Outbreak investigation in cargo ship in times of COVID-19 crisis, Port of Santos, Brazil / Investigação de surto em navio de carga em tempo de COVID-19, Porto de Santos, Brasil

ABSTRACT In February 2020, a Chinese cargo ship docked at the Port of Santos with reports of crew members with a feverish and respiratory condition. A team was gathered to verify the existence of suspected cases of COVID-19 inside the vessel and define its clearance. All 25 crew members were interviewed, and no suspected cases were found. The vessel was then cleared for port activities. The investigation resulted from the implementation of the contingency plan to face a public health emergency of international importance and several surveillance entities cooperated.

RESUMO Em fevereiro de 2020, um navio de carga vindo da China atracou no Porto de Santos com relato de tripulantes com quadro febril e respiratório. Uma equipe foi mobilizada para verificar a existência de casos suspeitos de COVID-19 dentro da embarcação e definir a liberação da embarcação no porto. Todos os 25 tripulantes foram entrevistados e não foram encontrados casos suspeitos. Então a embarcação foi liberada para atividades no porto. A investigação resultou da aplicação do plano de contingência diante de uma emergência de saúde pública de importância internacional e houve a colaboração de diversas entidades de vigilância.

An analysis of work-related musculoskeletal disorders and ergonomic loads in male welders in shipbuilding industry / 中华劳动卫生职业病杂志

Objective@#To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in male welders in different work areas of shipbuilding industry based on their operational working position and body position characteristics and to analyze the operational positions and ergonomic loads.@*Methods@#In February 2017, 412 male welders from the hull and block work areas of a large ship factory were selected by stratified sampling. The prevalence and effects of WMSDs within a year were investigated using the Nordic Musculoskeletal Disorders Questionnaire, and a rapid exposure checklist was used to obtain the ergonomic load index by comprehensive scoring; the exposure-response relationship between the ergonomic loads and WMSDs symptoms of subjects in the hull and block work areas was evaluated.@*Results@#Among the male welders working in the hull work area of shipbuilding industry, WMSDs occurred more commonly in the neck, lower back/waist, and legs, accounting for 53.16% (126/237) , 51.90% (123/237) , and 41.77% (99/237) , respectively; among those working in the block work area, WMSDs occurred more commonly in the lower back/waist, wrist, and legs, accounting for 52.57% (92/175) , 49.14% (86/175) , and 45.14% (79/175) , respectively. There were significant differences in the distribution of cases of pain within the last 7 days and one month, pain lasting more than one month, or absence from work due to pain within a year in the four positions between the two work areas (P<0.05). In the hull work area, high and extremely high exposure levels were mainly seen in the neck, lower back/waist, and legs, accounting for 76.79%(182/237), 69.20%(164/237), and 59.49%(141/237), respectively; in the block work area, high and extremely high exposure levels were mainly seen in the lower back/waist, wrist, and legs, accounting for 77.71%(136/175), 50.29% (88/175), and 46.29% (81/175), respectively. The detection rates of WMSDs in these four positions significantly increased as the exposure levels rose (P<0.01).@*Conclusion@#The WMSDs of male welders working in the hull and block work areas of shipbuilding industry occurs more commonly in the lower back/waist and legs. The risk of WMSDs symptoms increases with the rise of ergonomic load.

Asistencia médica a bordo de los buques en altamar basada en la telemedicina / Medical assistance via telemedicine on ships at sea

Introduction: Statistical study about the health care provided to seafarers on board their ships by the Spanish Radio Medical Center of the Marine Social Institute (Ministry of Employment and Social Security). Material and results: In 2015, 1658 calls were received requesting medical assistance and 1014 patients were attended (average: 1.64 calls / case). The use of satellite communication was the most common means of communication used (92.2%). The mean age of the patients was 44.51 (standard deviation = 9.892). The average age of Spanish and European Union crew members is higher than those of other origin (p < 0.01). Trawlers account for the 76.4% of the calls asking for medical assistance, merchant ships the 13.2%, travelling ships 1%, yachts 0.5% and others 8.8%. No significant differences were found between the pathology seen and the type of vessel (p> 0.1). 25% of medical consultations were due to trauma conditions and 75% to other diseases. In trauma patients, the affected body regions were: the upper limbs (40.2%), the head (10.8%), the lower limbs (16.7%) and the trunk (12.7%). Isolated eye traumas represented the 11.2% of cases. 81.6% of all the cases were treated on board until port destination. In the 18.4% of the cases, rescue was required (3.2% per helicopter). In the trauma cases, only 61.26% were able to remain on board. Rescue was more frequent in the event of trauma (p < 0.01). Conclusions: Assistances due to diseases are more frequent than those due to trauma. Most patients could be assisted on board. It was observed that seafarer population is becoming older.

Introducción: Estudio estadístico de la atención sanitaria prestada por el Centro Radio Médico Español del Instituto Social de la Marina a los marinos a bordo de sus buques. Material y resultados: Durante un año, se asistieron 1014 pacientes y se recibieron 1658 llamadas demandando consulta médica (media: 1.64 llamadas/caso). El satélite es el medio de comunicación más empleado para la consulta (92.2%). La media de edad de los pacientes fue de 44.51 (desviación estándar = 9.892). La media de edad de los tripulantes españoles y de la Unión Europea es mayor que el resto (p = 0,00). Los pesqueros representan un 76.4% de las asistencias; los mercantes, 13.2%; pasaje, 1%; buques de recreo, 0.5%, y otros, 8.8%. No se han encontrado diferencias significativas entre la afección consultada y el tipo de buque (p > 0.1). El 25% de las atenciones se debieron a accidentes y el 75% a enfermedades. En los accidentes, las regiones corporales afectadas fuern: miembros superiores (10%), cabeza (5.5%), miembros inferiores (4.1%) y tronco (3.2%). Los ojos representan el 2.8% de los casos. El 81.6% de todos los casos fue atendido a bordo hasta la siguiente llegada a puerto. En el 18.4% fue necesaria la evacuación (3.2% por helicóptero). En el caso de los accidentados, sólo el 6.26% pudo permanecer a bordo. La evacuación es más frecuente en caso de accidente (p = 0.00). Conclusiones: Son más frecuentes las asistencias por enfermedad que por accidente. La mayoría de los pacientes pueden permanecer a bordo. Se observa un envejecimiento de la población embarcada.

Metabolism evaluation of blood quality after marine storage and transportation / 军事医学

Objective To evaluate the quality of blood after marine storage and transportation,to establish a quantitative energy metabolism platform supported by extracellular flux(XF)technique to determine the glycolysis level of red blood cells(RBC), and to introduce the "functional dose", as a valuable supplement, into the quality evaluation of RBCs after marine storage and transportation.Methods The extracellular acidification rate(ECAR)of erythrocyte glycolysis was detected by XF.The levels of glycolysis, ATP contents and free hemoglobin of RBCs were detected before and after marine navigation.RBC suspensions stored at 4℃in a blood bank on land served as control.Results The results showed that the glycolysis level of RBCs was detected by XF.Indicators of blood quality and energy metabolism of RBCs were detected in the twice marine storage and transportation.Blood samples transported around the Gulf of Bohai had no significant change,indicating that the samples were well preserved.The energy indicators of blood samples navigated in the Pacific Ocean decreased significantly,and it was recommended that the samples be discarded.Conclusion XF technique has been applied to the measurement of erythrocyte glycolysis,enabling high-throughput and multi-indicator dynamic detection of viable cells.The energy metabolism of erythrocyte should be recommended as an important indicator for evaluating blood after marine storage and transportation.

Establishment and injury analysis of beagle dog model of blast craniocerebral injury caused by explosion in warship multiple cabins / 第二军医大学学报

Objective To investigate the characteristics of craniocerebral injuries in the Beagle dogs caused by explosion shock wave and quasi-static pressure by simulating the condition of multiple cabins explosion in warship. Methods A total of 24 Beagle dogs were randomly divided into 2 groups, with 12 in each group, and the Beagle dogs of 2 groups were tested in the multiple cabins with the same size of the real warship. A 0. 65 kg TNT equivalent bare explosion was blasted in the cabins, which was defined as the target cabin (I group), and the neighboring one was defined as the adjacent cabin (II group). Parameters of shock waves were measured using pressure transducers. The survival status of dogs, basic vital signs, neurological function scores and the gross and morphological changes of the brains were observed after the explosion. Results There were two reflected shock waves after the explosion in the cabins, and the peak pressure of the shock wave in the adjacent cabin was about 0. 39 limes of that of the target cabin. Seven Beagle dogs died instantly after the explosion, and four died within 24 h. The mortality rale of the dogs was 45.83% (11/24). with that in the target cabin being 66. 67% (8/12) and that in the adjacent cabin being 25. 0% (3/12). The basic vital signs and neurological function of the survival dogs underwent greal changes immediately after the explosion, which basically recovered after 24 h. The brain issues of the dogs thai immediately died after explosion had obvious contusions, and cerebral hemorrhage and cerebral edema were found in the dogs died within 24 h after explosion. Abnormal morphological structures and neuronal structures were also found in the brain issues of survival Beagle dogs under light microscope, with some neurons showing nuclei condensation and deep staining, nuclear dissolution or disappearance of nucleus, and the cell borders being blurred. Conclusion In multiple cabin explosion, the peak pressure of the shock wave in the target cabin is significantly higher than that in the adjacent cabin. There are two reflected shock waves in the cabins, which increases the damage to the dogs. The mortality rate of the Beagle dogs in the target cabin is higher than that in the adjacent cabin; and the acute injuries of Beagle dogs immediately after the explosion are the most serious ones, with obvious pathological changes of the brain tissues.

The Relationship Between Job Stress, Job Satisfaction, and the Symptom Checklist-90-Revision (SCL-90-R) in Marine Officers on Board / 예방의학회지

OBJECTIVES: This study was conducted to investigate the relationships among job stress, job satisfaction, and mental health in marine officers. METHODS: The researchers gathered data on marine officers working at a harbor in Chungcheong Province, South Korea, using a self-reported questionnaire. Mental health was measured by the Symptom Checklist-90-Revision (SCL-90-R), and general characteristics including socioeconomic factors, job stress, and job satisfaction were measured by structured questionnaires. Multiple regression analysis was performed to investigate the relationships among job stress, job satisfaction, and mental health status according to the symptom dimensions of the SCL-90-R. RESULTS: Among the marine officers, obsessive-compulsive behavior, depression, and somatization were the most problematic symptoms. Those who reported poor health, low job satisfaction, and high job stress had a higher prevalence of psychoticism, somatization, depression, anxiety, and phobic anxiety. CONCLUSIONS: An occupational health system should be introduced that would regularly check the mental health of marine officers in charge of ships and sailors, in order to help reduce their stress levels, enhance their job satisfaction, and thereby improve their mental health.

Medical system requirement of a large naval ship / 军事医学

Objective Medical system requirements of a large naval ship are presented in this paper to provide refer -ence for ship design and construction .Methods The relations between health service missions of a large naval ship and naval strategic needs were analyzed .According to the naval strategies in the new era , the health service mission of the ship was given.Results The medical system configuration scheme and ship design requirement related to the medical system were proposed .Conclusion The medical system design requirements and configuraion scheme can effectively improve the patient-treating capability in defensive combat on high seas and in diverse missions .They are also of great significance for maintaining troop strength and promoting a country′s ability to provide humanitarian aid .

Telemedical Marit Assistance Service by Fire Safety Headquarter

PURPOSE: Telemedical maritime assistance service (TMAS) is performed in several ways when a seafarer falls sick under circumstances where the ship is far away from shore without possibility of medevac. The current methods operating in Korea are described and compared in order to grasp the actual circumstances in terms of importance. METHODS: From June 2012 to July 2013, a total of 523 cases were consulted roughly by means of satellite-phone, e-mail, and website homepage at TMAS center of Busan metropolitan city fire safety headquarters and the final clinical outcomes of these registered cases according to illness or injury after a certain period of time was studied retrospectively. RESULTS: Statistically significant differences in classification of ship company, headquarters of ship company informed, added photos, added drug-list, and final clinical outcome (p<0.001, p<0.001, p<0.001, p<0.001, p=0.027, respectively) according to whether or not homepage-consultation were observed between crossed-analyzed groups; and significant differences in age-group, consult through satellite-phone, added photos, and final clinical outcome according to illness or injury were observed between crossed-analyzed groups (p<0.001, p=0.046, p=0.017, p<0.001, respectively). CONCLUSION: The website designated for TMAS is expected to play a positive role. In addition, education of seafarers should also be implemented at the same time because the off-shore circumstances are quite different from those of onshore.

Evaluación del Programa de Control Sanitario Internacional en el Policlínico "Nguyen Van Troi" de Centro Habana, La Habana, 2007 / Evaluation of the International Health Control in the "Nguyen Van Troi" polyclinic of Centro Habana municipality, La Habana, 2007

INTRODUCCIÓN: En 1962 se estructuró un Programa de Control Sanitario Internacional para puertos y aeropuertos, y en 1980 se puso en vigor el primer Programa Nacional de Control Sanitario Internacional que preveía acciones de control a realizar por una parte de la red de servicios de salud y que sirvió de base para ser modificado en 1985, cuando se extendió la vigilancia a toda la red de atención médica primaria y secundaria del país, con la incorporación de los primeros médicos de familia al programa. OBJETIVO: Evaluar el programa de Control Sanitario Internacional en el Policlínico "Nguyen Van Troi" durante el segundo semestre del año 2007, en cuanto a estructura, proceso y resultados. MÉTODOS: Se realizó un estudio evaluativo de tipo descriptivo. El universo estuvo constituido por el personal que participó en el Programa de Control Sanitario Internacional. Se tomó una muestra por conveniencia del 50 por ciento de los consultorios tipo 1, donde se revisó el 10 por ciento de las historias clínicas de los viajeros. RESULTADOS: En la evaluación de la estructura, el 52,9 por ciento encontró aceptable el funcionamiento del programa. La evaluación del proceso es de no aceptable porque no son satisfactorios los criterios esenciales, ni tampoco el 50 por ciento restante. Los criterios de resultados fueron satisfactorios porque durante el año no se reportaron casos de dengue ni de paludismo introducidos. CONCLUSIONES: La dimensión estructura resulta insuficiente y el proceso no aceptable, por lo que podemos plantear que el Programa de Control Sanitario Internacional en el área evaluada durante el 2008 resultó No satisfactorio.

INTRODUCTION: In 1962 The International Health Control Program was structured for ports and airports and in 1980 took effect the first National Health Control Program to plan actions of control to be carried out by a part of the health services network and was the base for its modification in 1985 when this type of surveillance was widen to all the primary and secondary medical care network of our country, with the incorporation of the first family physician into program. OBJECTIVE: To evaluate the International Health Control Program in "Nguyen Van Troi" clinic area during the second semester of 2007 related to structure, process and results. RESULTS: An evaluative and descriptive study was conducted. Universe included the staff involved in the International Health Control Program. By convenience a sample of 50 percent of type 1 consulting room was taken, where the 10 percent of medical records of travellers was reviewed. In the evaluation of structure, the 52,9 percent considered as acceptable the program' functioning. The evaluation of process is not acceptable due the non satisfactory of the essential criteria, neither the remainder 50 percent. The criteria of results were satisfactory due to throughout the year there were not reports of introduced cases of dengue or malaria. CONCLUSIONS: The structure's dimension was insufficient and the process was not stable, thus, it impossible to propose that the International Health Control Program in the evaluated area during 2008 be non-satisfactory.

Os navios de cruzeiros marítimos enquanto campo de atuação profissional no lazer / The sea cruise ships while professional acting in leisure

Um dos campos de atuaþÒo no lazer e entretenimento que tem tido um crescimento significativo no Brasil nos últimos anos Ú o de cruzeiros marÝtimos. Nos navios os profissionais do lazer tÛm desempenhado diferentes funþ§es. SÒo poucos os estudos brasileiros que focam o lazer neste setor e, por isto, o objetivo deste trabalho foi apresentar os navios de cruzeiros como campo de atuaþÒo profissional no lazer. Teve o prop¾sito de discutir criticamente como sÒo feitas as contrataþ§es, quais sÒo os cargos ocupados e as funþ§es que os profissionais do lazer desempenham nos navios. A partir de uma pesquisa bibliogrßfica este estudo mostrou que o os profissionais do lazer tem muitos gastos em suas contrataþ§es, o trabalho nos navios de cruzeiros Ú dinÔmico mas a jornada de trabalho Ú extensa e, ainda, ocorre muitos desvios de funções.

one of the acting s in leisure and entertainment that has had a significant increase in Brazil last years is the sea cruise one. In the ships the leisure professionals have diverse functions. Brazilian studies that focus the leisure on this sector are few and, so, the objective of this work was to present the cruise ships as a professional acting in leisure. It has had the purpose of critically discuss how the hiring is done, what the positions filled are and the functions that the leisure professionals perform on the ships. From a bibliographic research this study showed that the leisure professionals have a lot of expenses on their hiring, the job on the ships is dynamic but the workload is big and still occurs a lot of function misleads.

Clinical Characteristics of Patients who Suffered an Injury Associated with A Maritime Accidents

PURPOSE: This study was designed to determine the characteristics of patients who suffered from an injury associated with a maritime accident. METHODS: Using reviews of medical records, we retrospectively investigated the characteristics of maritime accident related injured patients that visited the emergency center of Inha University hospital. Variables analyzed were age, sex, sailor or passenger, type of accident, time required to arrive at the hospital, type of injury, site of injury, submersion or not, level of submersion, severity of injury, disposition of injury, type of ship, gross tonnage of ship, and distance from shore. RESULTS: Between January 1999 and December 2009, a total of 85 patients who were injured because of a maritime accident visited the emergency center of InHa Univ. hospital. The mean age of patients was 45.7+/-15.1 years old. Fifty four were male and 31 were female. The most common types of injury were submersion (40.0%) and contusion (38.8%). Submersed patients as a group had a higher injury severity and higher mortality than those not submersed. The most frequent sites of injury were the extremities (62.9%) and the head and neck (35.5%). The mean injury severity scale were 4.63+/-13.05 units?. Almost all patients (85.9%) had a mild degree of injury. The mortality rate was 10.6%; the most common cause of death was drowning. CONCLUSION: Submerged patients have a higher injury severity and mortality than non-submerged patients. Capsizing and sinking is associated with a higher severity of injury and mortality according to the type of accident, because submersion confers high risk for injury and mortality. Prevention of submersion is important for reducing injury severity and mortality in patients who have maritime accidents.

Reproducción y crecimiento del pargo mancha Lutjanus guttatus (Pisces: Lutjanidae) en el Golfo de Nicoya, Costa Rica

Reproduction and growth of the fish Lutjanus guttatus (Pisces: Lutjanidae) in the Gulf of Nicoya, Costa Rica. The fish Lutjanus guttatus is important in the fisheries of Golfo de Nicoya, Costa Rica where they are captured with varied gear mainly by the artisanal fleet. We measured specimens from the commercial catch of 2002-2006. Gonadal state was determined macroscopically and age with otoliths The total length-total weight relationship was y = 0.0236x2.8153 and total length-eviscerated weight y = 0.0216x2.8129. Simplified relationships were y = 0.0173x3 and y = 0.0162x3. There is year-round reproduction with peaks in March (dry season) and September (rainy season). Male-female sexual ratio was 1:1. The age-length key for the gulf shows availability until the 6 years of age. The von Bertalanffy growth curve is L (t) = 65,9 (1-e -0,13(t+2,66)). Rev. Biol. Trop. 57 (1-2): 125-131. Epub 2009 June 30.

Una de las pesquerías más importantes en el Golfo de Nicoya es la del pargo mancha (Lutjanus guttatus); su captura se realiza con diversas artes y principalmente por la flota artesanal. Estudiamos especímenes de la captura comercial artesanal entre el 2002 y 2006. Se analizaron las relaciones morfométricas para aplicar la ecuación P = aLb; el análisis del estado de madurez gonadal se hizo macroscópicamente; se determinó la edad a través de la lectura de anillos anuales de los otolitos sagitales y los parámetros de crecimiento fueron aplicados en la ecuación de von Bertalanffy: L (t) = * [1-exp (-K*(t-t0))]. La relación longitud total-peso total es y = 0.0236x 2.8153 y longitud total-peso eviscerado y = 0.0216x2.8129; las relaciones simplificadas correspondientes fueron y = 0.0173x3 y y = 0.0162x3. La reproducción es todo el año con dos picos en marzo y setiembre (época seca y lluviosa, respectivamente). La proporción macho-hembra es 1:1. Se generó para la población del Golfo de Nicoya una clave edad-talla donde su utilidad se presenta como adecuada hasta los 6 años de edad. La curva de crecimiento von Bertalanffy es L (t)=65,9(1-e -0,13(t+2,66)).

Maritime Remote Medical Advice Performed by Emergency Medical Information Center in South Korea

PURPOSE: Seafarers injured at sea need appropriate and prompt medical advice. Since 2002, the Busan emergency medical information center (BEMIC) has provided remote medical advice to vessels on the distant ocean via telephone, e-mail, facsimile and radio-transmission. METHODS: Seventy-four cases had requested remote medical advices to BEMIC from Jan 2005 to Jul 2005, and they were studied retrospectively. We analyzed patients' general characteristics, type of disease or injury, dispositions, and so forth. The cases were classified into three groups according to disposition. Class I was defined as a case which required simple treatment. Class II involved medical or surgical treatment with close observation. Class III required transfer to the nearest harbor instantly due to severe or uncertain condition. RESULTS:The nationalities of subjects were Korean (32.4%), Southeast Asians (35.1%), Chinese (24.3%) and others. The most common symptom was abdominal pain (24.3%). The patients'disease types were acute disease (53.4%), trauma (20.3%), burn (13.7%), chronic disease (8.2%) and others. There were 8 voluntary medication cases, which were performed by seamen before taking medical advice. The dispositions were class I (6.8%), class II (39.7%), and class III (53.5%), respectively. A cross-sectional study between the types and the dispositions was performed, revealing a statistical significance (p<0.001). CONCLUSION: Despite the lack of any kind of direct support from ship companies or governments, the remote medical advice service has performed. Enhancing educational programs based on this data is necessary in order to provide effective education of seafarers.

Variance analysis of the effects of simulant magnetic field, high-temperature and noisy enviroment on ships / 解放军医学杂志

Objective To investigate the characteristics of interactive effects of magnetic field of two intensities combined with high-temperature and noise simulating ship environment. Methods Orthogonal trial design of three factors and two levels and variance analysis method were employed. The rabbits and rats were grouped into eight combined exposure groups and eight controls, respectively, according to orthogonal table L_8 (2~7). Animals in all groups underwent the experiments and the indices were determined at the same time. Results Analysis of the radius of capillary vessels on rabbit's conjunctiva and HSP70 of rat's liver and spleen showed that magnetic field was the dominant factor (P