This paper analyses the impact of highly input intensive rice production in the Mekong Delta (MKD) of
Vietnam on farmers’ health. This is done by using two household surveys that were undertaken with a
four-year period in between (1997 and 2001), covering a similar area in the MKD, and including a sub-set
of the households being present in both surveys, which provided good insights in dynamic changes of
particularly fertilizer and pesticide use. Impact on health is measured through the use of health cost model.
While the use of chemical inputs per hectares diminished during the period, double and triple cropping
increased, hence total use still rose. With the introduction of integrated pest management (IPM), indeed a
shift can be measured towards a more sustainable use of chemical inputs, while also more awareness has
grown with farmers on the possible health impairments of toxic substances, with beneficial impact.