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PubMed1993

European Community research on environmental mutagenesis and carcinogenesis.

Within the 12 Member States of the European Community (EC), environmental policy is now formulated primarily at Community level. As a result, the EC has important regulatory responsibilities for the protection of workers, consumers, and the general public from risks that may arise from environmental chemicals, foremost among them potential carcinogens and mutagens. An important part of EC environmental research and development is intended to provide a scientific basis for these regulations as well as increasing understanding of the basic mechanisms involved in environmental carcinogenesis and mutagenesis. This paper contains a brief introduction to EC environment policy and research, followed by an overview of EC chemicals control activities that are of particular relevance to the research and development program. Community-level research on environmental mutagenesis and carcinogenesis is then reviewed in some detail, including the achievements of recent projects, the scientific content of the current program, and perspectives for the future.

Animals↗
PubMed1993

The detection and assessment of the aneugenic potential of environmental chemicals: the European Community Aneuploidy Project.

Within the framework of its' Environment Research and Development Programme, the European Communities (EC) Directorate General (DG) XII has supported a research project aimed at developing and validating assay systems for the detection and evaluation of chemicals capable of inducing numerical chromosome changes such as aneuploidy and polyploidy. A range of test chemicals were selected, which include a core set comprising; colchicine, econazole nitrate, chloral hydrate, hydroquinone, diazepam, thiabendazole, cadmium chloride, thimerosol, pyrimethamine and vinblastine sulphate. These test chemicals were used to evaluate the ability of test systems ranging from tubulin polymerisation, fungal cultures, cultured mammalian cells and intact rodents to detect chemical aneugens and to assess the significance of such activity to exposed human populations.

Aneuploidy↗
PubMed1996

Smoking prevalence among women in the European community 1950-1990.

The paper reviews trends in tobacco use among women in the European Community (EC) between 1950 and 1990. The data suggest that EC countries occupy different points on what appears to be a common prevalence curve. Southern EC countries are represented in the early phases of this curve, marked out by sharply rising prevalence. In northern EC countries, female smoking prevalence appears to have peaked. Across the EC, the commodification of tobacco use, and the production and promotion of manufactured cigarettes in particular, underlies this prevalence curve. Young women in higher socio-economic groups have led the way into cigarette smoking in both northern and southern Europe, with smoking prevalence declining first among women who are privileged in terms of their education, occupation and income. Because the decline in prevalence has yet to be repeated among women in more disadvantaged circumstances, cigarette smoking among women in the EC is likely to become a habit increasingly linked to low socio-economic status.

Adolescent↗
PubMed1993

EURONEST: a concerted action of the European community for the study of organic solvents neurotoxicity.

EURONEST, a concerted action of the European Community with the participation of most EC and some COST countries, is a project aimed at studying the epidemiological impact of CNS effects from protracted exposure to industrial chemicals in the participating countries. After a review of current knowledge, the paper examines the structure and detailed aims, i.e., the qualitative and quantitative study of exposure to neurotoxic chemicals, the performance of an investigation to contribute to the controversial issue of organic solvents CNS toxicity, the definition of the solvent-induced psychoorganic syndrome as well as its epidemiological relevance, and the influence of exposure on the quality of life, in particular on aging. The primary target population consists of workers with long-term exposure to toluene in the printing industry to establish CNS effects and no-effect level; depending on local priorities mixed solvents exposure can also be investigated. The study design is an ambidirectional cohort and sample size requirements are given. The approach as to the methods is not to choose at once among the available neurobehavioral batteries, but to produce a register of the 20-25 tests more commonly used in the different participating laboratories, in order to examine their validity, sensitivity, and reliability. From this exercise, a new more flexible battery is expected to be more effectively applicable under different conditions. Criteria for clinical diagnosis of the solvent-induced psychoorganic syndrome are given in order to be utilized in the investigation of the prevalence rates of these disorders included in the concerted action's program.

Chemistry, Organic↗
PubMed1986

Strengthening the practice of epidemiology in the European Community.

At the request of the COMAC EPID committee of the Commission of the European Communities the author visited all the countries of the EEC except Luxembourg in 1983-84 in order to prepare a report on 'Upgrading in epidemiology'. The report was presented at a meeting organized by COMAC EPID in April 1984 and subsequently revised and finally presented in January 1985. This paper is an abbreviated version of the report and describes some main features and some of the obstacles in the organization of undergraduate and postgraduate education, and research in epidemiology in the EEC. The application of epidemiological knowledge at national, regional and local level and communications between epidemiologists are also discussed.

Education, Medical, Graduate↗
PubMed1987

Certification and coding of two underlying causes of death in The Netherlands and other countries of the European Community.

Differences in certification and coding of causes of death between countries of the European Community were studied by sending sets of case histories to samples of certifying physicians. Completed certificates were coded by national coding offices and by by a WHO reference centre. Detection fractions ranged from 60% to 92% in a first study (concerning cases of chronic obstructive pulmonary disease) and from 80% to 94% in a second study (concerning cases of cancer). A detailed analysis of the findings for the Netherlands, which performed very well in both studies, reveals a substantial frequency of errors in certification (as opposed to errors in diagnosis). Comparison of national and reference centre coding suggests that the Dutch coding process is to a certain extent adapted to the frequency of these certification errors, leading to deviations from WHO coding rules. It is concluded that certification and coding practices should be studied together and that further international standardisation of coding practices will not necessarily improve the validity of national cause of death statistics.

Cause of Death↗
PubMed2002

Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey.

OBJECTIVE: To assess whether the severity of asthma is associated with sensitisation to airborne moulds rather than to other seasonal or perennial allergens. DESIGN: Multicentre epidemiological survey in 30 centres. SETTING: European Community respiratory health survey. PARTICIPANTS: 1132 adults aged 20-44 years with current asthma and with skin prick test results. MAIN OUTCOME MEASURES: Severity of asthma according to score based on forced expiratory volume in one second, number of asthma attacks, hospital admissions for breathing problems, and use of corticosteroids in past 12 months. RESULTS: The frequency of sensitisation to moulds (Alternaria alternata or Cladosporium herbarum, or both) increased significantly with increasing asthma severity (odds ratio 2.34 (95% confidence interval 1.56 to 3.52) for either for severe v mild asthma). This association existed in all of the study areas (gathered into regions), although there were differences in the frequency of sensitisation. There was no association between asthma severity and sensitisation to pollens or cats. Sensitisation to Dermatophagoides pteronyssinus was also positively associated with severity. In multivariable logistic regressions including sensitisation to moulds, pollens, D pteronyssinus, and cats simultaneously, the odds ratios for sensitisation to moulds were 1.48 (0.97 to 2.26) for moderate v mild asthma and 2.16 (1.37 to 3.35) for severe v mild asthma (P<0.001 for trend). CONCLUSIONS: Sensitisation to moulds is a powerful risk factor for severe asthma in adults. This should be taken into account in primary prevention, management, and patients' education.

Adult↗
PubMedDate not supplied

[Mortality of children aged 1 to 4 years in the countries of the European Community].

Mortality rates of children aged 1 to 4 years in each country of the European Community were reviewed. Data was drawn from statistics published by the individual countries. Overall, mortality rates were 61 per 100,000 in boys and 51 per 100,000 in girls and are highest in the Republic of Ireland, the FRG and Belgium. Between 1960 and 1980, mortality decreased in all countries and for both sexes; improvement was greatest in the countries where mortality rates were the highest in 1960. Accidents of different types were the main causes of death in each country. Some were related to age group specific behaviour, such as drownings and falls in young children and suffocations in infants. However, most deaths were due to traffic accidents.

Accidents↗
PubMedDate not supplied

Guidelines of the Commission of the European Communities: a challenge for the control of packaging.

Questions arising from the Commission of the European Communities Directives and guidelines regulating packaging materials are discussed in relation to whether compliance ensures safety in use and the consequent analytical problems. Difficulties may arise from interactions between food contact materials and food involving mass transfer (migration, off-odours, 'scalping', loss of aroma) or mass transfer and chemical interactions and the implications for safety assurance and regulation are addressed. The criteria for suitable low molecular weight fatty food simulants and conditions for migration testing are presented. In food surveillance, the usefulness of various methods of analysis differs for monomers and for additives. For monomers, IR spectroscopy can identify the polymer type and which specific monomers need controlling; for unknown mixtures of additives, preliminary functional group identification by techniques such as 1H-NMR is useful.

European Union↗
PubMed1993

Childhood cancer mortality in the European Community, 1950-1989.

A descriptive study on childhood cancer mortality was carried out in the European Community (EC) covering the period 1950-1989. An annual total of 3392 cancer deaths were seen among children in the EC during the period 1979-1988, yielding an age-standardised cancer mortality rate of 50 per 10(6). Leukaemia was the most prevalent cause of death among children with cancer (39%). Excess mortality was observed among boys for cancers at all sites combined and for cancers at specific sites, exclusive of malignant tumours of the kidney. This excess is presumed to be due mainly to sex differences in incidence. Markedly higher mortality rates of childhood cancer were seen in southern countries of the EC than in central and northern countries. This difference appeared to be due mainly to differences in cancer incidence among the countries and to a lesser degree to differences in treatment and survival. An overall decline in mortality from childhood cancer in the EC occurred from the early 1960s. In spite of the improvements in survival, however, childhood cancer remains a major cause of death in the EC, affecting about 15% of children between the ages of 1 and 14.

Adolescent↗
PubMedDate not supplied

Effect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the European Community Respiratory Health Survey: a cross-sectional study.

BACKGROUND: Passive smoking is widespread, and environmental tobacco smoke contains many potent respiratory irritants. This analysis aimed to estimate the effect of passive smoking on respiratory symptoms, bronchial responsiveness, lung function, and total serum IgE in the European Community Respiratory Health Survey. METHODS: This analysis included data from 7882 adults (age 20-48 years) who had never smoked, from 36 centres in 16 countries. Information on passive smoking, respiratory symptoms, asthma, and allergic rhinitis was gathered through a structured interview. Spirometry and methacholine challenge were carried out, and total and specific IgE were measured. The effect of passive smoking was estimated by means of logistic and multiple linear regression for each country and combined across countries by random-effects meta-analysis. FINDINGS: In 12 of the 36 centres, more than half the participants were regularly involuntarily exposed to tobacco smoke. The prevalence of passive smoking in the workplace varied from 2.5% in Uppsala, Sweden, to 53.8% in Galdakao, Spain. Passive smoking was significantly associated with nocturnal chest tightness (odds ratio 1.28 [95% CI 1.02 to 1.60]), nocturnal breathlessness (1.30 [1.01 to 1.67]), breathlessness after activity (1.25 [1.07 to 1.47]), and increased bronchial responsiveness (effect -0.18 [-0.30 to -.05]). Passive smoking in the workplace was significantly associated with all types of respiratory symptoms and current asthma (odds ratio 1.90 [95% CI 0.90 to 2.88]). No significant association was found between passive smoking and total serum IgE. INTERPRETATION: Passive smoking is common but the prevalence varies widely between different countries. Passive smoking increased the likelihood of experiencing respiratory symptoms and was associated with increased bronchial responsiveness. Decreasing involuntary exposure to tobacco smoke in the community, especially in workplaces, is likely to improve respiratory health.

Adult↗
PubMed2003

Smoking and occupation from the European Community Respiratory Health Survey.

BACKGROUND: Smoking is among the most important personal and modifiable risk factors for adverse health outcomes. The workplace offers a potentially effective venue for tobacco prevention programmes; identifying occupational groups with high smoking prevalence may assist in targeting such programmes. AIMS: To examine smoking prevalence among occupational groups in the European Union. METHODS: The European Community Respiratory Health Survey (ECRHS), a cross sectional health survey conducted in 1992-93, was used to examine smoking prevalence by occupation among 14 565 subjects from 30 centres in 14 participating countries. RESULTS: There was an approximately twofold range in smoking prevalence by occupation. For occupational groups with at least 50 subjects, the highest smoking prevalence was seen in metal making and treating for men (54.3%) and cleaners for women (50.7%). Increased smoking prevalence by occupation persisted after adjustment for age, country, and age at completion of education. Smoking was also increased among occupations with high exposure to mineral dust and gas or fumes. CONCLUSIONS: Smoking rates vary significantly by occupation. Prevention efforts in the workplace should focus on occupations with high smoking prevalence and large employment bases.

Adult↗
PubMed2002

Housing characteristics, reported mold exposure, and asthma in the European Community Respiratory Health Survey.

BACKGROUND: The effects of home dampness and mold exposure on adult asthma are not clear. OBJECTIVE: We aimed to investigate the associations between housing characteristics related to dampness, mold exposure, and house dust mite levels and adult asthma in 38 study centers from the European Community Respiratory Health Survey. METHODS: Data about the present home, heating and ventilation systems, double glazing, floor covers, recent water damage, and mold exposure were obtained by means of an interviewer-led questionnaire. The associations between these factors and asthma, as defined on the basis of symptoms in the last year, and of bronchial responsiveness, as determined with methacholine challenge, were evaluated. Odds ratios (ORs) were obtained by using random-effects meta-analyses adjusted within study centers for sex, age group, and smoking status. RESULTS: Fitted carpets and rugs in the bedroom were related to fewer asthma symptoms and bronchial responsiveness (OR range, 0.69-0.91). This effect was consistent across centers and more pronounced among house dust mite-sensitized individuals. Reported mold exposure in the last year was associated with asthma symptoms and bronchial responsiveness (OR range, 1.14-1.44). This effect was homogeneous among centers and stronger in subjects sensitized to Cladosporium species. In centers with a higher prevalence of asthma, the prevalence of reported indoor mold exposure was also high. This association was observed for reported mold exposure by asthmatic subjects (Spearman r (s) = 0.46), as well as reported mold exposure by nonasthmatic subjects (r (s) = 0.54). Reported mold exposure was highest in older houses with recent water damage. CONCLUSION: We conclude that indoor mold growth has an adverse effect on adult asthma.

Adult↗
PubMed1994

[Concerted action program for quality assurance of European community hospitals as applied in Israel].

The concerted action program on quality assurance (QA) of the European Community (COMAC) was implemented in 14 hospitals in Israel. It was focused on prevention of pressure sores, preoperative assessment, prophylactic use of antibiotics in elective surgery and proper keeping of medical and nursing records. Mechanisms for quality assessment and interventions for improvement and monitoring were implemented. Improvement in QA infrastructure, processes of care in the project topics, and in QA awareness were found. Management involvement, previous motivation for professional improvement, behavioral strategies for change and having highly respected QA leaders were found to contribute to the development of effective QA. Professional associations and national authorities should be responsible for establishing support systems as well as promoting legislation, formulating guidelines, recommending allotment of resources, and developing educational programs.

Europe↗
PubMed2004

Geographic variations in the effect of atopy on asthma in the European Community Respiratory Health Study.

BACKGROUND: Atopy has long been related to asthma. The prevalences of both atopy and asthma have shown substantial variation. OBJECTIVE: We sought to assess geographic variations in the fraction of asthma attributable to IgE sensitization to specific allergens in the European Community Respiratory Health Survey. METHODS: A cross-sectional study was undertaken during the years 1991 and 1992 on 13,558 individuals in 36 centers in 16 countries. Asthma was defined in several ways, variously incorporating reported symptoms, bronchial responsiveness to methacholine, and physician diagnosis. Specific IgE against house dust mite (Dermatophagoides pteronyssinus), cat, timothy grass, Cladosporium herbarum , and a local allergen (birch, Parietaria judaica , or ragweed) were measured. RESULTS: The overall attributable fraction (AF) of asthma symptoms caused by atopy was 30% but varied widely between centers, ranging from 4% to 61%. The overall AF increased to 43% when asthma was based on wheezing and bronchial responsiveness, to 45% with a physician diagnosis of asthma, and to 48% when the patient reported more than 12 attacks in the last year. Between centers, the AF for atopy was significantly correlated with the prevalence of atopy among the asthmatic patients ( r = 0.91) and with the sensitization to house dust mite ( r = 0.64), as well as with the prevalence of asthma among atopic individuals ( r = 0.43) and the prevalence of asthma among nonatopic individuals ( r = -0.51). CONCLUSION: The effect of atopy on the prevalence of asthma varies widely between centers, probably because of variations in factors related to the expression of asthma and to the prevalence of sensitization, particularly to house dust mite.

Allergens↗
PubMed1990

Freedom of movement in the European Community.

The regulations which operate with regard to the freedom of movement of dentists working within the European Community (EC) are described. The actual effects of these directives on dental manpower and planning are discussed, together with other aspects of EC policy and effects which they may have on the dental profession both currently and in the near future. Governmental controls over the dental profession are also discussed in relation to oral and general health with consideration being given to the 'consumer led' developments of health policies.

Dentists↗
PubMed1993

[Quo vadis--infant nutrition in the European Community? A comment on the guideline of the EC Commission on initial infant and subsequent nutrition].

The new European Community guidelines on infant nutrition formulas, their contents and their declaration, effective since January 1993, do not indicate a scientifically sound progress in infant nutrition. Several of the contents listed (i.e. carbohydrates) may be of potential risk to health. In the future, European paediatricians will have to occupy themselves more concisely with the contents of marketed infant formulas. Individual solutions may have to be found for some patients.

Europe↗
PubMed1994

[Comparison of public health systems within the European Community].

Only two out of three ideal types of health care systems can be observed in the European Community (EC): Centrally planned systems (countries with a national health service) and systems managed mainly by associations of health insurance funds and also of providers (countries with a social insurance system). We find no country with a market-type health care system in Europe. Both types of systems occurring in the EC are compared with each other, both with regard to their ideal types and also to their actual operations when judged on grounds of financing and production of health care. When seen as ideal types, we note considerable differences. Real types however exhibit only gradual differences. The shares of major subcategories of health spending differ widely between EC countries. These differences, however, cannot be attributed to the different health care systems. Similar observations can be made regarding different forms of payment for hospital care and for physician services and also regarding the share of total health expenditure in GDP.

Cost-Benefit Analysis↗