International Maritime Health最新文献

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.

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).

Infection with hepatitis B virus (HBV), despite the implementation of extensive preventive measures, has remained one of the biggest health problems worldwide. There are still people not covered by the compulsory vaccination programme and carriers of an actively replicating virus among professionally active seafarers. The article is based on a case report of a seafarer with life-threatening reactivation of long-term uncontrolled HBV infection that resulted in decompensated cirrhosis and liver transplant. The case shows clinical aspects of chronic hepatitis B and contributes to discussion about HBV infection with regard to seafarers. The article also analyses the current legal regulations and guidelines in terms of preventing new infections and detecting people already infected with HBV. Considering the specific nature of work on seagoing ships, it is justified to recognise the seafaring as a profession with a high risk of HBV infection. Monitoring the course of the disease can prevent reactivation of inflammatory process and serious consequences of chronic hepatitis B during a cruise. The elementary issue is specific prophylaxis, that is, covering the unvaccinated persons with the vaccination programme. The prevalence of HBV infection and the specifics of the seafarer labour market require development of new international regulations, which will unify Pre-Employment Medical Examination (PEME) protocols and take into consideration compulsory vaccination.