Consumption of addictive substances in mariners.

BACKGROUND: For many years, studies have confirmed that there is a high prevalence of addiction amongst seafarers. The effect of this is even more serious when one considers their isolated and even hostile living environment presenting risks which require vigilance and rapid reactions. The purpose of this article is to determine the extent of knowledge about addiction among seafarers. MATERIALS AND METHODS: This is a review of the literature between 1993 and 2013 with respect to the prevalence of consumption of alcohol, tobacco, cannabis, cocaine, heroin, and other drugs amongst seafarers. Total prevalence was calculated using the virtual population represented by the subjects of each article, when drug consumption definition was the same between articles and when mariners studied were different. RESULTS: 63.1% (range 38.4-96.3%) of seafarers smoked tobacco. 14.5% (range 8.8-75%) of seafarers drank alcohol. 3.4% (range 9-45%) had used cannabis during the previous month. Few studies concerned other drugs; 3-10% of seafarers used drugs on board. CONCLUSIONS: The prevalence of tobacco and alcohol consumption amongst seafarers was higher than that in the general population. Further studies on the use of drugs at work would be valuable for this population who are subject to significant occupational risk.

The business case for telemedicine.

BACKGROUND AND AIM: Following the coming into force of the International Labour Organisation Maritime Labour Convention (ILO/MLC) and International Maritime Organisation Standards for Training, Certification and Watchkeeping, Manila 2010 (IMO/STCW) amendments, the objective of this article is to provide the shipping community with an initial assessment of the economic reasons and business case, in support of both publicly financed and private telemedicine being implemented on board commercial vessels. MATERIALS AND METHODS: It provides the global scale of the requirement, the number of Telemedicine Assistance Services (TMAS) calls handled by participating TMAS, the average direct and indirect costs incurred by both TMAS and ship operators, responding to medical emergencies, and also provides a calculation of the market size of about 760 million Euro/year. It estimates a return on investment per ship, of implementing telemedicine on board to meet the MLC and STCW requirements at less than 1 year. RESULTS AND CONCLUSIONS: 1. There are both financial and soft benefits, such as crew retention and being perceived as a quality employer offering a telemedicine service on board. 2. It is quite possible to obtain a 20% savings to the industry of perhaps 152 million Euro/year from the deployment of telemedicine on board. 3. The deployment of a telemedical service on ships is an opportunity to encourage further cooperation between TMAS and also with the private TMAS sector. 4. There is clearly a great need, on a global basis, for more cooperation, particularly in standardisation of pre-boarding medical files available, the equipmentrequired on board at a minimum, and level of service quality provided. 5. A collection of a common TMAS annual set of normalised statistics from the stakeholders in the maritime industry is needed. Should someone not be tasked with collecting this? 6. Open registries and countries where the private sector only providestele medicine, should be encouraged to work with the global public TMAS system and contribute to its costs?