Country Presentation OCCUPATIONAL MEDICINE AND MEDICAL PRACTITIONERS IN VIETNAM HK, October 28-29, 2013 VU XUAN TRUNG DUONG KHANH VAN 1 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 2 STATISTIC OF OCCUPATIONAL DISEASES 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 Source: MoH, 2013 STATISTIC OF OCCUPATIONAL DISEASES Occupatinal diseases Silicosis Asbestosis Byssinosis Occ. Chronic Bronchitis Lead poisoning Benzene poisoning Mercury poisoning Nicotine poisoning Pesticide poisoning X-ray and Radioactive Hearing loss Arm-hand vibration Occ. Melanosis Occ. TB Occ. Hepatitis Occ. Leptospira Examined 29,961 1,894 842 13,019 1533 1516 240 3000 2422 321 58,475 65 2,524 108 941 0 Cumm. 12/2012 904 808 20,302 250 3 2 278 572 59 107 5 321 8 2 14 259 76 297 3 3 12 3,037 433 4,569 20 159 629 8 8 64 58 27 241 Source: National data on OSH 6 Diagnosed Appraisal OCCUPATIONAL HEALTH MANAGERMENT SYSTEM AND OCCUPATIONAL HEALTH SERVICES IN VIETNAM State management system for OH Ministry of Health Ministries of Industries Centre for Occ. And Env. Health at 63 provinces Medical Assessment Boards OH service Users OH Services Providers Big State Companies Industrial Health Centre MOLISA (OSH Labour Inspector System) Labour Offices at the provinces Other Companies Health Environment Managerment Centre at Provinces District Health Centers Small and medium companies Others OH Services Providers District Health Centers Hospitals at level of Provinces, Districs... Ministry of Health 5 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 6 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… 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). 9 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 profiles… every 6 months, with specific 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 Occ. disease resulting from manganese and 4 TT 08-1976 manganese poisoning 5 TNT poisoning TT 29-1991 Occ. disease resulting from arsenic and arsenic 6 QĐ 167-1997 compound poisoning 7 Nicotine poisoning QĐ 167-1997 Occ. disease resulting from insecticide 8 QĐ 167-1997 poisoning 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 Occ. disease resulting from working in low air 4 QĐ 167-1997 pressure Occ. disease resulting from whole body 5 TT 42/2011 vibration 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 Occupational ulcerative skin disease, 4 occupational inflammation around the nails and occupational nail inflammation disease. Group 5: Occupational Infectious Diseases 1 Occupational tuberculosis 2 Occupational viral hepatitis 3 Occupational Leptospirosis 4 HIV infection related to occupational risk QĐ 27-2006 Total: 28 diseases QĐ 27-2006 TT 29-1991 TT 29-1991 TT 29-1991 TT 42/2011 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 grassroots; for medical doctors at 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; 20 21 22 23 24 25 26 27 28 29 30 31 32 THANK YOU FOR YOUR ATTENTION! 33