Bulletin of the Institute of Maritime and Tropical Medicine in Gdynia最新文献

Evaluation of the reasons for loss of capability for performing heavy and very heavy loading operations was based on retrospective population examinations carried out in two loading sites in ports. Enrolled in the study were 701 people, their working period in port over 5 years (mean 18.9 +/- 6.1 years). The age of the examined averaged 42.4 +/- 11.3 years. In course of 6 years 32.4% of this group changed their work due to structural changes in port, 67.6% due to loss of health qualifications. In the evaluation of health reasons predominant were diseases of the peripheral nervous system, of musculoskeletal system and of connective tissue (22.4%). Second as to the incidence were chronic diseases of the respiratory system and upper respiratory tracts (17.8%), in that 6% of allergies and 1.3% tuberculosis. Next were diseases of the circulatory system (13.3%), out of 3.8% were hypertension and 4.7% heart ischaemic disease. Last position was occupied by diseases of the stomach and duodenum (7.1%) and posttraumatic states of the muscular and osseous system (4.3%). Changing of the working post for health reasons up to 30th year of age occurred in 6.8%, up to 40th year in 10.1% and to 50th year of life in 62.2% people examined. Change of the working post due to professional or educational promotion occurred chiefly below the age of 40.

A survey was conducted during a 15-years period (1981-1994) among a group of workers employed in shipyards and in cooperating plants, who were exposed to asbestos. In a group of 681 people surveyed a growing incidence of asbestosis of the lung was revealed: from 3.9% in 1981 to 17.9% in 1994. Since 1990, 19 persons have been found to have malignant neoplasms, in that number in 9 cases the location of neoplasm was evidently associated with the effects of the asbestos dust (3 mesotheliomas of the pleura and 6 bronchial cancers of the lungs). The smoking habit was probably a contributing factor in the occurrence of these diseases.

As a result of fusion of in vitro immunized mouse splenocytes and myeloma Sp2/0 cells, stable hybridomas secreting monoclonal antibodies against Vi antigen were obtained. The monoclonal antibodies were of IgM class. Reactivity of monoclonal antibodies to Vi antigen of different origin was tested. The reactivity was found to be independent of O-acetylation degree of Vi antigen.

In Poland, cases of imported malaria are noted at present. In Polish citizens who work abroad, malaria is considered as an occupational disease. 95 cases of malaria in Polish citizens treated at the Clinic of the Institute of Maritime and Tropical Medicine in 1984-1993 were subjected to retrospective analysis, considering their occupational, epidemiological and clinical aspects as well as permanent sequelae of the disease. The most numerous groups among the patients examined were seafarers, fishermen, priests and missionaries. They were infected mostly in West Africa, during the first year of work. The majority of patients neglected chemoprophylaxis of malaria. In about 1/3 of patients, the resulting incapacity for work exceeded 1 month and more. In 7% of patients, 6 months after the treatment, permanent sequelae of the disease were observed: damage to the central nervous system, liver, kidneys and heart. The social and material costs of this invasive occupational disease were high. Malaria is an important health problem in Poles who work in endemic areas. Malaria prevention should be intensified.

Conditions of work of seafarers depend on the influence of physical, chemical biological and psycho-social factors. In 1971-1973, the health of 3000 sefarers was examined; their main health problems were: neuroses (10.13%), arterial hypertension (4.63%), ulcer of stomach and duodenum (2.80%), renal calculi (2.80%), and the alcoholic addiction (1.73%). Those seamen worked on cargo ships which technically differed from ships which sail the seas in the nineties; they were slower, to load them and unload took much time, and they stayed in ports for long periods of time. Recent technical developments in shipbuilding, and the trend to build larger ships with more powerful engines and greater cruising speed, the mechanization and automation of ships operation, and computerization, caused the change in their crews structure and number. It also changes the psycho-social work environment. Using the same method, health examinations of 3,300 seafarers were conducted in 1983-1985. There was an increase in the prevalence of neuroses, arterial hypertension, ulcer of stomach and duodenum, and calculus of kidney. In 1990-1992, a group of 4,688 seafarers was examined. Their health problems were different, in comparison with the populations previously examined. For example, neuroses were recorded in 1.16% men, and ulcer of stomach and duodenum in 0.13% of men examined. The above differences in the health status of seafarers examined cannot be attributed only to the changes in their work conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

The objective of the present work was to determine prevalence of HIV-antibodies in the following population groups: 1. Seamen, fishermen and dockers from region of Gdańsk and Szczecin 2. Travellers abroad. 3. Special risk groups (intravenous drug users, prostitutes, homosexuals, haemophiliacs) mostly from Gdańsk region. 4. Hospital patients, prisoners, other people. Abbott recombinant HIV 1/HIV 2 EIA was used for the detection of antibodies to HIV type 1 and/or type 2. In the period from 1987 to 1992, 70,297 examinations were made. HIV-antibodies were detected in 165 people (0.23%). Out of 35,084 subjects in the first group (926 women and 34,158 men). 20 men were found seropositive (0.06%). The majority of them--16 men were seamen, 3 were fishermen and one was a harbour worker. In the second group made of 27,403 people including 3,640 females, HIV-antibodies were revealed in 9 men (0.04%) and one woman. In the third group, there were 965 people including 482 women; among them there were 104 men and 19 women infected (12.8%). Out of the 349 prostitutes examined 2 were infected (0.05%). Among 79 homosexuals, 4 were found infected. In the sample of 14 haemophiliacs none demonstrated HIV-antibodies. In 6,845 subjects of the fourth group (5938 males and 907 females), 12 males were seropositive (0.18%). In that number 5 were prisoners, other 5 were hospital patients and 2 were known to have homosexual relationship with infected men. The majority of subjects with HIV-antibodies were men--145 (88%) of the total number of subjects infected, aged 20-40.

Sea pilots must be capable of carrying out their work in all situations. Thus, they must not have any disease or defect, that could impair their job performance. By periodic medical examinations attempts are made to ensure their working capacity. In most countries these examinations are carried out by a general practitioner and they include only few if any objective laboratory tests. The aim of the present investigation was to study the effectiveness of the periodic medical examinations to find out in the population of pilots examined persons with health risks, especially risks for cardiovascular diseases. All the pilots examined were over 45 years old (n = 135, response rate 88%). Self-evaluation of health was carried out by a questionnaire. Blood analyses were made and chest X-ray as well as exercise-ECC were taken. The most common subjective symptoms concerned musculoskeletal and gastrointestinal systems; sleep disturbances were also quite common. The three most frequent diseases diagnosed earlier by a doctor were musculoskeletal and gastrointestinal diseases, and arterial hypertension. About 24% of pilots had a lower physical working capacity than predicted. The body mass index indicated at least 11% overweight in half of the cases. At exercise-ECG four pilots appeared to have an ischaemic heart disease and additionally eleven pilots had abnormal ECG. Over 80% of pilots had a serum cholesterol value higher than 5 mmol/l, and serum triglyceride values exceeded the normal value of 2.0 mmol/l in every fourth case. Serum glutamyl transaminase was pathological in over 20% of the cases, and serum glucose level in 8%. The findings by routine physical examinations were very few consisting of stiffness in musculoskeletal system, two cases of elevated blood pressure, two heart murmurs, varicose veins etc. In two cases an inguinal hernia was suspected. The current periodic health examinations does not seem to effectively prevent a person with possible health defect from working as a sea pilot. More objective tests must be included in these examinations and more attention should be paid to prevention of overweight, effective treatment of musculoskeletal symptoms, improving physical working capacity and helping pilots to manage their psychic stress.

To evaluate the problem of work-related accidents and injuries in fishermen, a survey was conducted among crews of deep-sea fishing trawlers-factory ships of 3 large fishing companies, covering the period of 10 years (1977-1986). In the surveyed population of 10,475 men and a control group of 4,073 workers employed on shore, there were altogether 1,688 work-related accidents recorded, including 33 fatal accidents. Their incidence was 16.54 per 1000 per year (0.32 fatal cases per 1000 men per year). In the control group (n = 4,073 workers), the incidence was 27.98 per 1000 men (0.03 fatal accidents per 1000). There were more accidents recorded in the control group, than in fishermen. But the incidence of fatal cases was about 10 times higher among fishermen than among workers employed on shore. Among 33 fatal cases in fishermen, there were 12 cases of drowning, 6--injuries, 2--intoxications, 1--burn, and 12 cases sudden death at sea considered as "work-related accidents".

Data on the incidence of work-related accidents and injuries in Baltic fishermen employed on medium-size and small fishing vessels were collected during 9 years, and were compared with this incidence in the control group of shore workers, and in a group of deep-sea fishermen surveyed previously. The non-fatal and fatal injuries in Baltic fishermen occurred much more frequently, than in deep-sea fishermen employed on large ocean-going trawlers-factory ships. This may be related to the difference in the conditions of work on various types of fishing vessels.