Egypt passed a revolution and changed its political system, but many problems are still lacking a solution. Especially in the field of water the North African country has to face many challenges. Most urgent are strategies to manage the limited water resources. About 80% of the available water resources are consumed for agriculture and the rest are for domestic and industrial activities. The management of these resources is inefficient and a huge amount of fresh water is discarded. The shortage of water supply will definitely influence the economic and cultural development of Egypt. In 2010, Egypt was ranked number 8 out of 165 nations reviewed in the so-called Water Security Risk Index published by Maplecroft. The ranking of each country in the index depends mainly on four key factors, i.e. access to improved drinking water and sanitation, the availability of renewable water and the reliance on external supplies, the relationship between available water and supply demands, and the water dependency of each countrys economy. Based on this study, the situation of water in Egypt was identified as extremely risky. A number of programs and developed strategies aiming to efficiently manage the usage of water resources have been carried out in the last few years by the Egyptian Government. But all these activities, however, require the availability of trained and well-educated individuals in water technology fields. Unfortunately, the number of water science graduates are decreasing and also there are few teaching and training courses for water science offered in Egypt. However, there is still a demand for several well-structured and international programs to fill the gap and provide the Egyptian fresh graduates with the adequate and up-to-date theoretical and practical knowledge available for water technology. IWaTec is designed to fill parts of this gap.
Objectives Within the framework of the burden of disease (BoD) approach, disease and injury burden estimates attributable to risk factors are a useful guide for policy formulation and priority setting in disease prevention. Considering the important differences in methods, and their impact on burden estimates, we conducted a scoping literature review to: (1) map the BoD assessments including risk factors performed across Europe; and (2) identify the methodological choices in comparative risk assessment (CRA) and risk assessment methods. Methods We searched multiple literature databases, including grey literature websites and targeted public health agencies websites. Results A total of 113 studies were included in the synthesis and further divided into independent BoD assessments (54 studies) and studies linked to the Global Burden of Disease (59 papers). Our results showed that the methods used to perform CRA varied substantially across independent European BoD studies. While there were some methodological choices that were more common than others, we did not observe patterns in terms of country, year or risk factor. Each methodological choice can affect the comparability of estimates between and within countries and/or risk factors, since they might significantly influence the quantification of the attributable burden. From our analysis we observed that the use of CRA was less common for some types of risk factors and outcomes. These included environmental and occupational risk factors, which are more likely to use bottom-up approaches for health outcomes where disease envelopes may not be available. Conclusions Our review also highlighted misreporting, the lack of uncertainty analysis and the under-investigation of causal relationships in BoD studies. Development and use of guidelines for performing and reporting BoD studies will help understand differences, avoid misinterpretations thus improving comparability among estimates. © The Author(s) 2023.
Background Burden of disease analyses quantify population health and provide comprehensive overviews of the health status of countries or specific population groups. The comparative risk assessment (CRA) methodology is commonly used to estimate the share of the burden attributable to risk factors. The aim of this paper is to identify and address some selected important challenges associated with CRA, illustrated by examples, and to discuss ways to handle them. Further, the main challenges are addressed and finally, similarities and differences between CRA and health impact assessments (HIA) are discussed, as these concepts are sometimes referred to synonymously but have distinctly different applications. Results CRAs are very data demanding. One key element is the exposure-response relationship described e.g. by a mathematical function. Combining estimates to arrive at coherent functions is challenging due to the large variability in risk exposure definitions and data quality. Also, the uncertainty attached to this data is difficult to account for. Another key issue along the CRA-steps is to define a theoretical minimal risk exposure level for each risk factor. In some cases, this level is evident and self-explanatory (e.g., zero smoking), but often more difficult to define and justify (e.g., ideal consumption of whole grains). CRA combine all relevant information and allow to estimate population attributable fractions (PAFs) quantifying the proportion of disease burden attributable to exposure. Among many available formulae for PAFs, it is important to use the one that allows consistency between definitions, units of the exposure data, and the exposure response functions. When combined effects of different risk factors are of interest, the non-additive nature of PAFs and possible mediation effects need to be reflected. Further, as attributable burden is typically calculated based on current exposure and current health outcomes, the time dimensions of risk and outcomes may become inconsistent. Finally, the evidence of the association between exposure and outcome can be heterogeneous which needs to be considered when interpreting CRA results. Conclusions The methodological challenges make transparent reporting of input and process data in CRA a necessary prerequisite. The evidence for causality between included risk-outcome pairs has to be well established to inform public health practice. © The Author(s) 2022
Ziel des Arbeitspaketes ist die Erarbeitung intelligenter und effizienter Finanzierungslösungen für Investitionen in die Sicherheit von Netzinfrastrukturen mit dem Ziel des Nachweises der Vorteilhaftigkeit solcher Investitionen. Dazu wird exemplarisch das Projekt Desertec untersucht, welches die Idee verfolgt, ein umweltfreundliches Energiegewinnungskonzept durch Solar- und Windkraft in der Sahara zu entwickeln. Das IAS wird die zugrunde liegende Forschungsfrage anhand der Fallstudie Desertec bearbeiten. Dazu wird ein Vorgehen in acht Stufen gewählt: 1. Sichtung der kompletten Literatur zu Sicherheitstechnik/Arbeitsschutz sowie Projektfinanzierung/Risk Sharing; 2. Entwicklung eines Katalogs von Risiken und alternativen Handling-Möglichkeiten; 3. Abstimmung des Katalogs der relevanten Risiken bei Desertec sowie Aufnehmen des Risk-Handling Ansatzes von Desertec; 4. Analyse des Risikokatalogs auf Verbundwirkungen (Klumpenrisiken) und Strukturierung des Risikokatalogs; 5. Entwicklung alternativer Risk-Handling Maßnahmen (präventiv und ex-post); 6. Abschätzung der Kosten-/Nutzenwirkung der alternativen Maßnahmen in Kooperation mit den relevanten Desertec-Firmen; 7. Integration in Business Pläne und Ermittlung der Veränderungen anhand verschiedener Beurteilungskriterien wie Kapitalwert (DCF) oder sonstigen Zielgrößen; 8. Erarbeitung von Handlungsempfehlungen.
Das Ziel des vorliegenden Projektes ist es, die Wirkung niedriger, mittlerer und hoher Dosen ionisierender Strahlung in einem Bereich zwischen 0,2 Gy und 16 Gy auf mikrovaskuläre Endothelzellen (mECs) gewonnen aus unterschiedlichen Normalgeweben zu studieren. Im Besonderen sollen die Interaktionen zwischen mikrovaskulären ECs und Immuneffektorzellen in vitro und im Mausmodell untersucht werden. Wir werden uns auf Herz, Subkutis, Leber (Sievert et al. 2014; Hildebrandt et al. 1998) und die Lunge als Hochrisiko-Organe konzentrieren. Aufklärung der funktionellen und phänotypischen Änderungen von pathogener Relevanz in mikrovaskulären Endothelzellen (mECs) isoliert aus Herz, Haut, Leber und Lunge (Sievert et al. 2014). Interaktion von mECs (nicht bestrahlt und bestrahlt) mit Subpopulationen von Leukozyten. Erfassung der histologischen und immunhistologischen Änderungen von nicht bestrahlten und mit niedrigen Dosen bestrahlten mECs. Vergleichende Proteom- und Transkriptom-Anlalyse von mECs aus nicht bestrahlten Geweben. Integrierung der Daten zu einem Modell über den biologischen Mechanismus der strahleninduzierten Pathogenese (Azimzadeh et al. 2015).
Das Ziel des vorliegenden Projektes ist es, die Wirkung niedriger, mittlerer und hoher Dosen ionisierender Strahlung in einem Bereich zwischen 0,2 Gy und 16 Gy auf mikrovaskuläre Endothelzellen (ECs) gewonnen aus unterschiedlichen Normalgeweben zu studieren. Im Besonderen sollen die Interaktionen zwischen mikrovaskulären ECs und Immuneffektorzellen in vitro und im Mausmodell untersucht werden. Wir werden uns auf Herz, Subkutis, Leber (Hildebrandt et al. 1998) und die Lunge als Hochrisiko-Organe konzentrieren. Aufklärung der funktionellen und phänotypischen Änderungen von pathogener Relevanz in mikrovaskulären Endothelzellen (mECs) isoliert aus Herz, Haut, Leber und Lunge. Interaktion von mECs (nicht bestrahlt und bestrahlt) mit Subpopulationen von Leukozyten. Erfassung der histologischen und immunhistologischen Änderungen von nicht bestrahlten und mit niedrigen Dosen bestrahlten mECs. Vergleichende Proteom- und Transkriptom-Analyse von ECs aus nicht bestrahlten Geweben. Integrierung der Daten zu einem Modell über den biologischen Mechanismus der strahleninduzierten Pathogenese.
Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk-outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46ââą 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 341 million (95% uncertainty interval [UI] 333-350) deaths and 121 billion (114-128) DALYs were attributable to GBD risk factors. Globally, 610% (596-624) of deaths and 483% (463-502) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 104 million (939-115) deaths and 218 million (198-237) DALYs, followed by smoking (710 million [683-737] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (653 million [523-823] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 472 million [299-670] deaths and 148 million [986-202] DALYs), and short gestation for birthweight (143 million [136-151] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 49% (33-65) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 235% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 186% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. © 2018 The Author(s). Published by Elsevier Ltd.
Die EU Verordnung 1107/2009 führt das Substitutionsprinzip für die Zulassung von Pflanzenschutzmitteln ein, die Wirkstoffe enthalten, die als Substitutionskandidaten identifiziert wurden. Für dieses neue rechtliche Verfahren werden Wirkstoffe auf Kommissionsebene als Substitutionskandidaten gekennzeichnet, wenn sie bestimmte Kriterien hinsichtlich der Gefährdung der menschlichen Gesundheit oder der Umwelt erfüllen. Nachfolgend ist auf Ebene der Mitgliedstaaten eine vergleichende Risikobewertung für Präparate vorzunehmen, falls für ein Produkt eine Zulassung beantragt wird, welches einen solchen Substitutionskandidaten enthält. Fast ein Viertel der gegenwärtig in der EU zugelassenen Wirkstoffe könnten als Substitutionskandidaten gekennzeichnet werden, und viele davon werden aufgrund ihrer Persistenz, Bioakkumulation oder aquatischen Toxizität eine Kennzeichnung erfahren. Für Pflanzenschutzmittel, die gegenwärtig in Deutschland zugelassen sind, ist zu erwarten, dass rund ein Drittel der Präparate in die Kategorie fallen würde, für die bei einer Neuzulassung eine vergleichende Bewertung mit Alternativprodukten erforderlich werden könnte. Für rund 40% aller betroffenen Anwendungsgebiete existieren Alternativprodukte die keine Substitutionskandidaten enthalten, und alle Produkte mit Substitutionskandidaten weisen mindestens ein Anwendungsgebiet auf, in dem eine potentielle Alternative vorhanden ist. Die vergleichende Umweltrisikobewertung von Pflanzenschutzmitteln kann daher absehbar einen wesentlichen zusätzlichen Aufwand im Zulassungsprozess bewirken. Für die Durchführung einer vergleichenden Umweltrisikobewertung wird aus diesem Projekt heraus ein Satz von generischen Kriterien vorgeschlagen, die die rechtliche Bezugsgröße umsetzt, wonach ein Faktor von mindestens 10 für das Toxizitäts-/Expositions-Verhältnis als ein signifikanter Risikounterschied aufzufassen sei. Wir schlagen weiterhin vor, Risikovergleiche für alle unterschiedlichen Endpunkte vorzunehmen, die gegenwärtig in der Umweltrisikobewertung verwendet werden, und keinem Substitutionskandidaten die Zulassung zu verweigern, falls sich für das Alternativprodukt eine signifikante Risikoerhöhung in irgendeinem anderen Risikoendpunkt zeigt. Für zehn Fallstudien konnte dargelegt werden, dass mit Hilfe der verfügbaren zusammenfassenden nationalen Bewertungsberichte eine vergleichende Risikobewertung auf der Basis der vorgeschlagenen Prinzipien prinzipiell vorgenommen werden kann. Allerdings können bei Risikowerten, die nur als Grenzwertangaben vorliegen, beim Risikovergleich uneindeutige Befunde erzeugt werden. Um die bevorstehenden vergleichenden Bewertungen möglichst effizient vornehmen zu können, wäre es aus Ressourcensicht besonders lohnend, Risikomaße wie TER- oder HQ-Werte elektronisch zugänglich zu machen. Wir schlagen daher vor, die Etablierung von elektronischen Datenbasen vorzusehen, Bewertungsprozeduren zu harmonisieren und Konsens über Entscheidungsregeln herzustellen.<BR>Quelle: Forschungsbericht
The EU regulation 1107/2009 introduces the substitution principle for active substances in plant protection products that meet certain human or environmental hazard criteria. For products containing such candidates for substitution, their risk must be compared to alternative products during authorisation procedure. This report presents an approach for comparative risk assessment based on a profile of all different endpoints currently used in environmental risk assessment of plant protection products. It further suggests decision criteria for identifying significant differences in environmental risk, which would justify the substitution of a candidate product by a less critical alternative. Veröffentlicht in Texte | 47/2017.
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