Moerdijk Municipality Health Survey

Commissioned by the municipality of Moerdijk and in collaboration with GGD West-Brabant and the general practitioners in the municipality, Nivel is conducting a long-term health monitoring study focused on the health of Moerdijk’s residents. 

Research Methodology

• As with the previous study covering the 2013–2015 period, patient data from general practitioners in the area were again analyzed for the 2016–2019 period and compared with data from other areas.
• In addition, a questionnaire was distributed to approximately 7,000 residents this time. It was a comprehensive survey covering socioeconomic, individual (e.g., lifestyle), and environmental characteristics (such as housing, traffic, and working conditions). Participants were also asked about their perception of their own health and their views on (living near) industrial facilities.
• Finally, data from the monitoring stations that track air quality in the municipality were analyzed. 

The combination of these three research methods makes this study one of the most comprehensive investigations to date into the potential health effects of industry in the Netherlands.

Keeping a close eye on things

The data from general practitioners once again paint a consistent picture for the 2016–2019 period. 

• There are virtually no new health risks compared to the previous period.
• It is reassuring that serious chronic conditions such as COPD, leukemia, lung cancer, and diabetes are no more common here than in the control areas.
• As in the 2013–2015 period, headaches, fatigue, and dizziness were reported more frequently.
• During this new period, there is also a higher risk of acute respiratory infections.
• Another notable finding is that there are hardly any differences between the village and town centers: slightly fewer complaints in Willemstad, the most complaints in Fijnaart and Zevenbergen, but the communities around the port area do not deviate from the average for the municipality of Moerdijk. In most places, residents rate their health as (very) good.

Statements

• The results of the survey of residents show that obvious factors such as behavior and lifestyle (smoking, being overweight) can be ruled out. 
• However, the survey does show that residents who perceive the industrial park as a threat or a heavy burden are more likely to experience symptoms such as fatigue, nausea, and stomachaches, and these symptoms tend to last longer.
• A link has been found between the highest measured concentration of certain substances on a weekly basis and symptoms reported to a primary care physician in that same week and/or the following week. When it comes to nitrogen and particulate matter, there appears to be a higher risk of acute bronchitis and respiratory problems. In the case of benzene, there is a higher risk of dizziness. This association is found both in the village centers adjacent to the industrial park and in the other village centers. The measured concentrations may originate from multiple sources, such as industry, but also road traffic, shipping, or open fires. A link to any one specific source has not been established. It is important to note in this context that the national/statutory air quality standards are not exceeded anywhere in the municipality.

Pride

Councilmember Eef Schoneveld emphasizes the importance of the study: “As a municipality, we consider the health of our residents to be very important. That is why we commissioned this second health assessment. We opted for an approach that was as comprehensive as possible. I am proud that, in doing so, we have conducted one of the most comprehensive studies to date on the health effects of industry in the Netherlands. It is reassuring that serious health conditions do not occur more frequently here than in the comparison areas. At the same time, we do see a slightly higher number of other complaints. We take that signal seriously, of course. It’s unfortunate that we can’t pinpoint exactly where these complaints originate. That makes it difficult to take the right steps. That’s why we’ll continue to work on multiple fronts—such as our commitment to achieving a sustainable Moerdijk. We’re also going to focus more on prevention. Because there’s no doubt that a healthy lifestyle is of great importance to people’s overall health. To ensure we can continue to keep a close eye on the situation in the future, we’ll propose to the city council that the study be repeated periodically. That way, we’ll monitor the health of our residents on a regular basis.” 

About This Study

The 2016–2019 health survey utilized anonymized data from 8 general practice offices in the municipality of Moerdijk. This data was compared with a selection of practices from Nivel Primary Care Registries. These included control areas with industrial activity comparable to that of Moerdijk (10 general practice clinics in, for example, Terneuzen and IJmond) and rural areas in other regions without a high concentration of known environmental exposures (23 clinics, for example, on Texel). The questionnaire was distributed to 7,000 residents aged 16 and older (response rate: 32%). For the analysis of exposure to substances, measurement data were used for: NO₂ (nitrogen dioxide), NO (nitric oxide), PM₁₀ (particulate matter with particles smaller than 10 micrometers), NO_x (nitrogen oxides), and benzene, toluene, ethylbenzene, m-xylene, and o-xylene (so-called volatile organic compounds: VOCs).

Special thanks to

This study would not have been possible without the cooperation of the general practitioners in the municipality of Moerdijk. Special thanks go to Jula-Louise Vladár (general practitioner in Klundert) and Marloes van Hemsbergen (general practitioner in Willemstad) for their participation on the advisory committee. This study was made possible in part by the province of North Brabant.