Occurrence and risk assessment of glycidyl and 3-monochloropropanediol esters in infant formulas marketed in Taiwan

Glycidyl esters (GEs) and 3-monochloropropanediol esters (3-MCPDEs) are process contaminants commonly found in refined edible oils which are often added to infant formulas. The Taiwan Food and Drug Administration (TFDA) launched regulations for GEs in infant formulas that went into effect on 1 July 2021. To investigate levels of GEs and 3-MCPDEs in infant formula powder, 45 products were sampled and analysed during 2020-2021. The contents of GEs and 3-MCPDEs in formulas of different brands significantly varied, but their concentrations in all of the formulas complied with European Union (EU) regulations. Infant formulas containing palm oil had significantly higher 3-MCPDE levels in both extracted oils and milk powder than those without palm oil. Concentrations of GEs and 3-MCPDEs in infant formula powder and extracted oils were significantly lower in products from Europe than those from Australia and New Zealand. Infants aged 0-1 years in Taiwan who consumed only infant formula showed a margin of exposure (MoE) exceeding 25,000. Mean consumer exposures to 3-MCPDEs stayed below the tolerable daily intake (TDI), while high exposures at the 95th percentile (P95) exceeded the TDI by 1.7-fold. Herein, we present the changing trends in the risk assessment results of infant formula across various countries in the decade. Implementation of regulations and mitigation strategy effectively reduced the risk of infants being exposed to GEs and 3-MCPDEs through infant formula.

Cultured meat in the European Union: Legislative context and food safety issues

The current food system, which is responsible for about one third of all global gas emissions, is considered one of the main causes of resource depletion. For this reason, scientific research is investigating new alternatives capable of feeding an ever-growing population that is set to reach 9-11 billion by 2050. Among these, cell-based meat, also called cultured meat, is one possible solution. It is part of a larger branch of science called cellular agriculture, whose goal is to produce food from individual cells rather than whole organisms, tracing their molecular profile. To date, however, cultured meat aroused conflicting opinions. For this reason, the aim of this review was to take an in-depth look at the current European legislative framework, which reflects a 'precautionary approach' based on the assumption that these innovative foods require careful risk assessment to safeguard consumer health. In this context, the assessment of possible risks made it possible not only to identify the main critical points during each stage of the production chain (proliferation, differentiation, scaffolding, maturation and marketing), but also to identify solutions in accordance with the recommendations of the European Food Safety Authority (EFSA). Further, the main challenges related to organoleptic and nutritional properties have been reviewed.. Finally, possible future markets were studied, which would complement that of traditional meat, implementing the offer for the consumer, who is still sceptical about the acceptance of this new product. Although further investigation is needed, the growing demand for market diversification and the food security opportunities associated with food shortages, as well as justifying the commercialisation of cultured meat, would present an opportunity to position cultured meat as beneficial.

Cost minimization analysis of indication-specific osteosynthesis material in oral and maxillofacial surgery

PURPOSE

Following the introduction of the Regulation (EU) 2017/745 by the European Parliament, any bioactive substance or surgical implant introduced into the human body must be documented. The regulation requires any implant to be traced back to the manufacturer. Lot numbers need to be available for every single medical implant. Also, the manufacturer is required by law to provide implants individually packaged and sterilized. Previously, model tray systems (MOS tray) were used for osteosynthesis in oral and maxillofacial surgery, in which the individual implants could not be registered separately. The new regulation made it impossible to use such processes during surgery anymore and a need for a change in the medical practice surged. We examined a possible solution for the new legislation. The aim of this prospective cohort study is to analyze the MOS tray systems to osteosynthesis materials prepackaged in sets. We record and evaluate parameters such as surgical time and documentation time. We perform a short cost analysis of our clinic. The primary aim is to determine how much time is gained or lost by the mandatory increased patient safety. The secondary aim is to describe change in costs.

METHODS

Patients that underwent standard surgical procedures in the clinic of oral and maxillofacial surgery of the faculty hospital Carl Gustav Carus in Dresden were included. We chose open reduction and internal fixation (ORIF) of anterior mandibular corpus fractures as well as mandibular advancement by means of bilateral sagittal split osteotomies (BSSO) as standardized procedures. Both of these procedures require two osteosynthesis plates and at least four screws for each plate. MOS trays were compared to prepackaged sterilized sets. The sets include a drill bit, two plates, and eight 5-mm screws. A total number of 40 patients were examined. We allocated 20 patients to the ORIF group and the other 20 patients to the BSSO group. Each group was evenly subdivided into a MOS tray group and a prepackaged group. Parameters such as the incision-suture time (IST) as well as the documentation time (DT) by the operating room (OR) staff to complete documentation for the implants are the main focus of investigation.

RESULTS

For open reduction, the incision-suture time was significantly different in favor of the MOS tray (p < 0.05). There was no difference in the BSSO groups. However, we observed a significantly different (p < 0.01) documentation time advantage for the prepackaged sets in both the ORIF and BSSO groups. On top of that, we find that by using the prepackaged kits, we are able to reduce sterilization costs by €11.53 per size-reduced container. Also, there is also a total cut of costs of €38.90 and €43.70, respectively, per standardized procedure for implant material.

CONCLUSIONS

By law, a change in the method of approaching surgery is necessary. For standardized procedures, the right choice of implants can lead to a reduction of documentation time and costs for implant material, sterilization, as well as utilizing less instruments. This in turn leads to lower costs for perioperative processing as well as provision of state-of-the-art implant quality implementing higher patient security.

Changes of trans and saturated fatty acid content in savory baked goods from 2015 to 2021 and their effect on consumers' intake using substitution models: A study conducted in Greece

BACKGROUND

In Greece, nearly a third of savory baked goods (SBGs) exceeded the limit of 2 g of nonruminant or industrial trans fatty acids (i-TFA) per 100 g fat in 2015. The impact of the Commission Regulation (European Union) 2019/649 on exposure to trans fatty acids (TFA), i-TFA, and saturated fatty acid (SFA) from SBGs has not been previously evaluated.

OBJECTIVES

The study aimed to explore fatty acid reformulation of SBG products and assess differences in TFA, i-TFA, and SFA intakes using a sample of Greek SBG consumers from a nationally representative survey.

METHODS

In 2021, 140 samples of SBGs were collected in the greater metropolitan area of Athens, and their fat profile and content were compared to those from 2015. Based on these measurements, food consumption substitution models were employed to examine TFA and SFA intake differences, and the percent contribution from SBG among consumers was calculated (N = 1008). Nutrient densities were calculated by adjusting all fat intakes by individual mean energy intake (percentage of daily total energy intake).

RESULTS

The 2% i-TFA legislative limit/100 g of fat in measured SBGs was exceeded by 11.4% in 2021 compared to 31.1% in 2015 (19.7% increase in compliance). Median i-TFA and TFA intakes from SBGs were reduced from 0.05 (0.01, 0.12)% and 0.13 (0.03, 0.27)% in 2015 to 0.03 (0.01, 0.09) and 0.06 (0.03, 0.13)% in 2021, respectively. In terms of SFA, a mean increase/100 g was calculated, resulting in an increased intake in 2021 compared to 2015 [5.18% (2.78, 8.37) and 3.55 (1.99, 5.73), respectively].

CONCLUSIONS

Despite the reductions seen in i-TFA content of SBGs, food product reformulation efforts in Greece should focus not only on TFA content but also on SFA reduction to improve public health.

Oenological potential of wines produced from disease-resistant grape cultivars

Within the EU, changes in policy and public sentiment have made it more urgent to consider the adoption of sustainable agricultural practices. Consequently, one of the EU's goals is to reduce pesticide use by 50 per cent by 2030, including in viticulture. One of the proposed approaches is to expand the use of disease resistant hybrid grape-cultivars (DRHGC), such as 'PIWI' grapes (German, Pilzwiderstandsfähige Rebsorten), and to introduce new DRHGCs. However, the characteristics of DRHGCs are different from those of Vitis vinifera, which makes it necessary to take measures and make changes in winemaking technology to maintain high wine quality. This paper examines the chemistry of wines made from DRHGC and discusses their impact on aroma and flavor profiles. It also reviews the main winemaking practices suggested to produce high-quality wines from DRHGCs. The chemistry of DRHGCs is different to wine produced from V. vinifera, which can lead to both challenges during winemaking and unusual flavor profiles. Although newer DRHGCs have been bred to avoid unexpected flavors, many DRHGCs are still rich in proteins and polysaccharides. This can make tannin extraction difficult and produce wines with little astringency. In addition to this, new or alternative winemaking techniques such as thermovinification and the use of alternative yeast strains (non-Saccharomyces) can be used to produce wines from DRHGCs that are acceptable to consumers.

EU regulation of gene-edited plants-A reform proposal

This article presents a proposal on how the European Union's regulatory framework on genetically modified (GM) plants should be reformed in light of recent developments in genomic plant breeding techniques. The reform involves a three-tier system reflecting the genetic changes and resulting traits of GM plants. The article is intended to contribute to the ongoing debate over how best to regulate plant gene editing techniques in the EU.

Voluntariness or legal obligation? An ethical analysis of two instruments for fairer global access to COVID-19 vaccines

Introduction

There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation.

Methods

The main documents discussing the two strategies are examined with a qualitative content analysis. The ethical values reasonableness, openness and transparency, inclusiveness, responsiveness and accountability serve as categories for our ethical analysis.

Results

We observed that the decision-making processes in a legal solution to expand access to vaccines would be more transparent than in COVAX initiative, would be more inclusive, especially of nation states, and the values responsiveness and accountability could be easily incorporated in the development of a new regulation.

Discussion

A legal strategy that offers incentives to the pharmaceutical industry in return for global distribution of vaccines according to the Fair Priority Model is an innovative way to achieve global and equitable access to vaccines. However, in the long term, achieving the Sustainable Development Goals will require from all nations to work in solidarity to find durable solutions for global vaccine research and development. Interim solutions, such as our proposed legal strategy for equitable access to vaccines, and efforts to find long-term solutions must be advanced in parallel.

What on earth? The impact of digestates and composts from farm effluent management on fluxes of foodborne pathogens in agricultural lands

The recycling of biomass is the cornerstone of sustainable development in the bioeconomy. In this context, digestates and composts from processed agricultural residues and biomasses are returned to the soil. Whether or not the presence of pathogenic microorganisms in these processed biomasses is a threat to the sustainability of the current on-farm practices is still the subject of debate. In this review, we describe the microbial pathogens that may be present in digestates and composts. We then provide an overview of the current European regulation designed to mitigate health hazards linked to the use of organic fertilisers and soil improvers produced from farm biomasses and residues. Finally, we discuss the many factors that underlie the fate of microbial pathogens in the field. We argue that incorporating land characteristics in the management of safety issues connected with the spreading of organic fertilisers and soil improvers can improve the sustainability of biomass recycling.

QT shortening: a proarrhythmic safety surrogate measure or an inappropriate indicator of it?

OBJECTIVE

To examine whether QT interval shortening is an overlooked adverse event as compared to QT prolongation through a review of preclinical, clinical and post-marketing adverse event data available to the regulator for centrally and nationally authorized medicinal products.

METHODS

Potential safety signals of QT shortening related to authorized medicinal products were detected from Eudravigilance using proportional reporting ratios. Active substances identified as having unexpected signals of QT shortening were assessed in depth using the Bradford-Hill criteria for causation. Preclinical, clinical and adverse event data related to each active substance was used in the assessments. Post marketing adverse event cases were reviewed for imputability using the French method.

RESULTS

80 adverse event cases of electrocardiogram QT shortening were detected from 13 different active substances which included antipsychotics and antiepileptics (Clozapine, Ziprasidone, Quetiapine, Olanzapine, Carbamazepine), cardiovascular drugs (Atenolol, Digoxin, Ramipril, Simvastatin), anti-inflammatories and analgesics (Ibuprofen, Paracetamol) and other substances Calcium Carbonate (Mineral Supplement/Antacid) and Fingolimod (Immunosuppressant). By comparison 404 active substances were found have a potential safety signal of Electrocardiogram QT prolongation. Following in depth review none of the 13 active substances identified were found to be clearly associated with QT shortening using the minimum level of evidence for regulatory action. In the preclinical data reviewed we observed cases of morphological changes to the action potential (AP) where the Action Potential Duration at 90% (APD₉₀) was not affected.

CONCLUSIONS

From a regulatory perspective one cannot refute the possibility of a clinically relevant risk from QT shortening through the current testing requirements. Lack of further investigations into any potential morphological changes to the AP, or APD₉₀ shortening beyond a specified threshold in our opinion does not fully exclude the possibility of proarrhythmic effects of active substances.

Outcomes and endpoints in clinical trials supporting the marketing authorisation of treatments in paediatric acute lymphoblastic leukaemia

The improvement in acute lymphoblastic leukaemia (ALL) treatment has led research efforts to focus on the unmet medical needs of an increasingly smaller patient cohort with resistant leukaemia and to develop more-targeted agents. Survival and response rates remain the most-prevalent endpoints in paediatric ALL research, but other intermediate clinical endpoints and molecular biomarkers for efficacy and mid- and long-term safety endpoints are also being investigated. The success of current ALL treatment appears to be driving new paradigms to optimise clinical drug development, while at the same time, regulatory tools in place are supporting meaningful drug development in the area.

The changing landscape of treatment options in childhood acute lymphoblastic leukaemia

New paediatric acute lymphoblastic leukaemia (ALL) treatments have been developed and innovative products are in the pipeline. However, despite many active clinical trials, bridging bench science to clinical development to authorised medicines remains challenging. Research in first-line treatment continues to focus on multidrug chemotherapy with the potential addition of new targeted molecules being studied. Research in second- and third-line treatment represents a shift from cytotoxic intensification to an area of precision medicine through emergent innovative and immuno-oncology products. The collaborative research model in ALL involving different stakeholders should intensify to facilitate bench-to-bedside clinical translation for the benefit of patients.

Phytosanitary prescription to minimize pesticide use risk on human and animal health and the environment at European level

Incorrect, inappropriate or abusive use of plant protection products (PPPs) can lead to some serious problems for human and animal health, and the environment. It is well-known that global transition to sustainable food and agriculture will require major improvements in the efficiency of the resources used, in environmental protection and in systems resilience. This study aims, firstly, to revise the challenges of the primary production and the essential role of plant protection, together with a deep overview of the EU pesticide regulatory framework. Secondly, being the European framework one of the most advanced ones in the world, even in such scenario, in order to minimize pesticide use risk at European level, the study raises the need to establish a phytosnitary prescription for certain cases, subject to the figure of the Phytosanitary Prescriber. It would be a competent specialized technician with extensive training and technical intervention capacity specialized in plant health, with civil liability insurance and endorsed by a Professional Association. The Phytosanitary Prescriber would be a strategic figure and of great responsibility to achieve the sustainable use of PPPs, being responsible for diagnosis of the phytosanitary practice to be followed and the prescription and recipe for the dispensing of PPPs.

Does the EU COVID Digital Certificate Strike a Reasonable Balance between Mobility Needs and Public Health?

The need to fight a highly aggressive virus such as SARS-CoV-2 has compelled governments to put in place measures, which, in the name of health protection, have constrained many freedoms we all enjoy, including freedom of movement, both nationally and within the European Union. In order to encourage and facilitate the return to free movement, the European Parliament has launched a "COVID-19 digital certificate". A spirited debate centered around the use of this certificate is still ongoing among scholars, many of whom have pointed out the uncertainties relative to COVID-19 immunity, privacy issues and the risk of discriminatory effects. The authors, while highlighting some critical aspects, argue that the COVID digital certificate in its current approved version can effectively help prevent the spread of the infection and promote free movement, while upholding the right to health as much as possible. However, they also stress the need for a thorough information campaign to illustrate the advantages and limitations of this document in order to avoid creating a false sense of security in the public opinion, who may wrongly assume that the emergency has been overcome for good.

False and misleading health-related claims in food supplements on Spanish radio: an analysis from a European Regulatory Framework

OBJECTIVE

The excessive growth of the food supplements' industry highlights the need to focus attention on all aspects involved in their proper consumption; one that takes centre stage is advertising. The aim of this research is to analyse the presence of false and misleading claims in food supplements advertising. To this end, a relationship is established between the different types of health-related claims and the substances on which they are based, whether authorised or not by European Food Safety Authority (EFSA).

DESIGN

This empirical work conducts a content analysis of all radio mentions broadcast throughout 2017 on news/talk radio stations.

SETTING

Spain.

PARTICIPANTS

All radio mentions broadcast on news/talk commercial radio stations in Spain with the highest audience levels. The corpus is composed of 437 advertisements.

RESULTS

Results indicate that 80·3 % of function claims included in the analysed advertisements are not authorised by EFSA, while 20·4 % of disease claims are not allowed by EU regulation. Likewise, almost half of the substances referred to (43·7 %) are illicit: 54·1 % in function claims, 57·3 % in disease claims and 73·7 % in the case of reduction of disease risk claims.

CONCLUSIONS

This work reveals consistent failures to comply with European regulation on food supplements advertising. The widespread use of unauthorised health claims and substances is aggravated by the indirect recourse of illness as a persuasive argument, descriptions of alleged benefits as product attributes and the omission of essential information. This leads to dangerous misinformation and can pose serious health risks. Stronger legal mechanisms are needed for effective consumer protection.

The Balance between Energy, Environmental Security, and Technical Performance: The Regulatory Challenge of Nanofluids

Nowadays, numerous studies on nanomaterials (NMs) and Nanofluids (NFs) are account a plethora of applications. With the scientific society’s common goal of fulfilling the target of sustainable development proposed by the UN by 2030, it is necessary to combine efforts based on the scientific and technological knowledge already acquired, to apply these new systems with safety. There are thousands of publications that examine the use of NFs, their benefits and drawbacks, properties, behaviors, etc., but very little is known about the safety of some of these systems at a laboratory and industrial scale. What is the correct form of manipulating, storing, or even destroying them? What is their life cycle, and are they likely to be reused? Depending on the nanoparticles, the characteristics of the base fluid (water, propylene glycol, or even an ionic liquid) and the addition or not of additives/surfactants, the safety issue becomes complex. In this study, general data regarding the safety of NF (synthetic and natural) are discussed, for a necessary reflection leading to the elaboration of a methodology looking at the near future, intended to be sustainable at the level of existing resources, health, and environmental protection, paving the way for safer industrial and medical applications. A discussion on the efficient use of nanofluids with melanin (natural NM) and TiO₂ in a pilot heat collector for domestic solar energy applications illustrates this methodology, showing that technical advantages can be restricted by their environment and safety/security implications.

The EU endocrine disruptors' regulation and the glyphosate controversy

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Endocrine disruptors are compounds that alter the functioning of the endocrine system of humans and wildlife.

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Regulation 2017/2100 and Regulation 2018/605.

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Glyphosate as Endocrine Disruptor.

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EU EDs Regulation and pesticide legislation.

Endocrine disruptors are compounds that alter the functioning of the endocrine system of humans and wildlife. A large number of chemicals have been identified as EDs and humans can be exposed to them through dietary and/or environmental exposure (air, water, soil). At international level, scientific discussion on the topic of EDs focuses on the issue of setting out the scientific criteria according to which the key properties of these substances that render them EDs are determined. Regulatory action in EU has been impacted by the aforementioned discussion and, in particular, Regulation 2017/2100 and Regulation 2018/605 have been issued. However, these scientific criteria do not constitute a complete framework for the detection of EDs and, therefore, their adoption does not entail a fully effective human health protection. Moreover, glyphosate-based herbicides (GBH), are the most widely used pesticides worldwide. The glyphosate controversy turned the spotlight on pesticide regulation in the EU. The disagreement between IARC and regulatory evaluations of EFSA/ECHA has received great attention of citizens, organizations and stakeholders, as a result of methodological differences in the evaluation of the available evidence have been identified. This paper outlines the glyphosate controversy, following an overview of the EU EDs Regulation and pesticide legislation.

Chemical profiling of Ulva species for food applications: What is in a name?

Seaweeds are increasingly used in European cuisine. Until the recent use of molecular techniques, species identification was solely based on morphology which cannot easily discriminate morphologically simple but phenotypically plastic taxa such as the green algal genus Ulva. For example, current taxonomic protocol effectively reassigned the previously known European 'Ulva lactuca L.' under the name Ulva fenestrata Postels & Ruprecht. Also, the presumptive Ulva lactuca approved by the Institute for Reference Materials and Measurements (IRMM, Joint Research Center, European Commission) as Certified Reference Material (CRM) for analytical quality assurance was genetically identified as U. rigida C.Agardh. It is very likely that different Ulva species under various names have been consumed as food not only in Europe, but also worldwide. In this regard, when chemical composition and nutritional quality of different seaweed species meet a set of food standard criteria, and food safety hazards are mitigated, they should be endorsed for consumption. In the case of Ulva, we propose that different bladed and tubular species should generally be accepted for food consumption in Europe.

Advanced Therapy Medicinal Products Challenges and Perspectives in Regenerative Medicine

Recently, the design and development of a modern health policy in the field of regenerative medicine leads to the formation of a new and integrated cognitive field, which requires systematic research and study in order to produce innovative answers and best practices. Advanced therapy medicinal products (ATMPs) is a new product category, which is at the heart of concern since it has to deal with diseases in which traditional medicine has proven to be ineffective so far. The aim of this review is to provide evidence for the state of the art ATMPs and their modern applications in the field of regenerative medicine. The ATMPs are characterized by a great heterogeneity and variation in methods of isolation, which cover the entire spectrum from a single intravenous injection to a surgical placement. Clinical development of ATMP encounters specific challenges due to the nature of the product and the limited availability of non-clinical data. The gold standard of a controlled, randomized, clinical trial may not be feasible or ethically justified for all indications, particularly in life-threatening diseases, where there is no satisfactory standard of care. Therefore, the European Commission (EC) took initiatives in order to set standards and operating rules concerning authorization and supervision of ATMPs and on pharmacovigilance in relation to them. The European Union (EU) Regulation 1394/2007 provides the possibility of exceptions. In particular, the “hospital exemption” allows for the administration of an ATMP without a license on certain conditions. Although the Regulation 1394/2007 has led to the commercial exploitation of ATMPs, the reality today, 11 years after its first implementation, is completely different. While the Committee for Advanced Therapies (CAT) has already registered 285 products as ATMPs, only 10 licenses were granted which only remained six (the rest related to products withdrawn). The key players in the development and delivery of ATMPs still remain the academic/research centers and small and medium-sized enterprises; while the involvement of pharmaceutical companies is focusing on recent developments in the treatment of oncological incidents with in vitro modified cytotoxic T lymphocytes, and chimeric antigen receptor (CAR)-T cells.

A comparison of impact and risk assessment methods based on the IMO Guidelines and EU invasive alien species risk assessment frameworks

A comparative analysis of two risk assessment (RA) frameworks developed to support the implementation of the international Ballast Water Management Convention (BWMC) and European Regulation on Invasive Alien Species (IAS) was performed. This analysis revealed both differences and similarities between the IMO Risk Assessment Guidelines (IMO, 2007) and EU Regulation supplement on RA of IAS (EU, 2018) in RA approaches, key principles, RA components and categories of IAS impacts recommended for assessment. The results of this analysis were used to produce a common procedure for the evaluation of the bioinvasion risk and impact assessment methods intended to support international, regional and/or national policy on IAS. The procedure includes a scoring scheme to assess compliance with the key principles, RA components and categories of bioinvasion impacts taken into account by the methods. In these methods the categories of impacts on human health and economy are underrepresented comparing with impacts on environment.

Lights and shadows about health claims: analysis of food labels in a field survey in Florence

BACKGROUND

Health claims (HC) are those statements on food labels that state, suggest, or imply that a relationship exists between a food category, a food product, or one of its constituents, and health of consumer. The European legislation on the use of HC aims to encourage responsible consumption by people. The aim of this study is to assess the adherence of HC to EU norms in foodstuffs sold in the large-scale retail distribution in Florence.

METHODS

Two independent researchers have separately selected and assessed the foodstuffs with HC sold in at least two of four supermarkets identified randomly in Florence. Each selected product was assessed by a checklist with seven macro-criteria, extrapolated from the 'Specific Conditions' and 'Restrictions of Use' provided by EU regulations, rating the adherence of the chosen foods to the legislation.

RESULTS

Seventy-seven products were assessed. Only a limited number of products show full compliance to all the criteria. Specifically, noncompliance related to Criterion 3 ("the amount of the food and pattern of consumption required to obtain the claimed beneficial effect are reported") is the most significant: the absence of indications about the maximum amount to be consumed or the modality of consumption could represent a risk of overconsumption and, consequently, a risk for health.

CONCLUSION

According to the results, we hypothesize a lack of knowledge of the EU norms on the part of the manufacturer. A great deal of work is still to be done to assess and manage these products in the right way, as well as to communicate the right messages to the consumers.

Mass balance of emerging contaminants in the water cycle of a highly urbanized and industrialized area of Italy

The occurrence of several classes of emerging contaminants (ECs) was assessed in the River Lambro basin, one of the most urbanized and industrialized areas of Italy. The study aims were to identify the main sources of ECs, quantify their amounts circulating in the water cycle, and study their fate in the aquatic environment. More than 80 ECs were selected among pharmaceuticals (PHARM), personal care products (PCPs), disinfectants (DIS), illicit drugs (IDs), perfluorinated compounds (PERF), alkylphenols and bisphenol A (Alk-BPA), and anthropogenic markers (AM). Specific analytical methods were developed for quantitative analysis based on solid phase extraction and liquid chromatography tandem mass spectrometry. ECs were measured in rivers upstream and downstream of the main city (Milan), and in untreated and treated wastewater from Milan to assess the contribution to river contamination, and in superficial and deep groundwater in the city area to study the relationship between river and groundwater contamination. Samples were collected in a two-year monitoring campaign. Almost all ECs were ubiquitous in untreated wastewater, at concentrations up to the μg/L range, and the most abundant classes were PHARM and AM. Removals during different wastewater treatment processes were studied and the most stable substances were PHARM, PCPs and PERF. The mass loads increased for all the classes of ECs along the River Lambro basin. A mass balance was done in the river basin and allowed to identify the main sources of contamination, which were domestic, from treated or untreated wastewater, for PHARM, PCPs and IDs, mainly industrial for PERF, and both industrial and domestic for Alk-BPA. The study of AM helped to identify direct discharges of untreated wastewater. A substantial contribution of surface water to groundwater contamination was observed. This study improves the knowledge on occurrence, sources and fate of multiple classes of ECs in a highly urbanized area providing useful information to help the establishment of EU regulations for ECs.

(Q)SARs as Adaptations to REACH Information Requirements

REACH is a regulation of the European Union adopted to improve the safe use of chemicals with regard to human health and the environment. The safe use of chemicals can be achieved only if the hazard and the exposure of the substances are well characterized. Testing on animals has been traditionally the main tool for hazard assessment. For ethical and economic reasons, alternative ways of testing that do not use laboratory animals have been developed by different parties (regulatory agencies, researchers, industry) over the recent decades, and their proper use in hazard assessment is encouraged under REACH. In this chapter, we describe how (Q)SAR models and predictions are included into REACH and their adequate use promoted by the European Chemicals Agency (ECHA).

Legislation on the preparation of medicinal products in European pharmacies and the Council of Europe Resolution

Introduction

The rights of patients should be sufficiently protected even when an appropriate authorised medicine does not exist or is unavailable on the market. The Resolution, which was adopted by the Committee of Ministers of the Council of Europe in 2011, aims at harmonising quality and safety standards for pharmacy preparation of medicinal products in Europe.

Two pillars of EU regulation and the exceptions to them

The system of regulation of medicinal products is built upon two pillars: the marketing authorisation of the medicinal product and the licence for manufacturing and wholesale. This article provides insight into the recent interpretation of the European Court of Justice concerning the scope of European Union (EU) regulation of medicinal products and the circumstances in which the EU regulation does not apply: pharmacy preparations, specialties and the compassionate use of medicines, including manufacturing licence.

EU regulation and the Resolution concerning pharmacy preparation

Pharmacy preparations are allowed under certain strict conditions according to EU regulations. However, pharmacies specialised in preparation and distributing medicinal products to local pharmacies do not fulfil these strict conditions in EU regulation. Apart from the legal context, relevant standards for safety and quality assurance are needed in Europe in order to protect patients' rights and to avoid risks from pharmacy preparations.

Discussion and conclusions

The Council of Europe Resolution provides a means of establishing standards for safety and quality assurance for pharmacy preparations through Good Manufacturing Practice Guidelines. The Resolution is available to authorities and pharmacists in order to prevent incidents with medicines prepared in pharmacies which may threaten patients' safety. The authors conclude that pharmacy practices have changed over time in Europe and this may imply a reason for a reform of EU regulation on medicinal products.

The new EU General Data Protection Regulation: what the radiologist should know

The European Society of Radiology (ESR) informs its membership and its associated Institutional Members about the new General Data Protection Regulation (GDPR) of the European Union (EU,) which will apply from 25 May 2018. Radiologists and radiology departments should be prepared to comply with several new rules for the protection of imaging data. Although the new GDPR applies to all domains of the public and private sectors, some specific derogations are defined for data concerning health, aiming at protecting the rights of data subjects and confidentiality of their personal health data, whilst preserving the benefits of processing data, including digital images for research and public health purposes. Specific new obligations which healthcare providers (including radiologists/radiology departments) should prepare for include data access for patients, rules for data processing including explicit consent of the data subject in the absence of derogations, or technical and organisational safeguards. National health authorities can define exceptions and derogations from certain obligations by means of national law. They will also define sanctions in the form of penalties or fines that may be applicable for organisations of the public and private sector that fail to comply with the rules of the GDPR.

MAIN MESSAGES

• Explicit consent prior to data processing will be necessary. • Explicit consent prior to communication of imaging data will be necessary. • Providing patient access to their personal data, including portability, will be required. • Certain derogations and exceptions exist for healthcare and research. • Additional specific rules may be defined by national law.

Limited impact of EU paediatric regulation on Finnish clinical trials highlights need for Nordic collaboration

The Finnish Investigators Network for Paediatric Medicines (FINPEDMED) was established in 2007, to meet the expected increase in paediatric clinical trials following the new EU Paediatric Regulation. Between 2007 and 2012, FINPEDMED received 91 trial requests, 18 trials were started, and in 24 cases, Finnish investigators were not selected by sponsors.

CONCLUSION

This experience from Finland highlights the need for Nordic collaboration to increase expertise, recruitment base and attractiveness for sponsors.