International Maritime Health最新文献

Background: Marine fishermen experience high levels of environmental and relationship stress and anxiety. The current study explored the role of stress in the relationship between neuroticism and anxiety symptoms among marine fishermen.

Materials and methods: Participants (fishermen from Tanmen in Qionghai city, Hainan Province) completed three questionnaires: the NEO-Five-Factor Inventory-Neuroticism Subscale (NEO-FFI-N); the Mental Stressor Investigation Questionnaire (MSIQ); and the Mood and Anxiety Symptoms Questionnaire-30-item-Anxious Arousal Subscale (MASQ-D30-AA) within 1 week before embarking on a fishing trip and then again within 1 week after their return to port. The data were subjected to correlational analyses and structural equation modelling.

Results: Positive correlations were found between NEO-FF-N (neuroticism) score, MSIQ score (total stress), MSIQ work-relationship score, ship environmental stress score, and MASQ score (anxiety symptoms). Regression analyses showed environmental stress had a significant moderating effect on the relationship between neuroticism and anxiety symptoms, and further analysis showed a mediating effect of work-relationship stress on the relationship between neuroticism and anxiety symptoms.

Conclusions: Marine fishermen with high environmental stress had greater anxiety symptoms than those with low environmental stress. Neuroticism in marine fishermen further affects anxiety symptoms by affecting the level of work-relationship stress.

Background: The onset of the coronavirus disease 2019 (COVID-19) pandemic has greatly impacted maritime telemedicine services. The aim of this study is to describe the impact of the pandemic, both quantitatively and qualitatively, by analysing the teleconsultations by doctors from the French Tele-Medical Assistance Service (TMAS).

Materials and methods: We carried out a descriptive observational study of retrospective data from the TMAS files. The main inclusion criterion for the files was a diagnosis of "influenza due to an unidentified virus". We extracted the following data: type of ship, gender, age, nationality, role on board, reason for the call and symptoms, number of calls, navigation zone, severity, medical decision, whether or not a COVID-19 test had been carried out, and treatments prescribed on board.

Results: One hundred and ninety-nine files were included of which 39 (20%) were clusters. We were able to analyse data from 384 patients. The study population comprised 376 suspected COVID-19 patients, of whom 334 (87%) were symptomatic and 42 (10.9%) asymptomatic. Eight (2.1%) patients were not thought to have COVID-19 but their call was related to the pandemic. Of the symptoms presented by the patients, fever was the most frequent (n = 196; 59%), while 129 (39%) presented a cough, 60 (18%) a headache, 41 (12%) non-specific ear, nose, throat signs, and 40 (12%) dyspnoea. Two hundred fifty-two (75%) patients stayed on board, 55 (17%) were disembarked, for 14 (4%) a ship diversion was arranged, and 13 were evacuated including 4 medical evacuations.

Conclusions: The most important problem encountered related to managing asymptomatic or pauci-symptomatic patients at sea, which was the subject of the majority of calls. The TMAS doctors played an important role in managing the pandemic by emphasising the need for social distancing and quarantine procedures at sea to limit the spread of the virus, while adapting to the sometimes difficult implementation conditions and logistics for medical decision and quarantine.

Background: This study examines the impact of work-related exposure on the cognitive performance of Faroese deep-sea fishers. Faroese fishing crews work long hours in demanding and noisy environments amidst highly uncertain and challenging weather conditions. These factors, together with compromised patterns of rest and sleep, are known to increase fatigue. Our aim was to study if changes could be measured in fishers' cognitive performance at the end of the trip when compared with the baseline measure at the beginning.

Materials and methods: Data was collected over 15 months (May 2017 to July 2018) from 157 fishers on 18 fishing trips which involved 202 investigative days on board. Questionnaires and six computerised cognitive tests: Simple Reaction Time, Numeric Working Memory, Corsi Blocks, Rapid Visual Information Processing, Digit Vigilance, and Card Sorting Test were used for data collection at the beginning and end of the trip. Differences between the outcomes on the two test points were analysed with one-way ANOVA comparing the performances at the beginning and end of the voyage, and two-way ANOVA to examine the interactive effect of chronotype and test occasions on the outcomes. Mixed models were used to test for the effects of predictor variables.

Results: Significant declines in cognitive performance were observed from the beginning to the end of the trip, with decreases in visuospatial memory and reaction times, and increases in cognitive lapses. Furthermore, slowing in response times was observed in the second half of the Digit Vigilance test when comparing the halves.

Conclusions: Declines in performance were observed from the start to the end of the trip. Furthermore, fishers performed significantly worse in the second half of some parted tests, and evening types seem less influenced by irregular work hours. These findings call for improving the safety of the vessels and their crew.

Self-medication could be a public health concern if done inappropriately, and additional research is required to better comprehend the population-wide nature of the problem. Seafarers are more inclined to self-medicate due to the nature of their work. We performed a rapid bibliometric analysis to determine the volume of research on self-medication habits among seafarers. Our analysis revealed a major knowledge gap regarding self-medication practices among seafarers. There is an urgent need to address this paucity of data and formulate appropriate interventions.

Background: Venturing onto the water for business or pleasure is not a risk-free activity. Despite the dangers facing crew and passengers there is little data on the characteristics of fatal accidents involving vessels in the water. The goal of this study was to review accident reports from the National Transportation Safety Board (NTSB) to determine characteristics of fatal marine accidents.

Materials and methods: Data was obtained from the Marine Accident Reports issued by the NTSB. Information regarding the number of people involved, fatalities and the accident itself was collected.

Results: Fifty-two accidents involving 5045 people from 1972 to 2019 were included in the study, with 468 fatalities reported. Of the fatalities, 155 (33.1%) were definitely on the vessel when they died, 49 (10.5%) were probably on the vessel, 65 (13.9%) were definitely or likely in the water, and the location of 199 (42.5%) was unknown. The most common cause of death was drowning (88, 18.8%), the most common accident cause was sinking (63.5%), and accidents most often started during nighttime hours (7pm-7am, 30, 57.7%).

Conclusions: This study found that sinking was the most common accident cause for fatal marine accidents, drowning the most common cause of death, and where fatality location was known most were on the vessel when they died. This suggests that, particularly when a ship is in the process of sinking, it is of paramount importance to ensure passengers and crew are familiar with exit routes, are able to exit the vessel, and are instructed to do so in a timely manner.

Background: The epidemiological and environmental security of states is the most important component for the functioning of the International Transport Corridors (ITC). The growing capacity of passenger and cargo flows increases the risk of the spread of dangerous infectious diseases in the territories of the countries on the route of the ITC. Preventing the introduction of dangerous infections by various vehicles and the activation of local natural foci are the priority in the anti-epidemic provision of the population of Ukraine.

Materials and methods: The study of the features of the functioning of border checkpoints (BCPs) for various types of transport in different regions of Ukraine made it possible to create their classification, taking into account the nature of the goods and the intensity of passenger traffic.

Results: The functioning of 204 checkpoints in 20 different localities, employing more than 29,000 specialists, was studied. When conducting a retrospective epidemiological analysis of documentation for maritime, aviation, road and rail transport for 2000-2013, non-compliance with sanitary-hygienic and anti-epidemic requirements to prevent the introduction and spread of dangerous infections and their carriers were revealed. The authors scientifically substantiated recommendations on sanitary-hygienic and anti-epidemic support of the BСP. Based on the results of a survey of 112 BCPs (54.9 ± 1.2%), taking into account the degree of epidemiological danger in the areas of their operation, indicators of the presence of rodents, blood-sucking insects and the nature of the goods transported, five epidemic zones were identified.

Conclusions: Inadequate operation of the BCP was expressed in non-compliance with sanitary and anti- -epidemic requirements. Control of the personal property of passengers and luggage was less than 30%. The analysis of the functioning of the BCPs made it possible to unify their work and identify priority areas for improvement.

Background: Linked to the increase in international travel and development of insecticide resistance, a resurgence of bed bug infestation has been observed since the 2000's and become now a worldwide public health problem. Passenger ships as part of the tourism industry are traditionally infested by bed bugs, but the whole maritime world is now concerned.

Materials and methods: We conducted a short questionnaire-survey among the 22 doctors of the French seafarers' health services to assess the level of this phenomenon in the occupational maritime environment.

Results: Twenty seven per cent of the doctors reported that a patient shared to them a bed bug infestation on board. In that case, all declared that the infestation impacted the patient's life on board. Eighteen per cent responded that a shipowner had already sought their support in face of a bed bug infestation. Lastly, 27% considered that bed bug infestation is an increasing problem.

Conclusions: Bed bugs infestation on board has a major impact on the seafarers and passengers, and significant economic consequences. Preventive measures need to be implemented to limit the risks of dissemination. It is essential to inform and educate seafarers on best practice.

Background: Follow-up of patients who had coronavirus disease 2019 (COVID-19) proves that clinical symptoms persist for months after recovery. A complex of such persistent manifestations is defined as the post-COVID-19 syndrome. One of the criteria for post-COVID-19 syndrome may be typical changes in white blood cell count and white blood cell (WBC) differential. The aim of the work is to study the frequency of haematological changes in sailors who had the acute coronavirus infection.

Materials and methods: The retrospective study covered 30 candidate sailors aged 21 to 60 years with a history of COVID-19 and persistent changes in the WBC count and WBC differential and who did not have haematological abnormalities during the previous medical examinations.

Results: Analysis of WBC and WBC count at the long-term period after COVID-19 confirmed persistent changes in the form of neutrophilia, lymphopenia, changes in the neutrophils and lymphocytes ratio. The revealed changes in the WBC count were typical and fit into several patterns: A. Absolute leukocytosis, absolute and relative neutrophilia, relative lymphopenia; B. Relative and absolute lymphopenia, relative neutrophilia; C. Relative and absolute lymphocytosis, relative neutropenia; D. Relative lymphopenia, without other changes in WBC differential.

Conclusions: The most typical laboratory change in WBC count in patients with the past COVID-19 is relative or absolute leukopenia. Persistent changes in WBC count are not always outside of the reference range for absolute values and should be assessed by a complex of typical changes. The presence of typical changes in WBC count in a patient with the past COVID-19 requires a profound examination for the post-COVID-19 syndrome.