Screening for type 2 diabetes and hypertension in seafarers' medical examinations.

BACKGROUND: The aims of the study are: 1) to replace the urine glucose test for diabetes with more than 50% false negatives, with an accurate screening for type 2 diabetes and hypertension in the mandatory biannual fit-for-duty medical examinations of seafarers; 2) to produce data driven "Green Ship" health pro-motion in the ships. A new health promotion and disease prevention public health intervention programme integrated in the fit-for-duty medical examinations for seafarers is being developed. MATERIALS AND METHODS: The lack of an accurate diagnosis of type 2 diabetes is replaced by accurate HbA1c and/or fasting glucose tests and the test for hypertension in various disease stages is based on the International Associations' Guidelines. A "Green Ship" health promotion programme is proposed for all on board, not only for diseased crew members. RESULTS: A protocol for an accurate biannual screening for diabetes and hypertension is presented. Educational programmes for medical doctors and seafarers on the management of hypertension and diabetes on board will be developed. Presuming that all crew members are potentially on their way to be pre-diseased or are diseased, the "Green Ship" health promotion programme is implemented for the whole crew. CONCLUSIONS: The International Labour Organization and the National Maritime Authorities are prompted to revise the International and the National Guidelines for Seafarers Medical Examinations, respectively. Con-certed actions are requested to implement public health promotion projects in shipping. Maritime medical doctors are prompted to use health dialogues and to report the clinical data in the Excel file. Sustainability is obtained by complying with the Sustainable Development Goals (3, 4, 8, 10, and 17).

Rethinking the use of urine dipstick for early diagnosis of Type 2 diabetes mellitus.

Transport workers, seafarers and fishers have biannual mandatory fit-for duty medical examinations. Urinedipstick is used for early diagnosis of Type 2 diabetes mellitus. Due to low sensitivity with more than 80% false negatives the method should be replaced by highly sensitive blood tests, Hb1Ac or similar for diagnosis of Type 2 diabetes mellitus to pursue the UN Global Sustainable Goals, especially Goal 3: Good health and well-being for all workers and Goal 8: Decent Work and Economic Growth.

Early diagnosis of T2DM using high sensitive tests in the mandatory medical examinations for fishers, seafarers and other transport workers.

Transport workers like seafarers, truck-, bus-, train- and taxi drivers and fishers have a known great inequity in health at work including high risk of developing type 2 diabetes. Their routine mandatory medical examinations use urine glucose for diabetes check with more than 50% false negatives, which should be replaced by high sensitive tests for diabetes-2, like A1C, Fasting Glucose (FPG) or Oral Glucose Tolerance Test (OGTT).

Global occupational health research methods education.

Occupational and Public Health Research has been developed gradually over the last century, unfortunately not to the same levels in all continental parts of the globe. The aim is to supply an open modular educational program in Occupational- and Public Health research methodology for research of the risk indicators for the prevention of workers' health and safety globally. The modular educational program in research methodology is based on the Humboldtian university model with unity of research and teaching. Research data for the students comes from the research part of the "Maritime Education and Research Network" for all types of industries. The modules constitute the basic education in occupational health science research methodology. The proposal for Master of Science for medical doctor's specialization in occupational medicine with an emphasis on research includes 3 theoretical and a clinical module. The huge difference in research methodology globally indicates inequity in relation to the UN17 goals that need to be taken hand on. Global collaboration in teaching health research methodology is needed to reach the goals of equity in health science education. The aim is to reduce the inequity in global health by strengthening the education in health science research methodology.•Open access educational program for health science research methodology to reach the UN17 goals.•The modules constitute the education in research methodology for Public- and Occupational health.•Global education in health research methodology is needed to eliminate the inequity in global health.

Follow-up of citations of maritime epidemiological injury studies.

BACKGROUND: The article is based on a review and follow-up of the citations of 13 epidemiological studies that aimed to improve maritime health and safety. While it's well-recognised that epidemiology is needed in occupational health and safety, the main research question: "How can epidemiology help workers to return healthy from the sea" was unanswered. MATERIALS AND METHODS: The 13 articles were selected as a representative sample of different epidemiological design studies intended to contribute to improving safety management in fishing, merchant shipping and offshore industry. The PubMed, Research Gate, Cochrane-Library and Google Scholar were searched for authors that had cited our articles by using full bibliographic information and the results analysed. RESULTS: In all, 213 citation records were identified. After duplicates and records with insufficient information were removed, 123 full-text articles were eligible for evaluation with answers to the research questions: how did other authors use the studies, how has the injury epidemiology been developed, which recommendations are given for new policies and new studies and how can epidemiology help workers return safe and healthy from the sea? CONCLUSIONS: The answer to the main research question is yes, epidemiological studies are not only useful but a necessary component by providing the needed evidence for successful prevention programmes.

How to calculate incidence rates from proportionate data.

This paper describes the methodological aspects of calculation of incidence rates from incomplete datain occupational epidemiology. Proportionate measures in epidemiological studies are useful e.g. to describethe proportion of slips, trips and falls compared to other types of injury mechanisms within singleage-strata. However, a comparison of proportions of slips, trips and falls among the different age-stratagives no meaning and can hamper the conclusions. Examples of a constructed example and some selectedstudies show how estimates of incidence rates can be calculated from the proportionate data by applyingestimates of denominators available from other information. The calculated examples show how the risksbased on the incidence rates in some cases differ from the risks based on the proportionate rates withthe consequence of hampering the conclusions and the recommendations for prevention. In some casesthe proportionate rates give good estimates of the incidence rates, but in other studies this might causeerrors. It is recommended that estimates of the incidence rates should be used, where this is possible, byestimation of the size of the population. The paper is intended to be useful for students and teachers inepidemiology by using the attached Excel training file.

A Review of Epidemiological Studies in Latin American Fishing.

Objectives: Maritime health and safety research primarily comes from developed industrial countries, with sparse contributions from developing countries. The aim of this article is to give an overview of the research in Latin American fishery to point out the need for research and prevention in this part of the world.Methods: A systematic search was carried out with Medline/PubMed, Google Scholar, Google Academico, SciELO, Pan American Journal of Public Health, Medicina Maritima, and other relevant Spanish- and English-language journals in Latin America (1984-2018). By using the ICD-10 system we were able to identify the most important studies related to the research questions.Results: A total of 143 scientific articles were identified under the criteria. After duplicates, administrative reports, and conference abstracts were removed, 110 original articles were screened. Of those, 89 peer-reviewed articles on fishermen's health and safety fulfilled the inclusion criteria and were included in the final evaluation. Brazil accounted for the largest share (49), while eight other countries had one to nine studies (and the rest zero). Study objectives included occupational injuries, cancer, divers' disease, skin diseases, hearing loss, ergonomic problems, and environmental pollution. Non-fatal and fatal accident studies in fishing were absent.Conclusion: The lack of occupational injury studies is striking, and it urgently calls for establishing injury registers and monitoring safety in fishing. Among the occupational diseases, pityriasis of the eyes and different types of skin cancer (related ultraviolet radiation exposure) need critical attention and prevention. The scant number of epidemiological studies calls for collaborative international research to establish preventive polices and activities in fishing.

Social security for seafarers globally.

BACKGROUND: The social security protection is one of the essential elements of decent work. The issue is complexand no previous epidemiological studies of the coverage among the seafarers have yet been performed. AIM: The aim was to overcome the gap of knowledge to promote the further discussion and plan the implementationof the social security for all the seafarers. MATERIALS AND METHODS: The seafarers completed a short questionnaire concerning their knowledge abouttheir social security status. RESULTS: The significant disparities in the social security coverage were pointed out among the nationalities.Especially it is worth mentioning that more than half of the respondents believe they are economicallyuncovered for disability from an injury on board and from a work-related disease. CONCLUSIONS: The results confirm the ILO (Convention No. 143) statements that the significant part of theseafarers comes from the poorer countries without the substantial social security systems. The solutionssuggested are to implement the minimum requirements as recommended by the ILO 2006 Convention, tosurvey the implementation and - in the long term - to struggle for a global social equality.