Incidence of occupational injuries and diseases among seafarers: a descriptive epidemiological study based on contacts from onboard ships to the Italian Telemedical Maritime Assistance Service in Rome, Italy.

OBJECTIVES: Workers at sea have high mortality, injuries and illnesses and work in a hazardous environment compared to ashore workers. The present study was designed to measure the incidence of occupational injuries and diseases among seafarers and quantify the contribution of differences in rank and job onboard on seafarers' diseases and injuries rates. DESIGN: Descriptive epidemiological study. SETTING AND PARTICIPANTS: This study's data were based on contacts (n=423) for medical requests from Compagnie Maritime d'Affrètement/Compagnie Générale Maritime (CMA-CGM) container ships to the Italian Telemedical Maritime Assistance Service in Rome from 2016 to 2019, supplemented by data on the estimated total at-risk seafarer population on container ships (n=13 475) over the study period. OUTCOME MEASURES: Distribution of injuries by anatomic location and types of diseases across seafarers' ranks and worksites. We determined the incidence rate and incidence rate ratio (IRR) with a 95% CI. RESULTS: The total disease rate was 25 per 1000 seafarer-years, and the overall injury rate was 6.31 per 1000 seafarer-years over the 4 years study period. Non-officers were more likely than officers to have reported gastrointestinal (IRR 2.12, 95% CI 1.13 to 4.26), dermatological (IRR 3.66, 95% CI 1.27 to 14.42) and musculoskeletal (IRR 2.25, 95% CI 1.11 to 5.05) disorders onboard container ships. Deck workers were more likely than engine workers to be injured in the wrist and hand (IRR 3.25, 95% CI 1.19 to 10.23). CONCLUSIONS: Rates of reported injury and disease were significantly higher among non- officers than officers; thus, this study suggests the need for rank-specific preventative measures. Future studies should consider risk factors for injury and disease among seafarers in order to propose further preventive measures.

Survey on smoking habits among seafarers.

BACKGROUND: Populations living in stressful environments experience higher mortality from lung cancer and chronic diseases. Work-related stress was identified as important determinant of smoking together to health problems caused by a incorrect lifestyles. Aim of the work was to analyze tobacco smoking addiction in seafarers working on merchant ships. Only a few studies are available on this topic. METHODS: The survey was conducted using an anonymous questionnaire. The total number of questionnaires filled-in was 1478, out of 2000 distributed (response rate 73.9 %). RESULTS: About half of the sample (55.07%) has never smoked, the 28.96% is currently a smoker, while 15.97% of responders belong to the category of ex-smokers. Analysis of the number of cigarettes smoked every day based on the rank shows that captains and officers smoke more cigarettes than the crew members who smoke 10 cigarettes maximum per day. Analysis of the level of dependence among the smokers group by the Fagerström Test for Nicotine Dependence (FTND) revealed that a 89.0% of sample has a low/very low dependence level, and only the 10.98% of the sample show a high/very high dependence. A further analysis of the results of FTND in the different age groups has shown that the 41-50 and 51-60 age groups have high dependence levels. CONCLUSIONS: Working on board is associated to a high risk for chronic, lifestyle-related diseases, due also to lifestyle behaviours. This study suggests to further investigate the presence of other risk factors such as diet, physical exercise, combined with tobacco smoking, obesity. (www.actabiomedica.it).

Point-of-care syndrome-based, rapid diagnosis of infections on commercial ships.

BACKGROUND: Suspicion of contagious disease on commercial ships tends to be poorly managed, as there is little capacity to confirm a case on board except for malaria. Here we implemented a point-of-care (POC) laboratory on one container ship and one cruise ship for the rapid syndrome-based diagnosis of infectious diseases on board. METHODS: In 2012 we implemented a POC laboratory on board a freight ship and on board a cruise ship. The POC laboratory ran a total of six different color-coded, syndrome-based kits incorporating 10 different commercially available immunochromatographic tests. The POC tests were taught within 1-hour as part of training to staff without any previous knowledge in microbiology. RESULTS: Compared with terrestrial POCs, specific constraints included the necessity to secure POC devices into the motile ship, to use robust devices, to overcome difficulties in communicating with the core laboratory, and to overcome limited intimacy of patients. However, a total of 36 POC tests were easily performed and yielded contributive negative results. CONCLUSIONS: This first experiment indicates that it is possible to run POC laboratories by nonexpert staff after providing rapid teaching course on board commercial ships. Generalization of on-board POC laboratories is expected to help in improving the medical management of staff and passengers.