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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


Van Den Hazel P.,Public Health Services Gelderland Midden | Keune H.,Research Institute for Nature and Forest INBO | Keune H.,University of Namur | Randall S.,Norwegian Institute For Air Research | And 3 more authors.
Environmental Health: A Global Access Science Source | Year: 2012

Background: The fields of environment and health are both interdisciplinary and trans-disciplinary, and until recently had little engagement in social networking designed to cross disciplinary boundaries. The EU FP6 project HENVINET aimed to establish integrated social network and networking facilities for multiple stakeholders in environment and health. The underlying assumption is that increased social networking across disciplines and sectors will enhance the quality of both problem knowledge and problem solving, by facilitating interactions. Inter- and trans-disciplinary networks are considered useful for this purpose. This does not mean that such networks are easily organized, as openness to such cooperation and exchange is often difficult to ascertain. Methods. Different methods may enhance network building. Using a mixed method approach, a diversity of actions were used in order to investigate the main research question: which kind of social networking activities and structures can best support the objective of enhanced inter- and trans-disciplinary cooperation and exchange in the fields of environment and health. HENVINET applied interviews, a role playing session, a personal response system, a stakeholder workshop and a social networking portal as part of the process of building an interdisciplinary and trans-disciplinary network. Results: The interviews provided support for the specification of requirements for an interdisciplinary and trans-disciplinary network. The role playing session, the personal response system and the stakeholder workshop were assessed as useful tools in forming such network, by increasing the awareness by different disciplines of others positions. The social networking portal was particularly useful in delivering knowledge, but the role of the scientist in social networking is not yet clear. Conclusions: The main challenge in the field of environment and health is not so much a lack of scientific problem knowledge, but rather the ability to effectively communicate, share and use available knowledge for policy making. Structured social network facilities can be useful by policy makers to engage with the research community. It is beneficial for scientists to be able to integrate the perspective of policy makers in the research agenda, and to assist in co-production of policy-relevant information. A diversity of methods need to be applied for network building: according to the fit-for-purpose-principle. It is useful to know which combination of methods and in which time frame produces the best results. Networking projects such as HENVINET are created not only for the benefit of the network itself, but also because the applying of the different methods is a learning tool for future network building. Finally, it is clear that the importance of specialized professionals in enabling effective communication between different groups should not be underestimated. © 2012 van den Hazel et al; licensee BioMed Central Ltd. Source


Scheepers P.T.J.,Radboud University Nijmegen | van Brederode N.E.,National Institute of Public Health and the Environment | Bos P.M.J.,National Institute of Public Health and the Environment | Nijhuis N.J.,Public Health Service Amsterdam | And 3 more authors.
Toxicology Letters | Year: 2014

Biological monitoring in humans (HBM) is widely used in the field of occupational and environmental health. In the situation of an unexpected release of hazardous materials HBM may contribute to the medical support and treatment of exposed individuals from the general population or of emergency responders. Such exposure information may also be used to respond to individual concerns such as questions about a possible relationship between the chemicals released during the incident and health effects. In The Netherlands a guideline was prepared to support early decision-making about the possible use of HBM for exposure assessment during or as soon as possible following a chemical incident. The application of HBM in such an emergency setting is not much different from situations where HBM is normally used but there are some issues that need extra attention such as the choice of the biomarker, the biological media to be sampled, the time point at which biological samples should be collected, the ethics approval and technical implementation of the study protocol and the interpretation and communication of the study results. These issues addressed in the new guideline will support the use of HBM in the management of chemical disasters. © 2014 Elsevier Ireland Ltd. Source


Keune H.,University of Namur | Ludlow D.,University of the West of England | Van Den Hazel P.,Public Health Services Gelderland Midden | Randall S.,Norwegian Institute For Air Research | Bartonova A.,Norwegian Institute For Air Research
Environmental Health: A Global Access Science Source | Year: 2012

Background: The EU FP6 HENVINET project reviewed the potential relevance of a focus on climate change related health effects for climate change policies at the city region level. This was undertaken by means of a workshop with both scientists, city representatives from several EU-countries, representatives of EU city networks and EU-experts. In this paper we introduce some important health related climate change issues, and discuss the current city policies of the participating cities. Methods. The workshop used a backcasting format to analyse the future relevance of a health perspective, and the main benefits and challenges this would bring to urban policy making. Results: It was concluded that health issues have an important function as indicators of success for urban climate change policies, given the extent to which climate change policies contribute to public health and as such to quality of life. Simultaneously the health perspective may function as a policy integrator in that it can combine several related policy objectives, such as environmental policies, health policies, urban planning and economic development policies, in one framework for action. Furthermore, the participants to the workshop considered public health to be of strategic importance in organizing public support for climate change policies. One important conclusion of the workshop was the view that the connection of science and policy at the city level is inadequate, and that the integration of scientific knowledge on climate change related health effects and local policy practice is in need of more attention. In conclusion, the workshop was viewed as a constructive advance in the process of integration which hopefully will lead to ongoing cooperation. Conclusions: The workshop had the ambition to bring together a diversity of actor perspectives for exchange of knowledge and experiences, and joint understanding as a basis for future cooperation. Next to the complementarities in experience and knowledge, the mutual critical reflection was a bonus, as ideas had the opportunity to be scrutinized by others, leading to more robustness and common ground. The structured backcasting approach was helpful in integrating all of this with one common focus, embracing diversity and complexity, and stimulating reflection and new ideas. © 2012 Keune et al; licensee BioMed Central Ltd. Source


Zuurbier M.,Public Health Services Gelderland Midden | Zuurbier M.,University Utrecht | Hoek G.,University Utrecht | Oldenwening M.,University Utrecht | And 4 more authors.
Environmental Health Perspectives | Year: 2010

Background: Commuters are exposed to high concentrations of air pollutants, but little quantitative information is currently available on differences in exposure between different modes of transport, routes, and fuel types. oBjectives: The aim of our study was to assess differences in commuters' exposure to traffic-related air pollution related to transport mode, route, and fuel type. Methods: We measured particle number counts (PNCs) and concentrations of PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), PM10, and soot between June 2007 and June 2008 on 47 weekdays, from 0800 to 1000 hours, in diesel and electric buses, gasoline- and diesel-fueled cars, and along two bicycle routes with different traffic intensities in Arnhem, the Netherlands. In addition, each-day measurements were taken at an urban background location. results: We found that median PNC exposures were highest in diesel buses (38,500 particles/cm3) and for cyclists along the high-traffic intensity route (46,600 particles/cm3) and lowest in electric buses (29,200 particles/cm3). Median PM10 exposure was highest from diesel buses (47 μg/m3) and lowest along the high- and low-traffic bicycle routes (39 and 37 μg/m3). The median soot exposure was highest in gasoline-fueled cars (9.0 × 10-5/m), diesel cars (7.9 × 10-5/m), and diesel buses (7.4 × 10-5/m) and lowest along the low-traffic bicycle route (4.9 × 10-5/m). Because the minute ventilation (volume of air per minute) of cyclists, which we estimated from measured heart rates, was twice the minute ventilation of car and bus passengers, we calculated that the inhaled air pollution doses were highest for cyclists. With the exception of PM10, we found that inhaled air pollution doses were lowest for electric bus passengers. conclusions: Commuters' rush hour exposures were significantly influenced by mode of transport, route, and fuel type. Source

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