Skin problems among farmers engaged in Skin problems among farmers engaged in Peri-urban Aquatic Production Systems in Peri-urban Aquatic Production Systems in

Hanoi and Phnom PenhHanoi 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

ObjectivesObjectives• 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

Sites Sex Survey 1(May ’05)

Survey 2(Sept ’05)

Survey 3(Dec ’05)

Hoang Liet(ww)

MaleFemale

2396

2998

29101

Long Bien(non-ww)

MaleFemale

2994

3595

3594

Study population: more women involved in farm work than men

Results: Hanoi

20,2

26,0

16,2

3,3 3,82,3

0,0

5,0

10,0

15,0

20,0

25,0

30,0

%

Survey 1 Survey 2 Survey 3 Survey 1 Survey 2 Survey 3

Survey number

Percentage of respondents reporting skin problem in last 3 months

ww site non-ww site

Results: Hanoi

Perentage of respondents reporting dermatitis in last 3 months

11,811,0

6,9

0,8

0,0

2,0

4,0

6,0

8,0

10,0

12,0

14,0

Survey 1 Survey 2 Survey 3 Survey 3

%

ww site

non-ww site

Location of skin problems

0,0

10,0

20,0

30,0

40,0

50,0

60,0

70,0

Survey1

Survey2

Survey3

Survey1

Survey2

Survey3

%

Foot

Leg

Hand

Fore-arm

Results: Hanoi

ww Non-ww

Mainly nails!

Results: Hanoi

Sites Survey 1(May ’05)

Survey 2(Sept ’05)

Survey 3(Dec ’05)

Hoang Liet(ww)

42 (35%) 27 (21%) 19 (14%)

Long Bien(non-ww)

6 (5%) 7 (5%) 3 (2%)

Prevalence of skin problems registered at the time of interview

Number of working hours in contact with ww

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

1 2 3

survey number

%

<4

4 to 8

8 to 10

> 10

Results: Hoang Liet commune (ww)

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