D A N H GIA SlTTimNG DONG - KHAC 0 I | T GliyA CAC KHOANG THAM CHIEU SINH HOC CUA XET N G H I I M HUYET HOC. DONG M A U DANG SUTDUNG TAI CAC PHONG XET NGHIEM
T R A N HLfU T A M , V U T H | NHa OANH, L E TRUNG PHU'dNG, N G U Y I N T H I H I ^ U Y E N , NGUYEN THj KIM LI^N, VO THj THUY TRAM
Trung tim Kiim chuin Xdt nghidm TP.HCM N G U Y I N T R ( DUNG -S&Ytd TP.HCM T 6 M T A T
Trong xdt nghidm y hgc. cdc bdnh vidn vd phdng xdt nghidm y khoa (PXN) tmng d nw&c diu sw dung khoing tham chidu sinh hgc (KTC) dwge nghidn cuu trdn ngwdi Chiu Au, do dd, khdng phu hgp vdi thd tr$ng cOa ngwdi Chdu A ndi chung vd ngwdi Vidt Nam ndi riing.
Vdi mgc tidu timg bw&c xdy dung khoing tham chiiu sinh hqc cho ngwdi Vidt Nam tmng twang lai, Tmng tdm Kiim chuin Xit nghiim TP.HCM dd hap tdc v&i Ddi hgc Y khoa Yamaguchi (Nhdt Bdn) thwc hidn di tii nghidn cCfu khoa hge 'Nghidn cCeu tinh dja phwang tmng ch! sd xdt nghidm vd khodng tham chiiu sinh hgc khu vyc Chdu A'vdo ndm 2009. Sau khi thwc hidn di tii ndy thinh cdng.
chung tdi nhdn thiy vide nghidn ciru khio sdt, phdn tich thwc tr^ng su dijng cic KTC tgi cic PXN TP.HCM ddi vdi cdc xdt nghidm huyit hgc. ddng mdu Id rit cin thiit. kit qui thu dw&c tir nghidn cOv ndy sd giup cho cdc nhd khoa hgc. nhi qudn l^ cd thdm nhiiu dw lidu phi^c vu nghidn cCru sdu han vi KTC sinh hgc cho ngwdi Viit Nam tmng twang lal, cung nhw cd nhiing quyet djnh phu hgp nham nang cao chit Iwang xdt nghigm
Tir khda- Khpang tham chiiu sinh hgc, huyit hgc, dong mdu.
SUMMARY
In medical diagnosis, the hospitals and medical iabomtories in Vietnam use the mfemnce intervals researched fmm Eumpean, which are not suitable with the Asian in general and with the Vietnamese in particular.
With the aim step by step reseamhing and setting up the mfemnce intervals for the Vietnamese in the futum.
Center for Standardization and QC In Medical Lab of HCMC had a collaboration with Yamaguchi University (Japan) in the msearch "Study of mgionality In labomtory test msults and collaborative derivation of mfemnce intervals in Asialn 2009. After finishing this study successfully, we mcognlze that it is necessary to do the study of surveying, evaluating the situation of mfemnce intervals of hematology, coagulation which am using at medical Iabomtories. so that the scientists, the policymakers have mom essential informations to do other studies, or to set up policies, that help to Impmve the quality of medical diagnosis.
Keywords: mfemnce inten/als researched DAT V A N D E :
TCf trudc d i n nay, cdc bgnh vign vd phdng xdt nghigm (PXN) y khoa trong ca nudc d i u su" dyng khoang tham chilu (KTC) sinh hpc dupc nghidn ciJu vd cing b i d i i vdi t h i trgng ctja ngudi Chdu Au, do dd, cd the khdng phu hpp vdi t h i trgng eua ngudi Chdu A ndi ehung vd ngudi Vigt Nam ndi ridng.
Ngodi ra, eac KTC sinh hpc dd dup'c tham khao I d nhilu nguon khde nhau nhu cde Idi ligu ctia Bg Y t l , cdc
Irudng Dgi hpc y khoa, cdc chuydn gia d i u ngdnh trong vd ngodi nudc, cdc hdng cung d p mdy xdt nghigm vd thuic thu... do dd, cd dg ehgnh nhit dinh trong vtgc dii chilu KTC sinh hpc d l bign lugn k i t qud cho bgnh nhdn.
Ddy Id mgt trong nh&ng nguydn nhdn gdy khd khSn trong vige k l l lugn bgnh ly, thira nhgn kit qua lln nhau giO-a ede PXN,
Nhim cd dup'c nhO'ng s i ligu khoa hpc d l phdn tich ddnh gid, t u dd nil ra dugrc nhO'ng k l l lugn giCip <^nh hudng ede ehinh sdch, cdc nghign cCru Itip theo, hu'dng d i n vigc tdng budc xdy dung khoang tham chilu sinh hpc cho ngudi Vigt Nam trong luang lai, chijng tdi dd tiln hdnh nghidn cuu khdo sdL phdn tich khoang tham ehilu sinh hpc cua cdc xdi nghigm huylt hpe, dflng mau dang si> dung tgi ede PXN.
D 6 1 TU'Q'NG v A PHU-ONG P H A P NGHIEN CUU:
1. D i l tup'ng:
(a) Khoang tham chilu stnh hpe ciJa eac xdt nghigm thugc nhdm huyel hpc, ddng mdu dang su dyng tgi 161 PXN trgn d|a bdn TP.HCM, cy I h l :
26 x6l nghigm huyet hpe; RBC, Hb. HbF. HCT, MOV, M C H , M C H C , R D W , H D W , P L T , M P V , W B C , Neu, Lym, Mon, Eos, Bas, LUC, MID, Retie, MCVr, MCHCr, CHr, VS, HbA2, HbF.
10 xdt nghigm ddng mdu: TQ, TCK, FIB, TS-TC, factor V, factor Vll, factor VIII, factor IX. factor XI, homocysteine.
2. Phuang phdp:
Phuang phdp nghien cuu Id phuang phdp elt ngang m i l a
GUI philu dieu tra den cdc PXN tgi TP.HCM de Uiu thgp s i ligu ve KTC sinh hpc dang su dyng.
Phdn tich cdc s i ligu thu dupc bing phan mim thing kg Stata 10,0.
Kit qua thing kd se dup'c quan sdt vd bign lugn 3e phdn tich sy tuang ding - khde bigt cua cde KTC, vigc su dyng hg SI, nguin tai ligu tham khao xdy di,png KTC...
K t T QUA V A B A N LUAN;
Sau khi thu thgp cdc philu dieu tra, chtjng tdi chi phdn tich nhung thing s i xet nghigm cd so lupng PXN thyc hign tuang d i i nhilu (n a 30), bao gim nhiJng thing s i sau:
14 xdt nghigm huylt hpc. RBC, Hb, HCT, MOV, MCH. MCHC, PLT, WBC, Neu, Lym, Mon, Eos, Bas, VS.
5 xdt nghigm ddng mdu: TQ, TCK, FIB, TS, TC.
1. Sv t u a n g d i n g - khde bigt giua cdc ICTC:
Trong phgm vi gidi hgn cua bdi vilt, chung tdl c^i Irinh bdy vigc phdn tich m i l nhdm xet nghigm huyet hgc, ddng mdu mpt Ihdng so dgi dign, cac thdng s i cdn Igi thi edeh phan tich va bign lugn tuang ty.
1.1. Xdt nghidm huyit hgc: phan tleh thdng sd Red blood cell (RBC)
Y HQC THl/C HANH (815) - SO 4/2012
06 156 PXN trong t6ng s6 161 PXN tham gia khio sit CO thu'c hi$n thSng sfi RBC. Th6ng kd KTC cda c i c PXN difiyc ket qua nhu sau:
Bang 1: Thfing k% KTC tif c i c PXN dfii v6i thfing sfi RBC
KTC GHT GHD
N 136 136
Trung vi 5.5 3.8
Khodng t d ph9n vi 5.4-6.0 3,55-4,02
Gid trj nhd n h i t -
Idn nhdt 4.5-6,9 2.845-4.725
K T C c d gid tri cdch bigt
3 (2,2%) Chu thich: GHT: Gifi-i han trfin: GHD: Gifii han du'di
'iiiiiip iiiiir
^
Hinh 1. Dd thj bieu diin sw phdn tdn cua cdc KTC ddi vdi thong sd RBC
Nhgn xet:
- KTC eua cdc PXN tgp tmng d khoang 3.8 - 5.5 T/L.
- Cd 3 (2.2%) PXN d tuyin 1 vd 2 cd KTC cd gid tri cdch bigt.
1.2. Xdt nghidm ^ng mdu: phdn tich thdng sd Temps de quick (TQ)
CCd 80 PXN Irong ting s i 161 PXN tham gia khao sdt cd t h i ^ hign thing s i TQ Thing kd cdc KTC tii' cdc PXN dupc k l l qua nhu sau:
Bang 2: Thing ke GHT cua cae KTC ICP cdc PXN d i i vdi thgng so TQ
KTC GHT GHD
N 66 66
Tmng vi 14 11
K t i o i n g tiJ- phdn vj 1 3 - 1 5 1 0 - 1 1 . 5
Gid trj nhd nhSt -
Idn n t i l t 1 0 - 1 8 7 . 7 5 - 1 3 . 7 5
K T C c 6 giStrj cdch bi$t
9 (13 64%) Chu thich: GHT: Gidi hgn trdn, GHD: Gidi hgn dudi.
=.
s la s.
o.
iiiir
lllll i
iiiiiiiiiiiii
TEMPS DE QUICK |
llli |li|i|||llllll|NlHIIII|'
I
- KTC cCia cdc PXN tgp trung a khodng 1 1 - 1 4 gidy.
- Cd 9 (13.64%) PXN d ca 3 luyin cd KTC ed gid trj edeh bigt
2. Dan v| do Ov(yc si> dyng:
2.1. Xit nghidm huyit hqc:
Bdng 3: Thing kd dan vj do cda cdc KTC nhdm xdt
Hinh 2: Dd thi bldu diin sw phdn tin cua cdc KTC Si v& thdng sd TQ
Sit 1.
2 3, 4, 5.
6.
7.
8.
9, 10, 11, 12.
13.
14.
15 ThOng s i
RBC Hb HCT MCV MCH MCHC PLT WBC Neu Lym Mon Eos Bas VS1 VS2
D a n vi SI T/L mmol/L
fL pq q/L G/L G/L
mm/h mm/h
PXN si> dyng KTC Theo hd dan
vi SI (%) 93 55
0 6,33 81.38 100 16 22 96 8
93 0 0 0 0 0 100 100
PXN si> dgng KTC Theo hg don vi
khde(%) 6,45 100 93.67 18.62 0 83,78
3,2 7 100 100 100 100 100 0 0 Nhgn xdt: Trong nhdm x6t nghigm huylt hpe dup'c khao sdt
- Cdc thdng s6 xdt nghigm cd Iren 80% PXN su dgng KTC theo hg dan vj Sl Id RBC. MCV, MCH, PLT.
WBC, VS gid 1 vd VS gid 2. Trong dd, cdc thdng so xdt nghigm MCH, VS gid 1 vd VS gid 2 dugc 100% PXN sir dung KTC theo hg don vj SI vl cdc thdng s i ndy khgng thay dii dan vj do khi dCing theo hg SI.
- Cdc Ihdng s i xdt nghigm cd tren 80% PXN SLP dung KTC k h i n g theo hg don vj Sl Id Hb, HCT, MCHC, Neu, Lym. Mon, Eos vd Bas. Trong dd, cde thdng s i xel nghigm Hb, Neu. Lym. Mon, Eos vd Bas cd 100% PXN su dung KTC k h i n g theo hg dan vj SI.
2.2. Xet nghigm ddng miw
Bang 4: Thong ke dan vj do cua eac KTC nhdm xel nghigm ddng mdu
Stt 1.
2, 3.
4.
5.
Th6ng s6 TQ TCK FIB TS TC
D a n vi SI s s pmol/L
PXN si> dgng KTC Theo hd dan
vi SI {%) 83 75
92 1.75 94.59 96.88
PXN si> dgng KTC Theo hg don vi
khde (%) 16 25
8 98.25
5 4 1 3,12 Nhgn x6t: Trong nhdm xdt nghigm Ddng mdu dup'c khao sdt, hlu het ede xdt nghigm cd trdn 80% dan vj su dgng KTC theo hg don vj SI.
3. Nguin tham khdo d l xdy dg>ng KTC:
Bang 5: Thong ke nguin tham khao cda cdc KTC theo li Ig %
STT Thftng
si Nqudn tham khSo (%)
1 | 2 | 3 | 4 | 5 | 6 | 7
1 Xdt nqhiem hu 1.
2.
3.
4.
5.
RBC Hb HCT MCV MCH
6.45 7.59 8.23 6.90 8.11
45.81 43 67 45.57 46 21 46 62
26,45 22 78 21.52 23.45 22.97
e t h o c 5.16 6 33 6,33 4 83 4 73
6.45 6,96 7 59 4.83 4.73
0.65 1.27 1,2/
0,69 0,68
9.03 11.39 9.49 13,10 12.16
Y HQC T H V C H A N H (815) - S O 4/2012
STT 6.
7 6, 9.
10 1 1 . 12 13.
14 15.
Thflng
si
MCHC PLT WBC Neg Lym Mon Eos Bas VS1 VS2
Naufln tham khdo (%) 1
7.43 6.41 6,37 6.00 6,29 4.59 5,75 5,95 9.89 10,11
2 47.30 46,79 45,66 42.40 44,76 44,04 40.23 36,90 19,78 19.10
3 22,30 25.00 26,11 2 6 4 0 23,78 23.85 33 33 30,95 38,46 39,33 4 4.73 6,41 3,82 6.40 6,29 5,50 2.30 5,95 3,30 0.00
5 5,41 7.05 6,92 4,60 5 59 8.26 8.05 9,52 7,69 10.11
6 U.6B 0.64 0.64 O.UU 0,70 1.83 M b 2,38
o,uo
1.12 7 12,16
7,69 6.28 11.20 12,59 11,93 9.20 6,33 19.78 20,22 l l . X d t n a h l d m d d n a m d u
18, 17.
18 19.
20, TQ TCK FIB TS TC
7,50 8 0 0 8 77 5,41 6,25
41.25 42.67 31,58 5.41 6.25
31.25 24.00 31,58 41.89 42,19
5.00 2.67 3.51 4.05 3,13
2,50 2.67 S.26 8.11 9,38
0.00 O.OU 0.00 0.00
o,uo
12,50 20.00 19.30 35,14 32,61
Stt Thdng s i Tuydn (%)
1 1 2 3
1 X£t nqhidm huydt hoc 1.
2 3 4.
5- 6 7 8 9 10.
11 12 13 14 15
RBC Hb HCT MCV MCH MCHC PLT W B C Neu Lym Mon Eos Bas VS1 VS2
33.33 25 9 09 4,76 9.09 5 88 4 11 77 9 09
0 0 33-33
0 0 0
66.67 75 18,18
3 8 1 36 36 26.47 36 31 37 36 36
0 50 0 44 44 83 33 45.45
0 0 72 73 57.14 54,55 67 65 60 56.86 54.55 100 50 66.67 55 56 16.67 54.55 11. Xdt nghigm ddng mdu 16
17, 18 19 20.
TQ TCK FIB TS TC
11.11 30 5.89
0 0
55.55 40 35.29 33.33 41.67
33 34 30 56.82 66.67 58,33
nhd sdn xult thuic thi> ndn chCing tdi tidn hann iim meu su cdch bigt cua KTC giO'a cdc nhd sdn xult thuic thu.
D l quan sdt thdm v l su cdch bi§t cua KTC giO'a cdc nhd sdn xult thuic thu, chCtng t i i chpn 2 thing s6 xdt nghigm cd s i lupng PXN tham gia khdo sdt nhilu nhit (158 PXN) Id HCT vd Hb t i l n hdnh phdn tich.
Chu thich: Nguin tham khio; (1): Bg Y l l ; (2): Nhd SX thuie lhi>; (3): Tdi ligu chuydn mfin trong nude; (4):
Tdi ligu chuygn mfin nudc ngodi; (5): Tham khio ICK PXN khde; (6): T y xdy dung; (7): Nguin khde.
Nhgn xdt:
- Khfing cfi thfing s i xdt nghigm ndo cd KTC dup-c cdc PXN tham khdo cCing mgl nguin,
- Cdc PXN tham khdo KTC tu 7 nhdm nguin tham khdo, Igp trung chu y i u d 3 nhdm chinh Id: nhd sdn xult thuie thCr, Idi ligu chuydn mfin trong nude vd ngufin khde. Trong dfi. KTC ed nguin thdm khdo tu- nhd sdn xult thuic Ihu chilm ti ig eao nhiL
4. Phdn tich 8V khde bigt KTC giira cdc PXN cCing tuydn d i l u trj:
Bang 6: Ty Ig PXN ed KTC cdch bigt trong cung mfit tuyin dieu trj
Chu thich: (1): Tuyin trung uang; (2): Tuyin tinh/lhdnh p h i thugc TW; (3): Tuyin qugn huygn.
Nhgn xdt: Cd su cdch bigt KTC eua cdc thfing s i xdt nghigm giua cdc PXN Irong cung tuyin dilu In.
S. Quan sdt sv cdch bigt cCia KTC giipa cdc nhd san x u i t t h u i c t h u
Do cde PXN tham khao KTC chu y i u tCr nguin Id
I PXW • • Ttwifl vt 1 Hinh 3: Sw cdch bidt cua KTC giira cdc nhd sin xuit thudc thO'ddi v&i HCT
* T n i i g v > |
Hinh 4: Sw cich bidt eua KTC giira eic nhd sdn xu^
thudc thi> ddi vdi Hb
Nhgn xdt: Giua cdc nhd sdn xult thuic thi> cd sv khde bigt v l KTC.
KtT LUAN
Qua 19 thfing s l xdt nghigm huyll hpc. dfing mdu dupc chpn d l khdo sdt, phdn Uch, chting t i i nhgn ttily:
T i t cd PXN du(7c khdo sdl chua cd PXN nto hodn lodn su dgng hg dan vj SI cho l i t c l thfing s6 ) ^ nghigm, h l u h i t cdc xdt nghigm cd trdn 80% dan vj si>
dgng KTC theo hg dan vj SI thugc nhdm xdt nghigm Ddng mdu, vd cdc xdt nghigm RBC, MCV, MCH, PLT, WBC, VS gid 1 vd VS gid 2.
- Khdng cd thdng s i xdt nghigm ndo cd KTC flinj^
cdc PXN Iham khao cdng mgl nguin.
- Cdc PXN tham khdo KTC tir 7 nhdm nguin Iham khdo. tdp trung chu y i u d 3 nhdm chinh Id: nhd san xuat thuic thu". Idi ligu y khoa trong nudc vd nguin k h ^ Trong dfi, KTC cd nguin thdm khao ICP nhd san xuat thuic thu chilm tl Ig cao n h i t Tuy nhien, gi&a cdc nha sdn xult thuic thir eung cd su khac bigt v l KTC. J
- Khdng cd thdng s i ndo cd 100% PXN thing tim v l gid tri cua KTC.
Y H p c THV'C HANH (815) - SO 4 f l |
- Cd su cdch bigt KTC cua cdc thfing s i xdt nghigm giira cdc PXN Irong cCing luyin vd giOa cdc tuyin vdi nhau.
KI£N NGHI
- c i n ed vdn bdn quy djnh thing nhit vigc sd dgng hg dan vj do ludng trong cdc PXN y khoa Id hg dan vj SI theo cdc khuyin cdo cua quic t l .
- Cin cd khuyin cdo hogc quy djnh nhdng Idi ligu (nguin tdi ligu) ddng tin cgy d l PXN su' dgng Idm KTC, nham Ihing nhit gid trj KTC dang su dgng Igi cdc PXN.
- C i n cd bign phdp de gidm thilu su cdch bigt KTC giua cdc bgnh vign eung tuyin hogc khde tuyin, nhit Id tuyin 2 vd luyin 3, ddy Id mgl trong nhdng nguydn nhdn cde bgnh vign chua tin tudng k i t qud cua nhau, phdi lam xdt nghigm igi khi bgnh nhdn chuyin vign cdng tuyin hogc tuyen dudi Ign luyin trdn.
- Qua nghidn cCfu d l Idt cho Ihly KTC ddnh eho ngudi Vigt Nam chua dup'c nghidn cdu cgn ke. Do dd, chtjng Ifii d l nghj nghign euu sdu hon v l su tuang ding cua KTC danh cho ngudi Vigt Nam vdi KTC cua quic l l , tung budc xdy dyng KTC ddnh ridng cho ngudi Vigt Nam,
T A I L1$U T H A M K H A O :
1. Bfi Y l l , Quylt dinh 23/2005/QD-BYT ngdy 30/8/2005 v l vigc phdn tuyin k9 thugt vd danh mgc k?
thugt trong khdm chOa bgnh,
2. Bg Y t l , Thdng tu s i 23/2005/TT-BYT ngdy 25/8/2005 v l hudng ddn x l p hgng cdc dan vj su nghigp y t l ,
3. Trin HlJu Tdm vd cs. Kiyoshi Ichihara, "Nghidn ciru tinh dja phuang trong ehi s i xdt nghigm vd khoang tham chilu khu vuc Chdu A", Dd til NCKH mS sd CS/KCA}9/01 h&p tdc vdl DH Yamaguchi Nhdt (2009).
4. Bland M. (2003), An introduction to Medical Statistics, 3rd Edition, New York.
5. Burtis, C, A., E. R. Ashwood, D. E. Bruris (2005), Tiefz textbook of clinical chemistry and molecular diagnostics, A^ Edition, WB Saunders Co. Ltd., Germany.
6. Westgard, J. 0., P, L Batry (2008), Refemnce Interval tmnsfemnce. Basic method validation, Third edition.
DIEU KIEN c a s a VA THUt; TRANG fi NHllM HfiA CHJT BAO VE THOC VAT, VI KHUAN TRONG THUC P H £ M TAI CAC CO SOT KINH DOANH THQC A N DirfTNG PHO THUfiC THI XA U l CH&U
T6M TAT
Qua diiu tm dt ngang thwc trgng d nhiim hod chit BVTV. vi khuin vd didu kign ca sd cua cdc ca s& kinh doanh thue Sn dwdng phd tgi thj xd Lal Chdu. Kit qud:
Ve ty Ig d nhiem do E eoli tren thOe an: Ty Ig nhiem Chung li 38%, tren cd vd cdc sdn phim tie ci Id 40%, trdn tiijt vd cdc sdn phim tir thjt ii 34,3%, trin mu ludc la 40,0%. vi mue nhiim E cr^l eao nhat: trdn cd li 165 con trdn thjt li 28 con. trdn mu ludc 21 con. Vd d nhiim hdachitBVTV: T^ 1$ d nhiim chung tren mu Id 16,6%.
Tmng dd, d nhidm do hda chit trdn rau Sn li li 15%;
tren rau dn qud li 25% vi rau an sdng la 10%. Vi diiu kign ciia cic ca sd: Cdc ca sd kinh doanh thue dn dudng phd da diip hdnh cdc quy dinh vd diiu kidn VSATTP theo quy dtnh nhw: Cd che ddy tO kinh 84%;
bdn cao dung qui d/nh 92%; ddc bidt li 100% cdc ca sd da sir dqng tdi nilon vi hdp xop di gdi thwc phim, khdng sw dgng giay bio dd gdi thuc phim.
Tir khda; An todn thwc phim, E coli, hda chit bio vg thwc vgt
SUMMARY;
By applying the descriptive cmss-sectional study on chemical contamination, bacteria, and the basic condition of the business establishment of stmet food In Lal Chau distric. Result: The pementage of E.coli contamination on food: the general infection was 38%.
On tish and tish pmduct was 40%. On meat and pork meat was 34.3%. On vegetable was 40%. The highest level contamination E coli: 28/165 on the tish, on vegetable was 21 E coli. The mte of chemical contamination of pesticide: the genami vegetable infection was 16.6%. On vegetable leaves 15%. On Root vegetables was 25% and raw vegetable was 100%.
NINH TH| NHUNG, D^i hqc Y Thdt Blnh DUONG NGQC HUONG, Chi cifc ATTP tinh Lai Chiu
N G U Y I N X U A N T H I ; C , Bgnh vign B^ch IVIal The basis of food safety in accordance, such as: cover- up. 84% cupboard; table's tall as mquim 92%, especially
100% of the facility used plastic bags and box to packagetixxi, do not use newspaper to wmp food.
Keyswords: safty food, E. coll. pesticide DAT VAN Dt
Hign nay tinh trgng thuc phim bj d nhilm vi khuan, l i n du HCBVTV dang Id van d l xa hpi. Id noi lo ldng Ihudng true eua cde ca quan chue ndng eung nhu ngudi tidu dCing. Theo s i ligu cda Cgc ATTP, tCr ndm 1999 den Ihdng 6/2004 nude ta dd xay ra 1.282 vg ngg dgc thuc phim vdi 27,731 ngudi mac, 336 ngudi tu vong. Trong dd, nguyen nhdn do t i n du hod chat BVTV trong rau, cu. qud chilm tdi 25%. Ndm 2006, nghien eCru eua Trin Huy Quang, ty Ig d nhiem vi khuan ehung d cdc m i u thuc dn dudng p h i Id 57.74%, d nem chua Id 76,7%, thjt vd cdc sdn phim tCr thjt Id 51,7%, ed vd cdc SP td cd Id 43,3%, Djch vg thCrc dn dudng phi tilm I n nhieu nguy ca gdy ra ngfi dgc thu'c phim cap llnh do tinh trgng vg sinh mdi trudng, vg sinh nguin nudc, trang thilt bj, dgng eg ehl biln, bao qudn nguygn ligu, Irang thilt bj bdn hdng cdn thd sa, ngudi true tilp san xuat c h i bien thuc phim cd hilu b i l l v l VSATTP chua day dtj, ngu'di Ueu dung do thieu kiln Ihuc VSATTP ndn chua b i l l chpn lua nhdng thuc pham bdo dam c h l l lupng VSATTP hogc Id do chu quan, ham re, ham Ipi md mua nhdng thuc phim bdn via hd, ldng, l l dudng, thg'C phim khdng rd nguin gic, khdng dam bdo chat lupng, chua cd y thuc d i u tranh khi su dgng nhung Ihuc phim khdng dam bao chit lup'ng Id nhirng yeu to nguy ca cao Idm cho ngfi dfic thg'C phim gia tdng. Xult phdt td thg'C te dd ehung t i i tien hdnh nghidn ciru de tai nhim mge tidu: Xic i^nh (hyc trgng d nhiim hd chat
J Y H p c THV'C HANH (815) - SO 4/2012
