Nguy cơ ảnh hưởng đến sức khỏe từ việc sử dụng nước thải trong nông nghiệp ở một số vùng ven đô tại Việt Nam (Health risks associated with wastewater use in agriculture and aquaculture in periurban areas in Vietnam)
Tóm tắt
Mục tiêu: Đánh giá nguy cơ ảnh hưởng đến sức khỏe của người dân liên quan đến việc sử dụng nước thải trong nông nghiệp ở Hà Nội và Nam Định, Việt Nam.
Phương pháp: Thực hiện nghiên cứu ở xã Yên Sở (Hà Nội) và huyện Mỹ Lộc (Nam Định). Tại Yên Sở, 636 người (15-70 tuổi) được theo dõi các bệnh tiêu chảy, ngoài da, và tìm hiểu về các yếu tố nguy cơ mắc bệnh cũng như căn nguyên gây bệnh tiêu chảy. Tại Nam Định, 1103 người (≥15 tuổi), gồm 546 người ở xã Mỹ Tân (có dùng nước thải) và 557 người ở xã Mỹ Trung (không dùng nước thải) được theo dõi trong 12 tháng về các bệnh ngoài da và các phơi nhiễm liên quan.
Kết quả: Tỉ lệ mới mắc bệnh tiêu chảy ở Yên Sở là 28 ca/100 người-năm với căn nguyên chính gây bệnh là E.histolytica, rotavirus, Shighella và E.coli. Làm việc trong môi trường nước thải, vệ sinh môi trường và cá nhân kém là những yếu tố nguy cơ gây mắc bệnh tiêu chảy. Tỉ lệ mới mắc bệnh ngoài da ở Yên Sở là 33 ca/100 người-năm, còn tỉ lệ mới mắc cộng dồn ở Nam Định là 21%. Các bệnh ngoài da phổ biến là viêm da và nhiễm nấm, thường mắc ở chân tay. Yếu tố nguy cơ gây mắc bệnh ngoài da là nữ giới, tiếp xúc với nước thải, các hoạt động nông nghiệp có sử dụng nước thải, và không sử dụng phương tiện bảo hộ lao động.
Kết luận: Vệ sinh môi trường, vệ sinh cá nhân tốt cũng như việc sử dụng các phương tiện bảo hộ lao động giúp giảm nguy cơ mắc các bệnh ngoài da và tiêu chảy trong cộng đồng dân cư sống và làm việc trong môi trường sử dụng nước thải.
English abstract
Objective: This combination study aimed to assess health risks of people engaged in wastewater irrigation in Hanoi and Nam Dinh, Vietnam.
Methods: The studies were conducted in Yen So commune (Hanoi) and My Loc district (Nam Dinh province). In Yen So, 636 peope aged 15-70 years were followed up on the incidence of diarrhea diseases and skin problems. A nested case-control study was conducted to investigate the risk factors of the diseases and aetiologies of diarrhea. In Nam Dinh, 1103 people (546 people from the wastewater-irrigation My Tan commune and 557 people from non-wastewater irrigiation My Trung commune) were followed up during 12 months for their occurrence of skin diseases and related exposures.
Results: The incidence density of diarrhea diseases was 28 episodes/100 person-years at risk, with E.histolytica, rotavirus, Shighella and E.coli as the main aetiologies. Wastewater exposure, poor sanitation and personal hygiene were the risk factors for diarrhea diseases. For skin diseases, the incidence rate was 33 episodes/100 person-years at risk in Yen So commune, while the accumulative incidence in Nam Dinh site was 21%. The most common skin problems were dermatitis (eczema) and superficial fungal infections, which often occurred in the extremeties. The main risk factors for skin diseases included wastewater contact, wastewater-related cultivations, being female and absence of personal protective equipment.
Conclusion: Improved sanitation, hygiene and using personal protective equipment will reduce the risks of skin and diarrhea diseases among people engaged in wastewater-irrigation.
Từ khóa
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