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Maritime Health Research and Education-NET/BACKGROUND - open

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Seafarers

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Studies over the decennia show an over-frequency of cancer, cardiovascular disease diabetes and occupational accidents in seafaring compared to other occupations, now decreasing to about the same level as for shore based occupations [1][2]; [3]. The specific physical, chemical and psychological working environment factors on board also relate to the seafarers health conditions. [4] [5]; [6]. Work on tankers carrying gasoline with more or less closed handling of the cargo may still lead to significant benzene exposure for deck crew members .Work-related diseases are primarily the result of physical work environment impacts in the form of noise and vibration, but also hearing damage and seasickness are well known[7] Finally, infectious diseases, including tropical diseases, are a particular problem in certain geographical areas, where also strong exposure to ultraviolet radiation from the sun can cause sunburn and skin cancer. The quality of the mental work environment is dependent on a number of factors which have been carefully described in the past approx. 30 years [8], [9] , [10] Ships with on-going replacement of crew present great challenges for the managers, the employees and the culture at the workplace [11], [12] During navigation, the sailors are often moved to very small working groups, where conflict management can be difficult. The requirements are very variable, the nature of the work requires considerable discipline and thus less self-control. Support from superiors and colleagues can be made difficult by the fact that crews come from many different nationalities. These conditions can lead to experienced stress and burnout [13] [14]. Fatigue is considered a significant health and safety problem [15]. Jet lag after long flights for joining is described as part of this.(12) [16].In the latest research Helen Sampson, director of Cardiff University's Seafarers International Research Centre, said that seafarers working on cargo ships "experience very little happiness on board". She said there was evidence recent-onset psychological disorders were increasing among serving seafarers but 55% of employers said they had not introduced any policies or practices to address mental health for a decade. The report, Seafarers' mental health and wellbeing, found that internet access would make the most significant contribution to improving the mental health and wellbeing together with other key recommendations were underscored in the report and the BBC News [17], [18].

Fishermen

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The conditions of work in the fisheries sector are arduous with high rates of occupational non-fatal and fatal accidents [19], [20]. Logically, the prevention activities up till now mainly focussed on accident prevention with little attention to the emerging chronic diseases, especially diabetes and cardiovascular diseases related to the specific risk factors. Several studies have shown that fishermen have a higher morbidity and mortality from cardiovascular disease, diabetes, cancer than other occupations [21]. The results are consistent with the causal explanations in studies about obesity and related health conditions also called the metabolic syndrome. The main risk factors include alcohol, fatty food consumption, smoking and lack of physical exercise. And the negative health effects are causally related the mentioned risk which in turn relate to the specific working conditions and culture in small-scale fishing [22].  Skin and airway diseases in fish harvesting and seafood proses work according to Haz Map attention in one or more of the following: (1) eviscerating fresh fish by removing heads, fins, scales, bones, and entrails; (2) shucking and packing fresh shellfish; (3) manufacturing frozen seafood; and (4) processing fresh and frozen marine fats and oils [23] Use of a standard questionnaire for screening of skin complaints and hazardous exposures would be relevant as one of other tools for identification of the needs.

Port workers

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Work on the ports is most often carried out outdoors in all kinds of weather, with exposure to a number of different work-related factors [24] Diesel exhaust emission that also threatens workers' health is measured [25] Noise is one of the major occupationally harmful factors and in other areas, there is not only noise but also exposures to various harmful chemicals, including when working with containers [26]. A cross-sectional study among port workers in three cities in Denmark, using both quantitative and qualitative methods, found that the port workers feel secure about the safety of their workplace and that good cooperation between colleagues was the reason for the feeling of security [27]. Most of them were very satisfied with their work and they enjoy working hours. Most of them did not find it stressful to be unemployed where there is no guarantee of work (and half had never felt stressed). The working environment of port workers has been investigated quite sporadically internationally and repeated surveys are needed. </ref> https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/normativeinstrument/wcms_107615.pdf ILO Guidelines </ref>

Offshore workers

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A review of studies health and safety in the oil- and gas offshore industry concluded there is a need for more epidemiological studies in order to identify the specific areas that need attention for health and safety promotion [28]. Besides the few epidemiological studies, there are plenty of administrative reports. However there is a problem with their quality compared to peer-reviewed publications. The methods are not always sufficiently described and the definitions of the injury inclusion criteria or the study populations are absent or unclear. Even where the research quality is good, it may be difficult to get copies of the reports. Another problem arises with reports written in languages other than English. The methodical problem hinders for a wide international use of the results and collaboration between the companies and nations and is an impediment to the establishment of international evidence based injury preventive initiatives.

Professional divers

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Professional divers are exposed to several types of risks [29]. Depending on their specific profession, they may be exposed to risks related to biological, chemical or psychological hazards, etc.[30], [31]. All professional divers are also subject to the risks associated with diving in water, as are recreational divers. The literature reports many risks for divers, whether professional or recreational. On the one hand, we have the risk of developing a pathology related to hyperbaric stress, such as dysbaric osteonecrosis, decompression sickness, thoracic barotrauma or barotraumatic otitis, and many other pathologies. On the other hand, there is also the risk of an accident occurring underwater, even if the origin is not hyperbaric stress in itself. For example, a fainting episode could lead to drowning. Some of these accidents are therefore life-threatening, [32], [33], [34], [35]

Seafarers social relations

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Sampson et al. explores and sees the changes in attitudes, values and daily life among women married to seafarers from Mumbai and Goa seen as resulting from their husbands’ occupations. The isolation upon women married to seafarers has developed an independence that is recognized as unusual within their local contexts. She also notes that the access to higher incomes allows seafarers and their partners to make change their domestic living arrangements which are not available to others in the local area [36].

References

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  1. ↑ Petersen KU, Hansen HL, Kaerlev L, Hansen J. Turning the tide: reducing mortality among Danish merchant seafarers. Occupational and environmental medicine. 2020;
  2. ↑ Poulsen TR, Burr H, Hansen HL, Jepsen JR. Health of Danish seafarers and fishermen 1970-2010: What have register-based studies found? Scand J Public Health. 2014
  3. ↑ Oldenburg M. Risk of cardiovascular diseases in seafarers. Int Marit Health. 2014;65(2):53–7.
  4. ↑ Oldenburg M, Jensen H-J, Latza U, Baur X. Seafaring stressors aboard merchant and passenger ships. Int J Public Health. 2009;54(2):96–105.
  5. ↑ Oldenburg M, Baur X, Schlaich C. Cardiovascular diseases in modern maritime industry. Int Marit Health. 2010;62(3):101–6.
  6. ↑ MacLachlan M, Kavanagh B, Kay A. Maritime health: a review with suggestions for research. Int Marit Health. 2012;63(1):1–6.
  7. ↑ Jezewska M, Leszczyńska I, Jaremin B. Work-related stress at sea self estimation by maritime students and officers. Int Marit Health. 2006;57(1–4):66–75.
  8. ↑ Levi L. Occupational stressors, biological stress reactions, and worker’s health. J UOEH. 1989 Mar 20;11 Suppl:480–1.
  9. ↑ Leka S. Psychosocial hazards and seafarer health: priorities for research and practice
  10. ↑ Int Marit Health. 2004;55(1–4):137–53.
  11. ↑ Oldenburg M, Jensen H-J, Latza U, Baur X. Seafaring stressors aboard merchant and passenger ships. Int J Public Health. 2009;54(2):96–105.
  12. ↑ Lodde B, Jegaden D, Lucas D, Feraud M, Eusen Y, Dewitte J-D. Stress in seamen and non seamen employed by the same company. Int Marit Health. 2008;59(1–4):53–60.
  13. ↑ Elo AL. Health and stress of seafarers. Scand J Work Environ Health. 1985 Dec;11(6):427–32.
  14. ↑ Oldenburg M, Jensen H-J, Latza U, Baur X. Seafaring stressors aboard merchant and passenger ships. Int J Public Health. 2009;54(2):96–105.
  15. ↑ Allen P, Wadsworth E, Smith A. Seafarers’ fatigue: a review of the recent literature. Int Marit Health. 2008;59(1–4):81–92.
  16. ↑ Wadsworth EJK, Allen PH, McNamara RL, Smith AP. Fatigue and health in a seafaring population. Occup Med. 2008 May 1;58(3):198–204.
  17. ↑ Seafarers mental health and wellbeing SIRC research Nov 2019 https://www.iosh.com/media/6305/seafarers-mental-health-wellbeing-summary-report.pdf
  18. ↑ BBC news on maritime mental health advice based on the research Nov 2019 https://www.bbc.com/news/uk-wales-50315080
  19. ↑ Case SL, Lincoln JM, Lucas DL. Fatal Falls Overboard in Commercial Fishing - United States, 2000-2016. MMWR Morb Mortal Wkly Rep. 2018 Apr 27;67(16):465–9.
  20. ↑ Jensen OC, Petursdottir G, Holmen IM, Abrahamsen A, Lincoln J. A review of fatal accident incidence rate trends in fishing. Int Marit Health. 2014;65(2):47–52.
  21. ↑ Kaerlev L, Dahl S, Nielsen PS, Olsen J, Hannerz H, Jensen A, et al. Hospital contacts for chronic diseases among Danish seafarers and fishermen: a population-based cohort study. Scand J Soc Med. 2007;35(5):481–489.
  22. ↑ Frantzeskou E, Jensen OC, Linos A. Health status and occupational risk factors in Greek small fisheries workers. Int Marit Health. 2016;67(3):137–43.
  23. ↑ https://pubmed.ncbi.nlm.nih.gov/15148019/
  24. ↑ Wang Y, Zhan S, Liu Y, Li Y. Occupational hazards to the health of port workers. Int J Occup Saf Ergon JOSE. 2016 Jul 18;1–5.
  25. ↑ Debia M, Neesham-Grenon E, Mudaheranwa OC, Ragettli MS. Diesel exhaust exposures in port workers. J Occup Environ Hyg. 2016 Jul;13(7):549–57.
  26. ↑ Baur X, Budnik LT, Zhao Z, Bratveit M, Djurhuus R, Verschoor L, et al. Health risks in an international container and bulk cargo transport due to volatile toxic compounds. J Occup Med Toxicol Lond Engl. 2015;10:19
  27. ↑ Nielsen NO, Nielsen SRG. Dockworkers’ health and safety. A cross-sectional study of self-perceived safety and psychosocial work environment amongst Danish dockworkers. Int Marit Health. 2019;70(3):171–179.
  28. ↑ Jensen O, Laursen LH. A review of epidemiological injury studies in the oil-and gas offshore industry. Ann Public Health Res. 2014;1(1):1–4.
  29. ↑ Pougnet R, Pougnet L, Dewitte J-D, Loddé B, Lucas D. Temporary and permanent unfitness of occupational divers. Brest Cohort 2002-2019 from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P). International maritime health. 2020;71(1):71–77.
  30. ↑ Epp T, Waldner C. Occupational health hazards in veterinary medicine: zoonoses and other biological hazards. Can Vet J. 2012; 53(2) 144–150
  31. ↑ Maestre FT. Ten simple rules towards healthier research labs. PLoS Comput Biol. 2019; 15(4)
  32. ↑ Gempp E, Louge P, de Maistre S. Predictive factors of dysbaric osteonecrosis following musculoskeletal decompression sickness in recreational SCUBA divers. Joint Bone Spine. 2016; 83(3): 357–358
  33. ↑ Sharareh B, Schwarzkopf R. Dysbaric osteonecrosis: a literature review of pathophysiology, clinical presentation, and management. Clin J Sport Med. 2015; 25(2),
  34. ↑ Azizi MH. Ear disorders in scuba divers. Int J Occup Environ Med. 2011; 2(1): 20–26
  35. ↑ Tseng WS, Huang NC, Huang WS, et al. Brown-Séquard syndrome: a rare manifestation of decompression sickness. Occup Med (Lond). 2015; 65(9):758–760
  36. ↑ Sampson H. Left high and dry? The lives of women married to seafarers in Goa and Mumbai. Ethnography. 2005;6(1):61–85.
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