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Groningen, Netherlands

van Loenhout J.A.F.,Public Health Services Gelderland Midden | van Loenhout J.A.F.,Catholic University of Louvain | le Grand A.,Municipal Health Services Groningen | Duijm F.,Municipal Health Services Groningen | And 4 more authors.
Environmental Research | Year: 2016

Introduction: Exposure to high ambient temperatures leads to an increase in mortality and morbidity, especially in the elderly. This relationship is usually assessed with outdoor temperature, even though the elderly spend most of their time indoors. Our study investigated the relationship between indoor temperature and heat-related health problems of elderly individuals. Material and methods: The study was conducted in the Netherlands between April and August 2012. Temperature and relative humidity were measured continuously in the living rooms and bedrooms of 113 elderly individuals. Respondents were asked to fill out an hourly diary during three weeks with high temperature and one cold reference week, and a questionnaire at the end of these weeks, on health problems that they experienced due to heat. Results: During the warmest week of the study period (14-20 August), average living room and bedroom temperatures were approximately 5 °C higher than during the reference week. More than half of the respondents perceived their indoor climate as too warm during this week. The most reported symptoms were thirst (42.7%), sleep disturbance (40.6%) and excessive sweating (39.6%). There was a significant relationship between both indoor and outdoor temperatures with the number of hours that heat-related health problems were reported per day. For an increase of 1. °C of indoor temperature, annoyance due to heat and sleep disturbance increased with 33% and 24% respectively. Outdoor temperature was associated with smaller increases: 13% and 11% for annoyance due to heat and sleep disturbance, respectively. The relationship between outdoor temperature and heat-related health problems disappeared when indoor and outdoor temperatures were included in one model. Conclusions: The relationship with heat-related health problems in the elderly is stronger with indoor (living room and bedroom) temperature than with outdoor temperature. This should be taken into account when looking for measures to reduce heat exposure in this vulnerable group. © 2015 Elsevier Inc. Source


Greven F.E.,Municipal Health Services Groningen | Greven F.E.,University Utrecht | Rooyackers J.M.,University Utrecht | Kerstjens H.A.,University of Groningen | Heederik D.J.,University Utrecht
American Journal of Industrial Medicine | Year: 2011

Background: The aim of the present study was to determine the prevalence and risk factors associated with respiratory symptoms in common firefighters in the Netherlands. Methods: A total of 1,330 firefighters from the municipal fire brigades of three provinces of the Netherlands were included in the study. All subjects were administered a Dutch web-based version of the European Community Respiratory Health Survey questionnaire. Results: General respiratory symptoms were associated with the number of fires fought in the last 12 months with odds ratios between 1.2 (95% CI 1.0-1.4) and 1.4 (95% CI 1.2-1.7) per 25 fires. A strong association was found between an inhalation incident and present respiratory symptoms with odds ratios between 1.7 (95% CI 1.1-2.7) and 3.0 (95% CI 1.9-4.7). Adjustments for smoking, sex, atopy, and age did not change any of the associations. After stratification, atopics showed elevated odds ratios. Conclusions: It is recommended that firefighters are aware of these elevated healthcare risks associated with exposure to fire smoke and that they increase as much as possible the use of self-contained breathing apparatus. © 2011 Wiley-Liss, Inc. Source


Rosbach J.,University Utrecht | Krop E.,University Utrecht | Vonk M.,Municipal Health Services Groningen | van Ginkel J.,Municipal Health Services IJsselland | And 4 more authors.
Indoor Air | Year: 2016

Inadequate ventilation of classrooms may lead to increased concentrations of pollutants generated indoors in schools. The FRESH study, on the effects of increased classroom ventilation on indoor air quality, was performed in 18 naturally ventilated classrooms of 17 primary schools in the Netherlands during the heating seasons of 2010–2012. In 12 classrooms, ventilation was increased to targeted CO2 concentrations of 800 or 1200 ppm, using a temporary CO2 controlled mechanical ventilation system. Six classrooms were included as controls. In each classroom, data on endotoxin, β(1,3)-glucans, and particles with diameters of <10 μm (PM10) and <2.5 μm (PM2.5) and nitrogen dioxide (NO2) were collected during three consecutive weeks. Associations between the intervention and these measured indoor air pollution levels were assessed using mixed models, with random classroom effects. The intervention lowered endotoxin and β(1,3)-glucan levels and PM10 concentrations significantly. PM10 for instance was reduced by 25 μg/m³ (95% confidence interval 13–38 μg/m³) from 54 μg/m³ at maximum ventilation rate. No significant differences were found between the two ventilation settings. Concentrations of PM2.5 and NO2 were not affected by the intervention. Our results provide evidence that increasing classroom ventilation is effective in decreasing the concentrations of some indoor-generated pollutants. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Source


Rosbach J.T.,University Utrecht | Vonk M.,Municipal Health Services Groningen | Duijm F.,Municipal Health Services Groningen | Van Ginkel J.T.,Municipal Health Services IJsselland | And 2 more authors.
Environmental Health: A Global Access Science Source | Year: 2013

Background: Classroom ventilation rates often do not meet building standards, although it is considered to be important to improve indoor air quality. Poor indoor air quality is thought to influence both children's health and performance. Poor ventilation in The Netherlands most often occurs in the heating season. To improve classroom ventilation a tailor made mechanical ventilation device was developed to improve outdoor air supply. This paper studies the effect of this intervention. Methods. The FRESH study (Forced-ventilation Related Environmental School Health) was designed to investigate the effect of a CO2 controlled mechanical ventilation intervention on classroom CO2 levels using a longitudinal cross-over design. Target CO2 concentrations were 800 and 1200 parts per million (ppm), respectively. The study included 18 classrooms from 17 schools from the north-eastern part of The Netherlands, 12 experimental classrooms and 6 control classrooms. Data on indoor levels of CO2, temperature and relative humidity were collected during three consecutive weeks per school during the heating seasons of 2010-2012. Associations between the intervention and weekly average indoor CO2 levels, classroom temperature and relative humidity were assessed by means of mixed models with random school-effects. Results: At baseline, mean CO2 concentration for all schools was 1335 ppm (range: 763-2000 ppm). The intervention was able to significantly decrease CO2 levels in the intervention classrooms (F (2,10) = 17.59, p < 0.001), with a mean decrease of 491 ppm. With the target set at 800 ppm, mean CO2 was 841 ppm (range: 743-925 ppm); with the target set at 1200 ppm, mean CO2 was 975 ppm (range: 887-1077 ppm). Conclusions: Although the device was not capable of precisely achieving the two predefined levels of CO2, our study showed that classroom CO2 levels can be reduced by intervening on classroom ventilation using a CO2 controlled mechanical ventilation system. © 2013 Rosbach et al.; licensee BioMed Central Ltd. Source


Greven F.,Municipal Health Services Groningen | Greven F.,University Utrecht | Krop E.,University Utrecht | Burger N.,University Utrecht | And 2 more authors.
Biomarkers | Year: 2011

Serum Clara cell protein (CC16) and surfactant-associated protein A (SP-A) were measured in a cross-sectional study in 402 firefighters. For the population as a whole, no associations were detected between serum pneumoproteins and smoke exposure. SP-A levels were increased in symptomatic subjects exposed to fire smoke within 2 days before testing. SP-A levels were higher after an inhalation incident ever. CC16 was negatively associated with the number of fires fought in the last 12 months in current nonsmokers. These associations between pneumoprotein levels reiterate the importance of adequate use of self-contained breathing apparatus by firefighters. © 2011 Informa UK, Ltd. Source

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