The MEM Seminar Series 2003 /2004


Villagers living downstream from a pulp and paper mill complained of skin rashes after the plant was built. It was believed that the skin rashes occurred because of polluted water and dioxin contamination. A community-based approach was adopted to investigate the complaint. The investigation involved representatives from a local non-governmental organization (NGO), environmental and health staff of the mill, academics from the fisheries department of the local university (UNRI), and external consultants from Finnish Environmental Research Group (FERG) and National University of Singapore (NUS). Funding for the investigation was from the mill.

The FERG findings confirmed that the pulp and paper mill used an Elemental Chlorine Free (ECF) bleaching process and had stringent environmental pollution controls. River water quality parameters that were measured upstream and downstream from the mill discharge points were similar in terms of physical, chemical and biological characteristics. The river ecology findings indicated adequate biotic diversity to support the continued productivity of the river for fresh water fish and the maintenance of other aquatic life.
In the health survey, the prevalence of dermatitis was used as a marker for environmental skin disease due to exposure to waterborne pollutants. Both adults and children in villages upstream and downstream from the mill had low, non-statistically significant different, prevalence rates of dermatitis.

Health risk communication, follow-up activities in health education, and activities to increase immunization coverage in the villages are now in progress. This example clearly illustrates the importance of multidisciplinary inputs and the community based approach when population clusters of environmental skin disorders are investigated and managed.

About the Speaker

David Koh is Professor and Head of the Department of Community, Occupational and Family Medicine of the Faculty of Medicine, and Deputy Director of the Centre for Environmental and Occupational Health Research, National University of Singapore (NUS). Dr. Koh serves on the advisory boards of several international occupational and environmental health journals, and has undertaken international consulting work with several large organizations and multinational companies. Within Singapore, he is Chairman of the Ministry of Health Specialist Training Committee (Occupational Medicine), Visiting Consultant at the National Skin Centre, a Visitor’s Board member at the Institute of Mental Health. He serves on various advisory committees and panels in the Ministry of Health, Singapore Police Force, Singapore International Foundation, National Trades Union Congress and the Singapore Society of Occupational Health Nurses.






Public Seminar on


An Approach to Environmental Health Investigation -
A case study of Residents near a Pulp and Paper Mill




Professor David Koh,

Head, Department of Community, Occupational and Family Medicine,
National University of Singapore

Visiting Consultant,
National Skin
Centre, Singapore



Saturday, 17 January 2004

10:00 am – 12:00 noon

Executive Room 5

SDE 2 Level 3


All are Welcome



For more information,

please call Ms Cherry Lin @ 6874 1663

or e-mail