Tuan Nguyen, MBA, CIH, CSP, ARM, an industrial hygiene consultant for the State Compensation Insurance Fund in California, and Mary O'Reilly, PhD, CIH, CPE, who is currently an ergonomist at ARLS Consultants, Inc. in New York, are connected by Workplace Health Without Borders (WHWB), a nonprofit organization working to address occupational health and safety issues around the world. A few years ago, Nguyen, AIHA’s ambassador to Vietnam, was working to establish a relationship between AIHA and Vietnam’s National Institute of Occupational and Environmental Health (NIOEH). As part of that collaboration, Nguyen organized and co-taught an introductory occupational hygiene course to more than 50 students at NIOEH in Hanoi last summer with the support of AIHA, OHTA, WHWB and WHWB-US, an independent branch of WHWB that works to both prevent occupational disease in underserved populations in the U.S. and raise awareness of the need for worker health. Mary O’Reilly, a director on the board of WHWB and current president of WHWB-US, co-presented the course in Vietnam as a WHWB volunteer along with Course Director Dr. Elaine Lindars, OHTA Director Noel Tresider, and Jonathan Haney, a retired CIH from New York State. In June 2017, Nguyen and O’Reilly, with the director of NIEOH, will present the educational session “Vietnam Takes New Initiatives on Lead Exposures” at AIHce in Seattle, Wash. The Synergist: I understand that you both will be presenting an AIHce session on Vietnam's initiatives on lead exposures. What can you tell us about that? Mary O’Reilly: Dr. Doan Ngoc Hai, who is the director of the Vietnamese National Institute, will be coming to the conference in June in Seattle to present with Tuan and me at an educational session. My understanding is that there is a village in Vietnam where people have been disassembling lead batteries for several generations, so there’s a lot of lead contamination. There was an initial traditional remediation project that ran out of money before it was finished, and so the people in Vietnam were taking a different approach to reducing blood lead levels in both adults and children by using activated pectin that prevents reabsorption of lead from the intestine, which decreases the amount of lead in the bloodstream. One of the things the Institute is doing is a scientific study of the blood lead levels after this treatment with activated pectin. This is very different from what we do in the U.S. The people in Vietnam don’t have the resources that we have here. They don’t have space enough to truck out all the contaminated soil like we sometimes try to do here, and they don’t have the resources to actually move the people who live in the lead-contaminated area because it’s their home and they don’t have anywhere else to go. So what can you do? They came up with the activated pectin approach to reduce the blood lead levels. We are also talking to a chemistry professor whose doctoral research was on the use of fish bones to bind lead in the soil. It’s not removing the lead, but it’s making the lead biologically unavailable. This is another thing people might want to try in the village where there is high lead contamination. I’ve found the willingness to consider new approaches very inspiring. Tuan, do you have anything to add?

Tuan Nguyen: In Vietnam, there are many small villages specialized in making the same products. For example, in the village that Mary talked about, most of the people are involved in the lead-acid recycling business, and they have been for a couple of generations. While we were in Vietnam, we also had an opportunity to visit a pottery village where the situation was the same: most of the people in this village make pottery and they sell it all over the world. Virtually the entire village manufactures pottery, and they do it in their own houses. Their live-and-work business model is economical and practical. They live upstairs and the downstairs is used for pottery manufacturing. For that reason, they do have lead and silica exposures as well as the contamination issues. TS: What other exposures and hazards affect workers and others in Vietnam? TN: There are many. In construction, people don’t have enough protective equipment, so the exposures are very high in that industry. Vietnam also has a mining industry with a very high annual injury rate. There is one village near Hanoi where they do coal mining, and it is on the way to Ha Long Bay, a tourist destination. Along the way, you pass through several pottery places where they have kilns that use firewood. You can see smog and a lot of smoke, and it’s very hard to breathe. Then when you get closer to the mine, you see coal dust everywhere. A big pickup truck will run by and you’ll see a black cloud of dust. There is noise exposure, too; people honk all the time. We took a two-hour trip and we heard the honking sounds for almost the whole time. This is because people there don’t obey traffic rules. There’s so much traffic and congestion, so people try to go as fast as they can to make up time. They’ll cut in front of you and go every which way. Some of the streets are very narrow, and people will routinely pass each other on a two-lane highway. Sometimes you’ll see cars coming at you head-on, and then at the last minute they’ll change lanes. It’s kind of scary. MO: It took me a few days to get up enough courage to cross the street. You really had to trust everyone else on the road that they weren’t going to run you over, to just go out and go where you were going. One thing that struck me is that people at the Institute are very concerned about climate change. It’s already quite hot in Vietnam and it will get hotter, so workplace stress from heat is a real concern. TN: Yes, sometimes the temperature gets to 35 or 36 degrees Celsius, or around 95 degrees Fahrenheit with the average relative humidity level above 70 percent, which is very humid. There are many concerns about climate change because a portion of Vietnam is very low. If sea level rises three or four feet, they will lose a lot of land.
Editor's note: Exclusive to the digital Synergist, Pole to Pole focuses on the challenges of practicing industrial and occupational hygiene around the world. Each month, the digital Synergist features an edited Q&A based on an interview with an industrial hygienist about how the IH/OH profession differs from country to country. The
previous installment
of “Pole to Pole” features AIHA member Michael Ridosh, who discussed his role in the Agent Orange cleanup at the airport in Da Nang, Vietnam. This month, the series focuses on a different IH perspective of Vietnam.
Pole to Pole:
Vietnam, Revisited
An Interview with Tuan Nguyen and Mary O’Reilly
"With many people working out of their homes—doing manufacturing, running restaurants, everything—they don’t have available resources to devote to safety and health or protective equipment."
-Tuan Nguyen
TS: How do you hope that occupational health will move forward in Vietnam?
TN: Vietnam’s economy is supported by small and medium-sized businesses. With many people working out of their homes—doing manufacturing, running restaurants, everything—they don’t have available resources to devote to safety and health or protective equipment. It will take a long time to help spread the safe work practices to the people of Vietnam. I hope that in the future we can continue with the Occupational Health Training Association (OHTA) training series to certify people so that we’ll have more trainers who can spread throughout the country to train others. MO: I think we can learn as much, if not more, from the Vietnamese people than what we can teach them. They have a lot fewer resources than we do in this country, but they are working very hard to make a safe workplace for all their people. Their creativity and dedication is inspiring. TN: I can see that they’re trying very hard. The country’s infrastructure for research and its health service delivery system are very limited right now, so they’re trying to improve and work with what they have. One thing I noticed was that quite a few people have gone overseas for training and come back to Vietnam to work. But after working in Vietnam for a while, they encountered many issues because the support infrastructure is still lacking. TS: Do you have plans to do further training in Vietnam?
TN: Well, the OHTA training series includes seven modules, and we taught the first one. We put together a proposal to ask for funding support so that we can complete the other modules, but we haven’t heard much from that yet. MO: That is one of the things that WHWB hopes to raise money for. The travel cost is about $2,000 a person, and then of course there’s living expenses when you’re in country. The Vietnamese government was extremely generous to us when we taught the course last summer and treated us extremely well. I’m very grateful to the Institute and the Vietnamese government for doing that. That made it possible, with WHWB funding some and the Vietnamese government filling in the rest.
It’s expensive to put on these courses for a variety of reasons, and the expense goes up when the students or someone else has to pay for the exam. The typical cost per student is about 140 U.S. dollars, excluding instructor teaching and travel costs. It’s difficult for a lot of people in developing countries to pay that.
This is an area where WHWB would like to be able to help people out. We’re not quite at that point yet, but that’s where we’re hoping to get with the development of our training program.
View this article on your desktop or tablet to see a slideshow of photos Nguyen took during the trip to Vietnam.