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Country Presentation

OCCUPATIONAL MEDICINE AND

MEDICAL PRACTITIONERS

IN VIETNAM

HK, October 28-29, 2013

VU XUAN TRUNG

DUONG KHANH VAN

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CONTENT

Some data related occupational diseases

OH services system in VN

Laws related for OH.

Process of Diagnosis for Occupational Disease

Training on OH/OD

Expectations from this meeting

STATISTIC OF OCCUPATIONAL DISEASES

Source: MoH, 2013

TT OSH resources Local Ministerial Total

1 OSH specialists 305 265 570

2 In which, M.D 129 145 274

  Pharmacists 11 7 18

  Graduated 58 37 95

  High school 106 76 182

3 OD appraisal specialists 29 16 45

4 OH units 50 8 58

5 OD clinics 34 3 37

STATISTIC OF OCCUPATIONAL DISEASES

Source: National data on OSH

Occupatinal diseases Examined Diagnosed AppraisalCumm. 12/2012

Silicosis 29,961 904 808 20,302Asbestosis 1,894 250   3Byssinosis 842 2   278Occ. Chronic Bronchitis 13,019 572 59 107Lead poisoning 1533 5   321Benzene poisoning 1516 8   2Mercury poisoning 240     14Nicotine poisoning 3000     259Pesticide poisoning 2422 76   297X-ray and Radioactive 321 3 3 12Hearing loss 58,475 3,037 433 4,569Arm-hand vibration 65     20Occ. Melanosis 2,524 159   629Occ. TB 108 8 8 64Occ. Hepatitis 941 58 27 241Occ. Leptospira 0     6

Total 119,072 5,171 1,338 27,515

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Other Companies

Small and medium companiesBig State Companies

Ministry of Health

MOLISA(OSH Labour

Inspector System)

Ministries of

Industries

Centre for Occ. And Env. Health at 63

provinces

Labour Offices at the provinces District

Health Centers

Medical Assessment Boards

Health Environment Managerment Centre

at Provinces

Industrial Health Centre

District Health Centers

Hospitals at level of Provinces, Districs...

Others OH Services Providers

Ministry of Health

State management system for OH

OH service Users

OH Services Providers

OCCUPATIONAL HEALTH MANAGERMENT SYSTEMAND OCCUPATIONAL HEALTH SERVICES IN VIETNAM

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Officials, experts of Faculties of Occupational Health, clinics for occupational diseases

Particulars Localities Industries Total in 2006

Total of full-time officials 305 265 570

Of which: Doctors 129 145 274

Pharmacists 11 7 18

Other undergraduate levels 58 37 95

Middle-rankinglevel 106 76 182

Assessors for occupational diseases 29 16 45

Faculties of Occupational Medicine 45 8 53

Clinics for occupational diseases 31 6 37

Resource: NATIONAL PROFILE ON OSH Period 2005-2009

National Institute Related to OH

National Institute for Occupational and Environmental Health (Under Ministry of Health)

National Institute for Labour Protection (Occupational Health Centre) (Under Labour Union).

National Institute of Medical Appraisal

Occupational & Environmental Health support organizations

Vietnam Occupational Safety and Health Technical Science Association (VOSHA).

Vietnam Occupational Health Association

ILO

WHO

AFEDA…

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Law related OH

Chapter IX (Labour Code 2012): articles 143 – 145.

Circular No. 01/2011/TTLT-BLĐTBXH- BYT on 10/01/2011 by MOLISA&MOH on guiding the implementation of safety - occupational health in Enterprise: articles 7 – 9: Mission of Medical Unit.

Circular No. 19/2011/TT-BYT on 06/06/2011 by MOH: A guidelines for hygienic management , workers health and occupational disease.

Circular No. 14/2013/TT-BYT on 06/05/2013 by MOH on guiding medical examination (recruitment and periodical examinations).

Related periodic health examination

Health examination at least once/year

Twice/year (heavy, hazardous and dangerous

work)

The occupational disease patients must be treated

according to specialists, health care and health

examination every 6 months, with specific

profiles…

Related Monitoring Work Environment

Monitoring hazardous factors in the work place at

least once/year

Monitoring hazardous factors in the work place

twice/year (very heavy, hazardous and dangerous

work)

Establish profile of industrial hygiene for the

factory…

List of insured occupational diseases in Vietnam

No Occupational disease Year issued

Group 1: Lung and Pulmonary OD

1 Silicosis TT 08-1976

2 Asbestosis TT 08-1976

3 Byssinosis TT 29-1991

4 Occupational chronic bronchitis QĐ 167-1997

5 Occupational bronchial asthma QĐ 27-2006

No Group 2: Occupational Poisoning Year issued

1 Lead poisoning TT 08-1976

2 Benzene poisoning TT 08-1976

3 Mercury poisoning TT 08-1976

4 Occ. disease resulting from manganese and manganese poisoning

TT 08-1976

5 TNT poisoning TT 29-1991

6 Occ. disease resulting from arsenic and arsenic compound poisoning

QĐ 167-1997

7 Nicotine poisoning QĐ 167-1997

8 Occ. disease resulting from insecticide poisoning

QĐ 167-1997

9 Occ. carbon monoxide contaminated disease QĐ 27-2006

10 Cadmium poisoning TT 42/2011

No Occupational disease Year issued

Group 3: Occupational Diseases due to Physical factors

1 Diseases due to X - ray and radioactive TT 08-1976

2 Noise - induced hearing loss TT 08-1976

3 Vibration diseases TT 29-1991

4 Occ. disease resulting from working in low air pressure

QĐ 167-1997

5 Occ. disease resulting from whole body vibration

TT 42/2011

No Group 4: Occupational Skin Diseases Year issued

1 Occupational melanosis (Melanodermia) TT 29-1991

2 Skin diseases due to Chromium TT 29-1991

3 Occupational oil acne disease QĐ 27-2006

4 Occupational ulcerative skin disease, occupational inflammation around the nails and occupational nail inflammation disease.

QĐ 27-2006

Group 5: Occupational Infectious Diseases

1 Occupational tuberculosis TT 29-1991

2 Occupational viral hepatitis TT 29-1991

3 Occupational Leptospirosis TT 29-1991

4 HIV infection related to occupational risk TT 42/2011

Total: 28 diseases

Process of Diagnosis for Occupational Disease:

Circular No. 12/2006/TT-BYT by MOH dated 11th October, 2006 on guiding occupational disease examination:

Work environment measurements (*)

Occupational Disease Examination (*)

Medical Assessment Boards: Make decision and the reduction of work ability level.

Patients get payment from Social Insurance and employers

Work environment measurements and Occupational Disease Examination

Carried out by OD clinics of Centres for OEH/Centre for Preventive Medicine/Hospitals at provincial and national lelvel; Medical centre of industries/sectors; National institutes.

Others certified by MoH or Provincial DoH

Carried out at the workplace or at the OD examination providers.

The examination and diagnosis of OD must be based on the results of monitoring working environment, occ. exposure factors and results of periodic health examination

Training on OH/OD

Training providers:

Undergraduate:

Medical Universities: M.D, Nurses, Technicians, PH practitioners

Medical College: Nurses, Technicians

Public Health School: PH practitioners, Health management

Graduate: As above and Institutes (MoH)

Specialist: As above and Institutes (MoH)

Expectations What: Importance of OD examination and diagnosis; Knowledge and skills in recognition of OD at

early stage; OHS knowledge for medical doctors at

grassroots; Techniques in diagnosis of common and new

OD; Who: OHS practitioners at national and local level; OHS system managers/policy makers; Health Service at grassroots;

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THANK YOU FOR YOUR ATTENTION!