Effectiveness of the adapted bivalent mRNA COVID-19 vaccines against hospitalisation in individuals aged ≥ 60 years during the Omicron XBB lineage-predominant period: VEBIS SARI VE network, Europe, February to August, 2023.

We conducted a multicentre hospital-based test-negative case-control study to measure the effectiveness of adapted bivalent COVID-19 mRNA vaccines against PCR-confirmed SARS-CoV-2 infection during the Omicron XBB lineage-predominant period in patients aged ≥ 60 years with severe acute respiratory infection from five countries in Europe. Bivalent vaccines provided short-term additional protection compared with those vaccinated > 6 months before the campaign: from 80% (95% CI: 50 to 94) for 14-89 days post-vaccination, 15% (95% CI: -12 to 35) at 90-179 days, and lower to no effect thereafter.

Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level.

In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol-Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine-131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure-response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual level.

Childhood leukaemia near nuclear sites in Belgium, 2002-2008.

This paper describes an ecological study investigating whether there is an excess incidence of acute leukaemia among children aged 0-14 years living in the vicinity of the nuclear sites in Belgium. Poisson regression modelling was carried out for proximity areas of varying sizes. In addition, the hypothesis of a gradient in leukaemia incidence with increasing levels of surrogate exposures was explored by means of focused hypothesis tests and generalized additive models. For the surrogate exposures, three proxies were used, that is, residential proximity to the nuclear site, prevailing winds and simulated radioactive discharges, on the basis of mathematical dispersion modelling. No excess incidence of acute leukaemia was observed around the nuclear power plants of Doel or Tihange nor around the nuclear site of Fleurus, which is a major manufacturer of radioactive isotopes in Europe. Around the site of Mol-Dessel, however, two- to three-fold increased leukaemia incidence rates were found in children aged 0-14 years living in the 0-5, 0-10 and the 0-15 km proximity areas. For this site, there was evidence for a gradient in leukaemia incidence with increased proximity, prevailing winds and simulated radioactive discharges, suggesting a potential link with the site that needs further investigation. An increased incidence of acute leukaemia in children aged 0-14 years was observed around one nuclear site that hosted reprocessing activities in the past and where nuclear research activities and radioactive waste treatment are ongoing.

Human biomonitoring of heavy metals in the vicinity of non-ferrous metal plants in Ath, Belgium.

BACKGROUND: A previous study revealed an environmental contamination by heavy metals in the vicinity of two non-ferrous metal plants in Ath, Belgium. The purpose of the current cross-sectional study was to estimate exposure of the population to heavy metals in the vicinity of the plants, in comparison with population living further away. METHODS: We did a random sampling in the general population of Ath in two areas: a central area, including the plants, and a peripheral area, presumably less exposed. We quantified cadmium, lead, nickel, chromium and cobalt in blood and/or urine of children and adults in three age groups: (i) children aged 2.5 to 6 years (n = 98), (ii) children aged 7 to 11 years (n = 74), and (iii) adults aged 40 to 60 years (n = 106). We also studied subclinical health effects by quantifying retinol-binding protein and microalbuminuria, and by means of a Strengths and Difficulties Questionnaire. RESULTS: We obtained a participation rate of 24 %. Blood lead levels were significantly higher in young children living in the central area (18.2 µg/l ; 95 % CI: 15.9-20.9) compared to the peripheral area (14.8 µg/l ; 95 % CI: 12.6-17.4). We observed no other significant mean difference in metal concentrations between the two areas. In the whole population, blood lead levels were higher in men (31.7 µg/l ; 95 % CI: 27.9-36.1) than in women (21.4 µg/l ; 95 % CI: 18.1-25.3). Urine cadmium levels were 0.06 µg/g creatinine (95 % CI: 0.05-0.07), 0.21 µg/g creatinine (95 % CI: 0.17-0.27), and 0.25 µg/g creatinine (95 % CI: 0.20-0.30) for children, men, and women, respectively. CONCLUSIONS: Despite higher blood lead levels in young children living close to the plants, observed metal concentrations remain in the range found in other similar biomonitoring studies in the general population and are below the levels of concern for public health.

Thyroid cancer incidence around the Belgian nuclear sites: surrogate exposure modelling.

BACKGROUND: In a recent ecological study among residents living around Belgian nuclear sites (the NUCABEL study), significant increased incidences of thyroid cancer were observed around the two nuclear facilities with industrial and research activities (Mol-Dessel and Fleurus), prompting further research. METHODS: The data from the NUCABEL study were reanalysed to test the hypothesis of a gradient in cancer incidence with increasing levels of exposure from these sites using three measures of surrogate exposure, being (i) residential proximity, (ii) prevailing wind directions and (iii) simulated dispersion of radioactive discharges. Single-site focussed hypothesis tests were complemented with Generalized Additive Models to estimate the exposure-response relationships. RESULTS: For Mol-Dessel, the results of the focussed hypothesis tests were far from significant. For Fleurus, the p-values were much closer to significance with p=0.05 for Bithell's Linear Risk Score using radioactive discharge estimates as surrogate. CONCLUSIONS: The re-analyses refute an association with the nuclear facilities for the site of Mol-Dessel. For the site of Fleurus, one of Europe's major production sites of radio-iodines, the results were less conclusive and further research suggests itself.

Thyroid cancer incidence in the vicinity of nuclear sites in Belgium, 2000-2008.

BACKGROUND: Public health concern about nuclear activities have existed since the 1980s. Most studies on this subject investigated childhood leukemia. Thyroid cancer may be another health outcome of interest, because some nuclear installations are a potential source of radioactive iodine isotopes in the environment and because thyroid cancer is known to occur after exposure to these isotopes. METHODS: This study describes an ecological study investigating whether there is excessive thyroid cancer incidence among residents living in the vicinity of nuclear sites. Single-site analyses using indirect standardization (standardized incidence ratios [SIRs]) and Poisson regression modeling (rate ratios [RRs]) were conducted. The proximity area is typically defined as a circular zone with a radius of 20 km centered on the site. However, the choice of the size of this area is somewhat arbitrary. Therefore, a sensitivity analysis was carried out to investigate whether the results vary with radii of increasing proximity. RESULTS: No increased thyroid cancer incidence was found within the 20 km proximity area around the nuclear power plants of Doel (SIR=0.74 [95% confidence interval (CI)=0.64; 0.84] and RR=0.72 [95% CI=0.63; 0.83]) and Tihange (SIR=0.86 [95% CI=0.70; 1.01] and RR=0.85 [95% CI=0.70; 1.02]). For the sites of Mol-Dessel and Fleurus, where a combination of nuclear research and industrial activities are located, the incidences of thyroid cancer within the 20 km proximity area were higher than expected (Mol-Dessel: SIR=1.19 [95% CI=1.01; 1.36] and RR=1.19 [95% CI=1.02; 1.38]; Fleurus: SIR=1.15 [95% CI=1.02; 1.28] and RR=1.17 [95% CI=1.04; 1.33]). For Chooz, a French nuclear power plant close to the Belgian border, the results were unstable as a result of the small population denominator. For all Belgian nuclear sites, the results were generally insensitive to the choice of the proximity area. CONCLUSIONS: No evidence for excessive thyroid cancer incidence around the Belgian nuclear power plants was found. On the other hand, an increased incidence of thyroid cancer was observed around the sites with other nuclear activities. Further research is recommended to verify whether the observed increases could be related to the site-specific nuclear activities.

Human biomonitoring on heavy metals in Ath: methodological aspects.

The municipality of Ath is characterised by the presence, in its center, of two non-ferrous metal industries whose emissions make local residents concerned for their health. Therefore, authorities of the Walloon Region and the municipality of Ath undertook biomonitoring to assess the impact of those industrial emissions on heavy metal body burden in humans.This paper describes the study design and methodology used to carry out this human biomonitoring.A random sampling was done in the general population, in two areas of Ath: an area centered around the industries and a peripheral area. The target population was children (2.5-11 years) and adults (40-60 years) without occupational exposure. The three-stage sampling procedure consisted of a mixture of both mail and telephone recruitment. Firstly, 3259 eligible people, identified from a population register, were mailed an introductory letter. In a second stage, eligible individuals were contacted by phone to propose them to participate in the study. They were randomly contacted until the required sample size was obtained. In the third stage, a second mail was sent to those who agreed to participate with a questionnaire to be filled out. Finally, biological samples (blood and urine) from 278 persons were collected. The final participation rate of this study was 24%.This sampling procedure, especially designed for the purpose of this biomonitoring study in Ath, allowed us to recruit a sample representative of the population of children and adults of Ath, reaching the expected sample size in a short period of time.

Impact of iron and steel industry and waste incinerators on human exposure to dioxins, PCBs, and heavy metals: results of a cross-sectional study in Belgium.

We evaluated the impact of two iron and steel plants and two municipal solid waste incinerators (MSWI) in Wallonia (Belgium) on the exposure of residents to dioxins, polychlorinated biphenyls (PCBs), and heavy metals. In total, 142 volunteers living around these facilities were recruited and compared with 63 referents from a rural area with no industrial source of pollution. Information about smoking habits, dietary habits, anthropometric characteristics, residential history, and health status was obtained from a self-administered questionnaire. The volunteers provided blood under fasting conditions in order to evaluate the body burden of dioxins (17 polychlorinated dibenzo-p-dioxins/dibenzofurans [PCDD/Fs] congeners) and PCBs. Samples of blood and urine were also taken for the determination of cadmium, mercury, and lead. After adjustment for covariates, concentrations of cadmium, mercury, and lead in urine or blood were not increased in subjects living in the vicinity of MSWIs or sinter plants by comparison with referents. Residents around the sinter plants and the MSWI located in the industrial area had concentrations of dioxins and PCBs in serum similar to that of referents. By contrast, subjects living in the vicinity of the MSWI in the rural area showed significantly higher serum levels of dioxins (geometric mean, 38 vs. 24 pg TEQ/g fat) and coplanar PCBs (geometric mean, 10.8 vs. 7.0 pg TEQ/g fat). Although age-adjusted dioxin levels in referents did not vary with local animal fat consumption, concentrations of dioxins in subjects living around the incinerators correlated positively with their intake of local animal fat, with almost a doubling in subjects with the highest fat intake. These results indicate that dioxins and coplanar PCBs emitted by MSWIs can indeed accumulate in the body of residents who regularly consume animal products of local origin.

Environmental and human impact of an old-timer incinerator in terms of dioxin and PCB level: a case study.

The impact of a recently closed old municipal solid waste incinerator (MSWI) on polychlorodibenzo-p-dioxin (PCDD), polychlorodibenzofuran (PCDF), and polychlorinated biphenyl (PCB) levels in the surrounding environment and resident serum has been studied in a small rural area of France. Studied soils and eggs from chickens foraging on these soils were sampled in the vicinity of the MSWI underthe prevailing wind stream, while comparison samples were collected outside the assumed impact zone. PCB levels observed in soils and eggs did not differ statistically from comparison sites. This confirmed the low impact of MSWI PCB emission on environmental media, compared to other well-known sources. PCDD/PCDF levels in soils and eggs were significantly higher than in comparison samples, pointing out the impact of MSWI emission on the surrounding environment. The high dioxin concentrations in eggs set aside for private consumption would increase the dioxin intake for the studied population. Blood specimens of 10 nonoccupationally exposed volunteers who had lived within a 2 km radius of the incinerator for at least 25 years have been analyzed. When adjusted for age, PCB and PCDD/F blood levels were higher than general European populations and comparable to a similarly exposed Belgian population.

Cloning and embryonic expression pattern of the mouse Onecut transcription factor OC-2.

Onecut (OC) transcription factors are evolutionarily conserved proteins with important developmental functions. They contain a bipartite DNA-binding domain composed of a single cut domain associated with a divergent homeodomain. The human genome contains three Onecut paralogues, Hnf6 (also called Oc1), Oc2 and Oc3. We describe here the cloning of mouse (m) OC-2 and its expression pattern in the mouse embryo. The mOc2 gene was localized on chromosome 18. Analysis of the mOC-2 amino acid sequence revealed overall identities of 67% with mHNF-6 and of 56% with mOC-3, and the presence of functional domains delineated earlier in HNF-6. The sequence of the 153 residue-long cut-homeodomain was very conserved, as it was 92% identical to that of mHNF-6 and 89% identical to that of mOC-3. In situ hybridization showed expression of mOc2 in the developing nervous system and gut endoderm. Like Hnf6, Oc2 was expressed in developing liver and pancreas. As many genes that are targeted by Onecut factors are recognized by both OC-2 and HNF-6, this overlap of expression patterns may have functional implications.

Dioxin accumulation in residents around incinerators.

To evaluate the human exposure impact of municipal waste incinerators, dioxin and coplanar polychlorinated biphenyl (PCB) concentrations were determined in blood of 84 subjects who resided approximately 18 yr in the vicinity of two old incinerators, one located in a rural area (n=51) and the other in an industrial area (n=33). These subjects were compared with 63 controls from an unpolluted area. While no change was found in contaminant levels in residents living around the incinerator in the industrial area, subjects residing around the incinerator in the rural area possessed significantly higher serum levels of dioxins (38 vs. 24 pg TEQ/g fat) and coplanar PCBs (10 vs. 7 pg TEQ/g fat) than controls. These results were confirmed by multiple-regression analysis, showing that residence around the incinerator in the rural area (partial r2=.18) was the major contributor to dioxin accumulation followed by age (partial r2=.07). A two-way analysis of variance (ANOVA) on age-adjusted dioxin levels revealed a significant interaction between residence around incinerators and the consumption of fat from local origin, especially bovine and poultry products. Although age-adjusted dioxin levels in controls did not vary with local animal fat consumption, concentrations of dioxins in subjects living around the incinerators increased proportionally to their intake of local animal fat, with almost a doubling in subjects with a fat intake higher than 150 g fat/wk. Extrapolation from these data suggests that a significant increase of dioxin body burden is likely to occur only when dioxin emissions exceed 5 ng TEQ/Nm3, a threshold considerably above most emissions standards currently in force.

Dioxin/polychlorinated biphenyl body burden, diabetes and endometriosis: findings in a population-based study in Belgium.

Dioxins and polychlorinated biphenyls (PCBs) are persistent organic pollutants widely distributed in the food chain, which is the main source of human exposure. Their effects on human health at background exposure levels are still poorly understood. Recent epidemiological evidence suggests a possible association between these pollutants and diabetes. We report here the results of a population-based study in Belgium on 257 (142 women and 115 men) environmentally exposed subjects, including 10 cases of endometriosis and nine cases of diabetes. Seventeen 2,3,7,8-polychlorinated dibenzodioxins/dibenzofurans (PCDD/Fs or dioxins), four coplanar PCBs (International Union of Pure and Applied Chemistry [IUPAC] nos 77, 81, 126 and 169) and 12 PCB markers (IUPAC nos 3, 8, 28, 52, 101, 118, 138, 153, 180, 194, 206 and 209) were quantified in serum fat from fasting blood samples in order to estimate the body burden of these pollutants. Whilst no difference was found between women with endometriosis and their controls, diabetic patients had significantly increased serum levels of dioxins, coplanar PCBs and the 12 PCB markers. After adjustment for age and other covariates, serum total toxic equivalent activity (sum of PCDD/Fs and coplanar PCBs) and 12 PCB marker concentrations in diabetics were 62% (p = 0.0005) and 39% (p = 0.0067) higher, respectively, than in controls. The risk of diabetes was significantly increased in subjects in the top decile for adjusted concentrations of dioxins (odds ratio 5.1, 95% confidence interval [CI] 1.18-21.7), coplanar PCBs (odds ratio 13.3, 95% CI 3.31-53.2) or 12 PCB markers (odds ratio 7.6, 95% CI 1.58-36.3). These findings warrant further studies to assess the significance of the associations between diabetes and environmental exposure to polychlorinated pollutants.

Low bone density and renal dysfunction following environmental cadmium exposure in China.

This paper presents the main findings of a study on health effects of environmental cadmium pollution in China, performed in 1998, i.e. approximately 25 years after the first warnings of such effects were published in Ambio. Forearm bone mineral density (BMD) and renal dysfunction were assessed in population groups exposed to cadmium via rice. Decreased BMD was found in postmenopausal women with elevated urinary cadmium (CdU) or cadmium in blood (CdB) and among men with elevated CdB. Also, clear and statistically significant dose-effect and dose-response relationships were found between CdB or CdU and renal dysfunction (increased excretion of retinol-binding protein). This is the first report of bone effects among Cd-exposed population groups in Asia outside Japan. The report is also of interest since it demonstrates that bone effects, a comparatively severe adverse health effect of Cd, in combination with renal dysfunction, still occurs in environmentally exposed population groups in Asia. Recent reports on bone effects in Cd-exposed population groups in Europe are discussed.