A Medical Support in Offshore Racing - Workshop on Medical Support for Offshore Yacht Races, Telemedical Advice Service (TMAS), 1-2 December 2018, London, United Kingdom.

The safety and health of sailors offshore is of major concern. World Sailing (WS) and International Maritime Health Association (IMHA) are taking seriously the potential dangers to the safety and health at sea. By the nature of their sport, the sailors racing in offshore racing environment can be exposed to injuries and other health problems that can endanger their lives. Being aware of the potential dangers caused by the distance from onshore health facilities and lack of professional help on board, IMHA and WS decided to support the activities that are leading to the enhancement of safety and health protection on board. With common initiative, joint Workgroup on Medical Support in Offshore Racing has been formed and the series of workshop organised. The WS/IMHA Workgroup on Medical Support for Offshore Yacht Races previously reached consensus on the common competences and learning outcomes for medical training for offshore racing. In addition, the Workgroup has also set standards for required medical kit inventory for yachts par- ticipating in the various categories of offshore yacht races. Documents were both approved by WS Medical Commission and the IMHA Board. Fourth workshop on Medical Support for Offshore Yacht Races was held in London, United Kingdom, 1-2 December 2018 and workgroup reached consensus on the standards for availability of Telemedical Advice Services (TMAS) for the various categories of offshore yacht races held under the authority of WS. This position paper sets out how the TMAS should be integrated with the practical usage of medicines and medical equipment on board offshore racing yachts. In addition, this position paper also sets out how the level of medical training integrates with appropriate use of the TMAS. Overall, the three WS/IMHA position papers on the triad of medical inventories, medical training and TMAS, are aimed at providing the best possible medical care on offshore racing yachts, by fully integrating each part of the triad of medical support.

The challenge and prevention of epidemics: experience from offshore petroleum installations and its extrapolation to ships.

The risk of epidemics represents an important challenge in offshore petroleum activities. All personnel are needed for regular operations, and the outbreak of an epidemic will soon affect the operations. The economical consequences can be vast. The risk of an epidemic is raised due to the closeness of living and catering offshore combined with frequent changes of personnel who travel offshore from many nations. The article is based on the experience gained by the author during 22 years as a senior medical officer in a Norwegian oil company. Some endemics and epidemics are described. None of these resulted in the shutdown of production, but they still represented a major challenge to the company and to the medical staff in particular. The transfer value from experience offshore to ships is obvious but there are differences. Risk analysis and quality assurance systems play an important part in the prevention and limitation of epidemics offshore. The infrastructure of the food supply chain as well as education and training of personnel are key elements. Campaigns on different hygiene topics that address all personnel are launched at regular intervals. Contingency plans must be established and be ready for use in case of a threatening epidemic. Identification of the type and source of the infection or food poisoning, isolation of the infected personnel, safe evacuation of patients, and the establishment of other necessary barriers for reduction of spread of infection are necessary to control an outbreak of an epidemic.

Loss of health certificates among offshore petroleum workers on the Norwegian Continental Shelf 2002-2010.

BACKGROUND: A health certificate is required to work on the offshore petroleum installations of the Norwegian Shelf. Loss of health certificate (loss of licence, LOL) may cause economic problems for the individual worker. A private compensation system (OSO) was established for Norwegian offshore workers in 2002, comprising 8000-11,000 individual members of workers organisations: approximately one third of the population offshore. This study aims at describing the reasons for compensation of offshore workers who have lost their certificates. MATERIALS AND METHODS: Of 595 workers who applied for compensation in the period 2002-2010, 38 declined to participate in the study. Of the remaining 557, 507 were granted and 50 were denied compensation. All medical records held by the scheme concerning the 507 compensated applicants were examined. Health data were systematically extracted, analysed, and compared with general population statistics. RESULTS: Musculoskeletal conditions were the most frequent conditions causing LOL for both sexes (42.5%), followed by psychiatric, neurological, and malignant diseases for women, and cardiovascular (19%), neurological, and psychiatric conditions for men. Musculoskeletal disorders were more prevalent than in the general population, and the prevalence of knee problems was particularly high. Among malignant diseases we found a high proportion of brain tumours and renal cancer. The causes are unknown and warrant further investigation in this population. Among women granted compensation, 78% were catering workers, while 50% of the men were process workers, reflecting the gender distribution in these working groups. CONCLUSIONS: Musculoskeletal conditions were the most frequent cause of application for LOL compensation for both sexes, followed by psychiatric, neurological, and malignant diseases for women, and cardiovascular, neurological, and psychiatric conditions for men. The cause of the higher incidence of musculoskeletal diseases, brain tumours, and renal cancer found in this study compared to the general population warrants further investigation.

Crew accidents reported during 3 years on a cruise ship.

STUDY OBJECTIVE: To register and analyze data from all crew injuries reported to the medical center of a cruise ship with a median crew of 630 during a three-year period and to determine high risk areas, equipment and behavior. METHODS: All crew injuries reported to the medical center aboard were registered on a standardized form at first visit. An injury was classified at follow-up as 'lost time accident' (LTA) if it caused the victim to be off work for more than one day and/or to be signed off for medical attention (medical sign-off). RESULTS: During 3 years, 361 injuries (23% women) were reported aboard. Thirty percent were LTA. The marine department accounted for 14% (deck 5%; engine 9%), the hotel'department for 79% and contractors for 7% of the reports. Filipinos comprised half the crew, reported 35% of the accidents, and their rate of serious injuries were lower than non-Filipino crew (p<0.01). Hotel crew had a higher rate of LTA occurring during work than marine crew (p<0.05). The dancers' rate of serious injuries was higher than other hotel crew (p<0.05) and marine crew (p<0.01). The upper extremity was the most frequently injured body part (51%), open wounds the most common injury type (37%), and galleys the most common accident location (30%). Less than one in ten reported injuries caused medical sign-off. KEY MESSAGE: Well-equipped, competent medical staff aboard can after crew injury effectively reduce time off work, as well as number of referrals to medical specialists ashore, helicopter evacuations and ship diversions, and medical sign-off.

Seafarers' wives and intermittent husbands-social and psychological impact of a subgroup of Norwegian seafarers' work schedule on their families.

OBJECTIVE: To examine the psycho-social impact of work schedules (absence from home) on the families of a subgroup of Norwegian seafarers as reported by their wives (sea wives). Their husbands worked 4-6 weeks on and 4-6 weeks off Norwegian-registered multipurpose vessels (MPV) supporting the off-shore oil industry. METHODS: Questionnaires addressing demographic characteristics, marital satisfaction, social support, subjective health and psychological well-being were distributed to sea wives and controls. The response rate was 57% (192/336) for sea wives and 39% (45/114) for controls RESULTS: There was no difference in demographic characteristics between sea wives and controls except that the sea wives were younger (p<0.01). No differences between sea wives and controls were found with regard to the quality of marital relationships, the subjective evaluation of own health, or mental well-being. Two percent of sea wives and controls had scores suggesting severe depression. In some respects, the sea wives had less social support than the controls. However, the majority of sea wives were content with their families' life style. CONCLUSIONS: The MPV seafarers' absence from home in a 4 weeks on and 4 weeks off (or a 6 weeks on and 6 weeks off) rotation schedule appears to be well tolerated by their families. However, being alone for weeks at the time may exaggerate acute and chronic shore-side problems, and some sea wives may feel a need for more social support during their husbands' absence.