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Skin problems among farmers engaged in
Peri-urban Aquatic Production Systems in
Hanoi and Phnom Penh
Hanoi: Vuong Tuan Anh1, Wim van der Hoek4, Nguyen Dang
Tuan1, Nguyen Van Thuong5, Phung Dac Cam1, Anders
Dalsgaard2
PhnomPenh: Vuong Tuan Anh1, Wim van der Hoek4, Chan
Vichet6, Phung Dac Cam1, Anders Dalsgaard2
1Division
of Enteric Infectious Diseases, National Institute of Hygiene and
Epidemiology, Vietnam; 2Department of Pathobiology, Royal Veterinary and
Agricultural University, Denmark; 3Faculty of Fisheries Royal University of
Agriculture, Cambodia; 4International Water Management Institute, Sri Lanka;
5National Institute of Dermatology, Vietnam; 6National Clinic for Dermatology &
STD Unit, Cambodia
Objectives
•
•
Estimate the prevalence of skin problems
among people involved in agricultural and
aqua-cultural work
Determine whether wastewater exposure is
associated with skin problems
Formulate recommendations for
preventing/reducing skin
diseases and discuss these
with stakeholders
Methodology I: Hanoi and
Phnom Penh
• Survey in ww (100 households (HHs)) and non ww sites
(100 HHs)
• Cross-sectional study:
– Hanoi: May, Sept, and Dec 2005
– Phnom Penh: July 04, Jan 05, and March 05
• Household questionnaire interviews:
– Hanoi: adult farmers
– Phnom Penh: all members > 15 yrs
• Information collected on current skin problems and skin
problems experienced during the previous 3 months
• Clinical manifestations and patient information collected
by dermatologist
• Free treatment provided
Methodology II
• Local assistants were
trained for data
collection
• Studies supervised and
quality assured by
NIHE/KVL
• Data entry and
analysis: Access
database and SPSS
11.5
Results: Phnom Penh
• Data from each of the three cross-sectional studies
were entered into individual database files
• However, problems are experienced with merging
these databases into one common database. Thus,
data is not shown
Results: Hanoi
Study population: more women involved in farm
work than men
Sites
Hoang
Liet
(ww)
Long Bien
(non-ww)
Sex
Survey 1
(May ’05)
Survey 2
(Sept ’05)
Survey 3
(Dec ’05)
Male
Female
23
96
29
98
29
101
Male
Female
29
94
35
95
35
94
Results: Hanoi
Percentage of respondents reporting skin problem
in last 3 months
30,0
26,0
25,0
20,2
16,2
20,0
% 15,0
10,0
3,3
3,8
2,3
5,0
0,0
Survey 1
Survey 2
ww site
Survey 3
Survey 1
Survey number
Survey 2
Survey 3
non-ww site
Results: Hanoi
Perentage of respondents reporting dermatitis in
last 3 months
ww site
14,0
12,0
11,8
11,0
10,0
8,0
%
6,9
non-ww
site
6,0
4,0
2,0
0,8
0,0
Survey 1
Survey 2
Survey 3
Survey 3
Results: Hanoi
Location of skin problems
ww
Mainly nails!
Non-ww
70,0
60,0
%
50,0
Foot
Leg
Hand
Fore-arm
40,0
30,0
20,0
10,0
0,0
Survey Survey Survey Survey Survey Survey
1
2
3
1
2
3
Results: Hanoi
Prevalence of skin problems registered at the time
of interview
Sites
Hoang
Liet
(ww)
Long
Bien
(non-ww)
Survey 1 Survey 2 Survey 3
(May ’05) (Sept ’05) (Dec ’05)
42 (35%) 27 (21%) 19 (14%)
6 (5%)
7 (5%)
3 (2%)
Results: Hoang Liet commune (ww)
Number of working hours in contact with ww
80.0
70.0
60.0
<4
%
50.0
4 to 8
40.0
8 to 10
30.0
> 10
20.0
10.0
0.0
1
2
survey number
3
Results: diagnosis of current skin
problems made by the dermatologist
Most common diagnosis was contact dermatitis
Other diagnoses:
•Atopic dermatitis
•Urticaria
•Fungus infection
•Bacterial infection
Conclusions
High prevalence of self-reported skin
problems among farmers exposed to
wastewater
Contact dermatitis is the most common
skin condition but case numbers are small
Better assessment of exposure (specific
biologic and physical-chemical factors) is
needed
Future works
• Phnom Penh database to
be repaired and data
cleaned
• Data analysis:
– Descriptive analyses
– Multiple logistic
regression
• Manuscript submissions (2
x MS to be submitted to
international peer-reviewed
journals)
Acknowledgments
• We are grateful for the help and assistance offered
by members of the field Team at the Royal
University of Agriculture in Phnom Penh, local
people in Hoang Liet and Long Bien communes for
data collection
• Colleagues in the National Inst. of Hygiene and
Epidemiology (NIHE) for data entries
• EU-INCO-DEV (PAPUSSA) and the Danish
International Development Assistance (Danida) for
financial support