear research activities and radioactive waste treatment are ongoing.

VL - 27 CP - 2 M3 - 10.1097/CEJ.0000000000000272 ER - TY - JOUR T1 - Comparative long-term trend analysis of daily weather conditions with daily pollen concentrations in Brussels, Belgium. JF - Int J Biometeorol Y1 - 2018 A1 - Nicolas Bruffaerts A1 - Tom De Smedt A1 - Andy Delcloo A1 - Koen Simons A1 - Lucie Hoebeke A1 - Caroline Verstraeten A1 - An Van Nieuwenhuyse A1 - Ann Packeu A1 - Marijke Hendrickx KW - Allergy KW - Climate change KW - Meteorological factors KW - pollen AB -

A clear rise in seasonal and annual temperatures, a gradual increase of total radiation, and a relative trend of change in seasonal precipitation have been observed for the last four decades in Brussels (Belgium). These local modifications may have a direct and indirect public health impact by altering the timing and intensity of allergenic pollen seasons. In this study, we assessed the statistical correlations (Spearman's test) between pollen concentration and meteorological conditions by using long-term daily datasets of 11 pollen types (8 trees and 3 herbaceous plants) and 10 meteorological parameters observed in Brussels between 1982 and 2015. Furthermore, we analyzed the rate of change in the annual cycle of the same selected pollen types by the Mann-Kendall test. We revealed an overall trend of increase in daily airborne tree pollen (except for the European beech tree) and an overall trend of decrease in daily airborne pollen from herbaceous plants (except for Urticaceae). These results revealed an earlier onset of the flowering period for birch, oak, ash, plane, grasses, and Urticaceae. Finally, the rates of change in pollen annual cycles were shown to be associated with the rates of change in the annual cycles of several meteorological parameters such as temperature, radiation, humidity, and rainfall.

VL - 62 CP - 3 M3 - 10.1007/s00484-017-1457-3 ER - TY - Generic T1 - Determination of endocrine disrupting compounds in human placenta by UPLC-ESI-MS/MS: a preliminary study on parabens, bisphenols and alkyl phenols Y1 - 2018 A1 - Ilse Van Overmeire A1 - K. Vrijens A1 - Nawrot, T. A1 - An Van Nieuwenhuyse A1 - Joris Van Loco A1 - Tim Reyns JF - International symposium on halogenated Persistent Organic Pollutants (POPs) DIOXIN 2018 ER - TY - JOUR T1 - Heat and health in Antwerp under climate change: Projected impacts and implications for prevention. JF - Environ Int Y1 - 2018 A1 - Martinez, Gerardo Sanchez A1 - Julio Diaz A1 - Hans Hooyberghs A1 - Dirk Lauwaet A1 - Koen De Ridder A1 - Cristina Linares A1 - Rocio Carmona A1 - Cristina Ortiz A1 - Vladimir Kendrovski A1 - Raf Aerts A1 - An Van Nieuwenhuyse A1 - Dunbar, Maria Bekker-Nielsen KW - Antwerp KW - Climate change KW - Heat-related hospital admissions KW - Heat-related mortality KW - Heatwaves AB -

BACKGROUND: Excessive summer heat is a serious environmental health problem in several European cities. Heat-related mortality and morbidity is likely to increase under climate change scenarios without adequate prevention based on locally relevant evidence.

METHODS: We modelled the urban climate of Antwerp for the summer season during the period 1986-2015, and projected summer daily temperatures for two periods, one in the near (2026-2045) and one in the far future (2081-2100), under the Representative Concentration Pathway (RCP) 8.5. We then analysed the relationship between temperature and mortality, as well as with hospital admissions for the period 2009-2013, and estimated the projected mortality in the near future and far future periods under changing climate and population, assuming alternatively no acclimatization and acclimatization based on a constant threshold percentile temperature.

RESULTS: During the sample period 2009-2013 we observed an increase in daily mortality from a maximum daily temperature of 26°C, or the 89th percentile of the maximum daily temperature series. The annual average heat-related mortality in this period was 13.4 persons (95% CI: 3.8-23.4). No effect of heat was observed in the case of hospital admissions due to cardiorespiratory causes. Under a no acclimatization scenario, annual average heat-related mortality is multiplied by a factor of 1.7 in the near future (24.1deaths/year CI 95%: 6.78-41.94) and by a factor of 4.5 in the far future (60.38deaths/year CI 95%: 17.00-105.11). Under a heat acclimatization scenario, mortality does not increase significantly in the near or in the far future.

CONCLUSION: These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate, and the calibration of existing prevention activities in light of locally relevant evidence.

VL - 111 M3 - 10.1016/j.envint.2017.11.012 ER - TY - Generic T1 - Levels of organochlorinated pesticide residues and other persistent organic pollutants in breast milk: the Belgian results from the 6th WHO-coordinated survey Y1 - 2018 A1 - Ilse Van Overmeire A1 - Laure Joly A1 - Malarvannan,G. A1 - Poma,G. A1 - Covaci,A. A1 - A. Colles A1 - Koppen, G. A1 - E. Den Hond A1 - E. Van de Mieroop A1 - M.C. De Wolf A1 - F. Charlet A1 - Svetlana V. Malysheva A1 - Vanhouche,M. A1 - A. Dussart A1 - Joris Van Loco A1 - An Van Nieuwenhuyse A1 - Mirjana Andjelkovic KW - breast milk KW - organochlorinated pesticide residues KW - PERSISTENT ORGANIC POLLUTANTS AB -

Conclusions of the presentation given at the International symposium on halogenated Persistent Organic Pollutants (POPs) DIOXIN 2018

JF - International symposium on halogenated Persistent Organic Pollutants (POPs) DIOXIN 2018 ER - TY - JOUR T1 - Relationships between aeroallergen levels and hospital admissions for asthma in the Brussels-Capital Region: a daily time series analysis. JF - Environ Health Y1 - 2018 A1 - Ariane Guilbert A1 - Nicolas Bruffaerts A1 - Lucie Hoebeke A1 - Ann Packeu A1 - Marijke Hendrickx A1 - Koen De Cremer A1 - Sandrine Bladt A1 - Olivier Brasseur A1 - An Van Nieuwenhuyse AB -

BACKGROUND: Outdoor pollen grain and fungal spore concentrations have been associated with severe asthma exacerbations at the population level. The specific impact of each taxon and the concomitant effect of air pollution on these symptoms have, however, still to be better characterized. This study aimed to investigate the short-term associations between ambient concentrations of various aeroallergens and hospitalizations related to asthma in the Brussels-Capital Region (Belgium), an area recording especially high rates of admissions.

METHODS: Based on administrative records of asthma hospitalizations and regular monitoring of 11 tree/herbaceous pollen taxa and 2 fungal spore taxa, daily time series analyses covering the 2008-2013 period were performed. Effects up to 6 days after exposure were captured by combining quasi-Poisson regression with distributed lag models, adjusting for seasonal and long-term trends, day of the week, public holidays, mean temperature and relative humidity. Effect modification by age and air pollution (PM, NO, O) was tested.

RESULTS: A significant increase in asthma hospitalizations was observed for an interquartile range increase in grass (5.9%, 95% CI: 0.0, 12.0), birch (3.2%, 95% CI: 1.1, 5.3) and hornbeam (0.7%, 95% CI: 0.2, 1.3) pollen concentrations. For several taxa including grasses, an age modification effect was notable, the hospitalization risk tending to be higher in individuals younger than 60 years. Air pollutants impacted the relationships too: the risk appeared to be stronger for grass and birch pollen concentrations in case of high PM and O concentrations respectively.

CONCLUSIONS: These findings suggest that airborne grass, birch and hornbeam pollen are associated with severe asthma exacerbations in the Brussels region. These compounds appear to act in synergy with air pollution and to more specifically affect young and intermediate age groups. Most of these life-threatening events could theoretically be prevented with improved disease diagnosis/management and targeted communication actions.

VL - 17 CP - 1 M3 - 10.1186/s12940-018-0378-x ER - TY - JOUR T1 - Silicone Wristband Passive Samplers Yield Highly Individualized Pesticide Residue Exposure Profiles. JF - Environ Sci Technol Y1 - 2018 A1 - Raf Aerts A1 - Laure Joly A1 - Philippe Szternfeld A1 - Khariklia Tsilikas A1 - Koen De Cremer A1 - Philippe Castelain A1 - Jean-Marie Aerts A1 - Jos Van Orshoven A1 - Ben Somers A1 - Marijke Hendrickx A1 - Mirjana Andjelkovic A1 - An Van Nieuwenhuyse KW - Dietary exposure KW - environmental exposure KW - LC-MS/MS KW - passive sampler KW - Pesticide residues KW - wristband sampler AB -

Monitoring human exposure to pesticides and pesticide residues (PRs) remains crucial for informing public health policies, despite strict regulation of plant protection product and biocide use. We used 72 low-cost silicone wristbands as noninvasive passive samplers to assess cumulative 5-day exposure of 30 individuals to polar PRs. Ethyl acetate extraction and LC-MS/MS analysis were used for the identification of PRs. Thirty-one PRs were detected of which 15 PRs (48%) were detected only in worn wristbands, not in environmental controls. The PRs included 16 fungicides (52%), 8 insecticides (26%), 2 herbicides (6%), 3 pesticide derivatives (10%), 1 insect repellent (3%), and 1 pesticide synergist (3%). Five detected pesticides were not approved for plant protection use in the EU. Smoking and dietary habits that favor vegetable consumption were associated with higher numbers and higher cumulative concentrations of PRs in wristbands. Wristbands featured unique PR combinations. Our results suggest both environment and diet contributed to PR exposure in our study group. Silicone wristbands could serve as sensitive passive samplers to screen population-wide cumulative dietary and environmental exposure to authorized, unauthorized and banned pesticides.

VL - 52 CP - 1 M3 - 10.1021/acs.est.7b05039 ER - TY - RPRT T1 - Analyse des données sur l’allergie en Région de Bruxelles-Capitale - Exploitation de quatre bases de données relatives à la morbidité et la mortalité associées à l’asthme et la rhinite allergique. Y1 - 2017 A1 - Ariane Guilbert A1 - Koen Simons A1 - Raf Aerts A1 - Claire Demoury A1 - Michele Rasoloharimahefa A1 - Koen De Cremer A1 - Nicolas Bruffaerts A1 - Lucie Hoebeke A1 - Ann Packeu A1 - Marijke Hendrickx A1 - Bianca Cox A1 - Sophie Viart A1 - Charles Pilette A1 - An Van Nieuwenhuyse KW - asthme KW - bases de données KW - Bruxelles KW - épidémiologie KW - hospitalisations KW - médicaments KW - mortalité KW - rhinite allergique PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - JOUR T1 - Biomarkers in patients admitted to the emergency department after exposure to acrylonitrile in a major railway incident involving bulk chemical material. JF - Int J Hyg Environ Health Y1 - 2017 A1 - Colenbie, Sebastiaan A1 - Buylaert, Walter A1 - Stove, Christophe A1 - Deschepper, Ellen A1 - Vandewoude, Koenraad A1 - De Smedt, Tom A1 - Bader, Michael A1 - Göen, Thomas A1 - An Van Nieuwenhuyse A1 - De Paepe, Peter KW - acrylonitrile KW - ADOLESCENT KW - Adult KW - Aged KW - Aged, 80 and over KW - Belgium KW - Biomarkers KW - Chemical Hazard Release KW - Child KW - Child, Preschool KW - Emergency Service, Hospital KW - Environmental Monitoring KW - Female KW - Humans KW - Infant KW - Lactic Acid KW - Male KW - middle aged KW - Railroads KW - SMOKING KW - Thiocyanates KW - Valine KW - Young adult AB -

BACKGROUND: A railway incident with victims of exposure to the cyanogenic substance acrylonitrile (ACN).

AIMS: We retrospectively (i)built an inventory of the clinical characteristics of individuals admitted to surrounding emergency departments (ED's) and (ii)studied the correlation between N-2-cyanoethylvaline (CEV), a biomarker used in a population study for evaluating exposure to ACN, with lactate and thiocyanate (SCN), biomarkers determined during emergency care.

RESULTS: 438 patients from 11 ED's were included and presented with known symptoms of ACN poisoning but also with concern about the risks. A comparison of CEV with lactate or SCN was possible in 108 and 73 patients respectively. CEV was very high in a critically ill patient with a high lactate. There was no correlation with CEV in the patients with normal or slightly elevated lactate concentrations. A correlation of CEV with SCN was only observed in smokers.

LIMITATIONS: First there is a lack of data in some clinical files concerning the time and duration of exposure and the smoking-status. A second limitation is that blood samples for biomarkers were not taken systematically in all patients, which may have induced bias. A third limitation is that blood sampling was possibly done outside the correct time window related to the delayed toxicity of ACN. Finally the number of severely-intoxicated patients was low and ACN exposure may not have taken place e.g. in individuals consulting with psychological symptoms. These aspects may have contributed to the below detection limits' analyses of biomarkers.

CONCLUSIONS: CEV was markedly elevated in a severely-intoxicated patient with high lactate, a sensitive marker for CN intoxication. We found no correlation of CEV with normal or slightly elevated lactate concentrations but clinicians should consider the possibility of subsequent rises due to the delay in ACN toxicity. CEV correlated with SCN in smokers, which may be explained by ACN in tobacco smoke and deserves further exploration. Further studies are necessary to evaluate the correlation between biomarkers in acute chemical exposures to ACN and these should be carried out prospectively using a preplanned template.

VL - 220 CP - 2 Pt A U1 - http://www.ncbi.nlm.nih.gov/pubmed/28110842?dopt=Abstract M3 - 10.1016/j.ijheh.2016.12.012 ER - TY - RPRT T1 - Evaluation d’impact de l’exposition à la pollution émise par le trafic routier sur la santé de la population bruxelloise : projet pilote pour les personnes à faible et haut niveau d’exposition. Y1 - 2017 A1 - Ariane Guilbert A1 - Koen De Cremer A1 - Raf Aerts A1 - Claire Demoury A1 - An Van Nieuwenhuyse KW - biomonitoring KW - Bruxelles KW - épidémiologie KW - pollution de l’air KW - santé PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - RPRT T1 - Lessons learned from dosimetric and health screening, evacuation and health surveillance. The SHAMISEN project deliverable D5.56 to OPERRA, a final report, restricted (European commission). ST1 Y1 - 2017 A1 - Cardis, E A1 - Barquinero, J.F A1 - S Della Monaca A1 - P. Fattibene A1 - Kesminiene, A. A1 - Liutsko, L A1 - Nuccetelli, C A1 - Ohba,T A1 - Ostroumova, E A1 - Tanigawa, K A1 - An Van Nieuwenhuyse KW - dosimetric screening KW - health screening KW - OPERRAn surveillance KW - SHAMISEN PB - NA CY - NA ER - TY - RPRT T1 - Recommendations and procedures for preparedness and health surveillance of populations affected by a radiation accident. Final report. Y1 - 2017 A1 - Deborah Oughton A1 - Viviana Albani A1 - Francesc Barquinero A1 - Vadim Chumak A1 - Enora Clero A1 - Pascal Crouail A1 - P. Fattibene A1 - Ausrele Kesminiene A1 - Dominique Laurier A1 - Liudmila Liutsko A1 - Thierry Schneider A1 - Koichi Tanigawa A1 - Evgenia Tomkiv A1 - Luke Vale A1 - Elisabeth Cardis A1 - on behalf of the SHAMISEN Consortium A1 - An Van Nieuwenhuyse KW - preparedness KW - procedures KW - radiation accident KW - Recommendations KW - SHAMISEN PB - NA CY - NA ER - TY - RPRT T1 - Analyse van de dringende geneeskundige hulpverlening gedurende de acrylonitril treinramp te Wetteren van 04/05/2013 Y1 - 2016 A1 - Colenbie,S. A1 - Buylaert,W. A1 - Stove,C. A1 - Deschepper,E. A1 - An Van Nieuwenhuyse A1 - De Smedt,T. A1 - Devue,K. A1 - Vandewoude,K. A1 - De Paepe,P. KW - acrylonitril KW - blootstelling KW - care KW - data KW - de KW - IS KW - Patient KW - Test KW - toxische KW - Wetteren PB - UGent CY - Gent, Belgie U1 - 2602 ER - TY - Generic T1 - Assessing spatio-temporal relationships between respiratory health and biodiversity using individual wearable technology - the Respirit project Y1 - 2016 A1 - Raf Aerts A1 - Dendoncker,N A1 - Linard,C A1 - Marijke Hendrickx A1 - An Van Nieuwenhuyse A1 - Nawrot,T. A1 - Delcloo,A. A1 - Hamdi,R. A1 - Aerts,J.M. A1 - Somers,B ED - Van Orshoven,J. KW - biodiversity KW - European KW - health KW - ON KW - Practice KW - Respiratory JF - European One Health/EcoHealth Workshop, Belgian Biodiversity Platform, Belgian Community of Practice on Biodiversity and Health PB - Belspo CY - Brussels CP - BELSPO U1 - 2647 U2 - 06/10/2016 ER - TY - THES T1 - BruxAir. Short-term health effects of air pollution in the Brussels Capital Region 2004-2011: an epidemiological time series approach Y1 - 2016 A1 - Simons,K. A1 - An Van Nieuwenhuyse A1 - Buyl,R. A1 - Coomans,D. KW - air pollution KW - an KW - approach KW - Brussels KW - effect KW - effects KW - health KW - health effects KW - region KW - series KW - time KW - Time series PB - VUBPRESS Brussels University Press - Vrije Universiteit Brussel CY - Brussels SN - 978 90 5718 553 3 U1 - 2566 ER - TY - JOUR T1 - Childhood leukaemia near nuclear sites in Belgium, 2002-2008. JF - Eur J Cancer Prev Y1 - 2016 A1 - Bollaerts, Kaatje A1 - Simons, Koen A1 - Van Bladel, Lodewijk A1 - De Smedt, Tom A1 - Sonck, Michel A1 - Sébastien Fierens A1 - Poffijn, André A1 - Geraets, David A1 - Gosselin, Pol A1 - Herman Van Oyen A1 - Francart, Julie A1 - An Van Nieuwenhuyse AB -

This paper describes an ecological study investigating whether there is an excess incidence of acute leukaemia among children aged 0-14 years living in the vicinity of the nuclear sites in Belgium. Poisson regression modelling was carried out for proximity areas of varying sizes. In addition, the hypothesis of a gradient in leukaemia incidence with increasing levels of surrogate exposures was explored by means of focused hypothesis tests and generalized additive models. For the surrogate exposures, three proxies were used, that is, residential proximity to the nuclear site, prevailing winds and simulated radioactive discharges, on the basis of mathematical dispersion modelling. No excess incidence of acute leukaemia was observed around the nuclear power plants of Doel or Tihange nor around the nuclear site of Fleurus, which is a major manufacturer of radioactive isotopes in Europe. Around the site of Mol-Dessel, however, two- to three-fold increased leukaemia incidence rates were found in children aged 0-14 years living in the 0-5, 0-10 and the 0-15 km proximity areas. For this site, there was evidence for a gradient in leukaemia incidence with increased proximity, prevailing winds and simulated radioactive discharges, suggesting a potential link with the site that needs further investigation. An increased incidence of acute leukaemia in children aged 0-14 years was observed around one nuclear site that hosted reprocessing activities in the past and where nuclear research activities and radioactive waste treatment are ongoing.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0/.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/27380513?dopt=Abstract M3 - 10.1097/CEJ.0000000000000272 ER - TY - Generic T1 - Cumulative diversity dose CDD as an integrated measure of human exposure to biodiversity Y1 - 2016 A1 - Raf Aerts A1 - An Van Nieuwenhuyse A1 - Lucie Hoebeke A1 - Dendoncker,N. A1 - Linard,C. A1 - Dujardin,S. A1 - Verstraeten,W. A1 - Delcloo,A. ED - Marijke Hendrickx KW - an KW - AS KW - biodiversity KW - European KW - exposure KW - health KW - Human KW - human exposure KW - measure KW - ON KW - Practice JF - European One Health/EcoHealth Workshop, Belgian Biodiversity Platform, Belgian Community of Practice on Biodiversity and Health PB - Belspo CY - Brussels CP - BELSPO U1 - 2648 U2 - 06/10/2016 ER - TY - Generic T1 - Development of UPLC-MS/MS methods for endocrine disrupting chemicals (EDCs) in placenta in an ongoing mother-birth cohort in Belgium Y1 - 2016 A1 - Ilse Van Overmeire A1 - Tim Reyns A1 - Nawrot,T. A1 - Vrijens,K. A1 - Mirjana Andjelkovic A1 - Joris Van Loco A1 - An Van Nieuwenhuyse KW - an KW - Belgium KW - biomonitoring KW - chemicals KW - conference KW - Development KW - Human KW - Human biomonitoring KW - International KW - method KW - methods KW - ON KW - UPLC-MS/MS JF - 2nd International Conference on Human Biomonitoring PB - WIV-ISP CY - Germany CP - Federal Ministry for the Environment,Nature Conservation,Building and Nuclear Safety and the German Environment Agency U1 - 2515 U2 - 17-19/04/2016 ER - TY - JOUR T1 - Direct cost saving potential in medication costs due to a reduction in outdoor air pollution for the Brussels Capital Region. JF - Sci Total Environ Y1 - 2016 A1 - Simons, Koen A1 - Devos, Stefanie A1 - Putman, Koen A1 - Coomans, Danny A1 - An Van Nieuwenhuyse A1 - Buyl, Ronald AB -

INTRODUCTION: The adverse health effects of exposure to air pollution have been well-established and include mortality, hospital admissions, emergency department visits, etc, but also less severe outcomes such as medication use and purchase. The economic impact, an additional motivator for policy, has been studied primarily for the more severe outcomes.

METHODS: Purchase data of reimbursed medications typically prescribed for asthma and chronic obstructive pulmonary disease, were obtained through the mandatory Belgian health insurance system. A time series analyses approach was used to model daily sales on daily air pollution concentrations (NO2, PM10 and PM2.5) for residents of the Brussels Capital Region as a whole. In addition, a higher geographical resolution of both sales and pollutant concentrations allowed for a multi-sector approach. Annual savings were estimated for the scenario of a 10% reduction in each of the pollutants.

RESULTS: Medication purchase was significantly associated with NO2 concentrations, leading to an annual cost saving potential of € 107,845 [95%CI: € 71,483-€ 143,823] in R03 sales (WHO classification for drugs of obstructive airway diseases). Saving potentials of PM10 and PM2.5 were not significant. Estimates were not sensitive to the geographical resolution, however, higher precision can be obtained with higher resolution data, subject to the condition that the number of sales is sufficiently large.

VL - 562 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27110987?dopt=Abstract M3 - 10.1016/j.scitotenv.2016.04.022 ER - TY - JOUR T1 - Ensemble post-processing is a promising method to obtain flexible distributed lag models: : A simulation study of time series of air pollution and daily mortality. JF - Air Qual Atmos Health Y1 - 2016 A1 - Simons,K. A1 - De Smedt,T. A1 - An Van Nieuwenhuyse A1 - Buyl,R. A1 - Coomans,D. KW - air pollution KW - an KW - approach KW - AS KW - Benefit KW - benefits KW - Covariate KW - data KW - environmental KW - epidemiology KW - exposure KW - IS KW - method KW - MODEL KW - models KW - morbidity KW - mortality KW - Multiple KW - national KW - regression KW - Regression model KW - series KW - study KW - time KW - Time series KW - variables AB - Distributed lag models (DLM) are regression models that include multiple lagged exposure variables as covariates. They are frequently used to model the relationship between daily mortality and short-term air pollution exposures. Specifying a maximum lag number is but one of the difficulties in using a DLM for environmental epidemiology. We propose an easily extendible ensemble post-processing approach. The resultant estimates are both more parsimonious, approaching zero with increasing lag, and more efficient. The benefits are shown to be robust under various simulation scenario's and illustrated with data from the National Morbidity, Mortality and Air Pollution Study. VL - 9 CP - 7 U1 - 2565 M3 - http://dx.doi.org/10.1007/s11869-015-0388-6 ER - TY - Generic T1 - Environnement : impact des sites nucl‚aires sur les leuc‚mies de l'enfant. S‚minaire Pr‚disposition aux cancers de l'enfant : R“le de l'environnement, des facteurs ‚pig‚n‚tiques et g‚n‚tiques Y1 - 2016 A1 - An Van Nieuwenhuyse ED - Cliniques Universitaire Saint-Luc KW - cancer KW - Cancers KW - de KW - Impact KW - LE KW - x U1 - 2639 ER - TY - Generic T1 - Human biomonitoring as a tool for objective exposure assessment: A case-study of a major train accident with acrylonitrile in Belgium Y1 - 2016 A1 - An Van Nieuwenhuyse A1 - De Smedt,T. A1 - Smons,K. A1 - Stove,C. A1 - De Paepe,P. A1 - Nemery,B. A1 - Bader,M. A1 - Christiane Vleminckx A1 - Ilse Van Overmeire A1 - Sébastien Fierens A1 - Birgit Mertens A1 - Koen De Cremer A1 - T. Goen A1 - Schettgen,T. A1 - Herman Van Oyen A1 - Joris Van Loco KW - accident KW - acrylonitrile KW - approach KW - AS KW - assessment KW - biomonitoring KW - exposure KW - exposure assessment KW - health KW - Human KW - Human biomonitoring KW - International KW - Objective KW - Science KW - Societies KW - Society JF - Interdisciplinary Approaches for Health and the Environment PB - NA CY - NA CP - International Society of Exposure Science ISES, U1 - 2516 U2 - 9-13/10/2016 ER - TY - Generic T1 - Human biomonitoring in the Wetteren incident Y1 - 2016 A1 - An Van Nieuwenhuyse A1 - De Smedt ,T. A1 - Simons,K. A1 - Stove,C. A1 - De Paepe,P. A1 - Nemery,B. A1 - Bader,M. A1 - Christiane Vleminckx A1 - Ilse Van Overmeire A1 - Sébastien Fierens A1 - Birgit Mertens A1 - Koen De Cremer A1 - T. Goen A1 - Schettgen,T. A1 - Herman Van Oyen A1 - Joris Van Loco KW - biomonitoring KW - Cost KW - Diagnosis KW - European KW - exposure KW - Human KW - Human biomonitoring KW - Monitoring KW - prevention KW - Wetteren JF - European COST project DiMoPEX, Diagnosis, monitoring, prevention of exposure related non-communicable diseases PB - NA CY - NA CP - DiMoPEX U1 - 2642 U2 - October 18, 2016. ER - TY - Generic T1 - Impact of green/blue spaces on specific morbidity and cause-specific mortality in Belgium: the GRESP-HEALTH project Y1 - 2016 A1 - Mariska Bauwelinck A1 - Casas,L. A1 - An Van Nieuwenhuyse A1 - Deboosere,P. A1 - Isabelle Thomas A1 - Nawrot,T. A1 - Bouland,C. A1 - Nemery,B. KW - Belgium KW - European KW - Impact KW - morbidity KW - mortality KW - ON JF - European OneHealth/EcoHealth workshop PB - NA CY - NA CP - Belgian Science Policy U1 - 2632 U2 - 6-7/10/2016 ER - TY - Generic T1 - The impact of neighbourhood perceived greenness on health and mortality inequalities in Belgium: a census-based study. Y1 - 2016 A1 - Mariska Bauwelinck A1 - Casas,L. A1 - An Van Nieuwenhuyse A1 - Deboosere,P. KW - Belgium KW - environmental KW - epidemiology KW - health KW - Impact KW - inequalities KW - inequality KW - International KW - mortality KW - ON KW - perceived KW - Societies KW - Society KW - study JF - International Society for Environmental Epidemiology 2016 PB - NA CY - NA CP - International Society for Environmental Epidemiology (ISEE) U1 - 2583 U2 - 1-4/09/2016 ER - TY - Generic T1 - Respiratory medication sales and urban air pollution in Brussels (2005 to 2011). Y1 - 2016 A1 - An Van Nieuwenhuyse A1 - Simons,K. A1 - Nawrot,T. A1 - Brasseur,O. A1 - Declerck,P. A1 - Buyl,R. A1 - Coomans,D. A1 - Nemery,B. A1 - Casas,L. KW - air pollution KW - Brussels KW - electronic KW - European KW - International KW - medication sales KW - PRESENTATION KW - Respiratory KW - Societies KW - Society KW - urban JF - ERS International Congress PB - NA CY - NA CP - European Respiratory Society U1 - 2579 U2 - 03/09/2016-07/09/2016 ER - TY - JOUR T1 - Respiratory medication sales and urban air pollution in Brussels (2005 to 2011). JF - Environ Int Y1 - 2016 A1 - Casas, Lidia A1 - Simons, Koen A1 - Nawrot, Tim S A1 - Brasseur, Olivier A1 - Declerck, Priscilla A1 - Buyl, Ronald A1 - Coomans, Danny A1 - Nemery, Benoit A1 - An Van Nieuwenhuyse KW - ADOLESCENT KW - Adolescents KW - age KW - Age-group KW - Aged KW - air pollution KW - ALL KW - association KW - Associations KW - Brussels KW - Change KW - Changes KW - CI KW - data KW - Database KW - exposure KW - general KW - general population KW - General-population KW - Individuals KW - Linear Models KW - medication sales KW - method KW - methods KW - MODEL KW - models KW - Monitoring KW - morbidity KW - observed KW - past KW - PM10 KW - POISSON KW - POPULATION KW - RANGE KW - Ratio KW - region KW - Respiratory KW - result KW - results KW - risk KW - SOCIAL KW - urban AB -

BACKGROUND: We investigated the associations between daily sales of respiratory medication and air pollutants in the Brussels-Capital Region between 2005 and 2011.

METHODS: We used over-dispersed Poisson Generalized Linear Models to regress daily individual reimbursement data of prescribed asthma and COPD medication from the social security database against each subject's residential exposure to outdoor particulate matter (PM10) or NO2 estimated, by interpolation from monitoring stations. We calculated cumulative risk ratios (RR) and their 95% confidence intervals (CI) for interquartile ranges (IQR) of exposure for different windows of past exposure for the entire population and for seven age groups.

RESULTS: Median daily concentrations of PM10 and NO2 were 25μg/m(3) (IQR=17.1) and 38μg/m(3) (IQR=20.5), respectively. PM10 was associated with daily medication sales among individuals aged 13 to 64y. For NO2, significant associations were observed among all age groups except >84y. The highest RR were observed for NO2, among adolescents, including three weeks lags (RR=1.187 95%CI: 1.097-1.285).

CONCLUSION: The associations found between temporal changes in exposure to air pollutants and daily sales of respiratory medication in Brussels indicate that urban air pollution contributes to asthma and COPD morbidity in the general population.

VL - 94 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27346740?dopt=Abstract M3 - 10.1016/j.envint.2016.06.019 ER - TY - JOUR T1 - Short-term effect of pollen and spore exposure on allergy morbidity in the Brussels-Capital Region. JF - Ecohealth Y1 - 2016 A1 - Ariane Guilbert A1 - Simons, Koen A1 - Lucie Hoebeke A1 - Ann Packeu A1 - Marijke Hendrickx A1 - Koen De Cremer A1 - Buyl, Ronald A1 - Coomans, Danny A1 - An Van Nieuwenhuyse KW - Allergic rhinitis KW - ecology KW - Fungal spore KW - Medication KW - pollen KW - public health AB -

Belgium is among the European countries that are the most affected by allergic rhinitis. Pollen grains and fungal spores represent important triggers of symptoms. However, few studies have investigated their real link with disease morbidity over several years. Based on aeroallergen counts and health insurance datasets, the relationship between daily changes in pollen, fungal spore concentrations and daily changes in reimbursable systemic antihistamine sales has been investigated between 2005 and 2011 in the Brussels-Capital Region. A Generalized Linear Model was used and adjusted for air pollution, meteorological conditions, flu, seasonal component and day of the week. We observed an augmentation in drug sales despite no significant increase in allergen levels in the long term. The relative risk of buying allergy medications associated with an interquartile augmentation in pollen distributions increased significantly for Poaceae, Betula, Carpinus, Fraxinus and Quercus. Poaceae affected the widest age group and led to the highest increase of risk which reached 1.13 (95% CI [1.11-1.14]) among the 19- to 39-year-old men. Betula showed the second most consistent relationship across age groups. Clear identification of the provoking agents may improve disease management by customizing prevention programmes. This work also opens several research perspectives related to impact of climate modification or subpopulation sensitivity.

VL - 13 CP - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27174430?dopt=Abstract M3 - https://doi.org/10.1007/s10393-016-1124-x ER - TY - JOUR T1 - Short-term health effects in the general population following a major train accident with acrylonitrile in Belgium. JF - Environ Res Y1 - 2016 A1 - Simons, K A1 - De Smedt, T A1 - Stove, C A1 - De Paepe, P A1 - Bader, M A1 - Nemery, B A1 - Christiane Vleminckx A1 - Koen De Cremer A1 - Ilse Van Overmeire A1 - Sébastien Fierens A1 - Birgit Mertens A1 - Göen, T A1 - Schettgen, T A1 - Herman Van Oyen A1 - Joris Van Loco A1 - An Van Nieuwenhuyse KW - acrylonitrile KW - Adult KW - Belgium KW - Chemical Hazard Release KW - cotinine KW - Dose-Response Relationship, Drug KW - Environmental Monitoring KW - Female KW - Headache KW - Humans KW - Irritants KW - Male KW - middle aged KW - Nausea KW - Railroads KW - Self Report KW - SMOKING KW - Surveys and Questionnaires KW - Tremor KW - Valine AB -

BACKGROUND: Following a train derailment, several tons of acrylonitrile (ACN) exploded, inflamed and part of the ACN ended up in the sewage system of the village of Wetteren. More than 2000 residents living in the close vicinity of the accident and along the sewage system were evacuated. A human biomonitoring study of the adduct N-2-cyanoethylvaline (CEV) was carried out days 14-21 after the accident.

OBJECTIVES: (1) To describe the short-term health effects that were reported by the evacuated residents following the train accident, and (2) to explore the association between the CEV concentrations, extrapolated at the time of the accident, and the self-reported short-term health effects.

METHODS: Short-term health effects were reported in a questionnaire (n=191). An omnibus test of independence was used to investigate the association between the CEV concentrations and the symptoms. Dose-response relationships were quantified by Generalized Additive Models (GAMs).

RESULTS: The most frequently reported symptoms were local symptoms of irritation. In non-smokers, dose-dependency was observed between the CEV levels and the self-reporting of irritation (p=0.007) and nausea (p=0.007). Almost all non-smokers with CEV concentrations above 100pmol/g globin reported irritation symptoms. Both absence and presence of symptoms was reported by non-smokers with CEV concentrations below the reference value and up to 10 times the reference value. Residents who visited the emergency services reported more symptoms. This trend was seen for the whole range of CEV concentrations, and thus independently of the dose.

DISCUSSION AND CONCLUSION: The present study is one of the first to relate exposure levels to a chemical released during a chemical incident to short-term (self-reported) health effects. A dose-response relation was observed between the CEV concentrations and the reporting of short-term health effects in the non-smokers. Overall, the value of self-reported symptoms to assess exposure showed to be limited. The results of this study confirm that a critical view should be taken when considering self-reported health complaints and that ideally biomarkers are monitored to allow an objective assessment of exposure.

VL - 148 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27085497?dopt=Abstract M3 - 10.1016/j.envres.2016.03.031 ER - TY - JOUR T1 - Simulation enhanced distributed lag models for mortality displacement. JF - Springerplus Y1 - 2016 A1 - Simons, Koen A1 - Buyl, Ronald A1 - An Van Nieuwenhuyse A1 - Coomans, Danny AB -

Distributed lag models (DLM) are attractive methods for dealing with mortality displacement, however their estimates can have substantial bias when the data is generated by a multi-state model. In particular DLMs are not valid for mortality displacement. Alternative methods are scarce and lack feasibility and validation. We investigate the breakdown of DLM in three state models by means of simulation and propose simulation enhanced distributed lag models (SEDLM) to overcome the defects. The new method provides simultaneous estimates of the net effect (entry) and the displacement effect (exit). These have improved performance over the singular estimate from a regular DLM. SEDLM entry estimates have negligible bias and their variance is reduced. The exit estimates are unbiased and their variance is one order of magnitude lower with respect to the entry estimates. Applying SEDLM to the original Chicago data, the 95% highest posterior density intervals for both entry and exit contain 0, providing neither evidence for a 'displacement effect' nor for a 'net effect'.

VL - 5 CP - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27933234?dopt=Abstract M3 - 10.1186/s40064-016-3566-6 ER - TY - RPRT T1 - Wonen in de omgeving van nucleaire sites in Belgi‰: acute leukemie bij kinderen en schildklierkanker. Y1 - 2016 A1 - An Van Nieuwenhuyse A1 - Bollaerts,K. A1 - De Smedt,T. A1 - Sonck,M. A1 - Francart,J. A1 - Van Bladel,L. KW - Belgi‰ KW - de KW - nucleaire sites KW - schildklierkanker KW - x VL - X U1 - 2637 ER - TY - RPRT T1 - Zesde WHO-gecoördineerd onderzoek naar persistente organische polluenten (POP's) in moedermelk: Belgische resultaten 2014 Y1 - 2016 A1 - Ilse Van Overmeire A1 - Colles,A. A1 - Raf Aerts A1 - Janssens,B. A1 - Covaci,A. A1 - Mirjana Andjelkovic A1 - Laure Joly A1 - Poma,G. A1 - Malarvannan,G. A1 - De Smedt,T. A1 - Koppen,G. A1 - Joris Van Loco A1 - An Van Nieuwenhuyse KW - Belgische KW - moedermelk KW - POP KW - WHO AB -

In 2014 werd gestart met de vijfde WHO-gecoördineerde studie over de aanwezigheid van POPs in moedermelk begonnen. De verzamelde stalen werden in het huidig kader naar WIVISP overgebracht. Binnen gegeven tijdskader van zes maanden werden 206 melkstalen geanalyseerd. Deze werden na een initiële voorbereiding in het WIV-ISP (coördinator van de studie) en aanmaak van de mengstalen per provincie (en een geweest) verder geanalyseerd in het WIV-ISP, UA en EUROFINS. De mengstalen waren gemaakt door een bepaalde hoeveelheid van elk individuel staal in elk provincie samen te voegen.Sommige van de gevraagde en de gemeten POPs waren op verschillende niveaus teruggevonden. In algemeen werden er p,p-DDE (8-256ppb), HCB (2-17ppb) en BDE-153 (0-2ppb) in bijna elk individueel staal teruggevonden. Behalve alpha-HBCD (38-153ng/g) was geen andere gevraagde POP in melk mengstalen terug gevonden. Aan de andere kanten werden er chlordane-cis, chlordane-trans, nonachlore-trans, HCH-a, o,p-DDE, o,p-DDT en BDE 183 in geen enkele individuele melkstaal gedetecteerd. POPszoals hexachloorbutadieen, heptachloor, chloordecone, dieldrin, hexabromocyclododecanes (HBCDs) die enkel in de gemengde stalen waren geanalyseerd werden niet terug gevonden.

JF - WHO-gecoördineerd onderzoek naar persistente organische polluenten PB - WIV-ISP en VITO CY - Brussel/Mol VL - lot 1 UR - NA U1 - 2641 ER - TY - Generic T1 - Analysis of the short-term effect of pollen and spore exposure on allergy medication sales Y1 - 2015 A1 - Ariane Guilbert A1 - Koen Simons A1 - Ann Packeu A1 - Koen De Cremer A1 - Lucie Hoebeke A1 - Marijke Hendrickx A1 - An Van Nieuwenhuyse KW - allergy medication KW - exposure KW - pollen KW - sales KW - spores AB -

Allergic rhinitis takes a heavy toll in Belgium. Pollen is an important trigger but fungal spores might also influence the onset of symptoms. The purpose of this study was to assess the health impact of these aeroallergens based on their repercussion on allergy medication sales in the Brussels-Capital Region. Methods: The relationship between daily changes in pollen and spore concentrations and daily changes in reimbursable systemic antihistamine sales has been investigated with times series analysis. 8 pollen and 2 spore species were tested for different age and gender categories. A generalized linear model was used and adjusted for air pollutant concentrations, climate factors, flu, seasonal component and day of the week. Analysis focused on the 2005-2011 period. Results: For most age groups, the relative risk of buying allergy medications associated with an interquartile augmentation in pollen concentrations increased significantly for Betula, Carpinus and Gramineae. Associations existed but were less consistent across ages for Quercus, Fraxinus, and Taxus Cupressaceae. Considering a 10 days cumulative effect, the relative risk reached up to 1,11 (95%CI [1,09-1,12]) for Gramineae among the 19-39 years customers. Risk pattern varied according to gender. Discussion: Little research in this field has been carried out worldwide and extrapolation from previous studies is hazardous given the high influence of the local context. This multidisciplinary study is the first of this kind in Belgium and demonstrates the large health consequences of Gramineae and several common tree species for the Brussels area. It distinguishes itself by its duration, sensitivity and completeness of data (any sale of reimbursable drugs was captured, daily data of various cofactors were used). This work opens several research perspectives related to subpopulation sensitivity or impact of climate modification (changes in pollen concentration, occurrence of novel aeroallergens).

JF - 27th Conference of the International Society for Environmental Epidemiology PB - ISEE CY - São Paulo, Brazil ER - TY - RPRT T1 - Etat des lieux de l'allergie en Région de Bruxelles-Capitale. Recensement des bases de données relatives aux allergies respiratoires dans la région. Y1 - 2015 A1 - Ariane Guilbert A1 - Camille Chasseur A1 - Koen De Cremer A1 - An Van Nieuwenhuyse KW - allergique KW - asthme KW - bases de données KW - Bruxelles KW - hospitalisations KW - médicaments KW - mortalité KW - Observation KW - rhinite PB - WIV-ISP CY - Bruxelles, Belgique ER - TY - JOUR T1 - Thyroid cancer incidence around the Belgian nuclear sites: surrogate exposure modelling. JF - Cancer Epidemiol Y1 - 2015 A1 - Bollaerts, Kaatje A1 - Sonck, Michel A1 - Simons, Koen A1 - Sébastien Fierens A1 - Poffijn, André A1 - Van Bladel, Lodewijk A1 - Geraets, David A1 - Gosselin, Pol A1 - Herman Van Oyen A1 - Francart, Julie A1 - An Van Nieuwenhuyse KW - Belgium KW - environmental exposure KW - Female KW - Humans KW - incidence KW - Male KW - Models, Theoretical KW - Neoplasms, Radiation-Induced KW - Nuclear Power Plants KW - REGISTRIES KW - Thyroid Neoplasms AB -

BACKGROUND: In a recent ecological study among residents living around Belgian nuclear sites (the NUCABEL study), significant increased incidences of thyroid cancer were observed around the two nuclear facilities with industrial and research activities (Mol-Dessel and Fleurus), prompting further research.

METHODS: The data from the NUCABEL study were reanalysed to test the hypothesis of a gradient in cancer incidence with increasing levels of exposure from these sites using three measures of surrogate exposure, being (i) residential proximity, (ii) prevailing wind directions and (iii) simulated dispersion of radioactive discharges. Single-site focussed hypothesis tests were complemented with Generalized Additive Models to estimate the exposure-response relationships.

RESULTS: For Mol-Dessel, the results of the focussed hypothesis tests were far from significant. For Fleurus, the p-values were much closer to significance with p=0.05 for Bithell's Linear Risk Score using radioactive discharge estimates as surrogate.

CONCLUSIONS: The re-analyses refute an association with the nuclear facilities for the site of Mol-Dessel. For the site of Fleurus, one of Europe's major production sites of radio-iodines, the results were less conclusive and further research suggests itself.

VL - 39 CP - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25475063?dopt=Abstract M3 - 10.1016/j.canep.2014.10.011 ER - TY - JOUR T1 - Acrylonitrile exposure assessment in the emergency responders of a major train accident in Belgium: a human biomonitoring study. JF - Toxicol Lett Y1 - 2014 A1 - An Van Nieuwenhuyse A1 - Sébastien Fierens A1 - De Smedt, T A1 - Koen De Cremer A1 - Christiane Vleminckx A1 - Birgit Mertens A1 - Ilse Van Overmeire A1 - Bader, M A1 - De Paepe, P A1 - Göen, T A1 - Nemery, B A1 - Schettgen, T A1 - Stove, C A1 - Herman Van Oyen A1 - Joris Van Loco KW - acrylonitrile KW - Adult KW - Belgium KW - Chemical Hazard Release KW - Emergency Responders KW - Environmental Monitoring KW - Female KW - Humans KW - Male KW - middle aged KW - Occupational Exposure KW - Railroads KW - regression analysis KW - Surveys and Questionnaires KW - Valine AB -

BACKGROUND: On May 4, 2013, a train transporting chemicals derailed in Wetteren, Belgium. Several tanks loaded with acrylonitrile (ACN) exploded, resulting in a fire and a leakage of ACN.

OBJECTIVES: To determine exposure to ACN and to assess discriminating factors for ACN exposure in the emergency responders involved in the on-site management of the train accident.

METHODS: The study population consisted of 841 emergency responders. Between May 21 and June 28, they gave blood for the determination of N-2-cyanoethylvaline (CEV) hemoglobin adducts and urine for the measurement of cotinine. They also filled in a short questionnaire.

RESULTS: 163 (26%) non-smokers and 55 (27%) smokers showed CEV concentrations above the reference values of 10 and 200 pmol/g globin, respectively. The 95th percentile in the non-smokers was 73 pmol/g globin and the maximum was 452 pmol/g globin. ACN exposure among the non-smokers was predicted by (1) the distance to the accident, (2) the duration of exposure, and (3) the occupational function.

DISCUSSION AND CONCLUSION: Emergency responders involved in the on-site management of the train accident were clearly exposed to ACN from the accident. However, the extent of exposure remained relatively moderate with CEV concentrations staying within the ranges described in literature as background for a smoking population. Moreover, the exposure was less pronounced in the emergency responders as compared to that in the local population.

VL - 231 CP - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25128591?dopt=Abstract M3 - 10.1016/j.toxlet.2014.08.013 ER - TY - JOUR T1 - Acrylonitrile exposure in the general population following a major train accident in Belgium: a human biomonitoring study. JF - Toxicol Lett Y1 - 2014 A1 - De Smedt, T A1 - Koen De Cremer A1 - Christiane Vleminckx A1 - Sébastien Fierens A1 - Birgit Mertens A1 - Ilse Van Overmeire A1 - Bader, M A1 - De Paepe, P A1 - Göen, T A1 - Nemery, B A1 - Schettgen, T A1 - Stove, C A1 - Herman Van Oyen A1 - Joris Van Loco A1 - An Van Nieuwenhuyse KW - acrylonitrile KW - Adult KW - Belgium KW - Chemical Hazard Release KW - environmental exposure KW - Environmental Monitoring KW - Female KW - Humans KW - Male KW - middle aged KW - Railroads KW - Sewage KW - Surveys and Questionnaires KW - Valine AB -

BACKGROUND: On Saturday May 4, 2013, a train transporting chemicals derailed in the village of Wetteren (Belgium) and caused a leak of acrylonitrile (ACN).

OBJECTIVES: To assess the human exposure to acrylonitrile in the local population with the highest suspected exposure.

METHODS: Between May 18-25, 242 residents participated in the study. N-2-cyanoethylvaline (CEV), a biomarker that is highly specific for ACN exposure, was measured in the blood. To account for potential influence by smoking, cotinine was determined in the urine. Participants also filled in a short questionnaire.

RESULTS: In the evacuated zone, 37.3% of the non-smokers and 40.0% of the smokers had CEV concentrations above the reference values of 10 and 200 pmol/g globin, respectively, at the time of the train accident. Spatial mapping of the CEV concentrations depending on the residential address showed a distribution pattern following the sewage system.

DISCUSSION AND CONCLUSION: The train derailment resulted in a highly atypical sequence-of-events. In addition to exposure in the direct vicinity of the site of the train derailment, exposure also occurred via the sewage system, into which acrylonitrile had entered shortly after the accident.

VL - 231 CP - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25223249?dopt=Abstract M3 - 10.1016/j.toxlet.2014.09.009 ER - TY - Generic T1 - Biomonitoring survey of residents and emergency responders exposed to acrylonitrile after the train disaster in Wetteren (Belgium) Y1 - 2014 A1 - Joris Van Loco A1 - T. De Smedt A1 - Koen De Cremer A1 - Sébastien Fierens A1 - Christiane Vleminckx A1 - Ilse Van Overmeire A1 - Gijs,G. A1 - An Van Nieuwenhuyse A1 - Herman Van Oyen KW - acrylonitrile KW - Belgium KW - biomonitoring KW - chemistry KW - Emergencies KW - Emergency KW - environmental KW - International KW - ON KW - residents KW - survey KW - symposium KW - Wetteren JF - 38th International Symposium on Environmental Analytical Chemistry PB - NA CY - NA CP - IAEAC U1 - 2249 U2 - 17-20/06/2014 ER - TY - JOUR T1 - Thyroid cancer incidence in the vicinity of nuclear sites in Belgium 2000-2008 JF - Thyroid Y1 - 2014 A1 - Bollaerts,K. A1 - Sébastien Fierens A1 - Van Bladel,L. A1 - K Simons A1 - Sonk,M. A1 - Poffijn,A. A1 - Geraets,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Francart,J. A1 - An Van Nieuwenhuyse KW - Activity KW - ALL KW - an KW - Analyses KW - analysi KW - analysis KW - Area KW - AS KW - Belgian KW - Belgium KW - cancer KW - Cancer incidence KW - Combination KW - environment KW - evidence KW - exposure KW - Hand KW - health KW - Health outcome KW - incidence KW - Increase KW - Increases KW - Iodine KW - IS KW - Isotopes KW - Leukemia KW - living KW - nuclear site KW - observed KW - ON KW - outcome KW - plant KW - Plants KW - POISSON KW - Poisson regression KW - POPULATION KW - public KW - public health KW - Public-health KW - regression KW - Research KW - residents KW - result KW - results KW - SENSITIVITY KW - SENSITIVITY analysis KW - Size KW - study KW - THYROID AB -

Background:

VL - 24 CP - 5 U1 - 35251 M3 - 10.1089/thy.2013.0227 ER - TY - Generic T1 - Alleviating ecological bias in linking radon exposure to acute childhood leukaemia. Y1 - 2013 A1 - T. De Smedt A1 - K Simons A1 - Poffijn,A. A1 - Francart,J. A1 - An Van Nieuwenhuyse KW - aims KW - Area KW - Areas KW - AS KW - association KW - Associations KW - bias KW - childhood leukaemia KW - conference KW - Countries KW - Development KW - disease KW - distribution KW - ecological bias KW - ecological bias,ecological fallacy,ecological study design KW - environment KW - exposure KW - factors KW - Geographical KW - health KW - Indoor KW - IS KW - leukaemia KW - Linear Models KW - method KW - methodology KW - methods KW - MODEL KW - models KW - Multiple KW - public KW - public health KW - Public-health KW - Radiation KW - radon KW - RATES KW - regression KW - relative KW - Relative risk KW - result KW - results KW - risk KW - Risk Factors KW - study KW - threshold KW - use KW - VALIDATION KW - VARIABILITY AB -

Background

JF - Environment and Health - Bridging South, North, East and West, Conference of ISEE, ISES and ISIAQ T3 - Environ.Health Perspect. PB - NA CY - NA CP - ISEE,ISES and ISIAQ U1 - 35253 U2 - 19/08/2013 ER - TY - Generic T1 - Alleviating ecological bias in linking radon exposure to health outcomes. Y1 - 2013 A1 - T. De Smedt A1 - K Simons A1 - Poffijn,A. A1 - Francart,J. A1 - An Van Nieuwenhuyse KW - ALL KW - alternative KW - an KW - Area KW - Areas KW - AS KW - association KW - Associations KW - Belgium KW - bias KW - cancer KW - Cancer incidence KW - conference KW - Countries KW - Development KW - distribution KW - ecological bias KW - ecological fallacy,ecological study design KW - environment KW - exposure KW - function KW - health KW - Health outcome KW - Health outcomes KW - incidence KW - Indoor KW - IS KW - Linear Models KW - measurement KW - method KW - methodology KW - methods KW - MODEL KW - models KW - need KW - outcome KW - outcomes KW - radon KW - RANGE KW - RATES KW - regression KW - relative KW - Relative risk KW - risk KW - SKIN KW - study KW - use KW - VARIABILITY KW - Vector AB -

Background

JF - Environment and Health - Bridging South, North, East and West, Conference of ISEE, ISES and ISIAQ PB - NA CY - NA CP - ISEE,ISES and ISIAQ U1 - 35252 U2 - 19/08/2013 ER - TY - Generic T1 - Biomonitoring survey of residents and rescue workers for acrylonitrile after the train disaster in Wetteren (Belgium) Y1 - 2013 A1 - Joris Van Loco A1 - T. De Smedt A1 - Koen De Cremer A1 - Sébastien Fierens A1 - Christiane Vleminckx A1 - Ilse Van Overmeire A1 - Gijs,G. A1 - An Van Nieuwenhuyse A1 - Herman Van Oyen KW - Belgium KW - residents KW - survey KW - worker KW - Workers JF - BEMS meeting PB - NA CY - NA CP - Belgian environmental mutagen society U1 - 2204 U2 - 22/11/2013 ER - TY - Generic T1 - Biomonitoring survey of residents and rescue workers for acrylonitrile after the train disaster in Wetteren (Belgium) Y1 - 2013 A1 - Joris Van Loco A1 - Koen De Cremer A1 - T. De Smedt A1 - Sébastien Fierens A1 - Ilse Van Overmeire A1 - Gijs,G. A1 - An Van Nieuwenhuyse A1 - Herman Van Oyen KW - / KW - acrylonitrile KW - Belgium KW - biomonitoring KW - residents KW - survey KW - Wetteren KW - worker KW - Workers JF - / PB - NA CY - NA CP - Vlaamse Wetenschappelijke Vereniging voor Arbeidsgeneeskunde (VWVA) U1 - 35260 U2 - 04/12/2013 ER - TY - Generic T1 - A biomonitoring survey of the residents and the rescue workers for acrylonitrile after the train disaster in Wetteren (Belgium) Y1 - 2013 A1 - Joris Van Loco A1 - T. De Smedt A1 - Koen De Cremer A1 - Sébastien Fierens A1 - Ilse Van Overmeire A1 - An Van Nieuwenhuyse A1 - Herman Van Oyen KW - accident KW - acrylonitrile KW - ALL KW - Analyses KW - at KW - Belgian KW - Belgium KW - biomonitoring KW - blood KW - chemicals KW - conference KW - data KW - Data collection KW - demand KW - distribution KW - ET KW - Europe KW - European KW - exposure KW - function KW - Half-Life KW - health KW - Human KW - human exposure KW - INFORMATION KW - IS KW - living KW - measure KW - method KW - methods KW - nonsmokers KW - objectives KW - observed KW - ON KW - Participation KW - past KW - pattern KW - People KW - person KW - POPULATION KW - Populations KW - PRODUCTS KW - public KW - public health KW - Public-health KW - Questionnaire KW - RANGE KW - Reference Values KW - residence KW - residents KW - result KW - results KW - Sample KW - Samples KW - Service KW - Services KW - Smoke KW - smokers KW - SMOKING KW - SOCIAL KW - specific KW - Statistical KW - status KW - study KW - survey KW - System KW - time KW - tobacco KW - urine KW - values KW - Wetteren KW - WHO KW - worker KW - Workers AB - presentation at the 6th EUROPEAN PUBLIC HEALTH CONFERENCE - Health in Europe: are we there yet? Learning from the past, building the future JF - 6th EUROPEAN PUBLIC HEALTH CONFERENCE Health in Europe: are we there yet? Learning from the past, building the future PB - NA CY - NA CP - European Public Health Association (EUPHA) U1 - 235 U2 - 13-16/11/2013 ER - TY - Generic T1 - Childhood Leukaemia incidence around the Belgian nuclear sites: Surrogate exposure modelling. Y1 - 2013 A1 - K Simons A1 - Bollaerts,K. A1 - Sonk,M. A1 - Sébastien Fierens A1 - Poffijn,A. A1 - Van Bladel,L. A1 - Geraets,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Francart,J. A1 - An Van Nieuwenhuyse KW - age KW - an KW - approach KW - approaches KW - Area KW - AS KW - association KW - Belgian KW - Belgium KW - cancer KW - Cancer incidence KW - cancer registry KW - childhood leukaemia KW - CHILDREN KW - comparing KW - Control KW - data KW - evidence KW - exposure KW - Flemish KW - generalized additive models KW - health KW - Hypothesis KW - incidence KW - Industries KW - Industry KW - International KW - IS KW - Less KW - leukaemia KW - limitation KW - Limitations KW - living KW - measure KW - measures KW - method KW - methods KW - MODEL KW - models KW - Multiple KW - nuclear site KW - Nuclear sites KW - ON KW - Paper KW - period KW - plant KW - Plants KW - POPULATION KW - Populations KW - region KW - REGISTRIES KW - Registry KW - Research KW - result KW - results KW - sex KW - Statistical KW - Still KW - study KW - surrogate KW - Surrogate-exposure Modelling KW - survey KW - Test KW - tests KW - use KW - Wind AB - Background: Health eects among populations living in the vicinity of nuclear installations have been a major area of concern for several decadesalready. The main focus is on childhood leukaemia. The dominant approach is an ecological study using residential proximity to the nuclear site, however complexradio-active discharge models have also been used. Data: The Belgian Cancer Registry provided data on Childhood leukaemia incidence by commune, age and sex. For the Flemish region this data spans theincidence years 2000-08; for the Walloon and Brussels-Capital Region the data span 2004-08. The study considers four nuclear sites. For each site, the FederalAgency for Nuclear Control used survey stations to measure wind direction and velocity for the period 2003-08.Methods: This paper describes an ecological study on leukaemia incidence in children living in the vicinity of nuclear installations in Belgium. Each nuclear sitewas treated as a point-source and single-site focussed hypothesis tests were used to test for a gradient in childhood leukaemia incidence with residential proximityto the site. In addition, two other surrogate exposures were used: prevailing wind direction and simulated radioactive discharges. The hypothesis tests were com-plemented by estimating the shape of the exposure-response relationship using Generalized Additive Models.Results: For the nuclear power plants of Doel and Tihange, no evidence of a gradient in childhood leukaemia cancer incidence related to any surrogate exposurewas found. For the nuclear research- and industry sites of Mol-Dessel and Fleurus, individual tests were less uniform. Only for Mol-Dessel it can be concludedthat the evidence may be suggestive of a potential association with the site.Conclusions: The use of multiple measures of surrogate exposures and multiple statistical methods has added value when investigating a priori dened point-sources. Each surrogate has implicit assumptions and precision and each statistical method relies on its own assumptions. By combining and comparing theresults of multiple approaches, new insights can be gained. However, it should be noted that the results are still subject to the limitations of the ecological design. JF - 28th international workshop on statistical modelling VL - 2 CP - / U1 - 35258 U2 - July 8-12 2013 ER - TY - Generic T1 - Health impact assessment of PM10 and PM2.5 exposure in Wallonia Y1 - 2013 A1 - Voisin,C. A1 - Fierens,F. A1 - Charlier,V. A1 - An Van Nieuwenhuyse ED - The International Federation of Environmental Health KW - assessment KW - Congresses KW - environmental KW - exposure KW - health KW - health impact KW - health impact assessment KW - Impact KW - ON KW - PM10 KW - PM2.5 KW - world JF - 12 th World Congress on Environmental Health CP - THE INTERNATIONAL FEDERATION OF ENVIRONMENTAL HEALTH U1 - 35265 U2 - May 22-27 2012 ER - TY - RPRT T1 - Pollution de l'air intérieur : 1) revue de la littérature 2) plans d'action et de communication dans les écoles Y1 - 2013 A1 - Voisin,C. A1 - Camille Chasseur A1 - P Gosselin A1 - Sébastien Fierens A1 - An Van Nieuwenhuyse KW - Communication KW - de KW - ET KW - LE KW - pollution de l'air PB - WIV-ISP CY - Bruxelles SN - D/2012/2505/11 U1 - 35266 ER - TY - JOUR T1 - Samenvatting resultaten studie "wonen in de omgeving van nucleaire sites in België: monitoring van potentiële gezondheidseffecten" JF - Annalen van de Belgische Vereniging voor Stralingsbescherming (BVSABR) Y1 - 2013 A1 - K Simons A1 - Bollaerts,K. A1 - Sébastien Fierens A1 - Van Bladel,L. A1 - Sonk,M. A1 - Poffijn,A. A1 - Geraets,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Francart,J. A1 - An Van Nieuwenhuyse KW - België KW - de KW - gezondheidseffecten KW - Monitoring KW - nucleaire sites AB - / VL - 38 CP - 1 U1 - 35256 ER - TY - Generic T1 - The setup of a biomonitoring survey of the residents and the rescue workers for acrylonitrile after the train disaster in Wetteren (Belgium) Y1 - 2013 A1 - Joris Van Loco A1 - T. De Smedt A1 - Koen De Cremer A1 - Sébastien Fierens A1 - Christiane Vleminckx A1 - Ilse Van Overmeire A1 - An Van Nieuwenhuyse A1 - Herman Van Oyen KW - Belgium KW - conference KW - European KW - health KW - public KW - public health KW - Public-health KW - residents KW - survey KW - worker KW - Workers JF - European Public Health Conference CP - EUPHA U1 - 2205 U2 - 14-16/11/2013 ER - TY - JOUR T1 - Sick leave due to back pain in a cohort of young workers. JF - Int Arch Occup Environ Health Y1 - 2013 A1 - An Van Nieuwenhuyse A1 - Burdorf, A A1 - Crombez, G A1 - Verbeke, G A1 - Masschelein, R A1 - Mairiaux, Ph A1 - Moens, G F KW - Adult KW - Automobile Driving KW - Boredom KW - Career Mobility KW - Female KW - Health Care Sector KW - Humans KW - Low Back Pain KW - Male KW - Occupational Diseases KW - Posture KW - Risk Factors KW - sick leave KW - Surveys and Questionnaires KW - Transportation KW - Workload KW - Workplace KW - Young adult AB -

PURPOSE: Evidence on risk factors for sick leave from prospective studies in work settings is limited. Furthermore, most available studies focused on workers with substantial low back disorders. These studies consistently report that physical work factors constitute a hindrance to work. However, it remains unclear whether the same risk factors are relevant in workers with less severe conditions or in early phases of the development of back pain. Therefore, this article aims to study risk factors for the occurrence of sick leave due to low back pain (LBP) among young workers with no or a modest history of back pain.

METHODS: Participants were 716 young healthcare or distribution workers with no or minimal antecedents of LBP in the year before inclusion. We investigated the role of potential physical, psychosocial and individual risk factors at baseline on the occurrence of sick leave due to LBP 1 year later. To this purpose, we used Cox regression with a constant risk period.

RESULTS: Six per cent (95 % CI 4.1-7.6) of the workers reported sick leave 1 year later; they accounted for 12 % of the sick-leave days independent of cause. A non-stimulating psychosocial work environment turned out to be the strongest risk factor for sick leave due to LBP (RR 6.08; 95 % CI 1.42-26.07). Physical factors were not predictive.

CONCLUSIONS: In the early phases of back pain and in less severe conditions, the main benefit of interventions lies in targeting the organisation and design of jobs to create a challenging professional environment.

VL - 86 CP - 8 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23111535?dopt=Abstract M3 - 10.1007/s00420-012-0824-y ER - TY - Generic T1 - Absentéisme pour douleurs lombaires au sein d'une cohorte de jeunes travailleurs en Belgique. Y1 - 2012 A1 - An Van Nieuwenhuyse A1 - Burdorf,A. A1 - Crombez,G. A1 - Verbeke,G. A1 - Mairiaux,P. A1 - G.F. Moens KW - cohorte KW - de KW - douleurs lombaires KW - EN KW - International JF - Ve Congrès International de l'Epidémiologie ADELF EPITER T3 - Revue d'Epidémiologie et de Santé Publique VL - 60 CP - / U1 - 35261 U2 - September 12-14 2012 ER - TY - Generic T1 - Evaluation de l'incidence de leucémie chez les enfants habitants à proximité de sites nucléaires en Belgique Y1 - 2012 A1 - Sébastien Fierens A1 - Bollaerts,K. A1 - K Simons A1 - Francart,J. A1 - Poffijn,A. A1 - Sonk,M. A1 - Van Bladel,L. A1 - Geraets,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Van Eycken,L. A1 - An Van Nieuwenhuyse ED - Société Française de Santé environnementale KW - de KW - EN KW - ET KW - EVALUATION KW - LE KW - leucémies KW - national KW - santé KW - sites nucléaires JF - 3e congrès national de santé et environnement PB - NA CY - NA CP - Société Française de Santé environnementale U1 - 35254 U2 - September 5-6 2012 ER - TY - RPRT T1 - Les rayonnements radiofréquences: revue de la littérature de l'impact sanitaire. Support scientifique en vue de la création d'un outil de communication vers la population de la Fédération Wallonie-Bruxelles Y1 - 2012 A1 - Voisin,C. A1 - Pirard,W. A1 - Lowie,M. A1 - Sébastien Fierens A1 - An Van Nieuwenhuyse KW - Communication KW - de KW - EN KW - LE KW - POPULATION KW - rayonnements radiofrequences PB - WIV-ISP CY - Brussels SN - D/2012/2505/52 U1 - 35263 ER - TY - Generic T1 - Monitoring of possible health effects in the vicinity of nuclear sites in Belgium: is there an increases incidence of childhood leukemia? Y1 - 2012 A1 - Bollaerts,K. A1 - Sébastien Fierens A1 - Simmons,K. A1 - Francart,J. A1 - Poffijn,A. A1 - Sonck,M. A1 - Van Bladel,L. A1 - Geraerts,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Van Eycken,L. A1 - An Van Nieuwenhuyse KW - an KW - association KW - Belgium KW - CHILDHOOD KW - Childhood leukemia KW - Congresses KW - effect KW - effects KW - health KW - health effects KW - incidence KW - Increase KW - Increases KW - International KW - IS KW - Leukemia KW - Monitoring KW - Nuclear KW - nuclear site KW - Nuclear sites KW - protection KW - Radiation KW - Radiation Protection KW - Sites KW - Vicinity JF - 13th International Congress of the International Radiation Protection Association CY - Glasgow, Scotland CP - ? U1 - 36371 U2 - ? ER - TY - RPRT T1 - Monitoring of possible health effects of living in the vicinity of nuclear sites in Belgium Y1 - 2012 A1 - Bollaerts,K. A1 - Sébastien Fierens A1 - K Simons A1 - Francart,J. A1 - Poffijn,A. A1 - Sonk,M. A1 - Van Bladel,L. A1 - Geraets,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Van Eycken,L. A1 - An Van Nieuwenhuyse KW - Belgium KW - effect KW - effects KW - health KW - health effects KW - living KW - Monitoring PB - WIV-ISP CY - Brussels SN - D/2012/2505/01 U1 - 209 ER - TY - Generic T1 - Monitoring of thyroid cancer incidence in the vicinity of nuclear sites in Belgium Y1 - 2012 A1 - Bollaerts,K. A1 - Sébastien Fierens A1 - K Simons A1 - Francart,J. A1 - Poffijn,A. A1 - Sonk,M. A1 - Van Bladel,L. A1 - Geraets,D. A1 - P Gosselin A1 - Herman Van Oyen A1 - Van Eycken,L. A1 - An Van Nieuwenhuyse KW - cancer KW - Cancer incidence KW - European KW - incidence KW - International KW - Monitoring KW - THYROID JF - 1 4 th International Workshop Multidisciplinary European Low Dose Initiative (MELODI) PB - NA CY - NA CP - MELODI U1 - 35249 U2 - September 12-14 2012 ER - TY - Generic T1 - On smoothing time series with low average counts Y1 - 2012 A1 - K Simons A1 - An Van Nieuwenhuyse A1 - Coomans,D. KW - 2012 KW - Analyses KW - AS KW - Belgian KW - city KW - conference KW - data KW - effect KW - effects KW - generalized additive models KW - health KW - Health outcome KW - Health outcomes KW - Impact KW - International KW - IS KW - method KW - methods KW - MODEL KW - models KW - Monitoring KW - morbidity KW - mortality KW - ON KW - outcome KW - outcomes KW - scale KW - Selection KW - series KW - study KW - summary KW - time KW - Time series KW - Time-series AB - Generalized Additive Models have been widely adopted for studies of acute effects of particulate matter on mortality and morbidity. Monitoringof pollutants and health outcomes increased worldwide and investigators thus increasingly relied on automatic selection methods that exist ofsummary statistics such as AIC and PACF. Methodological studies have used simulations to compare selection methods and their impact on largescale multi-city analyses and concluded that aggressive smoothing is to be preferred. For smaller groups, these effects can be visualised with simpleresidual plots. Data from Belgian cities is used to illustrate the effect of over-smoothing on time series with low average counts. JF - 20th international conference on computational statistics (Compstat 2012) CP - / U1 - 35255 U2 - August 27-31 2012 ER - TY - JOUR T1 - Cytological screening for cervical cancer in the province of Limburg, Belgium. JF - Eur J Cancer Prev Y1 - 2011 A1 - M. Arbyn A1 - An Van Nieuwenhuyse A1 - Bogers, Johannes A1 - De Jonge, Eric A1 - De Beeck, Lode Op A1 - Matheï, Catharina A1 - Buntinx, Frank KW - Adult KW - Belgium KW - Female KW - Humans KW - Mass Screening KW - middle aged KW - Neoplasms, Squamous Cell KW - Papanicolaou Test KW - REGISTRIES KW - Uterine Cervical Neoplasms KW - Vaginal Smears AB -

Cervical cancer screening in Belgium is mainly opportunistic with periodic attempts to organize it according to the European guidelines. In the province of Limburg (north-east Belgium), a cervical cytology registry was set up in collaboration with local cytopathological laboratories, provincial health authorities and the Limburg Cancer Registry. Laboratories regularly communicated coded results of Pap smears from women residents in Limburg to the provincial cytological registry. All individual records contained a virtually unique identifying code allowing the study of longitudinal histories and linkage with the cancer registry. The screening coverage (percentage of women with a Pap smear in a defined period), the prevalence and incidence of squamous intraepithelial lesions and changes over time and geographical area were evaluated using a database of more than 600 000 Pap smear interpretations between 1996 and 2005. In 2000, 47% of women aged between 25 and 64 years had at least one Pap smear recorded in the last 3 years, and the average number of smears screened for each woman was 1.5. On account of incomplete registration, the coverage was 8% lower than estimated from health insurance data. The modal screening interval was in the range of 12-14 months; the first quartile, median and third quartile were 355, 440 and 676 days, respectively. Over the 10 years, 82% of the target population had their Pap smear recorded. The prevalence of cytological abnormalities was 3.7% (atypical squamous cells of undetermined significance: 2.2%, atypical glandular cells of undetermined significance: 0.1%, low-grade squamous intraepithelial lesion: 1.1%, high-grade squamous intraepithelial lesion or more serious lesions: 0.4%), but varied substantially among laboratories. The prevalence of atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion increased significantly over time. Pathologists from Limburg have pioneered cytology registration in the context of opportunistic screening in Belgium. The estimated screening coverage was slightly underestimated. Obligatory registration, use of a uniform terminology and linkage with population and follow-up data are needed to give a cytology registry its full role in an organized screening programme.

VL - 20 CP - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/20805755?dopt=Abstract M3 - 10.1097/CEJ.0b013e32833ecbc6 ER - TY - RPRT T1 - Feasibility study for establishing a registration system for studying the relationship between childhood cancer & environment Y1 - 2011 A1 - P Gosselin A1 - K Simons A1 - Luc Verschaeve A1 - An Van Nieuwenhuyse KW - childhood cancer KW - environment KW - feasibility study PB - NEHAP CY - Brussels, Belgium ER - TY - JOUR T1 - Human biomonitoring on heavy metals in Ath: methodological aspects. JF - Arch Public Health Y1 - 2011 A1 - Javiera Rebolledo A1 - Sébastien Fierens A1 - Versporten, Ann A1 - Brits, Ethel A1 - De Plaen, Pierre A1 - An Van Nieuwenhuyse AB -

The municipality of Ath is characterised by the presence, in its center, of two non-ferrous metal industries whose emissions make local residents concerned for their health. Therefore, authorities of the Walloon Region and the municipality of Ath undertook biomonitoring to assess the impact of those industrial emissions on heavy metal body burden in humans.This paper describes the study design and methodology used to carry out this human biomonitoring.A random sampling was done in the general population, in two areas of Ath: an area centered around the industries and a peripheral area. The target population was children (2.5-11 years) and adults (40-60 years) without occupational exposure. The three-stage sampling procedure consisted of a mixture of both mail and telephone recruitment. Firstly, 3259 eligible people, identified from a population register, were mailed an introductory letter. In a second stage, eligible individuals were contacted by phone to propose them to participate in the study. They were randomly contacted until the required sample size was obtained. In the third stage, a second mail was sent to those who agreed to participate with a questionnaire to be filled out. Finally, biological samples (blood and urine) from 278 persons were collected. The final participation rate of this study was 24%.This sampling procedure, especially designed for the purpose of this biomonitoring study in Ath, allowed us to recruit a sample representative of the population of children and adults of Ath, reaching the expected sample size in a short period of time.

VL - 69 CP - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22958427?dopt=Abstract M3 - 10.1186/0778-7367-69-10 ER - TY - JOUR T1 - Physical characteristics of the back are not predictive of low back pain in healthy workers: a prospective study. JF - BMC Musculoskelet Disord Y1 - 2009 A1 - An Van Nieuwenhuyse A1 - Crombez, Geert A1 - Burdorf, Alex A1 - Verbeke, Geert A1 - Masschelein, Raphael A1 - Moens, Guido A1 - Mairiaux, Philippe KW - Adult KW - Back KW - Cohort Studies KW - comorbidity KW - Female KW - Humans KW - Low Back Pain KW - Male KW - Mass Screening KW - Obesity KW - Pain Measurement KW - Physical Examination KW - Predictive Value of Tests KW - prevalence KW - Prospective Studies KW - Range of Motion, Articular KW - Risk Factors KW - Sciatica KW - Self-Assessment KW - Surveys and Questionnaires KW - Young adult AB -

BACKGROUND: In the working population, back disorders are an important reason for sick leave and permanent work inability. In the context of fitting the job to the worker, one of the primary tasks of the occupational health physician is to evaluate the balance between work-related and individual variables. Since this evaluation of work capacity often consists of a physical examination of the back, the objective of this study was to investigate whether a physical examination of the low back, which is routinely performed in occupational medicine, predicts the development of low back pain (LBP).

METHODS: This study is part of the Belgian Low Back Cohort (BelCoBack) Study, a prospective study to identify risk factors for the development of low back disorders in occupational settings. The study population for this paper were 692 young healthcare or distribution workers (mean age of 26 years) with no or limited back antecedents in the year before inclusion. At baseline, these workers underwent a standardised physical examination of the low back. One year later, they completed a questionnaire on the occurrence of LBP and some of its characteristics. To study the respective role of predictors at baseline on the occurrence of LBP, we opted for Cox regression with a constant risk period. Analyses were performed separately for workers without any back antecedents in the year before inclusion ('asymptomatic' workers) and for workers with limited back antecedents in the year before inclusion ('mildly symptomatic' workers).

RESULTS: In the group of 'asymptomatic' workers, obese workers showed a more than twofold-increased risk on the development of LBP as compared to non-obese colleagues (RR 2.57, 95%CI: 1.09 - 6.09). In the group of 'mildly symptomatic' workers, the self-reports of pain before the examination turned out to be most predictive (RR 3.89, 95%CI: 1.20 - 12.64).

CONCLUSION: This study showed that, in a population of young workers wh no or limited antecedents of LBP at baseline, physical examinations, as routinely assessed in occupational medicine, are not useful to predict workers at risk for the development of back disorders one year later.

VL - 10 U1 - http://www.ncbi.nlm.nih.gov/pubmed/19123931?dopt=Abstract M3 - 10.1186/1471-2474-10-2 ER - TY - JOUR T1 - Simultaneous determination of parabens, bisphenols and alkylphenols in human placenta by ultra-high performance liquid chromatography - tandem mass spectrometry Y1 - 0 A1 - Ilse Van Overmeire A1 - K. Vrijens A1 - Nawrot, T. A1 - An Van Nieuwenhuyse A1 - Joris Van Loco A1 - Tim Reyns KW - Alkylphenol KW - Bisphenol KW - endocrine disruptor KW - Paraben KW - Placenta KW - UHPLC-MS/MS AB - This study presents de development and validation of an ultra- high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous determination of four parabens (methyl-, ethyl-, propyl-, and butyl-paraben (MeP, EtP, PrP, BuP), four bisphenols (BP) (BPA, BPB, BPF, and BPS) and two alkylphenols (nonyl phenol (NP) and tert-octylphenol (OP) in human placenta samples. After a short sample preparation time the extracts are analysed by UHPLC-MS/MS using negative electrospray ionization. Labeled internal standards and matrix-matched calibration are used for quantification of the compounds. The method was validated according FDA guideline for bio analytical methods using spiked samples at three concentration levels (0.5–5 and 25 ng g−1). The parameters accuracy and precision fulfill the criteria. Calibration curves are linear between 0.5 and 50 ng −1. The limits of detection and quantification are in the range of 0.1–0.3 ng g−1 and 0.2–0.7 ng g−1, respectively. The applicability of the method was demonstrated on 71 human placenta samples from a Belgian cohort. The detection frequency was highest for OP (95%), EtP (86%), BPA (49%) and BPS (44%). Among the quantified compounds the highest quantification frequency was observed for OP (85%), EtP (65%) and BPA (25%). The concentrations of parabens ranged from 0.5 to 7.1 ng g−1 for MeP, from 0.5 to 4.5 ng g−1 for EtP and from 0.5 to 9.1 ng g−1 for PrP. The levels of bisphenols ranged from 0.5 to 3.9 ng g−1 for BPA, from 0.6 to 2.1 ng g−1 for BPF and from 0.8 to 1.3 ng g−1 for BPS. BPB and NP were not detected and OP levels ranged from 0.5 to 3.7 ng g g−1. The results demonstrate that the developed analytical method is very sensitive and that levels of several compounds with known /suspected endocrine disrupting properties could be detected or quantified in human placenta samples. The results therefore suggest that fetal exposure to these compounds occurs. The method will be useful for studies to evaluate the health effects associated with this prenatal exposure. ER -