Correction to: Exposure to arsenic in utero is associated with various types of DNA damage and micronuclei in newborns: a birth cohort study.

Following publication of the original article [1], the author reported that incorrect version of Tables 1, 3, 5 and 6 were published.

Exposure to arsenic in utero is associated with various types of DNA damage and micronuclei in newborns: a birth cohort study.

BACKGROUND: Growing evidence indicates that in utero arsenic exposures in humans may increase the risk of adverse health effects and development of diseases later in life. This study aimed to evaluate potential health risks of in utero arsenic exposure on genetic damage in newborns in relation to maternal arsenic exposure. METHODS: A total of 205 pregnant women residing in arsenic-contaminated areas in Hanam province, Vietnam, were recruited. Prenatal arsenic exposure was determined by arsenic concentration in mother's toenails and urine during pregnancy and in umbilical cord blood collected at delivery. Genetic damage in newborns was assessed by various biomarkers of early genetic effects including oxidative/nitrative DNA damage (8-hydroxydeoxyguanosine, 8-OHdG, and 8-nitroguanine), DNA strand breaks and micronuclei (MN) in cord blood. RESULTS: Maternal arsenic exposure, measured by arsenic levels in toenails and urine, was significantly increased (p <  0.05) in subjects residing in areas with high levels of arsenic contamination in drinking water. Cord blood arsenic level was significantly increased in accordance with maternal arsenic exposure (p <  0.001). Arsenic exposure in utero is associated with genotoxic effects in newborns indicated as increased levels of 8-OHdG, 8-nitroguanine, DNA strand breaks and MN frequency in cord blood with increasing levels of maternal arsenic exposure. Maternal toenail arsenic level was significantly associated with all biomarkers of early genetic effects, while cord blood arsenic levels associated with DNA strand breaks and MN frequency. CONCLUSIONS: In utero arsenic exposure is associated with various types of genetic damage in newborns potentially contributing to the development of diseases, including cancer, later in life.

Lead Environmental Pollution and Childhood Lead Poisoning at Ban Thi Commune, Bac Kan Province, Vietnam.

Lead poisoning is a public health problem in many areas of the world. Children are at particularly high risk for adverse effects of lead exposure; even at low concentrations, lead can affect physical, mental, and behavioral development. Children living near lead-zinc mines are at high risk for environmental lead poisoning, especially the contaminated soil. We conducted a cross-sectional descriptive study in Ban Thi Commune, northern Vietnam. 195 children (92,9% participation) aged 3-14 years old (average: 7.69 ± 2.90) were randomly selected from a list of all children prepared by the village health collaborators. 109 (55.90%) were boys and 86 (44.10%) were girls. The research measures were the lead concentration in native soil and the children's total blood lead concentration determined by the inductively coupled plasma-mass spectrometry (ICP-MS) method. The results showed that lead content in soil was many times higher than American Environmental Protection Agency and Vietnam standards (average 2980.23 ± 6092.84 mg/kg dry weight of soil (range 80.05 - 33820.62)). Average blood lead levels for children were 15.42 ± 6.45 µg/dL (95% CI: 14.50 -16.33 µg/dL). The percentage of children with lead levels >10 µg/dL (value considered to be lead poisoning for children according to the Ministry of Health of Vietnam) was 79.49% of the total number of children. None of the children in this study had blood lead level (BLL) that required chelation treatment according to Vietnam MOH guideline (BLL ≥45 µg/dL). There is weakly evidence that lead exposure relates to the physical development of children. Children with low lead concentrations (less than 10 µg/dL) had height and weight of 1.47-3.51 cm and 1.19-2.81 kg, greater than those with BLL >10 µg/dL (p>0.05).

Biomonitoring of polycyclic aromatic hydrocarbons exposure in small groups of residents in Brisbane, Australia and Hanoi, Vietnam, and those travelling between the two cities.

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with adverse health outcomes. Concentrations of urinary PAH metabolites (OH-PAHs) provide an integrated measure of human exposure to PAHs but measurement of urinary OH-PAHs has not been done in Australia and rarely in Vietnam, where air pollution is of concern. In this study, we assessed exposure to PAHs in 16 participants living in Brisbane, Australia and Hanoi, Vietnam, with 4 participants travelling between the two cities during the monitoring period. A total of 312 first morning urine samples were collected over 10weeks and were analysed for nine OH-PAHs. Concentrations of the urinary OH-PAHs were 2-10 times higher in participants from Hanoi than those from Brisbane. For example, the median concentrations of 1-hydroxypyrene were 292pg/mL in Hanoi, compared to 64pg/mL in Brisbane. For participants travelling from Brisbane to Hanoi and back, differences in exposure to PAHs in these two cities resulted in corresponding changes of urinary OH-PAH concentrations, demonstrating that the more polluted environment in Hanoi was likely the source for higher PAH exposure there.

Work-related injury surveillance in Vietnam: a national reporting system model.

Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam's Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system.

The utility of injury narratives for prioritising future prevention activities in small and medium enterprises in rural Vietnam.

OBJECTIVES: Injuries are a leading cause of work-related disability and death in rapidly developing countries such as Vietnam. The authors' objective was to demonstrate the utility of detailed injury narratives, derived from a household survey, in providing information on the determinants of work-related injuries to inform potential intervention targets. METHODS: In a cross-sectional survey administered to 2615 households of a rapidly developing community of Vietnam where many workers engage in both agriculture and industrial work, the authors collected information about self-reported work-related injuries, annual hours worked in each industry and narrative text describing the circumstances of each injury. The authors used a customised coding taxonomy to describe injury scenarios. RESULTS: Several intervention themes emerged, including the implementation of machine guarding, the use of cut resistant gloves and safety glasses which would benefit the small- and medium-sized enterprises. Calculation of incidence rates using full-time equivalents, stratified by work group, provided some unexpected observations of the risks of working in agriculture; workers who work in agriculture in addition to another industry are at an increased risk of fatigue or overexertion and other consequences of working too hard in their agricultural activities. CONCLUSIONS: A lack of aggregate injury statistics makes it difficult for the owners of small- and medium-sized enterprises to recognise a priori the most effective safety interventions. This analysis of detailed injury narratives with an appropriate taxonomic basis offers the ability to focus on the level of cause, activity and source and may inform the choice of various potential interventions at the workplace or enterprise level.

Studying the effectiveness of activated carbon R95 respirators in reducing the inhalation of combustion by-products in Hanoi, Vietnam: a demonstration study.

BACKGROUND: Urban air pollution is an increasing health problem, particularly in Asia, where the combustion of fossil fuels has increased rapidly as a result of industrialization and socio-economic development. The adverse health impacts of urban air pollution are well established, but less is known about effective intervention strategies. In this demonstration study we set out to establish methods to assess whether wearing an R95 activated carbon respirator could reduce intake of polycyclic aromatic hydrocarbons (PAH) in street workers in Hanoi, Vietnam. METHODS: In this demonstration study we performed a cross-over study in which non-smoking participants that worked at least 4 hours per day on the street in Hanoi were randomly allocated to specific respirator wearing sequences for a duration of 2 weeks. Urines were collected after each period, i.e., twice per week, at the end of the working day to measure hydroxy PAHs (OH-PAH) using gas chromatography/high resolution mass spectrometry. The primary endpoint was the urinary concentration of 1-hydroxypyrene (1-OHP). RESULTS: Forty-four participants (54.5% male, median age 40 years) were enrolled with the majority being motorbike taxi drivers (38.6%) or street vendors (34.1%). The baseline creatinine corrected urinary level for 1-OHP was much higher than other international comparisons: 1020 ng/g creatinine (IQR: 604-1551). Wearing a R95 mask had no significant effect on 1-OHP levels: estimated multiplicative effect 1.0 (95% CI: 0.92-1.09) or other OH-PAHs, except 1-hydroxynaphthalene (1-OHN): 0.86 (95% CI: 0.11-0.96). CONCLUSIONS: High levels of urine OH-PAHs were found in Hanoi street workers. No effect was seen on urine OH-PAH levels by wearing R95 particulate respirators in an area of high urban air pollution, except for 1-OHN. A lack of effect may be de to gaseous phase PAHs that were not filtered efficiently by the respirator. The high levels of urinary OH-PAHs found, urges for effective interventions. TRIAL REGISTRATION: ISRCTN74390617 (date of assignation: 04/08/2009).

The burden of occupational injury: a 1-year prospective study in Xuan Tien Commune, Viet Nam.

BACKGROUND: Developing nations carry a substantial portion of the global burden of injury, but without reliable injury surveillance, there is no way to characterize or prioritize the causes of work-related injury for prevention. METHODS: Injury data from 52 treatment sites in the Xuan Tien Commune, Vietnam with over 10,000 inhabitants were collected between January 1 and December 31, 2006. Injured residents were interviewed to determine work-relatedness, relevant causes, disability, and burden. RESULTS: Five hundred four work-related injuries were reported from formal treatment sites (incidence rate of 87 per 1,000 FTE) with a mean lost work day of 11 days. Four thousand five hundred seventy-four lost work day equivalents were estimated based on actual days lost to recover plus work days lost earning income to pay for medical costs, accumulating a total direct burden to the community of 8,641 lost work day equivalents. Almost half of that burden was caused by work in manufacturing. First aid boxes placed in 40 manufacturing enterprises yielded the 2nd highest reporting source. CONCLUSION: This study demonstrated the feasibility and value at the local level to build an active injury surveillance system which could have a large impact on preventing the burden of injuries in workplaces in Vietnam.

Occupational injuries in a commune in rural Vietnam transitioning from agriculture to new industries.

OBJECTIVES: We explored the impact on work-related injuries of workers splitting time between industry and agriculture, a common situation in developing countries. METHODS: In 2005, we administered a cross-sectional survey to 2615 households of Xuan Tien, a developing rural community of Vietnam, regarding self-reported injuries and hours worked for 1 year. We defined groups as working in industry, agriculture, or a mix of both. RESULTS: Overlapping employment (part time in agriculture and up to full time in industry) increased the risk of injury in both agricultural and industrial work. This pattern held across all work groups defined by the relative amount of time worked in agriculture. Those working fewer than 500 hours annually in agriculture had an agricultural injury rate (872 per 1000 full-time equivalents) that was more than 4 times higher than the average rate overall (203 per 1000) and the rate for workers employed only in industry (178 per 1000). CONCLUSIONS: Working in agriculture for short durations while working in industry increased the risk of injury substantially in both types of work.

The work-related burden of injury in a rapidly industrialising commune in Viet Nam.

BACKGROUND: Health and injury surveillance data of the highest achievable quality are needed in order to appropriately allocate scarce resources at the local and national levels. METHODS: This is the first reported surveillance study of injury using a complete community sample in Viet Nam. Workplaces in Xuan Tien Commune most likely to benefit from intervention were identified and ranked by the magnitude of the problem (or highest injury count), the risk (highest incidence rates) and the burden (the effect of injuries on the livelihoods of workers). RESULTS: 591 injuries occurring in the month prior to survey administration were recalled, which satisfied the injury case criteria of this study (the annualised incidence rate (IR) was 681 per 1000 residents). 482 were attributed to work activities (82%), yielding an annualised IR of 1001/1000 full time employee equivalents (FTE). The highest number of injuries occurred in the manufacturing sector (n=299), followed by agriculture with far fewer injuries (n=70). The highest rate of injury was in the transport, storage and communications sector (annualised IR 1583/1000 FTE), followed by manufacturing (1235/1000 FTE) and agriculture (844/1000 FTE). CONCLUSION: This study identified patterns of risk which, because data collection reflected work culture, are believed to be more reliable than those from previous studies. Interventions in the manufacture of machinery and equipment sector (the largest industry in the commune) would have the most impact in reducing occupational injuries. Despite the trend towards manufacturing, agriculture is still a high priority with a continuing substantial impact.

A survey of work-related injury in a rapidly industrializing commune in Vietnam.

Estimating the burden of occupational injury in developing countries might provide support for strengthening injury prevention during industrialization. A cross-sectional survey was administered to all households in the Xuân Tiên Commune in Vietnam to collect information on the characteristics of work and injuries in the month before the survey. Of all households, 2615 (99%) completed the survey, comprising 10,416 residents and 5485 workers with 8478 jobs. Respondents reported 591 injuries (an annualized incidence rate [IR] of 681 per 1000 residents), 482 (82%) of which occurred during work activities (annualized IR of 1011 per 1000 full-time equivalents). Nonagricultural work was considerably more hazardous than agricultural work (1033 vs. 844 injuries per 1000 full-time equivalents, respectively). Working at home was prevalent, with 28% of households having a family-owned business. The injury IRs in this study were approximately 10 times higher than those reported in prior studies from Vietnam. High injury rates represent a substantial economic and social burden on a rapidly industrializing country and underscore the importance of injury prevention guided by surveillance data.