Skin disease among farmers using wastewater in rice cultivation in Nam Dinh, Vietnam
To assess the risk of skin disease among farmers occupationally exposed to wastewater. Methods
One-year follow-up study with monthly assessments of wastewater exposure and skin disease in Nam Dinh, northern Vietnam, in two adjacent communes with contrasting levels of wastewater use. In each commune, 200 households were randomly selected. Results
Of the 1103 individuals aged ≥15 years, 381 reported a skin problem at baseline or at any of the monthly visits, primarily dermatitis (eczema) and superficial fungal infections. Among the 874 subjects who were free from skin disease at baseline and who could be followed up ≥11 months, 183 developed a new skin disease (cumulative incidence 21%). Exposure to wastewater was a major risk factor for skin disease with a relative risk (RR) of 1.89 [95% confidence interval (CI) 1.39–2.57] in multivariable analysis. Other risk factors for skin disease were involvement in agriculture in general (RR = 2.59, 95% CI 1.11–6.02), flower cultivation (RR = 1.36, 95% CI 1.01–1.83), vegetable farming (RR = 1.47, 95% CI 1.04–2.08), and a history of eczema (RR = 1.47, 95% CI 1.05–2.05). Conclusion
Exposure to wastewater is a major risk factor for skin disease. In future studies, an attempt should be made to link specific chemical or biological agents in the wastewater to specific skin diseases.
Document Type: Research Article
Affiliations: 1: International Water Management Institute, Colombo, Sri Lanka 2: Division of Enteric Infections, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam 3: Department of Epidemiology, Nam Dinh Preventive Medicine Centre, Nam Dinh, Vietnam 4: Department of International Health, University of Copenhagen, Denmark 5: Department of Veterinary Pathobiology, Faculty of Life Sciences, University of Copenhagen, Denmark
Publication date: December 1, 2007