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Knezevic Z.,Zavrtnica 3 | Serdar M.,Hrvatski zavod za javno zdravstvo
Arhiv za Higijenu Rada i Toksikologiju | Year: 2011

This review presents methods for the assessment of acute and chronic risk from pesticide residues in food. Multiple pesticide residues can often be found in food. Currently, there is no internationally accepted procedure for the assessment of cumulative exposure to multiple pesticide residues in food. Therefore, risk assessment is based on toxicological evaluation of single compounds in a food matrix. The international estimation of short-term intake model (IESTI) has been used to calculate acute intake. IESTI is based on "the worst-case scenario" and addresses the possibility that consumers sometimes eat large amounts of a food item, and such a large amount might contain residues at highest levels. However, it should take into account uneven distribution of pesticide residues in food. Chronic exposure is based on a deterministic approach, analogous to the calculation of the theoretical maximum daily intake.

Rodin U.,Hrvatski zavod za javno zdravstvo | Filipovic-Grcic B.,Klinika Za Pedijatriju | Drazancic A.,Klinika za Zenske Bolesti i Porode
Gynaecologia et Perinatologia | Year: 2010

Among the most important indicators to appreciate the achievement of Millennium Development Goals No. 4 and 5 are perinatal and infant mortality. As early neonatal mortality is an integral part of the overall perinatal and infant mortality, and since perinatal conditions significantly affect the growth and development of infants and young children, a study was made of the Croatian trends of perinatal and infant mortality over the last 10 years and causes of death in 2009 as well. Between 2000 and 2009, 3755 perinatal deaths occurred. The average perinatal mortality rate was 8.9/1,000 in all births with birth-weight ≥ 500 grams, while, according to the criteria for international comparison, the equivalent rate in all births with BW ≥1000 grams was 6.1‰. According to the total number and structure of perinatal deaths in the 10-year period, among all births the highest mortality rate was with BW of 500-999 grams - 31.9% of perinatal deaths. Among early neonatal deaths, the equivalent mortality rate was also highest in the 500-999 g BW group, with a share of 39.3% in overall early neonatal deaths. In fetal mortality, the highest rate (30.4%) was at BW ≥2500 grams. In the same period, 2538 infants died, while the average infant mortality rate was 6.1/1,000 live-births. Early neonatal deaths had the highest share - 59.1%, and were followed by late neonatal (15.6%) and postneonatal deaths (25.3%). In 2009, 53% of total early neonatal deaths belonged to the gestational age of 22-27 weeks; the causes of death were most commonly related to complications of multiple pregnancies and consequent immaturity with respiratory distress and/or intracranial hemorrhage. Deaths caused by perinatal conditions after completed 27 weeks of pregnancy accounted for 17% in overall early neonatal deaths. At the gestational age of 32-36 weeks and in term pregnancies, the most common cause of early neonatal deaths were congenital malformations with respective shares of 10% and 15%. Stillbirths were caused by conditions from the perinatal period in 92.2% of all cases, and by congenital malformations in 7.8%. Perinatal conditions as causes of stillbirth were more or less equally represented in a share of over 20% of mortality at the gestational ages of 22-27, 28-31, 32-36 and ≥ 37 weeks. Congenital malformations, however, occurred in 3.1% of the cases at the gestational ages of 22-27 and 32-36 weeks, 0.5% at the gestational age of 28-31 weeks and 1.1% in term pregnancies. The predominant causes of infant mortality were pregnancy-related complications and consequent immaturity in 52% of the cases, and congenital malformations in 36.6% of all infant deaths. A reduction in perinatal and infant mortality in Croatia can be achieved by introducing the measures of improving the organization and conditions of neonatal intensive care after birth, and antenatal diagnostic and intervention prior to delivery. Croatia has lower perinatal mortality in total births with BW ≥1000 grams than is the average of the EU and WHO Eur-A countries with good health indicators, but has considerably higher rates of early neonatal and overall infant mortality. Most of European countries with low perinatal, infant and early neonatal mortality have, unlike Croatia, implemented regionalization of perinatal health care, which has led to a significant decrease in perinatal and infant mortality.

Aleraj B.,Hrvatski zavod za javno zdravstvo
Infektoloski Glasnik | Year: 2013

Based on regular communicable disease reporting, outbreak reports and vaccination coverage reports collected routinely and monitored by the Epidemiology Service of the Croatian National Institute of Public Health, an overview of the epidemiological situation in Croatia in 2012 is described. Diseases of low hygienic standard of living (typhoid fever, bacillary dysentery, hepatitis A) were rare, as well as diseases covered by the national systematic immunization program (measles, rubella, mumps, tetanus, etc.) some even eradicated (polio, diphtheria). Classical sexually transmitted diseases (gonorrhoea, syphilis) were also rare. The incidence and prevalence of HIV/AIDS was in 2012 still comparatively low. Tuberculosis incidence was in favourable decline although the rates were still significant. Salmonellosis cases were still frequently recorded, although showing a decrease in the recent years. Vaccination coverage is constantly very high, which ensures a good control over vaccine preventable diseases in the future. There were no outbreaks of waterborne diseases related to public water supply, nor foodborne disease outbreaks. Since the limited autochthonous transmission episode of the dengue fever in Croatia in 2010, there were no such cases recorded in 2012. However, for the first time in Croatia, a few clinical (central nervous system) cases of the West Nile fever were diagnosed in 2012. Overall, it can be concluded that the epidemiological situation in 2012 was generally favourable. However, since there is still a number of potential risk factors present in our country, neighbouring countries and the rest of the World, such as inadequate sanitation in some areas of the country, increased risk for vector-borne diseases due to significant population of vectors present, especially mosquitos, and increased number of human cases of vector-borne diseases in European countries, more intense globalized travel of people, animals and goods, as well as climate change, the situation can still be described as potentially unstable. Therefore, further implementation of all established preventive and control measures according to good medical standards and respective national and EU legislation is required. © 2013, University Hospital of Infectious Diseases. All rights reserved.

Aleraj B.,Hrvatski zavod za javno zdravstvo
Infektoloski Glasnik | Year: 2011

The Epidemiology Service of the Croatian National Institute of Public Health brings an overview of the epidemiological situation in Croatia in 2010 based on national communicable diseases notification network, outbreak reporting network and vaccination coverage surveillance network data. The epidemiology situation in 2010 was assessed as rather favorable having in mind the following: diseases of poverty, pore sanitation and low education (typhoid fever, shigellosis, and hepatitis A) were rare and sporadic. Diseases included in the national mass immunization program were completely depressed (measles, rubella, mumps, whooping cough, tetanus) and even eliminated or eradicated (diphtheria, poliomyelitis). AIDS incidence remained low and stationary twenty five years since the first registered case. Classical sexually transmitted diseases, gonorrhoea, syphilis were under control, showing low incidence. However, the situation can also be assessed as potentially unstable, owing to certain potentially risk factors such as locally insufficient sanitation especially regarding waste disposal, still present war damages, postwar migrations, migrations related to economic, tourist reasons, etc, as well as a globally increased risk of emerging and reemerging diseases. In addition there were potential risks connected with international traffic combined with global warming, causing current widespread of new mosquito species Aedes albopictus capable of transmitting several tropical viral diseases like dengue, chikungunya etc., in a number of European countries including Croatia. Therefore, further systematic work on implementation of all preventive and control measures is essential, in order to maintain and improve current favorable situation, which makes Croatia fully comparable to other developed countries.

By the Croatian accession to the European Union, a legal framework related to the use of nutrition and health claims on foods was adopted, as well as rules on informing consumers about food. Since milk and dairy products are traditionally positioned as healthy and nutritionally valuable products, adjusting to the new legislation is challenging for the dairy industry. After the evaluation process of health claims for nutrients naturally present in milk and dairy products, as well as those added in the production process, the European Food Safety Authority (EFSA) confirmed the beneficial effect of many active substances and established their recommended doses and effects. By the adoption of Commission Regulation (EU) No 432/2012 of 16 May 2012 a list of permitted health claims made on foods other than those referring to the reduction of disease risk and to children’s development and health was established. Also claims related to the impact of specific nutrients on the development and health of children were authorised by certain EU regulations. Nutrients in milk and dairy products related to nutrition and health claims are calcium, vitamin D, protein, yogurt culture, but also some active substances that are added to products such as different types of fibre, phytosterols and omega-3 fatty acids. By development of dairy products with special characteristics, such as those for specific population groups, it is possible to add nutrition claims which, for example, indicate a low energy value. This paper presents possibilities of application of nutrition and health claims on different types of products. © 2015, Hrvatska Mljekarska Udruga. All rights reserved.

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