International Maritime Health最新文献

Schistosomiasis, caused by Schistosoma trematode worms, represents a significant global health challenge. This review offers a thorough examination of the disease's epidemiology, transmission dynamics, diagnostic modalities, and treatment options. Diagnostic techniques encompass direct parasitological methods, immunological assays, DNA/RNA detection, and biomarker utilization, each with distinct advantages and limitations. There is an urgent need for improved diagnostic tools with enhanced sensitivity and specificity. Praziquantel remains the cornerstone of treatment, exhibiting efficacy against all Schistosoma species, while the potential of artemisin derivatives in combination therapy is also explored. In this review, we focus on the importance of praziquantel administration as the central aspect of schistosomiasis treatment, highlighting ongoing efforts to optimize its utilization for improved patient outcomes.

Background: Saturation diving is a standard method of intervention for commercial diving during offshore operations. Current saturation procedures achieve a high level of safety with regards to decompression sickness but still put the divers under multiple stressors: 1) Environmental stress (long confinement, heat/cold, dense gases, high oxygen levels), 2) Work stress (muscular fatigue, psychological pressure, breathing equipment, etc.), 3) venous gas emboli associated with decompression, 4) Inflammation related to oxidative stress and microparticles. We present the results of a saturation divers monitoring campaign performed in the North Sea Danish sector, on the Tyra field, during 2022. The study was supported by TotalEnergies, the field operator, and performed by Boskalis Subsea Services, the diving contractor, onboard the diving support vessel Boka Atlantis. The objective was twofold: document the level of diving stress during saturation operations in the Danish sector, and compare the performances of two saturation procedures, the Boskalis and the NORSOK procedures.

Materials and methods: Fourteen divers volunteered for the study. The monitoring package include weight and temperature measurements, psychomotor tests (objective evaluation) and questionnaires (subjective evaluation), Doppler bubble detection and bioimpedance. The results were presented in a radar diagram that provides a general view of the situation.

Results: The data were analysed along 3 dimensions: work and environmental, desaturation bubbles, oxidative stress and inflammation. The results showed little or no variations from the reference values. No bubbles were detected after excursion dives and the final decompression, except for two divers with a grade 1 after arriving at surface. No statistical difference could be found between the Boskalis and the NORSOK saturation procedures.

Conclusions: At a depth of 40-50 msw corresponding to the Danish sector, the two saturation procedures monitored induce no or little stress to the divers. The divers know how to manage their diet, equilibrate their hydration and pace their effort. Data available on divers' post saturation period show a recovery over the 24-48 hours following the end of the decompression. Further research should focus on diving deeper than 100 msw where a greater stress can be anticipated.

Background: This study investigates seafarers' loneliness as a mediating variable between psychological well-being and resilience, and tests resilience as a mediating variable between psychological well-being and loneliness. It also examines the challenges faced by seafarers on different types of ships and evaluates the mediating roles of resilience and loneliness.

Materials and methods: The research uses descriptive data analysis, reliability analysis, correlation analysis, and mediation analysis with bootstrap-based regression models. An online survey was conducted with 471 active Turkish seafarers using a sociodemographic questionnaire and three standardized scales measuring psychological well-being (PW), loneliness at work (LAW), and psychological resilience (PR). Data were collected between 01/07/2023 and 01/09/2023.

Results: The findings indicate that ship type is a significant factor in the mediating roles of loneliness at work and psychological resilience. There is a partial mediating role of loneliness at work and resilience in psychological well-being across different ship types. Specifically, loneliness at work partially mediates the relationship between psychological resilience and psychological well-being among seafarers on tanker or bulk carrier vessels, but not on container vessels.

Conclusions: The study concludes with suggestions to address the mental health challenges faced by seafarers, emphasizing the importance of ship type in the mediating roles of loneliness and resilience. Regarding the mediating role of loneliness at work, it has been determined that there is partial mediation between psychological resilience and psychological well-being among seafarers working on tanker or bulk carrier vessels. However, on container vessels, loneliness at work does not mediate the relationship between psychological well-being and psychological resilience. Based on these findings, the authors conclude by offering a range of helpful solutions to address this problem.

Background: Seafarers are at increased risk of diabetes due to their lifestyle and working conditions on board ships. There is, however, limited evidence regarding the magnitude of diabetes and its risk factors. In this study, we aimed to assess the prevalence of self-reported diabetes among seafarers on board ships and identify risk factors associated with it.

Materials and methods: A cross-sectional epidemiological survey was conducted among seafarers aboard ships between November and December 2022. The study enrolled a total of 4,500 seafarers aged 18 and older. Data were collected using anonymous, standardized questionnaires. The association between the outcome variable and the independent variables was assessed using binary logistic regression models.

Results: In total, 2,986 participants were included in the study. The prevalence of self-reported diabetes among seafarers was found to be 8.2% (95% CI: 7.2-9.2). Self-reported diabetes prevalence among officers and non-officers was 7% and 9%, respectively. The mean age of study participants was 37.96 ± 10.22, while the mean age of participants with diabetes was 47.5 ± 9.46. Independent predictors of self-reported diabetes mellitus were age (51+ years) [adjusted odds ratio (AOR): 3.52, 95% confidence interval (CI): 1.46-8.95], rank (non-officer) [AOR: 1.65; 95% CI: 1.14-2.40], worksites (engine) (AOR: 2.08, 95% CI: 1.19-3.77), work experience (10-20 years) (AOR: 4.66, 95% CI: 2.33-10.05), work experience (21+ years) (AOR: 5.01, 95% CI: 2.32-11.55), working hours per week (57-70 hours) (AOR: 1.57, 95% CI: 1.08-2.31), working hours per week (71+ hours) (AOR: 1.80, 95% CI: 1.17-2.80), self-reported hypertension (AOR: 1.44, 95% CI: 1.03-1.99), overweight (AOR: 1.74; 95% CI: 1.24-2.47), and obesity (AOR: 2.93; 95% CI: 1.84-4.65).

Conclusions: This study revealed that one in twelve seafarers between the ages of 19 and 70 have self-reported diabetes. The present study identified significant risk factors associated with diabetes. Risk factor mitigation strategies aimed at high-risk groups should be implemented on board ships.

Background: Maritime transportation is the lifeblood of the world's economy. However, seafarers are exposed to isolated, confined and particularly extreme environments. Maritime operations in the face of geopolitical conflicts profoundly impact seafarers' mental health, well-being and safety.

Materials and methods: The study comprises 27 seafarer interviews and 21 stakeholder interviews covering 4 maritime education and training institutions, 11 crewing agencies, 4 medical facilities and 2 maritime authorities. An online questionnaire survey of seafarers who were affected by the conflict in Ukraine and had sailed in the conflict zone in the period 24 February 2022 to 30 September 2023 yielded 319 valid responses.

Results: The study suggests that seafarers in the conflict zone are exposed to constant imminent threats to personal safety, constant stress and anxiety, prolonged lack of sleep, limited opportunities of contact with families, and high risk to mental health among other things further exacerbated by a lack of mental health support from company, and anxiety resulting from loss of access to shore-based training facilities and uncertainty in updating competency certificates.

Conclusions: The study presents rare insights on the psychological and emotional toll on seafarers who continue to serve the critical needs of the maritime transportation industry in a newly ordained role as keyworkers. This study underscores the need for improved mental health support and counselling services within the maritime industry, in particular, maritime stakeholders likely affected by geopolitical conflicts.

Highlights: From the practical perspective, this is among the first studies to focus on the mental health and well-being of seafarers arising out of the situation in Ukraine since 24 February 2022. From the theoretical perspective, this is a maiden study attempting an exploration of social conditions in three different dimensions by integrating three distinct theoretical constructs namely, UN Human Security Framework, Holmes & Rahe Social Readjustment Rating Scale and ILO Maritime Labour Convention framework.

Background: Motion sickness, is the onset of a series of clinical signs when travelling in a means of locomotion. Boats are the most common source of kinetosis, causing seasickness. Although this condition is often benign, it can severely affect the quality of life of seafarers, as well as the quality of their work. The aim of this study is to focus on the point prevalence and characteristics of seasickness in a population of French civilian seafarers from all shipping sectors.

Materials and methods: During two months in 2023, we conducted a cross-sectional study based on a questionnaire containing 28 questions.

Results: One hundred nine men and 10 women completed the questionnaire. Of these, 34% said they were seasick. The main symptoms described by the sailors were nausea and cold sweats in 87.5% and 50% of cases, respectively. The prevalence of naupathy appears to be higher in women (60% compared with 31% in men). Women also seem to be less accustomed to the marine environment than men, with 71% of men and only 33% of women indicating that they get accustomed to life at sea. However, the symptoms of seasickness seem to disappear more slowly in men than in women. In terms of treatment, men (38%) were more likely to take medication than women (17%).

Conclusions: Our study shows a greater susceptibility to seasickness among women. This interpretation should be treated with caution given the small number of women who took part in the study. The relatively low point prevalence of seasickness (34%) could be due to under-reporting. Although ways of thinking are changing, seasickness is still a taboo subject for many sailors. Yet seasickness has major professional and personal repercussions. So it's important to raise the subject and discuss strategies for improving well-being at work.

By integrating health coaching into maritime medical clinics, we can provide tailored support to individuals at risk of developing diabetes and empower them to take control of their health.

Background: After COVID-19 restrictions were lifted, people started to travel again. Each year, thousands of Poles travel internationally, and many travel to tropical or subtropical destinations in Asia, Africa or South America. The aim of this article was to describe the characteristics of Polish travellers based on the information from a retrospective 12-month review of the medical records of Polish patients seeking pre-travel advice at the largest diagnostic and treatment travel medicine centre in Poland in 2023.

Material and methods: The retrospective study was based on the analysis of medical records of 2,147 patients seeking pre-travel advice at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland, between January and December 2023. The study focused on the analysis of the following patients' variables: age, sex, travel details (purpose of travel, length of travel, departure month, continents and countries to be visited). It also aimed to evaluate the range of prevention measures which were either recommended or administered to patients seeking pre-travel advice at the clinic (preventive vaccinations, chemoprophylaxis). In addition, it assessed the health status of the patients presenting at the travel medicine clinic; retrospective health assessments were based on the information from the interviews with the patients.

Results: Patients who sought pre-travel advice were mostly aged 36-65 years (49.5%), they were travelling for tourism purposes (78.3%), for a maximum period of 4 weeks (79.0%), mostly in November (15.2%) or in January (14.9%). Most travellers planned to visit Asia (55.5%) or Africa (29.0%); mainly Thailand (21.5%), Vietnam (8.5%), Kenya (8.3%) or India (8.2%). The most frequently administered immunoprophylaxis included vaccinations against typhoid fever and hepatitis A. Other commonly recommended/prescribed prevention measures included: insect repellents (69.3%), sunscreen (58.3%), antimalarials (35.8%), antithrombotic drugs (32.6%), and antidiarrheal drugs (25.6%). The analysis of patient interviews demonstrated that 61.8% of the travellers consulted at the clinic had no pre-existing medical conditions, while 38.2% required the use of chronic medications, mainly for allergies (14.3%), thyroid disorders (13.6%), cardiovascular diseases (9.3%), or psychiatric disorders (5.5%).

Conclusions: A large number of Polish travellers visit destinations where the risk of infectious and non-infectious diseases is high. Providing patients with professional advice during a pre-travel consultation will help protect against travel-associated health problems.