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PubMed1997

Malignant melanoma in Europe: changes in mortality rates (1970-90) in European Community countries.

Reducing mortality, especially premature death, is a major goal of the fight against cancer. In this study, we have analyzed trends in malignant melanoma (MM) mortality in the European Community (EC) as a whole and for each country. The data (obtained from the World Health Organization data bank) have been analyzed for the period 1970-90, by age groups (20-44, 45-64, 65-74, 75+ years). Trends are presented as percentage change of mortality rate for each three-year period in comparison with the rate in the first one (1970-72). The mortality from MM in the EC as a whole increased for both genders (men, +89.2 percent; women, +72.6 percent), with statistically significant trends in all age classes. Northern countries experienced mortality changes about 30 to 50 percent less than the EC average increase. Greater changes were seen in southern European countries, in which recent standardized rates are near to those observed in northern European populations. Among Mediterranean people, the highest increase (more than fourfold) was observed in Spain. The significant increase found for the younger age class makes unlikely the risk of misclassification with other skin cancers. No future decrease in MM mortality in the EC is indicated from these data.

Adult↗
PubMed1981

Mutagenicity of cosmetics ingredients licensed by the European Communities.

As part of our investigation into mutagenic effects of environmental compounds, we studied chemicals allowed as ingredients of cosmetics according to the guidelines of the Council of the European Communities (27 July 1976). We used three systems, the Salmonella/microsome test, the Basc test on Drosophila and the micronucleus test on mouse bone marrow. Of the 31 chemicals tested, 15 were mutagenic in the Ames test; and of these, 5 were also mutagenic in the Basc test and 2 in the micronucleus test.

Animals↗
PubMed1986

Control of warble fly in Great Britain and the European Community.

The costs of warble fly in cattle have been estimated at 35 million pounds for Great Britain in 1985 and $85 million for Italy in 1982. Control measures within the European Community vary from one country to another and from the voluntary application of systemic products by individual farmers to comprehensive national eradication schemes backed by legislation. Of the countries opting for national eradication measures, Denmark has been successful and the Federal Republic of Germany, the Netherlands, the Republic of Ireland, Northern Ireland and Great Britain have reduced the incidence of the disease to very low levels. In Great Britain in 1978, 38 per cent of cattle were found to be affected in a survey of selected fatstock markets by the Meat and Livestock Commission. In 1985 the incidence had fallen to 0.01 per cent. Seven hundred and five affected herds were found in Great Britain when the disease was made notifiable in 1982, falling to 419 affected herds in 1985. Treatment of all cattle over 12 weeks old is required in affected herds. Since 1982 parts of Great Britain where the disease has persisted or where there is evidence of a recrudescence have been designated 'infected areas' in which all cattle over 12 weeks old have been required to be treated within specific dates. In addition to statutory measures the control measures in Great Britain include the inspection of cattle at auction markets and on farms. Work on the application to field conditions of an ELISA test is in progress, with encouraging results. It is considered that Great Britain is now well placed to eradicate warble fly.

Animals↗
PubMed1998

Prevalence of respiratory symptoms, bronchial hyperreactivity, and asthma in a megacity. Results of the European community respiratory health survey in Mumbai (Bombay).

To estimate adult asthma prevalence in the world's most rapidly growing mega-city, we applied epidemiologic surveillance tools, as a cooperating center of the European Community Respiratory Health Survey, to a randomly selected sample of Mumbai (Bombay) residents in 1992 through 1995. From a metropolitan population of over 10 million, we took a one-in-ten random sample from electoral rolls in a socially diverse residential district, and examined asthma symptoms in adults age 20 to 44 yr. In Phase I, we interviewed 2,313 adults about symptoms, asthma diagnosis, and medications in the previous 12 mo. In Phase II, family and smoking history, socioeconomic data, housing characteristics, serum IgE, allergy skin tests, spirometry, and methacholine challenge tests were obtained in a subset of 20% of those who had completed Phase I. House dust mite was the most common positive skin test (18% prevalence) and the only one of the nine applied that was significantly associated with asthma symptoms and physician-diagnosed asthma. Asthma prevalence was 3.5% by physician diagnosis, and 17% using a very broad definition including those with asymptomatic bronchial hyperreactivity. Asthma prevalence was strongly associated with positive house dust mite skin test, family history of asthma, and total IgE.

Adult↗
PubMed1989

Regulatory aspects of chemical mutagenesis in Italy and in the European Community.

The first part of this paper outlines the guidelines on mutagenicity testing recommended in Italy by the National Advisory Committee on Toxicology. Thereafter, there is a description of the current Italian situation regarding the mutagenicity testing requirements for new chemicals of different use, which also takes into account the European Community approach and its legal implements (directives and recommendations).

Chromosomes↗
PubMed2001

Dietary habit profile in European communities with different risk of myocardial infarction: the impact of migration as a model of gene-environment interaction. The IMMIDIET Study.

The risk of myocardial infarction (MI) is lower in southern than in northern European countries. The lower rate of MI in the Mediterranean regions of Europe suggested a potential role of the traditional Mediterranean diet in the prevention of MI. Unfortunately, in the last 20 years, a tendency to adopt Westernised food habits even in southern regions of Europe is reflected by an increase in the prevalence of obesity. Therefore the impact of diet on MI risk profile among European populations needs to be reconsidered. Genetic risk factors have also been implicated in the development of MI. Genes, indeed, continuously interact with environmental factors in determining the pathogenesis of MI. The aims of the IMMIDIET study are to evaluate: 1. The present dietary habits and the risk profile of three European communities at different risk of MI; 2. The impact of migration on risk factors for MI. Dietary habits and genetic polymorphisms will be evaluated in an Italian, Belgian and British population sample. The historical Italian migration to Belgium and the integration through mixed marriage will be considered as a model of gene-environment interaction. As an index of MI risk profile, factors that are most likely under the combined influence of both dietary and genetic determinants will be investigated.

Belgium↗
PubMed1997

Variation in bronchial responsiveness in the European Community Respiratory Health Survey (ECRHS).

Attempts to compare bronchial responsiveness between populations have been hampered by between-study differences in the pharmacological agent of provocation, the method of administration and the summary statistic employed. The European Community Respiratory Health Survey used methacholine challenge delivered by Mefar dosimeter according to a standardized protocol used in 35 centres in 16 countries. Data were obtained from 13,161 men and women, aged 20-44 yrs at the start of the study. The dose of methacholine producing a 20% fall in forced expiratory volume in one second (FEV1) (PD20) and the regression coefficient of percentage decline in FEV1 with log dose, were calculated ("slope", after transformation), with and without calibration of nebulizers by weight and adjustment for nonresponse bias. Standardization for baseline lung function and variation in smoking prevalence was applied to slope. Results were robust to whichever summary measure was used, and to the various adjustments. Responsiveness was low in Iceland and Switzerland, and in most centres in Sweden, Italy and Spain, and high in New Zealand, Australia, the USA, Britain, France, Denmark and Germany. Bronchial responsiveness varies considerably in Europe, and high levels are not confined to the English-speaking world.

Adult↗
PubMedDate not supplied

Activities of the Commission of the European Communities concerning materials and articles intended to come into contact with foodstuffs--a review.

The removal of technical barriers to trade and consumer protection were the basic considerations behind the Council Resolution which gave the Commission of the European Communities the task of approximating the laws of the Member States as regards materials and articles intended to come into contact with foodstuffs. Considerable progress has been made in 14 years of Commission activity, but much remains to be done to construct a single market, the prime objective of the Treaty of Rome. This article provides a brief account of the principal results obtained, together with an outline of the strategy pursued by the Commission in its activities and the basic reasons behind the choices made. It also discusses prospects and future programmes.

European Union↗
PubMed1979

The approach of the European communities to the assessment of the carcinogenic risk of environmental chemicals, in particular, artificial colourings.

A brief outline is given of the rationale of the Environmental Research Programme of the European Economic Community and of its implementation. The major part of the programme is devoted to research on the exposure-effect relationships for mutagens and carcinogens and to the establishment of criteria. As a first step, a battery of test systems for mutagenicity screening is being established. These will be evaluated in a comparative test programme. The second part of the paper describes the specific legislative actions of the European Communities on food colourings. The historical background is given; and the criteria used by the Scientific Committee for Food for classifying and evaluating colouring matters are listed. Proposed regulatory action, on the basis of the report of the Committe, includes lists of colouring matters which are 'unacceptable', 'temporarily acceptable' and 'acceptable'.

European Union↗
PubMed1992

The surveillance of communicable disease in the European Community.

This article summarises the existing international structures in Europe which collate data produced by surveillance systems in individual countries. The surveillance of influenza, tuberculosis, and other infections in Europe is undertaken by the World Health Organisation (WHO), the European Community (EC), and national and international organisations set up to study specific diseases. The surveillance of foodborne infections, rabies, travel-associated legionellosis and AIDS/HIV is undertaken by WHO collaborating centres or WHO/EC programmes. Research into immunisation and sexually transmitted diseases other than HIV is carried out through EC concerted action programmes. The Maastricht treaty, if ratified, may lead to changes in the way communicable disease surveillance is undertaken in the EC.

Communicable Disease Control↗
PubMed2006

Changes in active and passive smoking in the European Community Respiratory Health Survey.

The aim of the present investigation was to study changes and determinants for changes in active and passive smoking. The present study included 9,053 adults from 14 countries that participated in the European Community Respiratory Health Survey II. The mean follow-up period was 8.8 yrs. Change in the prevalence of active and passive smoking was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period. Determinants of change were analysed and the results expressed as adjusted hazard risk ratio (HRR) or odds ratio (OR). The prevalence of active smoking declined by 5.9% (5.1-6.8) and exposure to passive smoking in nonsmokers declined by 18.4% (16.8-20.0). Subjects with a lower educational level (HRR: 0.73 (0.54-0.98) and subjects living with a smoker (HRR: 0.45 (0.34-0.59)) or with workplace smoking (HRR: 0.69 (0.50-0.95)) were less likely to quit. Low socio-economic groups were more likely to become exposed (OR: 2.21 (1.61-3.03)) and less likely to cease being exposed to passive smoking (OR: 0.48 (0.37-0.61)). In conclusion, the quitting rate was lower and the risk of exposure to passive smoking higher among subjects with lower socio-economic status. Exposure to other peoples smoking decreased quitting rates and increased the risk of starting to smoke.

Adult↗
PubMed1998

Pulmonary ventilatory defects and occupational exposures in a population-based study in Spain. Spanish Group of the European Community Respiratory Health Survey.

We assessed the association between occupational exposures and symptoms of chronic bronchitis and pulmonary ventilatory defects in a general population-based study of five areas in Spain. This study forms part of the European Community Respiratory Health Study (ECRHS). Subjects (n = 1,735; age range, 20-44 yr; 52.4% of those initially selected) completed a respiratory questionnaire on symptoms and occupation and underwent baseline spirometry. Occupation was translated with an ad hoc developed job-exposure matrix (EM) into none, low, and high exposure to biological dust, mineral dust, and gases and fumes. Exposure to high levels of biological dust was associated with cough for more than 3 mo (odds ratio [OR], 1.9; p = 0.07), a reduction in FEF(25-27) to 478 ml/s (SD 178), and a reduction in FEV1 to 151 mL (SD 71). These associations remained after excluding subjects with asthma symptoms or bronchial responsiveness. Smokers tended to have a higher risk for respiratory symptoms, but smoking did not modify the association of occupation with pulmonary function. Exposure to mineral dust and gases/fumes was less consistently related to pulmonary function or to respiratory symptoms and this association further decreased after excluding subjects with asthma. In conclusion, exposure to high levels of biological dust in young adults is associated with symptoms of chronic bronchitis and pulmonary ventilatory defects, independently of asthma and smoking.

Adult↗
PubMed1999

International variations in asthma treatment compliance: the results of the European Community Respiratory Health Survey (ECRHS).

Noncompliance to medication is a major barrier to effective asthma management. Its real extent and geographical variation throughout the world are not yet known. The data on compliance, collected in the framework of the European Community Respiratory Health Survey (ECRHS) on 1771 subjects (aged 20-44 yrs) with current asthma identified in 14 countries, offer a unique opportunity to assess the extent of noncompliance and its variation across countries. The median percentage of current asthmatics who had received a medical prescription at least once was 95%. The compliance of those patients who had received a medical prescription was found to be low in all countries (median 67%) but with wide variations, the rate ranging from 40% (USA) to 78% (Iceland). During exacerbations patients' rate of compliance increased to 72%. Age was the only variable which influenced compliance to treatment. A significant, although weak, negative correlation was found between patients' compliance and rate of hospital casualty department or emergency room admissions. This study documents that compliance to the treatment of asthma is poor worldwide and that there are large variations between countries. These results emphasize the necessity for further efforts to improve patients' education and to promulgate the international guidelines.

Adult↗
PubMed2004

Increase in diagnosed asthma but not in symptoms in the European Community Respiratory Health Survey.

BACKGROUND: Information on the epidemiology of asthma in relation to age is limited and hampered by reporting error. To determine the change in the prevalence of asthma with age in young adults we analysed longitudinal data from the European Community Respiratory Health Survey. METHODS: A self-administered questionnaire was completed by 11 168 randomly selected subjects in 14 countries in 1991-3 when they were aged 20-44 years and 5-11 years later from 1998 to 2003. Generalised estimating equations were used to estimate net change in wheeze, nocturnal tightness in chest, shortness of breath, coughing, asthma attacks in the last 12 months, current medication, "diagnosed" asthma, and nasal allergies. RESULTS: Expressed as change in status per 10 years of follow up, subjects reporting asthma attacks in the previous 12 months increased by 0.8% of the population (95% CI 0.2 to 1.4) and asthma medication by 2.1% (95% CI 1.6 to 2.6), while no statistically significant net change was found in reported symptoms. Reported nasal allergies increased, especially in the youngest age group. CONCLUSIONS: As this cohort of young adults has aged, there has been an increase in the proportion treated for asthma but not in the proportion of those reporting symptoms suggestive of asthma. Either increased use of effective treatments has led to decreased morbidity among asthmatic subjects or those with mild disease have become more likely to label themselves as asthmatic.

Adult↗
PubMed1998

Prediction equations for forced spirometry from European origin populations. Barcelona Collaborative Group on Reference Values for Pulmonary Function Testing and the Spanish Group of the European Community Respiratory Health Survey.

The objective of this study was the analysis of five sets of reference equations for forced spirometry (Crapo et al., ECSC, Knudson et al., Paoletti et al. and Roca et al.) using measurements of FVC and FEV1 obtained in the European Community Respiratory Health Survey (ECRHS) in Spain. Standardized forced spirometry was measured in 998 non-asthmatic subjects (20-44 years), randomly selected from the general population, participating in the ECRHS in four different Spanish cities. Observed minus predicted values for both FVC and FEV1 were examined for each set of predicted equations. Observed FVC (4448 +/- 980 ml) and FEV1 (3715 +/- 813 ml) showed a good agreement with values predicted by Roca et al. (99% and 101%, respectively). The mean observed minus predicted difference (residual) for FVC and FEV1 were -34 +/- 527 ml and 30 +/- 455 ml, respectively. The regression line between observed and predicted values was not different from the identity line for both FVC and FEV1. These results indicate that reference values obtained by Roca et al. are useful for the assessment of the ventilatory capacity in the general population of Spain. In addition, the study indicates that discrepancies among the reference equations from different authors compared in the present study are unlikely to be due to ethnic differences within European origin populations.

Adult↗
PubMed2000

The potential impact of the North American Free Trade Agreement on American dental licensure: a European community model.

Appropriate licensure is a significant barrier to entry to the practice of dentistry. The history of dental licensure in the United States is briefly examined, and current dental licensure requirements in the United States and Mexico are noted. The impact that establishment of the European Community had on dental licensure in Europe is examined, noting that changes were the result of political, rather than professional, input. Requirements of NAFTA are examined to see how they will impact current American dental licensure requirements. Some migration of dental professionals between the United States and Mexico is expected as a result of NAFTA.

Commerce↗
PubMed1997

Genes for asthma? An analysis of the European Community Respiratory Health Survey.

Besides environmental triggers, a family history of asthma is a strong risk factor for the development of asthma in offspring. The pooled data from 13,963 interviews of randomly selected, 20 to 48 yr-old participants from the 30 centers of the European Community Respiratory Health Survey (ECRHS) were analyzed with conventional logistic regression and a Class A regressive model adapted for the segregation of various transmission modes in families. The asthma prevalence in the interviewed index generation was 6.9% (95% confidence interval [CI]: 6.5 to 7.3), and in the parent generation was 6.1% (5.8 to 6.4). As with asthma prevalence, the risk of a subject having asthma if a parent had asthma also had a large geographic variation across the survey centers. The mean risk if a father had asthma was 2.9 (2.4 to 3.5), and If the mother had asthma was 3.2 (2.6 to 3.9). The risk increased to 7.0 (3.9 to 12.7) if both parents were affected. For developing extrinsic asthma, extrinsic asthma in any parent was a greater risk factor (4.9 [3.9 to 6.0]) than intrinsic asthma of the parent (1.5 [0.8 to 2.6]), and the risk for women was slightly higher than that for men (4.3 [3.3 to 5.5] versus 3.6 [2.6 to 5.0]). Applying different segregation models, only a model for a two-allele gene with a codominant inheritance could not be rejected, assuming a major gene with a population frequency of 24.2%. Further results make a multilocus/threshold model likely. In conclusion, a history of asthma in parents is a strong risk factor for asthma in the offspring. Under the assumptions of the applied segregation analysis, at least one major gene exists which could be a gene involved also in allergy. However, asthma is not fully described by a single-gene model. The risk for asthma varies within the European countries, and should be seen in the context of a complex genetic and environmental pathophysiology.

Adult↗
PubMed2005

European community legislation concerning schools of specialisation in orthodontics: the inexplicable inertia of Italy--contradictions and open issues.

Orthodontics was the first discipline to be acknowledged as such within the field of dentistry, initially in the USA and subsequently in Europe. The structural changes that led to the birth of the European Union (EU) laid the foundations for the free circulation of professions and services. Nevertheless a deep discrepancy in the quality of training of practitioners from different countries became apparent. It was necessary to address this issue and regulate the training process in order to guarantee a degree of uniformity. Up to this time only the duration of the School of Specialisation in Orthodontics has been set at a minimum of three years. While moving towards an increasing degree of integration of the various EU countries, it becomes paramount to be able to establish a School of Specialisation in Orthodontics with high academic standards based on the Erasmus Programme and above all to be able to award a specialisation degree which is acknowledged first of all in the country where it is issued and also on a wider European level. Freedom of circulation of intellectual activities requires the formal acknowledgement of a qualification, namely the Specialisation in Orthodontics. Also to that end, EFOSA (European Federation of Specialists in Orthodontics) was founded. Furthermore the European Community has, in the meantime, ruled that medical trainees should be remunerated for their work. Dentistry and its specialisations should not follow the model of Medicine given that the two are completely distinct, but many believe that the duration of the School of Specialisation in Orthodontics has to be set as the same as the medical specialisations.

Education, Dental, Graduate↗