natgillin/translations-raw huggingface dataset:
Markedsføringstilladelsesindehaveren påberåber sig imidlertid, at hans produkter giver en lavere eksponering og en lavere årlig belastning end andre zinkoxid-holdige veterinærlægemidler, men han har ikke fremlagt data, der kan understøtte en kvantitativ risikovurdering, ligesom han ikke inddrager det faktum, at hans produkter er tiltænkt svin med en legemsvægt på op til 40 kg, selv om hans påberåbelse af en begrænset zinkoxidfrigivelse til miljøet gælder anvendelse af produkterne til smågrise i alderen 3-4 uger (7-8 kg); behandling af større svin vil desuden øge belastningen af miljøet.
However, while the marketing authorisation holder claims a lower exposure and annual load from their products compared to other zinc oxide veterinary medicines, they have not submitted data supporting a quantitative risk assessment, and have not considered that, while their conclusion on a limited environmental release of zinc oxide was estimated from the use of these products on 3-4 week old piglets (7-8 kg), the claim for their products is for pigs up to 40 kg/bw, and treating heavier pigs would also increase the environmental load.
I alt fem forskellige miljørisikovurderinger vedrørende produkter, der indeholder zinkoxid og skal administreres oralt til smågrise i 2-6 uger i en koncentration på 2 500-3 100 ppm zinkoxid i foder, blev fremlagt for CVMP under denne indbringelsesprocedure.
A total of five different environmental risk assessments on products containing zinc oxide to be administered orally to piglets for 2-6 weeks, at concentrations ranging between 2500 to 3100 ppm zinc oxide in feed were made available to the CVMP during this referral procedure.
Mange af de fremlagte publikationer til understøttelse af doseringen har ingen relevans, da de enten understreger de vækstmæssige fordele ved zinkoxid eller omfatter kliniske undersøgelser, hvor zinkoxid og antibiotika kombineres.
Several of the publications submitted in support of the dose were not relevant since the investigations either focused on the growth benefits of zinc oxide or clinical trials combining both zinc oxide and antimicrobials.
Undersøgelsen understøtter imidlertid evidensen fra andre undersøgelsesresultater, der tyder på, at anvendelsen af zinkoxid som veterinærlægemiddel i svineopdræt vil føre til en gradvis akkumulering i landbrugsjord, som vil ende med ikke alene at overskride sikkerhedstærsklen for zinkkoncentration i jord, men også i sedimenter og vandsystemer.
However, the study supports the line of evidence that the use of zinc oxide as a veterinary medicinal product in pig farming will lead to a gradual accumulation in agricultural soils, which will eventually not only exceed safe concentrations of zinc in soil, but also in sediment and water systems.
Efter CVMP's udtalelse af 8. december 2016 vedrørende den omhandlede indbringelsesprocedure har flere markedsføringstilladelsesindehavere anmodet om en revurdering af udtalelsen (aniMedica GmbH, Huvepharma N.V., DSM Nutritional Products (UK) Ltd., Provimi Ltd., Andrés Pintaluba S.A., Bio Vet Aps, Calier Portugal S.A., Dunavet-B Zrt., Industrial Veterinaria S.A., Laboratorios Calier S.A., Laboratorios Support Pharma S.L., S.C. Crida Pharm S.R.L., ScanVet Animal Health A/S,
Following the CVMP opinion of 8 December 2016 on this referral procedure, several marketing authorisation holders (aniMedica GmbH, Huvepharma N.V., DSM Nutritional Products (UK) Ltd., Provimi Ltd., Andrés Pintaluba S.A., Bio Vet Aps, Calier Portugal S.A., Dunavet-B Zrt., Industrial Veterinaria S.A., Laboratorios Calier S.A., Laboratorios Support Pharma S.L., S.C. Crida Pharm S.R.L., ScanVet Animal Health A/S, Sintofarm S.p.A, Tekro, spol.
Den anførte indikation for kombinationsproduktet gælder behandling af diarré, men der foreligger ingen kliniske data til at understøtte anvendelsen af zinkoxid til behandling af diarré (dvs. hvor sygdommen allerede er til stede og infektionen allerede er bekræftet i besætningen ved starten af zinkoxid-behandlingen).
The proposed indication of the combined product is for treatment, but no clinical data to support the use of zinc oxide in the treatment of diarrhoea (i.e. in presence of the disease at the initiation of zinc oxide administration - infection already confirmed in the herd) was available.
Ved ovennævnte indbringelsesprocedure vurderede Udvalget for Veterinærlægemidler (CVMP), at der er en vis usikkerhed forbundet med de beregnede risici for nogle delmiljøer, da den forventede miljøkoncentration (PEC), der skyldes anvendelsen af zink som veterinærlægemiddel, ikke kunne valideres, og da den forventede nuleffektkoncentration (PNEC) ikke altid tog højde for zinks biotilgængelighed (navnlig hvad angår sedimenter).
In the frame of the aforementioned procedure, the Committee for Medicinal Products for Veterinary Use (CVMP) considered that there is some uncertainty associated with the calculated risks for some environmental compartments as the predicted environmental concentration (PEC) due to the use of zinc as a veterinary medicinal product could not be validated, and the predicted no effect concentration (PNEC) did not always account for zinc bioavailability (specifically for the sediment compartment).
Mateos et al. (1998)7 peger også på, at man ikke bør fortsætte med at give zinktilskud efter fravænningsperioden.
Also, according to Mateos et al., 19987 zinc supplement should not be prolonged further than the weaning period.
Det kan derfor konkluderes, at der ikke er belæg for at kombinere colistin og zinkoxid i den godkendte indikation (metafylakse og behandling af gastrointestinale infektioner forårsaget af ikke-invasiv E. coli, der er følsom over for colistin), hvor der skal gives behandling i 7 dage.
In conclusion, the combination of colistin and zinc oxide for the approved indication (metaphylaxis and treatment of gastrointestinal infections caused by non-invasive E. coli sensitive to colistin) for seven days duration of administration is not justified.
Effektvurdering
Effect assessment
Det zink-berigede foder blev givet i en periode på 14 eller 21 dage umiddelbart efter fravænning.
The administration period was 14 or 21 days immediately after weaning.
Markedsføringstilladelsesindehaverne anerkender en mulig forbindelse mellem zinkoxid-holdige veterinærlægemidler og multiresistente bakterier (f.eks. LA-MRSA, E. coli) i miljøet, men de mener, at fordelene ved deres produkter opvejer risiciene.
While the marketing authorisation holders acknowledge possible links between zinc oxide veterinary medicinal products to multi-resistant bacteria (e.g. LA-MRSA, E. coli) and the environment, the marketing authorisation holders regard that the benefits of their products outweigh the risks.
CVMP anerkender vigtigheden af biotilgængelighed ved vurdering af metallers toksicitet og mener, at selv om forskellige modeller kan tage hensyn til den biotilgængelige del af zinkoxid og træffe let afgivende konklusioner vedrørende tidsrammen for, hvornår (dvs. hvilket år) der forventes at opstå miljøproblemer, er der ingen af modellerne, der ikke forudsiger en miljørisiko ved brug af zinkoxid som veterinærlægemiddel, ligesom der ikke er nogen af modellerne, der forudsiger, at zinkkoncentrationer i jord ikke vil blive biotilgængelige i jord, vand eller akvatisk biota.
The CVMP recognises the importance of bioavailability when addressing toxicity of metals, and considers that while different models might take into consideration the bioavailable fraction of zinc oxide and conclude on a slight different timeframe for when (i.e., in which year) environmental risks are predicted to occur, none of the models support a prediction of no environmental risk from the use of zinc oxide as a veterinary medicinal product, nor that zinc in soil will not become bioavailable to soil, water or aquatic biota.
Zinkoxid anses for at være effektivt til forebyggelse af diarré hos fravænnede smågrise (dvs. til reduktion af forekomsten af diarré efter fravænning).
Zinc oxide is considered to be beneficial for the prevention of post-weaning diarrhoea (i.e. reduction in the incidence of diarrhoea during the post-weaning period) in piglets.
CVMP vurderer derfor, at ovenfor omtalte miljørisikovurdering for alle enkeltstofprodukter med zinkoxid alene også er egnet til beregning af miljøbelastningen ved anvendelse af Enteroxid-produkter i EU.
As a result, the CVMP considers that the environmental risk assessment presented above for all zinc oxide mono-products is also adequate to predict environmental risks from the use of Enteroxid products in the EU.
Syreflygtigt sulfid kan reducere zinks biotilgængelighed, og selv om niveauerne varierer, kan PNEC-værdierne, hvor der dannes zinksulfider, overskrides meget, inden der observeres negative virkninger.
The latter can reduce zinc bioavailability and, although levels are variable, where zinc sulfides are formed PNECs may be greatly exceeded before adverse effects are observed.
Akkumuleringen af zink medfører risici for alle delmiljøer, enten straks (sedimenter, visse typer jord og overfladevand) eller forsinket (andre jordtyper, grundvand, overfladevand).
Due to accumulation of zinc risks have been identified for all environmental compartments, either immediately (sediment, some soil and surface water types) or delayed (other soil types, ground-, and surface waters).
aniMedica's videnskabelige begrundelse for revurdering har fokus på fordelene ved brug af deres produkter (veterinærlægemidler, der indeholder colistinsulfat og zinkoxid), risikoen for (co-)selektion for resistensgener og miljørisiciene ved anvendelse af deres produkter.
aniMedica's scientific grounds for re-examination focused on benefits associated with the use of their products (veterinary medicinal products containing colistin sulfate and zinc oxide), risks for (co-)selection of resistance genes and risks for the environment associated with the use their products.
Omfanget af zinkakkumulering på landbrugsjord, der skyldes brug af zinkoxid-holdige veterinærprodukter, er omhandlet i en nylig rapport af Bak et al. (2015).
This trend of zinc accumulation on agricultural soils from the veterinary use of zinc oxide has been recently reported by Bak et al. (2015).
Under omtalte indbringelsesprocedure udførte CVMP ikke en komplet vurdering af benefit/risk-forholdet; udvalget forholdt sig ikke til de terapeutiske fordele ved Gutal, da produktet er generisk og anses for at være bioækvivalent med referenceproduktet, og der blev således ikke foretaget nogen vurdering af kvaliteten, måldyrssikkerheden eller sikkerheden med hensyn til udvikling af antibiotikaresistens og restkoncentrationer under indbringelsesproceduren (i betragtning af procedurens anvendelsesområde).
During the above-mentioned referral procedure, a complete benefit-risk assessment was not conducted by the CVMP, and while the therapeutic benefits of Gutal were not taken into account as the product is a generic and bioequivalence with the reference product was accepted, quality, target animal safety, user safety impact on antimicrobial resistance development and residues were not assessed during the initial referral procedure, (given the scope of that referral).
Med hensyn til at reducere brugen af antibiotika ved anvendelse af zinkoxid skønnes det, at de kliniske data ikke er tilstrækkeligt fyldestgørende til en konklusiv vurdering.
Concerning the reduction of the use of antibiotics by use of zinc oxide it is considered that the clinical data were too sparse to conclude on this potential effect.
I det akvatiske delmiljø beregnes zinks biotilgængelighed i vand ved hjælp af Det Forenede Kongeriges miljøagenturs værktøj til vurdering af metallers biotilgængelighed13, en brugervenlig udgave af den såkaldte Biotic Ligand Model, som er en model, der anvendes til at beregne de biotilgængelige metaller for forskellige akvatiske arter (alger, dafnier og fisk), og som er blevet anvendt og er velrapporteret i en lang række fagfællebedømte undersøgelser af zink, samt dataene i EU's risikovurderingsrapport for zink (2010).
In the aquatic compartment, zinc bioavailability in water has been predicted using the Metal Bioavailability Assessment Tool (United Kingdom Environment Agency)13, a user-friendly version of the Biotic Ligand Model, a model that is used to predict the bioavailable metals for different aquatic species (algae, Daphnia and fish) and has been used and well reported in a large number of peer-reviewed studies for zinc, and the data used in the EU RAR on zinc (2010).
Værktøjet til vurdering af metallers biotilgængelighed er baseret på resultaterne fra ovennævnte Biotic Ligand Model for zink og det datasæt, som anvendes til at udlede miljøkvalitetsstandarden for zink, og kræver kun inputdata for vands pH-værdi, koncentrationen af opløst organisk kulstof og opløst calcium, men tager ikke højde for tilstedeværelsen af andre ioner, der kan påvirke typebestemmelsen af zink og dermed biotilgængeligheden.
The Metal Bioavailability Assessment Tool is based on the outputs from the zinc Biotic Ligand Models and the dataset used in the derivation of the Environmental Quality Standard for zinc, and only requires input data for water pH, dissolved organic carbon and dissolved calcium concentration, but does not take into account the presence of other ions that could affect zinc speciation and, hence, bioavailability.
• De fleste af de fremlagte undersøgelser har ikke klarlagt ætiologien for den observerede diarré.
• The aetiology of the observed diarrhoea was not established in most of studies submitted.
Med hensyn til, hvor længe fravænnede smågrise bør have foder med højt indhold af zink (2 5003 000 ppm zink), pegede Hollis (2 000)6 på, at man ikke bør give foder med højt indhold af zink i mere end to uger efter fravænning, og at den anvendte zink bør have form af zinkoxid.
Considering the duration of the administration of high amounts of zinc in the feed of weaned piglets (between 2500 and 3000 ppm of zinc), Hollis (2000)6 advises that administration of high zinc content feed should not be prolonged for more than two weeks after weaning, and that zinc used should be in the form of zinc oxide.
Undersøgelsen konkluderede, at tilsætning i foderet af 2 400 ppm zink (i form af zinkoxid) i 14 dage efter fravænning reducerer forekomsten af diarré.
The conclusion of this study was that adding 2400 ppm zinc (as zinc oxide) for 14 days after weaning reduces the incidence of diarrhoea.
Markedsføringstilladelsesindehavernes begrundelse for at anmode om en revurdering af CVMP's udtalelse har fokus på risikoen for (co-)selektion for resistensgener og miljørisici.
The marketing authorisation holders' grounds for requesting a re-examination of the CVMP opinion focused on risks for (co-)selection of resistance genes and risks for the environment.
Eksponering baseret på doseringer, der anses for at være relevante ved anvendelse af zinkholdige veterinærlægemidler, beregnes derfor ud fra den foruddefinerede belastning i henhold til IDMM-modellen.
Therefore, exposure using application rates that are considered relevant from the use of zinc containing veterinary medicinal products are calculated from the pre-defined loading rates of the IDMM.
På sit møde i december 2016 har CVMP således vurderet, at den overordnede benefit/risk-balance for veterinærlægemidler, der indeholder zinkoxid og administreres oralt til fødevareproducerende arter, er negativ, da fordelene ved zinkoxid til forebyggelse af diarré hos svin ikke opvejer risikoen for miljøet.
Therefore, the CVMP, during its December 2016 meeting, considered that the overall benefit-risk balance for the veterinary medicinal products containing zinc oxide to be administered orally to food producing species is negative, as the benefits of zinc oxide for the prevention of diarrhoea in pigs do not outweigh the risks for the environment.
Der foreligger ingen data fra interne eller publicerede undersøgelser, der understøtter effektiviteten af zinkoxid til behandling af diarré hos smågrise efter fravænning.
No data from proprietary or published studies are available to support the efficacy of zinc oxide for the treatment of post-weaning diarrhoea in piglets.
En detaljeret risikovurdering til undersøgelse af de risici, der er forbundet med co-selektion for antibiotikaresistens ved anvendelse af zinkoxid, er ikke tilgængelig i øjeblikket.
At this time a detailed risk assessment to examine the risk(s) associated with the co-selection for antimicrobial resistance following the use of zinc oxide is not available.
For nuværende er det vanskeligt at rette op på tungmetalforurening, herunder zinkforurening, af jord- og vandsystemer med de eksisterende teknologier.
Contamination of soil and water systems by heavy metals, such as zinc, is currently difficult to remedy with existing technologies.
Det kan således konkluderes, at der ikke er belæg for at kombinere zinkoxid og sulfaguanidin.
In conclusion the combination of zinc oxide and sulfaguanidine is not justified.
Hvad angår sedimentsystemer, er der siden fastsættelsen af PEC-værdien for sedimenter i EU's risikovurderingsrapport (2010) sket store ændringer i den måde, som sedimentkoncentrationer bestemmes på.
For sediment systems, since the sediment predicted environmental concentration (PEC) was derived (EU RAR, 2010) there have been significant changes in the way sediment concentrations are determined.
Under revurderingen af den omhandlede indbringelsesprocedure har CVMP derfor udelukkende forholdt sig til markedsføringstilladelsesindehavernes videnskabelige begrundelser for revurdering.
As a result, procedural and legal considerations are not within the remit of the CVMP; therefore during the re-examination of the present referral procedure the CVMP considered only the marketing authorisation holders' scientific grounds for reexamination.
Rapportens overvågningsdata for jord i Danmark viser, at anvendelsen af svinegylle på jord har ført til en signifikant stigning i jordens samlede indhold af zink, navnlig i den seneste overvågningsperiode (1998-2014).
In this report, monitoring data in soil from Denmark showed that the use of pig slurry on soils has led to a significant increase in total soil concentrations of zinc, especially in the latest monitoring period from 1998 to 2014.
Udvalget har derfor vurderet, at der ikke er belæg for at kombinere et antibiotikum (der pr. definition kun er egnet til behandling og metafylakse af infektionssygdomme med et eller flere målpatogener) med zinkoxid, da en sådan kombination ikke er specifikt rettet mod et målpatogen, og da det ikke er påvist, at en sådan kombination er effektiv til behandling.
The Committee therefore considered that it is not justified to associate an antimicrobial substance (by definition, only appropriate for infectious diseases involving target pathogen(s) and for treatment and metaphylaxis) to zinc oxide because it is not specific-pathogen targeted and has not demonstrated efficacy for treatment.
Virkningen er begrænset til forebyggelse af uspecificeret diarré hos smågrise efter fravænning.
This effect is limited to prevention of unspecific diarrhoeas occurring at post-weaning period in piglets.
• CVMP anerkender, at der er en risiko for co-selektion for resistensgener forbundet med anvendelsen af zinkoxid, men at risikoen ikke kan kvantificeres på nuværende tidspunkt.
• the CVMP acknowledged that there is a risk of co-selection for resistance associated with the use of zinc oxide, but at the present time, that risk is not quantifiable;
Og CVMP har konkluderet, at man ved brug af "korrektion for biotilgængelighed"-tilgangen når frem til følgende:
And when using the bioavailability correction, then:
For den helt nære fremtid (år 2020) er der identificeret en risiko i 2 ud af 15 scenarier for overfladevand (sur sandjord) og i 15 ud af 15 scenarier for sedimenter.
At an earlier time (year 2020) a risk is identified for two of 15 surface water scenarios (acidic, sandy soils) and for all 15 sediment scenarios.
Men som bemærket ovenfor vil de foreslåede risikoreducerende foranstaltninger kun bremse akkumuleringen af zink i de enkelte delmiljøer og dermed blot forsinke den samlede zinkakkumulering i miljøet (dvs. det tidspunkt, hvor PEC-værdierne vil overskride PNEC-værdierne); på grund af zinks iboende egenskaber kan de ikke garantere, at de effektivt kan eliminere de nært forestående eller fremtidige miljørisici, der er identificeret i risikovurderingen.
However, and as noted above, the previously suggested risk mitigation measures would slow down the accumulation of zinc in each compartment, thus just delaying the total zinc accumulation in the environment (i.e. the time when PEC will exceed PNECs), but given the nature of zinc they cannot guarantee that they can effectively eliminate imminent and future environmental risks identified in the risk assessment.
Det ophæver ikke bekymringen for folkesundheden, at LA-MRSA CC398 i øjeblikket kun påvirker humane populationer i begrænset omfang.
The fact that LAMRSA CC398 has currently a low impact on human populations does not negate the public health concerns.
Uanset tilgang viser dataene, at hvis anvendelsen af zinkoxid som veterinærlægemiddel på svinefarme og gødskning af jord med gødning fra svin fortsætter i samme omfang som de seneste år, vil der akkumuleres zink i i jordens matrix; det vil føre til, at zinks biotilgængelige del bliver større, og dermed ende med at give højere zink-niveauer end PNEC.
Regardless of the approach presented, data indicates that if the uses of zinc oxide as a veterinary medicinal product in pig farming, and applications of manure to land continue as they have been in the last years, zinc will continue to accumulate within the soil matrix, leading to an increase in bioavailable fraction of zinc in soils, eventually to levels higher than the PNEC.
I en undersøgelse med fravænnede smågrise (Poulsen, 1995)8 observerede man, at tilskud af store mængder zink i form af zinkoxid i 1, 2 eller 3 uger efter fravænning påvirkede forekomsten af fravænningsrelateret diarré (som et af parametrene).
In a study on the administration of zinc oxide in weaned piglets (Poulsen, 1995)8, the administration of high amounts of zinc as zinc oxide for a duration of 1, 2 or 3 weeks after weaning affected the incidence of post-weaning diarrhoea, among other parameters.
CVMP har således vurderet, at den miljørisikovurdering, der er fremlagt under indbringelsesproceduren vedrørende Gutal (EMEA/V/A/108), jf. artikel 33, stk. 4, i direktiv 2001/82/EF, er videnskabeligt sund og bør anvendes ved vurdering af benefit/risk-balancen for produkter, der indeholder zinkoxid og skal administreres oralt til fødevareproducerende arter.
Consequently, the CVMP considers that the environmental risk assessment provided during the referral procedure under Article 33(4) of Directive 2001/82/EC for Gutal (EMEA/V/A/108) is scientifically sound and should be used in the benefit-risk evaluation for products containing zinc oxide to be administered orally to food producing species.
På grund af zinks iboende egenskaber (ikkeflygtig og ikkenedbrydelig) er det meget bekymrende, at PNEC-værdierne på et tidspunkt potentielt kan overskrides ved kontinuerlig og længerevarende gødskning af jord med gødning fra behandlede dyr, navnlig hvad angår de mest sårbare jordtyper (sur, veldrænet sandjord) og organismer i vandmiljøer.
Due to the intrinsic nature of zinc (non-volatile and nondegradable), the potential for PNECs to be eventually surpassed as a result of continual application of manure from treated animals to land over an extended period is a significant environmental concern, particularly with regard to the most vulnerable soil types (acidic, freely draining, sandy soils) and organisms of the aquatic compartments.
CVMP anerkender, at denne undersøgelse alene ikke udgør tilstrækkelig dokumentation for, at anvendelse af zinkoxid i svineproduktion medfører miljørisici.
The CVMP agrees that this study cannot be used, on its own, as proof that environmental risks exist from the use of zinc oxide in pig production.
Behandlingerne bestod af baseline-foder med 100 ppm zink i form af zinkoxid eller det samme foder med tilskud af 2 400 ppm zink (i form af zinkoxid).
Treatments consisted in a baseline diet of 100 ppm zinc in the form of zinc oxide or the same diet supplemented with 2400 ppm zinc (as zinc oxide).