International Maritime Health最新文献

Background: The fixed regimen and strict dietary habits of seafarers and trainee sailors, make them susceptible to several oral diseases. The aim of the study was to assess prevalence of dental caries, oral hygiene status and treatment needs among seafarers and trainee sailors in the state of Goa.

Materials and methods: This descriptive, cross-sectional study was carried out from January 2023 to March 2023. After a pilot study, convenience sampling technique was employed to recruit 261 participants. The investigators were standardized and calibrated to record World Health Organization Oral Health Assessment Form (1997) and Oral Hygiene Index-Simplified (OHI-S) which were instrumented in the study. Intra-examiner and inter-examiner reliability scores were recorded using kappa statistics (0.81, 0.83) and (0.83, 0.85), respectively. The data was analysed using descriptive analysis, chi-square test, Mann- -Whitney U test and multivariate linear regression analysis at statistical significance (p ≤ 0.05).

Results: The mean ages of seafarers (n = 133) and trainee sailors (n = 128) were 36.41 ± 6.40, and 25.36 ± 7.39, respectively. The prevalence of dental caries among seafarers and trainee sailors was determined to be 59% and 78%, respectively (p = 0.01). The mean OHI-S score of seafarers (1.31 ± 0.68) and trainee sailors (1.53 ± 0.82) was statistically significant (p = 0.015).

Conclusions: Seafarers and trainee sailors demonstrated high caries prevalence and poor oral hygiene status due to their distinctive lifestyle, representing a vulnerable community in terms of oral health.

A unique report of Schönlein-Henoch purpura (SHP) associated with a recent Giardia lamblia enteric infection is described and discussed on the ground of the available literature. Tinidazole plus an appropriate probiotic therapy, including Lactobacillus reuteri and vitamin D, proved to be effective in the condition. SHP is an immunocomplex-mediated disorder characterised by a number of differently associated signs and symptoms, leading to the possible involvement of the skin, joints, abdomen and kidneys. Recent bacterial, viral, or protozoan infections may trigger the disease onset in patients of all ages. The paper describes the first case of SHP triggered by a giardiasis. Tinidazole plus an appropriate probiotic therapy, i.e. L. reuteri and vitamin D proved to be effective in this condition. To our knowledge, this is the first reported case of lambliasis-associated SHP described in an international traveller.

Background: Medical emergencies and on-going medical conditions on board may seriously impair seafarers' health and safety, and also negatively impact on future work prospects for seafarers. When a seafarer gets ill or injured on a ship, medical treatment often relies on the competences on his colleagues on board. The aim of this project was to establish a consensus-based minimum standard for medical education for seafarers, in order to ensure competency for adequate management of ill-health on board.

Materials and methods: International Maritime Health Foundation (IMHF) conducted a workshop on medical training of seafarers. A research-based approach to gain consensus on core learning outcomes/competences developed by the Tuning Project, has been used. This method was used by Tuning (Medicine) to gain consensus on core learning outcomes for primary medical degrees (Master of Medicine) across Europe.

Results: The result of the project is a set of learning outcomes/competences in medical training for merchant seafarers.

Conclusions: The project resulted in a set of learning outcomes/competences on medical training of the seafarers that will be submitted to the relevant bodies of International Maritime Organization (IMO) in the process of the development of model courses 1.13, 1.14 and 1.15.

An enclosed space is an area with poor or no natural ventilation which is not designed for continuous occupancy, where access is limited and which may contain a dangerous atmosphere. Enclosed space atmospheres can be hazardous due to one or a combination of the conditions which includes oxygen deficiency; presence of toxic and/or flammable gases. When it is intended that personnel should enter or work in an enclosed space, care should be taken to create and maintain safe working conditions. The case report describes an incident on board an oil rig where the rig workers were exposed to noxious gases resulting in multiple fatalities. Work involved gas sampling/monitoring at various locations inside the "spud tanks" of the rig and certifying it free of noxious gases for marine surveyor's inspection. Contributory factors that have been frequently identified following enclosed space accident investigations are non-compliance with procedures, inappropriate equipment, poor supervision, complacency and over familiarity leading to short cuts being taken, detection and monitoring equipment not used or not working properly and improper action in an emergency. Preventive measures to avoid such accidents and create a safe working area are discussed.

Background: Coastal fishermen are particularly affected by occupational stress and burnout because they are exposed to high psychosocial factors at work and organizational constraints related to difficult working conditions.

Materials and methods: This survey aimed to assess the prevalence of burnout syndrome (BOS) of fishermen and its relationship with sociodemographic and occupational parameters. This cross-sectional study involved a representative sample of 761 fishermen. We used an individual questionnaire including socio-demographic and occupational parameters, the Karasek's Job Content Questionnaire, and Maslach BO Inventory. BOS includes three dimensions: emotional exhaustion, depersonalisation, and loss of self-efficacy. The positive diagnosis of BOS is retained if the scores of the three dimensions are abnormal (high for the first two and low for the third).

Results: Five hundred and twenty-six people agreed to answer the questionnaire. Of these, 16.1% had a high emotional exhaustion, 13.9% high depersonalisation, and 11.2% low personal accomplishment. Furthermore, 37.1% had at least one abnormal dimension of BOS: 16.9% had one abnormal dimension, 12.2% two, and 8% three (BOS). The prevalence of abnormal dimensions of BOS was significantly higher in pilots-copilots (67.9%), and in mechanics (63.5%) than in sailors (27.8%). It was higher in fishermen living alone (44.4%), having seasonal job (57.9%), suffering of job strain (42.1%) or isostrain (57.9%), and sleep disorders (55.4%). The multivariate logistic regression showed that job strain, isostrain, fatigue, sleep disorders, seasonal job and daily working > 14 h constituted a major risk factor of abnormal dimension of BOS.

Conclusions: It is imperative to identify priority actions to improve the working conditions of fishermen, and to develop a genuine prevention policy.