Presentation by Tran Thi Tuyet-Hanh, Hung Nguyen-Viet, Phuc Pham-Duc and Nguyen Thi Trang Nhung at the annual meeting of the Taiwan Society for Risk Analysis, 28 July 2023.

1. 1
Risk analysis in Vietnam: Current status
and ways forward
Tran Thi Tuyet-Hanh, Hung Nguyen-Viet, Phuc Pham-Duc and
Nguyen Thi Trang Nhung
Annual meeting of the Taiwan Society for Risk Analysis
28 July 2023

2. Outline
1. Challenges for risk analysis in Vietnam
2. Risk analysis training and research status in
Vietnam since 2010s
3. Future collaboration opportunities
2

3. 1. Challenges for risk analysis in Vietnam in
recent decades
 Growing concern about food safety: lack of confidence and trust of
consumers  “What to eat in order not to be death?”
 Drinking water supplies, sanitation, waste management
 Severe air pollution in major cities, dioxin at hot spots
 Impacts of Climate change and sea level rise
 Zoonotic diseases, emerging and re-emerging infectious diseases
 Rural-urban migration and EH/PH challenges...
 Risk communication activities have been poorly implemented; mainly done
by uncontrolled, untrained mass media, social media

4. Related ministries in EH risk management
 Ministry of Health
 General Department of Preventive Medicine and its provincial
departments
 Health Environment Management Agency and its provincial
departments
 Ministry of Natural Resource & Environment
 Ministry of Agriculture and Rural Development
 Ministry of Trade and Industry
  Challenges: limited capacity in risk assessment, risk
communication, and lack of strong integration and
coordination between ministries in EH risk management
1. Challenges for risk analysis in Vietnam in
recent decades (cont.)

5. 2. Risk analysis training and research in
Vietnam since 2010s
 No undergraduate or post-graduate training on Environmental
Health in Vietnam
 MPH, BPH programs at HUPH: 3 credit elective course on
“Environmental Health Risk Assessment and Management”
 ~10 Master thesis projects on risk assessment in 10 years at
HUPH.
 MOH, MARD, WHO: Short training courses on risk analysis,
food safety risk analysis, infectious diseases risk analysis, risk
communication etc.
 Food Safety Law 2010, Chapter VIII, Part 2 (articles 49-51):
Risk analysis for food safety.
5

6. 6
2. Risk
assessment
textbooks

7. 7
2. Risk analysis training and research in
Vietnam since 2010s (cont.)

8. Risk assessment
• Salmonella risk pathways developed for producers, slaughterhouse and
consumers
• Quantitative RA (risk for consumer)
• Chemical risk assessment
1275 samples (farms, SH, market) collected during 1 year
PigRISK: Pork safety in Vietnam (2012-2017)
Farm Transportation to SH Slaughterhouse Consumers
Retailer
• Feed in bags, remaining
feeds at the cages,
environment
• Pork
• Liver
• Kidney
• Consumption
survey

9. PigRISK - chemical hazards
 514 pig feed, kidney, liver and pork samples were pooled into 18
samples were analyzed for antibiotic residues, β-agonists, and heavy
metals, compared with current regulations.
 Presence of banned substances (e.g. chloramphenicol, salbutamol)
 Most of the samples: were negative or did not exceed the current MRL
 Risk misperception: what people worry about and what makes them
sick are not the same: Chemical risk is low; Salmonella risk is high
9
Tuyet Hanh et al, 2016, IJPH

10. 10
SafePORK - Cross-sectional study:
ILRI, CENPHER 2017-2022
 Sample size: 671 raw pork
samples
o Traditional pork shops: 266 shops
o Modern pork shops: 123 shops
o Food services: 77 stalls
 Data collection:
o 1-5 pork sample per shop
o Food safety condition
 Laboratory testing
o Salmonella presence: 671 samples
o TBC (Colony forming units (CFU)/g):
177 samples
Methodology Results
Salmonella
prevalence
TBC exceed standard
Traditional 60.5% 97.3%
Modern 50.9% 88%
Food
service
80.5% 94.6%
Overall 58.1% 93.8%
 Associated factors to microbial
contamination:
• Traditional shops:
o Use separate cloths
o Sewage or stagnant water
o Transportation time
• Modern shops:
o Selling many types of meat
o Storage temperature

11. INTERVENTION
Results at SH
Grid
Hand disinfection liquid
Faucet
Installed grid
Re-organized water and
electrical system
Training for SH
owners & workers
Food safety intervention at slaughter in Vietnam
Photo credit: Sinh Dang Xuan/Chi Nguyen ILRI 2020

12. Handbooks
INTERVENTION
Development of Instruction & Training materials
Food safety intervention at slaughterhouse and retail (2018-2022)
Approach:
• Participatory risk-assessment
• Supportive formative research with model
retailers
• Risk communication
Key content*:
-Grid slaughter
-Frequent washing
(and disinfection)
-Training
-Separation
clean/dirty
-Branding
Key content:
-Easy to clean surface
-Frequent washing (and
disinfection)
-Separation
(fresh/cooked)
-Training
-Hygienic cutting board
-Branding
*only Vietnam

13. Wastewater reuse and food safety
Health and environmental issues & livestock?
Crop Livestock
Fishery
Nguyen-Viet et al, 2014

14. Risk assessment: Vegetables and fish from
wastewater in Hanam province
 High risk from eating morning glory
and tilapia (diarrhea risks due to E.
coli 13%, G. lamblia and C. parvum: 0
– 23%, respectively.
 Highly contaminated Pb level, but low
risk for tilapia
 Local people seem to know the risk
 They sell contaminated vegetables
and fish to other towns
Truc et al. (2014)

15. EH risk assessment and risk management of dioxin
 Bien Hoa and Da Nang airbases: storages for AO &
other herbicides; spills occurred several times. 2/7
severe dioxin hot spots in VN
 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in soil,
mud, food, blood and milk samples were high
(Hatfield Consultants 2006, 2009, 2011; Arnold
Schecter et al. 2003…)
 Local residents living at dioxin hot spots are at high
risk of being exposed to dioxin in the environment,
especially in foods (Tuyet-Hanh et al. 2010).
Bài t?p th?o lu?n nhóm
8. T?i nhà máy d?t s?p t?i có đ?t tuy?n
công nhân cho phân xư?ng h?p s?i. Là
cán b? ph? trách y t? c?a nhà máy, b?n
đư?c giám đ?c phân công nhi?m v?
khám tuy?n công nhân vào làm vi?c ?
phân xư?ng này.
© Tuyet-Hanh Tran et al. 2015

16.  High risk foods: local freshwater fish, snail, free-ranging chicken meat and eggs,
free-ranging duck meat and eggs, beef.
 If consuming local high-risk foods:
o Estimated DI = 60.4 to 102.8 pg/kg bw/day (Bien Hoa)
o Estimated DI = 27.0 to 148.0 pg/kg bw/day (Da Nang).
o > TDI recommended by WHO (1-4 pg/kg bw/day)
 If consuming foods originate from other areas:
o Estimated DI = 3.2 to 6.2 pg/kg bw/day (Bien Hoa)
o Estimated DI = 1.2 to 4.3 pg/kg bw/day (Da Nang)
o TDI: Health Canada (10 pg/kg bw/day); WHO (1-4 pg/kg bw/day).
  Risk communication and risk management programs
 Environmental remediation projects
 In Da Nang dioxin hot spot: 110 million USD (2012-2018)
 In Bien Hoà dioxin hot spot 390 million USD (2019-2028)
Risk characterization
Bài t?p th?o lu?n nhóm
8. T?i nhà máy d?t s?p t?i có đ?t tuy?n
công nhân cho phân xư?ng h?p s?i. Là
cán b? ph? trách y t? c?a nhà máy, b?n
đư?c giám đ?c phân công nhi?m v?
khám tuy?n công nhân vào làm vi?c ?
phân xư?ng này.
© Tran T. Tuyet-Hanh et al. 2015

17. Health burden relating to exposure to ambient air
pollution in Vietnam:
Nguyen Thi Trang Nhung et al.
2012 2018 2019 2020 2022
One of the first
reports health
effects of air
pollution in Vietnam
Use data at Vietnam
National Children’s
hospital (2007-
2014)
Use data at Vietnam
National Children’s
hospital (2007-
2016)
Use data at multiple
hospitals from Ha
Noi, Phu Tho, and
Quang Ninh
One of the first health impact
assessment of air pollution in Ha Noi
First health impact assessment of air
pollution in multiple provinces of Viet
Nam
First health impact
assessment of air
pollution for all
Viet Nam

18. Policy translation: food safety risk analysis
Meeting with DPM
Vietnam, 2 Dec 2016
2011
2012
2016
Meeting with VFA, Photo: CENPHER
Meeting with DAH
Photo: CENPHER
The recent FSRA technical
group was established on
27/4/2023 by MOH
Members: researchers,
managers from agencies under
the MOH, the Ministry of
Industry and Trade and MARD.

19. Some organizations interested in/support
risk analysis in Vietnam

20. 3. Future collaboration opportunities
 Training & capacity building
 Joined research projects on risk assessment,
communication and management.
20

21. 21
1. Tran Thi Tuyet-Hanh, Nguyen Hung Minh, Le Vu-Anh, Michael Dunne, Leisa Toms, Thomas Tenkate,
Nguyen Thi Minh Hue, Fiona Harden (2015), Environmental health risk assessment of dioxin in foods at the
two most severe dioxin hot spots in Vietnam. International Journal of Hygiene and Environmental Health.
Volume 218, Issue 5, July 2015, Pages 471–478. http://dx.doi.org/10.1016/j.ijheh.2015.03.014.
2. Tran Thi Tuyet-Hanh, Le Vu-Anh, Michael Dunne, Leisa Toms, Thomas Tenkate, Fiona Harden (2015),
Dioxin risk reduction program at the most severe dioxin hot spot in Vietnam: residual knowledge, attitude and
practices five years post intervention. Global Public Health: An International Journal for Research, Policy
and Practice, DOI: 10.1080/17441692.2015.1062904
3. Tung Bui Huy, Tran Thi Tuyet-Hanh, Richard Johnston, Hung Nguyen-Viet 2014. Assessing Health Risk due
to Exposure to Arsenic in Drinking Water in Hanam Province, Vietnam. Int. J. Environ. Res. Public Health
2014, 11, 1-x manuscripts; doi:10.3390/ijerph110x0000x
4. Anh T.K. Bui, Ha T.H. Nguyen, Minh N. Nguyen, Tuyet-Hanh T. Tran, Toan V. Vu, Chuyen H. Nguyen,
Heather L. Reynolds 2016, Accumulation and potential health risks of cadmium, lead and arsenic in
vegetables grown near mining sites in Northern Vietnam, Environ Monit Assess (2016) 188:525 DOI
10.1007/s10661-016-5535-5.
5. Steven Lam, Hung Nguyen-Viet, Tran Thi Tuyet-Hanh, Huong Nguyen-Mai, and Sherilee Harper 2015,
Evidence for public health risks of wastewater and excreta management practices in Southeast Asia: A
scoping review. Int. J. Environ. Res. Public Health 2015, 12, 1-x manuscripts; doi:10.3390/ijerph120x0000x
Some related publications

22. 22
1. Tran Thi Tuyet-Hanh, Dang Xuan Sinh, Pham Duc Phuc, Tran Thi Ngan, Chu Van Tuat, Delia Grace, Fred
Unger, Hung Nguyen-Viet, 2016. Exposure assessment of chemical hazards in pork meat, liver, kidney and
health impact implication in Hung Yen and Nghe An provinces, Vietnam. International Journal of Public
Health. 62(1), 75-82. DOI: 10.1007/s00038-016-0912-y
2. Hung Nguyen-Viet, Tran Thi Tuyet-Hanh, Fred Unger, Sinh Dang-Xuan and Delia Grace 2017, Food safety in
Vietnam: where we are at and what we can learn from international experiences. Infectious Diseases of
Poverty 6:39 DOI 10.1186/s40249-017-0249-7.
3. Hung Nguyen-Viet, Delia Grace, Phuc Pham-Duc, Sinh Dang-Xuan, Toan Luu-Quoc, Fred Unger, Sethde
Vlieger, Ngoc Pham-thi, Nhiem Duong-Van, Long Nguyen-Hung, Luan Tran-Dinh, Tran Thi Tuyet-Hanh,
2018. Research and training partnership to assist policy and capacity building in improving food safety in
Vietnam. Global Food Security, Vol. 19, pp 24-30. Doi: https://doi.org/10.1016/j.gfs.2018.08.009
4. Nguyen Hung Minh, Tri Manh Chan, Nguyen Thi Minh Hue, Tu Binh Minh, Tran Thi Tuyet-Hanh 2019.
Bioaccumulation of PCDD/Fs in foodstuffs near Bien Hoa and DaNang airbases: assessment on sources and
distribution. Environmental Science and Pollution Research. Volume 26, Issue 28, pp 28852–28859. Doi:
https://doi.org/10.1007/s11356-019-06046-5
5. Kai Hsien Chi, Yu-Ting Huang, Hung Minh Nguyen, Tran Thi Tuyet-Hanh, Somporn Chantara, Tuan Hung
Ngo, 2022. Characteristics and Health Impacts of PM2.5-bound PCDD/Fs in Three Asian Countries.
Environment International. Doi: https://doi.org/10.1016/j.envint.2022.107441
Some related publications (cont.)
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