International Maritime Health最新文献

Background: Scientific underwater exploration could benefit from professional diving facilities. This could allow marine research for durations far exceeding anything currently possible. The closed-circuit rebreather expansion provides new perspectives by unleashing divers and their diving bell. "Under the Pole Expeditions" developed an innovative compact underwater habitat for this purpose.

Materials and methods: The habitat's depth was fixed at 20 m. Saturation lasted 3 days and was followed by a 245 min long decompression procedure with mandatory in-water phase. Isolation and environmental constraints will require specific medical and safety procedures. "In situ" medical concerns were considered, and a specific evacuation plan was established. This report describes the medical management of this atypical project and the systematic clinical follow-up mostly targeted on the cardiovascular system, fatigue and psychological tolerance.

Results: Seventeen individual saturation exposures were performed. All selected divers were professional. Neither severe illness nor decompression sickness was observed. These short-term saturation exposures appeared to be well tolerated. There was a relatively low bubble grade after decompression. Psychological tolerance appeared good. However, a transient moderate orthostatic hypotension suggested cardiovascular deconditioning after dive.

Conclusions: This first experiment demonstrates the interest and feasibility of a shallow revisited saturation dive with rebreather use. This isolation requires medical accompaniment and rigorous preparation. Medical and physiological risks assessment is essential in this context and must be consolidated by new experiences.

Background: Marine engineering is a profession that affects a high level of physical and psychological stress. Such a high level of stress was further aggravated during the coronavirus disease 2019 (COVID-19) pandemic. On the other hand, personality traits and perceived stress are linked with each other, while job ranks also influence stress levels among employees. However, very few clinical studies are available on this mechanism in seafarers. This study explores the hidden area through the collection of cross-sectional data.

Materials and methods: Big Five personality traits instrument, along with a stress augmentation questionnaire, were administered among 280 Indian marine engineers across job ranks who have sailed prior to and during the COVID-19 pandemic. The collected data were analysed using Kruskal-Wallis test and structural equation modelling.

Results and conclusions: The analysis reveals significant differences among Indian marine engineers across their job ranks towards their perception of augmented stress levels. It also indicates that, except for extraversion, personality traits have linkages with levels of augmented stress among Indian marine engineers during the pandemic.

The humanitarian crisis that followed the military aggression against Ukraine is getting worse. The war which has continued since February 2022 has already caused irreparable health damage in the local community, which is affected by such acts of Russian terror as the destruction of the Kakhovka dam on the Dnieper River. As a result of the explosion and destruction of the dam, which occurred on 6 June 2023, over 2,500 square kilometres of land were flooded and around 17,000 residents had to be evacuated.

Background: The number of international travels has grown substantially over the last decade, both globally and in Poland. Thousands of Poles travel to tropical or subtropical countries in Asia, Africa or South America each year. The aim of this paper was to discuss the characteristics of Polish travellers seeking pre-travel consultation at the largest diagnostic and treatment travel medicine clinic in Poland.

Materials and methods: This retrospective study was based on the analysis of medical records of 1291 patients seeking pre-travel advice at the University Centre of Maritime and Tropical Medicine in Gdynia, Poland, between 1 July and 31 December 2022. The study comprised the analysis of the following patient variables: age, sex, travel details (purpose and length of travel, continents and countries to be visited, activities planned). The study also aimed to evaluate the range of prevention measures which were recommended/ administered (preventive vaccinations, chemoprophylaxis). In addition, it assessed the health status of the patients presenting at the travel medicine clinic.

Results: Patients who sought pre-travel advice were mostly people aged 18-35 years old (50.1%), travelling for tourism (72.2%), for a maximum period of 4 weeks (85.0%), travelling in December (24.3%) or in November (22.2%). Most of the Polish travellers consulted at the clinic travelled to Asia (56.2%), mainly to Thailand (27.3%), Vietnam (10.8%) or India (8.7%). Most travellers were planning a beach holiday (56.4%). As regards extreme activities, scuba diving was the most popular among the patients involved in the study (22.5%). The most frequently administered immunoprophylaxis were vaccines against typhoid fever (76.3%) and hepatitis A (56.2%). Other commonly recommended/prescribed prevention measures included: probiotics (75.9%), repellents (73.6%), antimalarial drugs (60.9%), and antidiarrheal antibiotics (51.9%). The analysis of patient interviews demonstrated that 42.4% of Polish travellers consulted at the clinic complained of no medical problems while 36.0% were taking chronic medications, mainly for allergies (17.1%) or thyroid disorders (12.2%).

Conclusions: A growing number of people from Poland travel to destinations where the risk of infectious disease exposure or transmission is high. Providing a patient with appropriate advice during a pre-travel consultation will help protect the traveller against travel-associated risks at their intended destinations.

Dermatological disorders are among the most common complaints of patients seeking medical assistance after returning from trips to tropical countries. Among exotic dermatoses, one of the frequently encountered diagnoses is Cutaneous Larva Migrans (CLM), primarily caused by the nematodes Ancylostoma braziliense and A. caninum. Cats and dogs, which serve as the definitive hosts for these nematodes, excrete with their stool parasite eggs into the environment, where they transform into larvae. Human infection occurs through the invasive form of the larvae, which penetrate the skin, causing itching and the characteristic serpiginous, slightly raised, and enlarging lesion at the site of invasion. Diagnosis is made based on the highly characteristic clinical presentation, although in non-endemic countries, diagnostic errors and delays in initiating effective causal treatment are relatively common. Effective therapy includes oral albendazole and ivermectin. Prevention of CLM involves avoiding skin contact with potentially contaminated soil by wearing shoes and using towels and mats on the beach. Due to the high interest in travel and the risk of importing exotic diseases, it is important to promote knowledge of tropical medicine among healthcare professionals as well as the travellers.

Background: The seafarers' professional group is one of the most numerous in the world. According to the statistics of the European Maritime Safety Agency (2020), there are approximately 280,000 people employed at sea in the European Union. The specific work environment on the ship (climatic, physical, chemical, psychological factors, etc.) is related to experiencing long-term stress. The World Health Organization considers work-related stressors to be very important determinants of health and disease. One of the basic psychological resources related to adaptation to demanding working conditions are strategies for coping with stress. The aim of the study is to assess the occurrence of harmful psychosocial factors in the work of seafarers and the stress coping strategies and their relationship with somatic diseases.

Materials and methods: One hundred and fifteen seafarers who received a maritime health certificate participated in the study at the Occupational Medicine Clinic. The study was part of a larger project looking at the prevalence of cardiovascular risk factors among seafarers. The study used the Coping Questionnaire in Stressful Situations (CISS) (Endler and Parker) and a general questionnaire created for the purposes of the study.

Results: Thirty six per cent respondents were exposed to traumatic event and to having nightmares, 13% had been discriminated at least once in the workplace. A positive correlation was found between discrimination and depression, nightmares and trauma. In addition, people who admitted having experienced trauma slept shorter (also while at home) and experienced nightmares more often. The most common style of coping was task oriented (29; 28.5%), and avoidance oriented (15%). The study also found a positive correlation between depression and the style of emotion-oriented coping and avoidance-oriented coping.

Conclusions: The specific working conditions and exposure to traumatic events have a negative impact on the health of seafarers by increasing the risk of depression and cardiovascular diseases. The coping styles with stress depend on the position in the ship hierarchy.

Background: Hypertension is one of the leading causes of morbidity and mortality globally. It is a major risk factor for major cardiovascular events such as stroke, myocardial infarction, heart failure, kidney failure, and blindness. The aim of this research is to assess the prevalence and some factors related to arterial hypertension on Vietnamese seafarers aboard merchant vessels.

Materials and methods: Seven hundred eight Vietnamese seafarers working aboard merchant ships were examined at the Institute of Marine Medicine before going to sea during the period from January 2022 to December 2022. It was a cross-sectional descriptive epidemiological study. The following parameters were measured: blood pressure, height, weight, waist circumference, buttock circumference to assess the prevalence of hypertension, overweight, and obesity. Seafarers we directly interviewed about workplace on ships and physical exercise, smoking tobacco, alcohol abuse, and anxiety symptoms to identify several factors associated with hypertension.

Results: The prevalence of hypertension in seafarers was 32.9%, prehypertension 26.4%, overweight 32.4%, obesity 13.3%, abdominal obesity 47.7%. Factors related to hypertension of seafarers included: job duration at sea > 10 years, odds ratio (OR) = 8.23 (95% confidence interval [CI] 4.34-17.27); non-officers, OR = 2.11 (95% CI 1.45-2.82); engine room crew, OR = 2.11 (95% CI 1.45-3.58); obesity, OR = 3.34 (95% CI 2.15-5.63); abdominal obesity, OR = 9.12 (95% CI 4.23-18.45); current smoking, OR = 1.32 (95% CI 1.02-1.99); irregular exercise, OR =1.43 (95% CI 1.03-2.18); anxiety symptoms, OR = 1.56 (95% CI 1.08-2.27).

Conclusions: Hypertension is a health problem for Vietnamese seafarers. To minimise hypertension, seafarers need to adjust their lifestyle, increase regular exercise and improve psychological issues on board.