Vietnam's economy is rapidly expanding and the metal industry is a large and critical participant. Exposures to workers at Vietnamese foundries (where metal is formed into usable products) are at risk for a number of occupational diseases, such as respiratory disease (ie, silicosis), hearing loss, heat stress, and vibration-induced injuries. The occupational diseases related to the metal industry are so prevalent that the top two most predominant occupational diseases in Vietnam are related to this industry. For over a decade, the Vietnamese government has striven to protect the health of metal workers; however, progress has been gradual due to socioeconomic conditions. We report on the present challenges faced by the Vietnamese National Institute of Occupational and Environmental Health (VNIOEH) and their accomplishments in their efforts to decrease the incidence of silicosis in foundry workers. We also share a discussion about possible alternate approaches towards improving the workplace. The hierarchy of exposure control, as it applies to the prevention of worker inhalation of respirable silica, has been widely accepted in the US. The four control approaches are eliminating or substituting sand containing silicon dioxide, engineering controls on dust, administrative controls such as job rotation, and the use of personal protective equipment. These are stated in order of most to least effective. Because of a persistent lack of economic resources put towards worker protection, the Vietnamese have placed much emphasis on workers' personal responsibility and personal protective equipment. Regarding the former, the VNIOEH has studied foundry workers' knowledge of occupational health hazards and the Institute has also developed educational programs for workers. Regarding the latter, the VNIOEH has produced two mask designs and has begun to issue them to foundry staff. VNIOEH researchers have begun to dialog with US collaborators about encouraging employers to use measures more valued on the industrial hygiene hierarchy, such as improving ventilation and altering production processes to increase worker safety.
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