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Ladbury G.,RIVM Dutch National Institute for Public Health and the Environment | Ladbury G.,U.S. Center for Disease Control and Prevention | Morroy G.,Robert Bosch GmbH | van Hoeven-Dekkers S.,Robert Bosch GmbH | And 5 more authors.
Infection Control and Hospital Epidemiology | Year: 2012

We report a large scabies outbreak occurring in Tilburg, Netherlands, which affected several different healthcare settings that provide care to the elderly and the mentally disabled. The outbreak demonstrated how the complex system of care provision to vulnerable groups facilitated extensive scabies transmission among multiple linked healthcare settings and the community. © 2012 by The Society for Healthcare Epidemiology of America.

Posthuma L.,RIVM Dutch National Institute for Public Health and the Environment | Wahlstrom E.,Joint UNEP OCHA Environment Unit | Wahlstrom E.,Radboud University Nijmegen | Nijenhuis R.,Joint UNEP OCHA Environment Unit | And 14 more authors.
Environment International | Year: 2014

The United Nations response mechanism to environmental emergencies requested a tool to support disaster assessment and coordination actions by United Nations Disaster Assessment and Coordination (UNDAC) teams. The tool should support on-site decision making when substantial chemical emissions affect human health directly or via the environment and should be suitable for prioritizing impact reduction management options under challenging conditions worldwide. To answer this need, the Flash Environmental Assessment Tool (FEAT) was developed and the scientific and practical underpinning and application of this tool are described in this paper. FEAT consists of a printed decision framework and lookup tables, generated by combining the scientific data on chemicals, exposure pathways and vulnerabilities with the pragmatic needs of emergency field teams. Application of the tool yields information that can help prioritize impact reduction measures. The first years of use illustrated the usefulness of the tool as well as suggesting additional uses and improvements. An additional use is application of the back-office tool (Hazard Identification Tool, HIT), the results of which aid decision-making by the authorities of affected countries and the preparation of field teams for on-site deployment. Another extra use is in disaster pro action and prevention. In this case, the application of the tool supports safe land-use planning and improved technical design of chemical facilities. UNDAC teams are trained to use the tool after large-scale sudden onset natural disasters. © 2014 Elsevier Ltd.

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