Risk assessment in health research in Vietnam

Permanent URI for this collectionhttps://hdl.handle.net/10568/33827

Articles in a special edition of the Vietnamese Journal of Preventive Medicine (published June 2013)

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Risk assessment of Salmonella in pork in Hanoi, Vietnam
(Journal Article, 2013-06) Luu Quoc Toan; Hung Nguyen-Viet; Bui Mai Huong
Quantitative Microbial Risk Assessment (QMRA) was used to assess the health risk of pork meat contaminated by Salmonella spp. in Hanoi, Vietnam. A total of 72 pork samples were collected from 4 formal markets in Long Bien District, Hanoi. Salmonella spp. was analyzed by the Most Probable Number (MPN) method. A survey consisting of self-administered structured questionnaires was conducted in 210 households to determine the consumption of pork and examine cooking and eating habits. A health risk assessment was performed for 4 scenarios of cross-contamination of Salmonella spp. including contamination from raw meat to cooked food via i) hands, ii) knife, iii) cutting board, and iv) full cross-contamination. The results showed that Salmonella spp. was detected in 25% of pork samples (18/72). The concentration of Salmonella spp. varied from 100 to 27,500 per 25 grams of pork (mean: 673 per 25 grams). Pork consumption, a component of exposure assessment, was estimated by amount and frequency. The mean amount of pork consumption was estimated at 86.1 grams per person per day; mean frequency of pork consumption was 219 days per person per year. Infection risk of Salmonella spp. was from 2.1×10-4 to 4.9×10-4 by single exposure (per consumption). The annual risk was from 4.3×10-2 to 9.5×10-2. Although this study considered only one stage of exposure in the “farm to fork” chain, the findings showed that this stage is critical and represents a potential health risk for consumers. Appropriate practices for pork meat preparation and consumption at the household level need to me targeted as risk management measures.
Health risk due to exposure to chlorpyrifos for farmers in Thai Binh: Probabilistic risk assessment
(Journal Article, 2013-06) Phung Tri Dung; Hung Nguyen-Viet; Tran Thi Tuyet Hanh
Farmers in Vietnam are at high risk of exposure to pesticides, especially with chlorpyrifos, the most common insecticide registered for use in 2009 in Vietnam. The purpose of this study was to assess the health risks of chlorpyrifos exposure in farmers who were pesticide applicators. The research method included three steps: (i) 24-hour urine samples taken from farmers to analyse trichlorpyridinol (TCP), the main metabolite of chlorpyrifos, and then TCP was converted to Absorbed Daily Dose (ADD); (ii) dose-response (RADD) corresponding to acute effects on the nervous system was obtained and recalculated from epidemiologic studies on human population; (iii) the health risk of chlorpyrifos with farmers was evaluated using probabilistic health risk assessment approach with 10,000 trials simulated by Monte Carlo technique. The results showed that the baseline exposure level (ADDB) ranged from 0.03 - 1.98 µg/kg/d, and post-application exposure level (ADDA) ranged from 0.35 - 94 µg/kg/d. The total exposure level (ADDT), ranged from 0.4 - 94.2 µg/kg/d. Dose-response corresponding to neurological adverse effects (RADD) ranged from 5-181 µg/kg/d. The Hazard Quotient calculated from ADD and RADD revealed that the baseline exposure level did not contribute to a significant adverse effect, however the post-application and total exposure levels caused a high risk of adverse effects to farmers who were pesticide applicators at 33%. A needs assessment and intervention studies need to be conducted to explore methods to reduce the risks due to chlorpyrifos exposure among farmers.
Prevalence of Salmonella contamination in pig and pork at farms and slaughterhouses in the northern provinces of Vietnam
(Journal Article, 2013-06) Pham Thi Ngoc; Nguyen Tien Thanh; Tran Thi Hanh; Hung Nguyen-Viet
Salmonella is known as one of the most frequent foodborne zoonoses in the world and has been isolated from humans and pork products. The aim of this study was to assess the prevalence of Salmonella in the pig farms and during slaughter through practice analysis, serotyping, and focusing on the role of specific practices in the final carcass contamination. 82 Salmonella isolates were found among anal swabs, barn floor swabs, feed, drinking water, wastewater, and breeding equipment samples in pig farms and in the same type of samples and carcass swabs collected at slaughterhouses, In total, the main serovars were Salmonella enterica subsp. entericaserovar (S.) Derby (25.6%), S. Typhimurium (23.2%) and S.Rissen (13.4%). Other serovars including S. Anatum, S. Braenderup, S.Chartres, and S. Meleagridis appeared from 2.4% to 6.1%. Isolating and serotyping showed that live pigs’ faeces, probably through unloading, lairage or offal preparation, were the principal source of Salmonella contamination of the slaughter environment and carcasses. However, we could not establish a direct link between the environment and carcasses. Similarly, the direct contamination of carcasses through faecal material from the same pig was not clear. Thus, our results suggest that the main source of carcass contamination was indirect, through the environment, since the pigs are slaughtered on the ground. A direct contamination was observed probably through defective practices and the lack of wastewater management. Control measures could largely decrease the carcass contamination rate. Particular attention should be paid to the contact of the carcass with the ground or workers, especially after scalding, to improved separation between soiled and clean areas, to wastewater management and to the cleaning and disinfection protocol.
Taskforce of risk assessment for food safety in Vietnam: Linking science to policy to increase food safety and livelihood generation of the poor farmers
(Journal Article, 2013-06) Hung Nguyen-Viet
One way capacity for risk assessment could be strengthened is through a Risk Assessment Task Force, bringing together representatives from Ministry of Health and Ministry of Agriculture and Rural Development with researchers in Vietnam working on risk assessment and food safety from key universities, research institutes, and private food companies. The Task Force will work on developing guidelines for how to use risk assessment for food safety management in informal markets for domestic consumption. These guidelines will be used for trainings for a wide range of decision makers, including high level policy makers. A technical-level course and case studies on food safety from informal markets will be used to increase risk assessment capacity for implementers, followed by mentoring and on-the-job support. Support from international and regional research institutes, such as ILRI, IFPRI, CENPHER, and international bodies such as WHO and FAO are already in place.
Food-borne hazards in a transforming pork value chain in Hanoi: Basis for future risk assessments
(Journal Article, 2013-06) Fahrion, Anna S.; Lapar, Ma. Lucila; Nguyen Ngoc Toan; Do Ngoc Thuy; Grace, Delia
Pork is the most consumed meat in Vietnam. Driven by market liberalization and economic growth, food chains especially in urban areas adapt to convenience lifestyles (e.g., the promotion of refrigeration systems) and move away from the traditional methods of food retail and preparation. Along with these changes, as well the hazards, and consequently risks, from pork are changing. We investigated pork samples sourced from different retail types -traditional to modern- for a selection of typical food-borne hazards in order to compare levels of contamination and safety. We included samples from supermarkets and wet markets in urban Ha Noi, as well as samples from village markets. In addition, taking into account information about hygiene and practices related to handling and preparing pork, we tried to describe probable changes in consumer exposure. In this context, we carry out descriptive hazard characterization and exposure assessment for Enterobacteriaceae including E. coli O157, Listeria monocytogenes and antibiotic residues. This descriptive pilot study points out possible emerging risks to be addressed and supplies data to inform future risk assessments.
Environmental health risk assessment of dioxin in foods in Da Nang dioxin hot spot
(Journal Article, 2013-06) Tran Thi Tuyet Hanh; Le Vu Anh; Nguyen Ngoc Bich; Hung Nguyen-Viet
Da Nang Airbase served as a bulk storage and supply facility for AO and other herbicides during the Operation Ranch Hand 1961-1971, and is currently one of the three most severe dioxin hot spots in Vietnam. This study applies the Australian Environmental Health Risk Assessment Framework aimed to assess the risk of dioxin exposure through foods for local residents living in An Khe, Hoa Khe, Chinh Gian and Thanh Khe Tay wards, surrounding a severe dioxin hot spot – the Da Nang Airbase. Various stakeholders were involved in the risk assessment process, and related publications on dioxin characteristics, its toxicity, and the levels in the local soil, mud, foods, milk, and blood samples were reviewed. A food frequency and knowledge - attitude – practice survey of 400 randomly selected local households from the four wards was conducted to provide data for exposure assessment. Results showed that local residents who have been consuming local cultivated high risk foods, especially freshwater fish, snails, crabs, free range chicken, duck, pumpkin, and lotus caught/raised/harvested inside or surrounding the Airbase would be at a very high risk. Their dioxin daily intake levels would exceed the recommended tolerable daily intake level recommended by WHO (1-4 pg/kg/day). Followed this risk assessment, a multi-approach risk reduction program was developed, implemented during 2010-2011 to reduce the risks of dioxin exposure for local residents.
Air pollution as a health issue in Hanoi, Vietnam: An opportunity for intensified research to inform public policy
(Journal Article, 2013-06) Hung Nguyen-Viet; Le Thi Thanh Huong
As a result of increasing in population, personal vehicles, industrial zones and household emission, the air quality in Hanoi is becoming deteriorated and affecting human health. There is a gap in research on the relationship between air pollution and human health and involvement of policy makers in these issues. This paper reviews all research related to air pollution in Hanoi as well as briefs on the current situation of the local air pollution, in which large attention will be paid to emission source and the legal framework for air quality in Hanoi. We focus on filling the gap in previous evaluations on impact of air pollution on human health and the collaboration between researchers and policy makers in monitoring air quality and protecting human health. From the lessons learned in other countries and the previous studies in Vietnam, we recommend using risk assessment as a tool to analyze the relationship between air pollution and human health to inform policy.
Research projects on health risk assessment implemented by the Hanoi School of Public Health
(Journal Article, 2013-06) Hung Nguyen-Viet; Tran Thi Tuyet Hanh
The authors briefly introduce three research projects on health risk assessment at the Hanoi School of Public Health which were initiated in 2013 and are currently ongoing. Two projects, “PigRISK - Reducing Disease Risks and Improving Food Safety in Smallholder Pig Value Chains in Vietnam” and “FOODRISK - Strengthening the Capacity of Risk Assessment Application for Managing Food Safety within a Food Production-Environmental-Health Interaction Context in Vietnam,” apply the Quantitative Microbial Risk Assessment approach to assess the risks associated with microbial hazards in pork, vegetables and fish. Risk assessment due to hazardous chemicals in pork will be also undertaken within the scope of the PigRISK. The third project “Dioxin Exposure Risk Assessment and the Sustainability of Public Health Interventions at Dioxin Hot Spots in Vietnam” applies Environmental Health Risk Assessment to assess the risk of dioxin exposure through human consumption of contaminated foods at Bien Hoa and Da Nang dioxin hot spots. These research projects are financially supported by CGIAR Research Program 4 (CRP4) of the International Livestock Research Institute (ILRI), the Embassy of Switzerland to Vietnam, and the Australian Government under the Australian Development Scholarship Program.
Training and research programmes in health risk assessment in Vietnam
(Journal Article, 2013-06) Phuc Pham Duc; Tran Thi Tuyet Hanh; Hung Nguyen-Viet
Risk assessment is one of the three important components of the risk analysis framework. Risk assessment is the scientific method used to assess the level of a specific risk, from which different measures to control the risk is developed. In developed countries, risk assessment has been applied with sufficient guidelines and used in policy development. However, in developing countries, including Vietnam, the role of risk assessment in environmental health is still limited and not well applied in policy development, as the quantity and quality of studies on risk assessment is incomplete and not comprehensive. This paper reviews the current training, research programmes and policies on environmental health risk assessment in Vietnam. The authors also present possible solutions that could be applied in a comprehensive environmental health risk assessment in Vietnam. The results of the environmental health risk assessment should be tied with policy development to prevent diseases and to promote public health.
Health impact of exposure to arsenic-contaminated drinking water in Vietnam
(Newsletter, 2012-07-15) Bui Huy Tung; Tran Thi Tuyet Hanh; Hong, N.N.; Hung Nguyen-Viet
The public health situation of the population of Hanam Province in Vietnam is of great concern, as it is exposed daily to arsenic-contaminated drinking water. Optimising arsenic (As) removal efficiency of current sand filters at household level or switching to cleaner or As-free water sources is crucial to prevent or reduce community health risks.

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