Skin disease among farmers using wastewater in rice cultivation in Nam Dinh, Vietnam.
OBJECTIVE
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 > or =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 > or =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).


CONCLUSIONS
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.
Do
Thuy Trang
TT
Division of Enteric Infections, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam. tranghai16@yahoo.com
van der Hoek
Wim
W
Nguyen
Dang Tuan
DT
Phung
Dac Cam
DC
Vu
Huu Viet
HV
Do
Duc Luu
DL
Konradsen
Flemming
F
Dalsgaard
Anders
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D009783:Dermatitis, Occupational / Q000453:epidemiology* / Q000209:etiology; D003881:Dermatomycoses / Q000453:epidemiology* / Q000209:etiology; D004485:Eczema / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control; D012275:Oryza; D012307:Risk Factors; D012722:Sewage / Q000009:adverse effects*; D014744:Vietnam / Q000453:epidemiology
D012722:Sewage