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[Professional profile and responsibility of the qualified person within the European Union].

The European Community has established a fundamental condition for opening a pharmaceutical laboratory, i.e. the designation of a qualified person having the professional profile detailed in the European Community Directive and who is responsible for implementing specific obligations. It is the final responsibility of this qualified person to release medicine on the market. Do to the importance of this person, we have analyzed his/her functions, obligations and responsibilities. The training required to fulfil the functions of a qualified person is presented. The profiles of qualified persons in the most representative European countries are discussed to demonstrate analogies and differences in national legislations and their adaptation to European Community regulations.

Drug Evaluation↗

Quality and accreditation systems in clinical biochemistry in the European Union.

The European Community Confederation of Clinical Chemistry (EC4) formed in Nice in April 1993 has established a working group on laboratory accreditation. The aim of the group is to explore the possibilities for harmonisation of accreditation and quality systems in clinical laboratories in the European Community (EC). It is felt essential that professions should play a key role in the process, and that the principle of subsidiarity should be observed in relation to implementation and organisation in individual member states. The first task has been to collect information concerning such systems. In September 1993 a questionnaire was distributed to the twelve IFCC related societies for clinical chemistry in the EC. By December 1994 eleven societies had responded. The questionnaire related to the existence or planned introduction of quality and accreditation systems, the basis of the standards used and requirements for analytical aspects and qualifications of staff as well as professional aspects. Questions also addressed the way in which inspection were organised, the selection and training of inspectors, the organisation of systems and what interest there was in harmonisation. The results of this study are presented in this paper.

Accreditation↗

Synthesis of qualitative research on drug use in the European Union: report on an EMCDDA project. European Monitoring Centre for Drugs and Drug Addiction.

This paper is a synthesis of the information in the report Inventory, Bibliography and Synthesis of Qualitative Research in the European Union which was co-ordinated for the European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal, by the National Addiction Centre, London, UK. It is based on the work of a network of qualitative researchers from the European Union. The report includes detailed information from each member state on current qualitative projects, relevant publications from the last 10 years and a directory of those researchers active in this area. The paper introduces the project, outlines its future direction and discusses what can be defined as 'qualitative research'. Historical developments and the role of qualitative methodology in relation to research into drug use are examined. A summary of the project's findings is presented, and the relevance of qualitative research for policy-making is discussed. Finally, the methodology used to collect data for the project is described.

Crime↗

Cancer mortality and prevention in the European Union.

In the European Union (EU), approximately one in four people dies from cancer (27% of men and 21% of women) and one in three contracts the disease. In recent years, however, trends in cancer mortality appear to have changed, at least in some European countries. Standardized mortality rates among men have declined since the late 1980s or early 1990s. Among women, a continuous decrease in mortality has been observed over some decades. Nevertheless, due to population increase in the EU and the ageing population, the increase in the absolute numbers of new cancer cases continues. Lifestyle plays a crucial role in the aetiology of cancer and, because it is at least a principally modifiable determinant, we can assume that cancer could be avoided to a considerable extent via primary prevention.

Cause of Death↗

The new regulatory state: the social powers of the European Union.

The understanding of the European Union poses a challenge for Sociology and its traditional conceptions of the state. In particular, the impact of the social dimension has been underestimated and undervalued. This paper explores the implications of the developing social dimension of the European Union for European social relations in the context of globalization which allegedly reduces the power of states to act effectively in the social realm. It argues for a broader conceptualization of the social dimension and for a new conception of the regulatory state. It argues that the significance of a politico-legal project social justice. It concludes with a re-consideration of the powers of the state in an era of globalization

European Union↗

Surveillance of malaria in European Union countries.

The European Union countries are outside the endemic area for malaria, but many cases of malaria contracted elsewhere are imported into Europe each year. Several countries have reported high and increasing numbers of imported cases in recent years (France

Journal Article↗

External quality mechanisms for health care: summary of the ExPeRT project on visitatie, accreditation, EFQM and ISO assessment in European Union countries. External Peer Review Techniques. European Foundation for Quality Management. International Organization for Standardization.

This paper is a summary of the operation, findings and conclusions of a European Union project on external peer review techniques, termed 'ExPeRT', to research the scope, mechanisms and use of external quality mechanisms in the improvement of health care. Many of the themes outlined are described in detail in other papers that have been prepared specifically for this issue of The International Journal for Quality in Health Care. Although the emphasis of this project and of this issue of the Journal is on Europe, the conclusions are more widely relevant.

Accreditation↗

Risk assessment of butadiene for the Existing Substances Regulation (ESR) in the European Union.

The European Commission's Existing Substances Regulation (ESR) requires an evaluation of the risks to humans (workers, consumers and the general public) and the environment, posed by selected existing chemical substances. The Regulation focuses initially on high tonnage chemicals, and in this first year of the ESR, the UK undertook to produce the risk assessment document for 1,3-butadiene. This was in recognition of a need to reconsider the regulatory position in the light of new and ongoing research. In particular, the risk assessment was an opportunity to address the current debate over the animal toxicity data, where marked species differences exist, and the relevance of these data for human health. The human health part of the risk assessment of butadiene involves a comparison of health effects against exposures in the three population sectors. In this paper, the approach to risk assessment is exemplified for the occupational exposure setting. The conclusion reached for the human health hazard assessment has been influenced significantly by both the available animal and human data. Species differences in toxicity, in particular with regard to mutagenicity and carcinogenicity, have been considered, along with the mechanistic arguments for these differences and their relevance for human health. In addition, the evidence for health effects in humans is considered. The overall conclusion of the health hazard assessment is that there is concern for genotoxicity and for carcinogenicity, for which a threshold of effect cannot be identified. The occupational exposure assessment indicates that exposure in the workplace is generally well-controlled, of the order of 3-5 ppm or below. The overall conclusion of the risk assessment for the occupational setting is that there is concern for the possibility of genotoxicity and carcinogenicity at the exposure levels which occur in some European workplaces.

Animals↗

Review of recommendations on cervical cancer screening in the European Union.

In 2000 the European Commission Advisory Committee on Cancer Prevention published a position paper on cancer screening with recommendations. This followed working party deliberations in 1998 and conference discussion in 1999. Scientific advances, particularly in knowledge about the relationship of HPV and cervical cancer and political developments with the enlargement of the European Union, mean that the position paper and recommendations may shortly need revising in the light of changed circumstances.

European Union↗

[Do we understand Brussels? Risks and opportunities for the Netherlands' health care policy within the European Union].

Until recently, the European Union (EU) health agenda was limited to a selection of public health issues and good intentions of the Ministers of Health of the EU Member States. Lack of political will on the part of Member States to develop common policies in the fields of health care and social security is increasingly being bypassed by the political will and power of the European Parliament to initiate common action in these fields such as the Rocard report, for example, concerning the financing of health care. Furthermore, EU common market and other financial-economic regulations and policies already substantially affect the functioning of health care systems in Member States. The Netherlands' trade and professional associations should develop their organisation-specific EU strategies and policies as EU institutes, rules and culture substantially differ from national political and governmental systems; in recent years, the Dutch government has not always been successful in its approach and operations within the EU arena.

European Union↗

Safety assessment of food-contact paper and board using a battery of short-term toxicity tests: European union BIOSAFEPAPER project.

An European Union (EU)-funded project QLK1-CT-2001-00930 (BIOSAFEPAPER) involves the development, validation and intercalibration of a short-term battery of toxicological tests for the safety assessment of food-contact paper and board. Dissemination of the results to industry, legislators (e.g. DG Consumer Protection, DG Enterprises, DG Research), standardization bodies such as CEN, and consumers will create an agreed risk evaluation procedure. The project involves pre-normative research in order to establish a set of in-vitro cytotoxicity and genotoxicity tests that will be easily adaptable to food-contact fibre-based materials and have endpoints relevant to consumer safety, including sub-lethal cellular events. These tests will be performed on samples representing actual migration conditions from food-contact paper and board with respect to different foodstuffs, and should form an experimental basis for scientifically sound recommendations for a harmonized system of risk evaluation and product testing.

Animals↗

[The European Union and drugs].

1993 is a mythical year for the European Union which symbolizes at once the Achievement of the Internal market and the entry into force of Treaties of Policy and Economic Union. The European Union makes up, in all respects, a New Deal for Medicinal Products. Indeed, the scientific and technical harmonization is realized now at international level (ICH); the broader community competencies in the fields of Research, Industrial Policy and Environment predict a new positive context for innovation industry and competition probably in accordance with the European Agency. A contrario, the recognition of competences of Member States due to subsidiary in the following matters: Public Health, Social Security allow some flexibility in the interests of consumers, differences being explained by social and cultural behaviour in each Member State.

Drug Industry↗

[Application of the EUSOMA criteria in breast units in countries of the European Union].

All the countries of the European Union face similar challenges when providing adequate and high quality treatment in oncology. A working party was established to consider what should comprise a specialist service and the Requirements of a Breast Unit, published in 2000, represent the opinion of the European Society of Mastology (EUSOMA) on the standards required for creating high quality Breast Cancer Units across Europe. We studied the application of the mandatory requisites and general recommendations of EUSOMA: critical mass, or minimum number of patients, core team (composition and specific training), quality assurance, and application of diagnostic and treatment protocols. A thorough literature search was performed and was completed with information from search tools, the web pages of scientific societies, national associations for the fight against cancer, and health ministries of the countries belonging to the European Union. We also analyzed the latest reports of the European Parliamentary Committee for breast cancer. Distinct approaches to the multidisciplinary management of breast disease can be found in the United Kingdom, Sweden, Italy, France and Spain. A common European standard would be useful to improve the care provided to patients.

Breast Neoplasms↗

Occupational health in the European Union.

Despite extensive legislation in the European Union, employees remain exposed to occupational risks and there is still a significant burden of work-related ill-health. The trend for more people to work in service industries rather than manufacturing has resulted in a change in the nature of risk and pattern of occupational illness. Worker access to occupational health services ranges from 15 to 96% and depends on the country in which employees live and the type of operation in which they work. The increasing number of small enterprises provides a particular challenge when trying to provide occupational health support to the European Union's 158.4 million workers. European law alone is not sufficient to improve the health of those at work and further action is needed at state, employer and professional level. New initiatives seek to improve the health of the Union's workforce, including a drive for better compliance with new law by every member state. Governments are working with key stakeholders through partnering strategies to develop innovative approaches for better access to quality occupational health services. Furthermore, targets for reduction in occupational ill-health have been identified. Where country laws do not mandate the provision of occupational health services, employers need to see the benefit of providing occupational health support. Finally, the medical profession is making procedures for self-regulation more rigorous and professional bodies are actively engaged in issuing professional standards and guidelines. Ultimately, the individual practitioner is responsible for ensuring that he or she develops and maintains the necessary knowledge and skills to provide competent services.

Accidents, Occupational↗

Moving around Europe--an overview of European Union nursing legislation.

Making sense of the European Union (EU) and its institutions rests largely on the understanding that essentially all its endeavours are an attempt to guarantee the four freedoms of movement--of goods, services, labour and capital--that are the pre-requisites for the creation of an economic area without internal frontiers and the establishment of economic and social union. With the ratification of the Treaty on European Union (Maastricht Treaty) the EU also aims to assert its identity on the international scene; strengthen the protection of the rights and interests of the nationals of its Member States; develop close cooperation on justice and home affairs; and maintain in full the acquis communautaire (the evolving legacy of EU developed principles and laws). It is the four freedoms of movement, however, that remain the dynamo that drives EU thinking. To disregard this fundamental concept is to ensure that the EU will for ever remain a mystery.

European Union↗

Patenting biotechnologies: the European Union Directive 98/44/EC of the European parliament and of the council of 6th July 1998 on the legal protection of biotechnological inventions.

Before the Directive 98/44/EC of the European Parliament and the Council of 6th July 1998, notwithstanding some decisions of the European Patent Office (still presently under opposition) and some patents already granted by the Italian Patent Office, the existing legal framework did not allow the patentability of living organisms in the European Community countries. The Directive has dramatically changed the perspectives. It ensures free circulation of patented biotechnological products harmonising the national legal system of each Member State, guaranteeing compliance with the European Patent Convention signed in Munich on 5th October 1973, the Trade-Related Aspects of Intellectual Property Rights agreement of 15th April 1994 and the Rio de Janeiro Convention on Biological Diversity of 5th June 1992. The legal basis of the Directive and the fundamental principles of protection are that discoveries as such are not considered patentable. Plant and animal varieties as such, as well as essentially biological procedures for the production of plants and animals are excluded from protection by patent. On the contrary, the new field of patentability covers plants and parts of animals with new introduced genetic characters. Methods of surgical and therapeutic treatment and diagnostic methods applied to animal bodies are not considered inventions suitable for industrial applications and excluded from protection by patents. Biological materials and material isolated from its natural environment and isolated elements of the human body with technical processes may be patented. Excluded from patentability are inventions that are contrary to law and order or public morality as well as processes for human cloning for reproductive purposes and for modifying the germ-line genetic identity of human beings, as well as the use of human embryos. The processes for modifying the genetic identity of animals without any substantial medical benefit for man (with the exception of studying new medicinal products useful for treating serious diseases such as cancer, hepatitis or AIDS, by means of Oanimal modelsO) are also excluded. The rights of farmers are also guaranteed, by allowing them to re-sow seeds and freely use breeding stock covered by patents on their farms, without paying costly royalties to the holders of patents.

Animals↗

Undergraduate training in the European Union. Convergence or divergence?

A survey of dental schools in the European Union was carried out for two main reasons. Firstly to promote the exchange of information in respect of curriculum objectives in the different countries and secondly to ascertain the differences in the interpretation of the 1978 EU sectoral directives for dental education and training. Out of 127 schools, only 30 responded, yet the information provided is of considerable importance. It demonstrates wide divergence in the interpretation of the 1978 Directives and methods of assessment of clinical competence. There is a considerable difference throughout Europe in hours devoted to the various subjects included in the Dental Directives. There is little evidence of convergence in methods of assessment or quality assurance. The survey demonstrates the difference in resources, levels of staff, availability of clinical training places, output in research and patient treatments throughout the European Union. The results question the effectiveness of the 1978 Dental Directives in promoting convergence of standards. As there is free movement of dentists throughout the European Union, it is concluded that a different approach may be necessary to ensure that all European Union dental graduates achieve comparable standards in their education and training.

Curriculum↗