Environmental health

Environmental health is the branch of public health that: focuses on the relationships between people and their environment; promotes human health and well-being; and fosters healthy and safe communities. Environmental health is a key part of any comprehensive public health system. This is a new research problem that requires ICHR researchers to constantly update their knowledge to respond to the development of the scientific environment. Below are abstracts of the ICHR Institute's recent studies, with the names in bold being the members of the ICHR Institute.The full text can be found in the Institute's International publications directory.

1. Short - term effects of temperature on hospital admissions for acute myocardial infarction: A comparison between two neighboring climate zones in Vietnam

Thi Anh Thu Dang; Darren Wraith; Hilary Bambrick; Nguyen Dung; Thai Thanh Truc; Shilu Tong; Sue Naish; Michael P.Dunne

Background: Vietnam is one of the countries most affected by climate change, but few studies have focused on the population health effects of climate variation. Extreme heatwaves and cold spells might exacerbate underlying chronic conditions and precipitate hospitalization or early death. This study examined the short-term effects of ambient temperature extremes on hospital admissions (HAs) due to acute myocardial infarction (AMI) between different climate zones in the Central Coast region of Vietnam.

Methods: Information from medical records of all 3328 cases of AMI HAs (with hospital records cross-checked by clinicians) was collected from three hospitals in the South-Central Coast region (tropical savanna climate) and North-Central Coast region (tropical monsoon climate) for the period 2008–2015. Meteorological data were obtained from the National Hydro-Meteorological and Environment Network Centre. We used distributed lag non-linear models to assess the association between daily average temperature and AMI HAs, accounting for long-term trend and other meteorological variables.

Results: We found a negative and significant association between AMI HAs and temperature in the North-Central Coast region while conversely there was a positive and significant association in the South-Central Coast region. In the North-Central Coast region, the risk of AMI HAs increased by 11% (Relative risk (RR): 1.11, 95% CI: 0.91–1.35, p > 0.05) at moderately low temperatures (10th percentile of temperature range – 18.5 °C) and increased by 25% (RR: 1.25, 95% CI: 1.02–1.55, p < 0.05) at extremely low temperatures (5th percentile of temperature range – 16.8 °C). In the South-Central Coast region, the risk of AMI HAs increased by 18% (RR: 1.18, 95% CI: 0.95–1.47, p > 0.05) and 36% (RR: 1.36, 95% CI: 1.06–1.73, p < 0.05) at moderately high temperatures (90th percentile of temperature range −29.5 °C) and extreme high temperatures (95th percentile of temperature range – 29.9 °C), respectively.

Conclusions: Risk of AMI is associated with extremely high and extremely low temperature in Vietnam and the risk varies in relation to the local regional climate. Public health preparedness and multi-level interventions should attempt to reduce people's exposure in periods of disadvantageous temperatures.

Dr. Dang Thi Anh Thu - PhD student of QUT, Australia (red jacket) with her assisstant on data collection in "Impact of ambient temperature on hospital admissions for acute myocardial infarction in central coast of Vietnam" project.

2. Seafood safety compliance with hygiene regulations within Vietnamese domestic distribution chains

Phuc Hong Luu, Michael P. Dunne, Warwick Pearse and Belinda Davies

Purpose: In order to improve the safety of seafood in the domestic seafood distribution chains (DSDCs) in Vietnam, a better understanding of current hygiene and practices compliance with government regulations is needed. The paper aims to discuss this issue.

Design/methodology/approach: Infrastructure conditions and documents related to hygiene procedures of 50 trading places were evaluated using checklists. The hygiene handling practices of 135 fish distributors were also observed by using notational analysis methods. This notational analysis method focused on actions related to microbiological contamination in terms of hand washing or glove changing and the cleaning and sanitising of tools and equipment. Additionally, microbiological quality of 135 samples of raw finfish at points along distribution chains was compared with national standards.

Findings: The results indicated that all trading places could be classified as non-compliant or seriously non-compliant with the regulations. The practices of fish distributors were also assessed to be at high risk for contamination of raw fish. The findings showed that approximately 42 and 39 per cent of samples from fishing ports and fish markets, respectively were classified as unacceptable according to the microbiological standards of Vietnam.

Dr. Nguyen Thanh Gia - PhD student in Yamagata university, Japan on his data collection of his project "Health risk due to food contamination induced by urban flood". ICHR Institute plays the role of technical support and data collection and processing.

3. Sustainability of Public Health Interventions to Reduce the Risk of Dioxin Exposure at Severe Dioxin Hot Spots in Vietnam

Tran Thi Tuyet-Hanh, Le Vu-Anh, Michael Dunne, Leisa-Maree Toms, Thomas Tenkate, Fiona Harden

Severe dioxin contamination at Bien Hoa and Da Nang airbases, Vietnam is of international concern. Public Health risk reduction programs were implemented in Bien Hoa in 2007–2009 and in Da Nang in 2009–2011. In 2009 and 2011 we reported the encouraging results of these interventions in improving the knowledge, attitude and practices (KAP) of local residents in reducing the dioxin exposure risk through foods. In 2013 we revisited these dioxin hot spots, aimed to evaluate whether the results of the intervention were maintained and to identify factors affecting the sustainability of the programs. To assess this, 16 in-depth interviews, six focus group discussions, and pre and post intervention KAP surveys were undertaken. 800 respondents from six intervention wards and 200 respondents from Buu Long Ward (the control site) were randomly selected to participate in the surveys. The results showed that as of 2013, the programs were rated as ‘‘moderately sustained’’ with a score of 3.3 out of 5.0 (cut off points 2.5 to \3.5) for Bien Hoa, and ‘‘well sustained’’ with a score of 3.8 out of 5.0 (cut off points 3.5 to\4.5) for Da Nang. Most formal intervention program activities had ceased and dioxin risk communication activities were no longer integrated into local routine health education programs. However, the main outcomes were maintained and were better than that in the control ward. Migration, lack of official guidance from City People’s Committees and local authorities as well as the politically sensitive nature of dioxin issues were the main challenges for the sustainability of the programs.