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PubMed1997

Cancer incidence and mortality in the European Union: cancer registry data and estimates of national incidence for 1990.

Members of the European Network of Cancer Registries (ENCR) provide population-based data on cancer incidence for some countries and regions of Europe. These were supplemented by estimates in order to provide comparable information on cancer incidence and mortality in the 15 member states of the European Union (EU). The estimated numbers of new cases of cancer (excluding nonmelanoma skin cancer) in 1990 were approximately 706,900 in men and 644,200 in women. Approximately 497,500 men and 398,200 women died of cancer in the same year. The main sites of incident cases in men were lung (21%), large bowel (13%), prostate (12%), bladder (7%) and stomach (7%). For women, the predominant sites were breast (28%), large bowel (15%), lung (6%), uterine corpus (5%) and stomach (5%). The overall incidence rates for males were highest in continental Western Europe (France, The Netherlands, Austria, Luxembourg, Belgium, Germany and Italy) while the rates of Greece, Portugal, Sweden, Ireland, Spain, Finland, the U.K. and Denmark were below the average value for the EC. Rates for females were highest in Northern and Western Europe, with the exception of France, which had a relatively low rate for females, in common with Greece, Spain and Portugal. The geographical variations in incidence of the major cancers are discussed in relation to risk factors. The estimates show the substantial burden of cancer in European Union populations, but there are also indications of effects of past preventive measures and there is scope for further intervention. Cancer registries are an important source of information for cancer control since they provide population-based incidence and survival statistics. These, along with mortality data, are required to obtain a full picture of the frequency of cancer and its effects at the population level. Some 44% of the EU population is covered by registries. The European Network of Cancer Registries aims to standardise the information provided by existing registries and to provide practical assistance to those in development.

Adolescent↗
PubMed1999

Occupational physicians' education and training across European Union countries.

The framework directive on improvements in the safety and health of workers is being implemented into the national legislation of European Union countries, and occupational physicians are requested to play a key role in undertaking preventive measures. Since there is no common specific requirement for the training and education of these health professionals, this report aims to provide a comparative picture of the educational process across European Union training bodies. Each curriculum provides theoretical knowledge and practical experience, but deep differences exist among different countries. Core knowledge is mainly based on the traditional disciplines (such as occupational hygiene, occupational toxicology, ergonomics, epidemiology and biostatistics, relevant legislation, and preventive medicine). General learning objectives should include assessment of the workplace environment, communication and education, legislation, occupational diseases, and relationships between health and work. Core experience, often based on task-based learning, emphasizes the need for assessment of a range of working environments; for surveillance, including the biological monitoring, of workers at risk; for assessment of disability, impairment, and fitness for work; for the clinical ability to recognize occupational diseases; for the formulation of differential diagnosis; and for management of workers developing disease in the course of their employment. New curricular elements (such as management, economics, quality assurance, and marketing) are being introduced in some institutions with the aim of stressing the renewed role of the occupational physician in meeting society and employers' needs. The need to educate and train a professional figure whose competence should allow the delivery of high-quality occupational health services across European Union countries compels the harmonization of the formative process of occupational physicians.

Curriculum↗
PubMed2000

Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union.

An observational, cross-sectional study was conducted in a representative sample of the European Union (7155 men and 8077 women) to calculate the underestimation of body weight as assessed by body image among the overweight and obese population and identify the associated factors to this behavior. Participants were older than 15 years and they were living in the 15 European Union countries. Body mass index (BMI) was grouped into 4 categories using the cutpoints established by the WHO, while perceived body image (PBI) was assessed using a nine-silhouettes drawing. The degree of underestimation between PBI as compared to BMI was identified in overweight and obesity categories of BMI. A multivariable logistic regression model for each gender was used to adjust for potentially confounding variables. Men classified themselves worse than women, being more likely to underestimate their body weight (65.2% of men underestimated their weight vs 32.2% women), regardless of other socioeconomic and attitudinal variables. The greatest degree of underestimation was observed in Mediterranean individuals (68.7% of men and 37.9% of women underestimated their weight). The subjects in the 'maintenance' stage of physical activity tended more often to wrongly select their actual image (71.8% for men and 38.7% for women).

Adolescent↗
PubMed2004

Publication of European Union research on infectious diseases (1991-2001): a bibliometric evaluation.

The study presented here analyzed the contents of 36 international infectious diseases journals from 1991 to 2001 to determine the number of reports prepared by authors in the European Union and to compare the per country scientific productivity. Articles included in the study were identified using the PubMed website. The number of publications in infectious disease journals produced by authors in the European Union experienced an exponential growth from 461 (19.2% of world production) in 1991 to 2,401 (35.9%) in 2001. The mean impact factor increased from 2.259 in 1991 to 3.001 in 2001. The leading countries in the total number of publications were the UK, France, and Germany. After taking population figures into account, Sweden, Denmark, and Finland headed the list, and after correcting for gross domestic product, the greatest producers were Sweden, Finland, and the UK. Overall, the scientific production and repercussion index of European Union research on infectious diseases experienced a notable rise during the last decade of the 20th century.

Bibliometrics↗
PubMed2004

Compulsory admission of mentally ill patients in European Union Member States.

BACKGROUND AND AIMS: A standardised and systematic analysis of commitment laws in the European Union Member States is still missing. This study aimed at gathering, describing and analysing information on the differences or similarities of legal frameworks for involuntary placement and treatment of mentally ill patients across the European Union Member States. METHOD: Information was gathered by means of a detailed questionnaire filled in by experts from all EU Member States. Legal criteria for compulsory admission and details of the assessment and decision process of compulsory admission are outlined. RESULTS: Although common patterns among Member States can be identified upon comparison of crucial legislative or procedural details, these patterns are far from being consistent across all analysed items or approaches. With regard to compulsory admission quotas no significant influence of legal commitment criteria and the involvement of judicial authorities could be found, but Member States with an obligatory inclusion of a legal representative during the commitment procedure showed significantly lower compulsory admission quotas. CONCLUSION: Results of this study show the strong necessity for further research in this field. Common international health reporting standards as annually updated involuntary placement rates detailed for regular and emergency cases seem to be essential.

Commitment of Persons with Psychiatric Disorders↗
PubMed1997

Immunisation coverage in the European Union.

The 15 countries of the European Union have ratified the fifth objective of Health for all in the year 2000 programme of WHO Europe, which states: By the year 2000, there should be no indigenous cases of poliomyelitis, diphtheria, neonatal tetanus, measl

Journal Article↗
PubMed1998

[Immunization schedule in the European Union].

All nations that are part of the European Union share the same aim for the control and eradication of vaccine-preventable diseases. However, there are differences in child immunization strategies and schedules between nations, depending upon health care systems, immunization habits and epidemiology of infectious diseases. All nations immunize children against diphtheria, tetanus, poliomyelitis, measles, rubella and mumps. Immunization against pertussis, Haemophilus influenzae, hepatitis B and tuberculosis are not systematically applied.

Adolescent↗
PubMed2005

Modern regulatory impact analysis: the experience of the European Union.

This paper begins by explaining the importance of improving the quality of the regulatory process, particularly in the European Union (EU), using tools and techniques such as Regulatory Impact Assessment (RIA). It describes the principal features of the RIA process, including good practices and practical problems. The paper then outlines the historical development of the RIA process in the EU and describes the new approach adopted recently by the European Commission. It also evaluates the effectiveness of the new approach--in theory and in practice--using as one example the RIAs undertaken on the New Chemicals Policy (REACH) by the European Commission, Member States, and stakeholders. A further section describes recent work undertaken by Business Decisions Limited and THE WEINBERG GROUP on Impact Assessments for the Animal Health Industry, the Polycarbonates Industry and the Nickel Industry. The paper finally draws a number of conclusions and makes a number of recommendations for further improvements in the quality of the regulatory process in the European Union.

Decision Making↗
PubMed2005

[Structure of the Surveillance and management of infectious diseases in the European Union. The EU surveillance networks and the European Centre for Disease Prevention und Control (ECDC)].

In 1998, the European Parliament and Council published the Decision on setting up a network for the epidemiological surveillance of communicable diseases in the Community. As a first step, the Network Committee (representatives of the Member States) and the Commission determined the diseases for European surveillance. Subsequently, case definitions were developed for these diseases. For rapid information exchange among Member States on serious diseases, outbreaks and the control measures taken, a web-based, password protected early warning system was established. In parallel disease-specific networks were developed for enhanced surveillance of important diseases. A training programme (EPIET) and a European bulletin (Eurosurveillance) complete the network. The directive on the monitoring of zoonoses constitutes the basis for the joint analysis and evaluation of data on human illnesses, animals and foods. Starting in May 2005, the coordination and further development of the Community Network will be carried out by the European Centre for Disease Prevention and Control (ECDC).

Communicable Disease Control↗
PubMed2006

Overview of active personal dosemeters for individual monitoring in the European Union.

In 2001, the European Radiation Dosimetry Group, EURADOS, started a working group on 'Harmonisation of Individual Monitoring in Europe and the Dissemination of Information on New Techniques in this Field'. Within this group, one of the projects consisted of analysing the status of active personal dosemeters (APDs) in Europe. This paper reviews the regulatory requirements for APDs in 15 EU member states and summarises the main characteristics of commercial and new developments in this field. In particular, it focuses on the comparison of APD performance and standard passive dosimetry systems. Based on this information, an evaluation is initiated to establish why several countries are reluctant to accept APDs for dose records.

Environmental Exposure↗
PubMed2005

Patient mobility in European Union: health spas in Ischia, Italy.

In a new case on patients seeking medical services abroad, the Leichtle case, the European Court of Justice (ECJ) confirmed its previous rulings on patient mobility. According to the Court, patients in the European Union have a (conditional) right to receive health care abroad, whereas the sickness fund should reimburse the costs of treatment and travel expenditures. As such, the Court has strengthened patient mobility in the European Union, based on the free movement principles. Now, it is up to the European Commission to develop a communal strategy aimed at further strengthening patients' rights in the Union.

Europe↗
PubMed2001

White paper on the future chemical policy in the European Union - implications for animal welfare.

In February 2001, the European Commission adopted a White Paper on a Future Chemicals Policy. Its main goals are better to protect humans and the environment from unknown risks through chemicals. The "promotion of non-animal testing" is one of the key elements of the proposed strategy. For low production volume chemicals, only data from in vitro-tests are to be requested. The data requirements for higher production volume chemicals shall be designed flexibly so that only data relevant for the respective chemical are collected. From the point of view of animal welfare concrete risk management strategies should be defined before test batteries are put together. The test catalogues currently listed in the Classification Directive 67/548/EEC are to be replaced by tiered testing strategies, and concrete waiving strategies are to be designed so that the requested tailor-made testing can actually be realized. Another essential prerequisite for the promotion of non-animal testing is that the funding of alternative method research is formulated as a key action with a concrete budget in the Sixth Research Framework Program of the European Union.

Animal Testing Alternatives↗
PubMedDate not supplied

[European Union fight against smoking related activitiy].

This study is aimed at providing information concerning the provisions adopted by the European Union on both a compulsory and non-compulsory basis for its member States related in one way or another to the fight against smoking. To this end, a review is made of all of the provisions published in the Official Journal of the European Union as of the first published in 1986 up to March 2005, commenting upon the aspects of each provision having to do with the subject stated above.

Adolescent↗
PubMed2003

Indicators of children's development: considerations when constructing a set of national Child Health Indicators for the European Union.

BACKGROUND: In a recent project, commissioned by the European Union, a set of Child Health Indicators were identified and recommended for use in all Member States. In that work, by a group of European experts, children's development was one of the key areas that were reviewed to clarify its role in this set of indicators. This paper deals with neurological (in a broad sense), social and moral aspects of development; other aspects, such as nutrition and physical growth, mental health, quality of life were dealt with in other areas. METHODS: A number of methods are used to monitor children's neurodevelopment, to identify early deviations that could be treated or alleviated. Few tests fulfil basic criteria of screening and quality of evidence. For Child Health Programmes, developmental surveillance is instead recommended. As a proxy to social development, as part of children's process of adaptation into society, education indicators are recommended, such as suggested by OECD and UNICEF. Moral development is discarded as an indicator, because norms and values vary too much between countries. CONCLUSION: For now the Child Health Indicators of Life and Development Project found no ground to recommend any particular method or combination of methods for a general monitoring of children's neurological, intellectual, language and moral development, and for including the results as national indicators of children's health and well-being in EU. For social development, indicators in the educational area seem most promising, as they have been proposed and used by OECD and UNESCO. In an ambitious monitoring programme, these indicators could be included as determinants of children's health and development.

Adaptation, Psychological↗
PubMed2000

Comparisons of cervical cancer screening programmes in the European Union.

This paper summarises the similarities and differences between the cervical cancer screening programmes operating in the 15 Member States of the European Union as presented in the separate papers prepared by each country. The screening programmes are compared in terms of their duration of operation, type and sources of funding, invitation methodology, target population, organisation and quality assurance methodology with the aim of shedding some light upon the current situation of cervical cancer screening within the European Union.

Adult↗
PubMed2000

[Home and leisure accidents in young persons under 25 years of age in the European Union: challenges for tomorrow].

In all industrialised countries, the health status of children and adolescents has improved considerably. Today mortality in youngsters of one year and above is low, with the exception of mortality due to accidents: in childhood and adolescence, accidents (in particular those that occur at home or in leisure activities) represent the major cause of death. The objective of this paper is to assess the epidemiological evolution in the European Union in this respect and to review community actions aimed at reducing home and leisure accidents among youngsters living in the EU-region. Research underlines the multiple factors that bring about injuries caused by accidents and the role of environmental and behavioural factors in particular. The complexity and diversity of these factors suggest that priorities in prevention should be based on the severity of injuries and on the feasibility to prevent them. However, within the European Union, a consistent monitoring of mortality and morbidity related to home and leisure injuries is severely hampered by flaws in reporting current mortality and by the absence of a harmonized reporting system for morbidity. Launched in 1981, the European Home and Leisure Accident Surveillance System (EHLASS) is supposed to repair some of those deficiencies, but has not yet been in operation in all member states. Information from both systems is presented in this paper. Prevention policy itself requires coordination at various levels: between behavioural and environmental interventions and between various actors and intermediary groups involved. In the European Union a number of regulatory measures have been taken in order to improve of the safety of youngsters. However, only through clear-targeted programmes and well-coordinated structures and investments one can expect to achieve any change in injury among youngsters.

Accident Prevention↗
PubMed1995

How uniform are post-graduate training programs in medical oncology in the European Union?

BACKGROUND: Medical oncology is a relatively new discipline whose rapid evolution is not paralleled by advances in the academic curricula. The present study was designed to provide a description of the status of post-graduate training programs in medical oncology in the European Union. RESULTS: Our survey shows that 'some form' of training in medical oncology is available in 10 countries of the European Union, but that there are officially recognized Schools of Specialization in this discipline in only four (Great Britain, Portugal, Republic of Ireland and Spain). Italy and France offer training programs in medical oncology as specific tracks of the School of Specialization in Oncology. A 'special competence' in medical oncology, within the specialty of internal medicine, is issued in 3 additional countries (Denmark, Belgium and the Netherlands). Finally, training in medical oncology is linked to that in haematology in Germany. A wide variation was found among the different European countries regarding the requirements for admission to these training programs. Similarly, the duration of the programs in the various schools ranges between 2 and 6 years and the total number of years from graduation to achievement of the title of specialist ranges from 4 to 9 years. CONCLUSIONS: Our survey discloses a broad heterogeneity of academic attitude regarding medical oncology in the European Union and points to the need for recognition of this discipline as a specific and essential specialization.

Education, Medical, Graduate↗