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European Centre for Disease Prevention and Control.

In 1984 we made the first observation of a correlation between early age exposure to rural environment (and drinking well water) and development of idiopathic Parkinson's disease (IPD). 13 These findings were subsequently confirmed elsewhere (Barbeau, 1985 ; 25 Tanner, 1985 26 ). Analysis of all early age onset IPD (EPD) cases born and raised in Saskatchewan revealed that 20 of 22 had exclusively rural exposure during the first 15 years of life. This distribution was significantly different from the general population (p = 0.0141). Further study of the EPD group included sampling and metal analysis of childhood sources of drinking water in 18 cases and 36 age and sex-matched controls. Water collected from the two groups was analyzed for 23 metals (including 7 elements implicated in the etiology of IPD). There was no difference in the metal composition of the water between the two groups. 17 Finally, a review of herbicide and pesticide use in Saskatchewan agriculture was undertaken to determine if there was an increased incidence of EPD following utilization of any particular chemical. No increase was found in the incidence of EPD with the introduction of any pesticide or herbicide, including Paraquat, for agricultural use. We conclude that there is a strong correlation between early age rural environmental exposure and development of IPD. We believe well water is a likely vehicle for the causal agent, but neither water metal concentration nor any of the herbicides and pesticides used in Saskatchewan agriculture are related to the cause. RESUME: Etiologie de la maladie de Parkinson et site geographique, qualite chimique de l'eau potable, pesticides et herbicides. En 1984, nous avons rapporte pour la premiere fois l'obervation d'une correlation entre une exposition a un environnement rural dans le jeune age (et l'absorption d'eau provenant de puits) et le developpement de la maladie de Parkinson idiopathique (MPI). 13 Ces constatations ont ete confirmees subsequemment ailleurs (Barbeau, 1985; 25 Tanner, 1985 26 ). Une analyse de tous les cas de MPI a debut precoce qui sont nes et ont ete eleves en Saskatchewan a revele que 20 de ces 22 cas ont ete exposes a un environnement exclusivement rural pendant les 15 premieres annees de leur vie. Cette distribution etait significativement differente de la population en general (p = 0.0141). Une etude plus poussee du groupe de MPI comportait un echantillonnage des sources d'approvisionnement en eau potable utilisees dans leur enfance chez 18 des cas ainsi que chez 36 controles apparies pour l'age et le sexe et l'analyse des metaux contenus dans ces echantillons, soit 23 metaux dont 7 elements deja mis en cause dans l'etiologie de la MPI. II n'existait pas de difference dans la composition en metaux de l'eau entre les deux groupes.

In February 2015, an outbreak of recently acquired HIV infections among people who inject drugs (PWID) was identified in Dublin, following similar outbreaks in Greece and Romania in 2011. We compared drug and risk behaviours among 15 HIV cases and 39 controls. Injecting a synthetic cathinone, snow blow, was associated with recent HIV infection (AOR: 49; p=0.003). Prevention and control efforts are underway among PWID in Dublin, but may also be needed elsewhere in Europe.

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BackgroundPoor knowledge regarding STI and HIV transmission, testing and treatment among men who have sex with men (MSM) may be contributing to their disproportionate burden of STIs. However, factors which predispose MSM to having this low knowledge are less understood.AimThe aim of this study was to identify factors associated with having lower knowledge of HIV and STI transmission, testing and treatment among MSM.MethodsThe MSM Internet Survey Ireland 2015 was a self-completed online national survey available to MSM living in Ireland. Thirteen factual statements were used to assess participants’ knowledge of HIV and STI transmission, testing and treatment. Respondents were defined as having ‘lower knowledge’ if they indicated prior knowledge of fewer than 11 true statements. Multivariable-adjusted logistic regression was used to identify factors associated with having lower knowledge.Results3090 MSM completed the survey, of whom 2905 (94%) were included in this study. Thirty-six per cent (n=1055) had lower knowledge of HIV and STI transmission, testing and treatment. The factors associated with having lower knowledge included being 18–24 years of age (vs >40 years; adjusted OR (aOR) 1.98, 95% CI 1.50 to 2.61), born in Ireland (vs outside Ireland; aOR 1.62, 95% CI 1.25 to 2.10) and being out to none of their contacts (vs out to most/all; aOR 1.69, 95% CI 1.20 to 2.37). Knowledge was also lower among those who never tested for HIV (vs tested negative within last 12 months; aOR 2.32, 95% CI 1.88 to 2.86) and among MSM who never visited an MSM-specific health promotion website (vs visited website; aOR 1.81, 95% CI 1.45 to 2.25).ConclusionA range of demographic factors, sexual health variables and use of MSM-specific sexual health promotion materials are associated with low knowledge regarding HIV and STI transmission, testing and treatment among MSM in Ireland. Engagement with the main national MSM-specific sexual health promotion website was associated with higher knowledge levels.

Background: Little is known about the prevalence and determinants of drug use among men who have sex with men (MSM) in Ireland. The aims of this study were to measure the prevalence of recreational drug use among MSM in a national sample, and to identify subgroups of MSM who may benefit from targeted preventive interventions. Methods: The MSM Internet Survey Ireland (MISI) 2015 was a community-recruited, nationally-promoted, self-completed online survey for MSM. MISI 2015 included standardised questions on recreational drugs, poppers, and drugs associated with chemsex (i.e. crystal methamphetamine, GBL/GHB, mephedrone, ketamine). Multivariable-adjusted logistic regression was used to identify factors associated with use of these substances. Results: In the previous year, 36% of MSM used recreational drugs, 33% used poppers, and 7% used drugs associated with chemsex. Five percent were diagnosed HIV-positive. Recreational drug users were significantly younger than non-users (median=27 vs. 32 years; p<0.001); popper users were significantly older than non-users (median=34 vs. 28 years; p<0.001). The odds of recreational drug use were higher among MSM diagnosed HIVpositive (vs. never tested; AOR 2.27, 95%CI 1.39-3.70). Use of poppers, and use of drugs associated with chemsex, were also higher among MSM diagnosed HIV-positive (vs. never tested; AOR 3.77, 95%CI 2.41-5.90, and AOR 5.87, 95%CI 3.08-11.18 respectively). Conclusions: The prevalence of recreational drug use is higher among MSM than in the general population in Ireland, and it is particularly high among MSM diagnosed HIV-positive. Targeted harm reduction messages and preventive interventions are warranted to complement population-based approaches to reducing drug use in this population.