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.

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.