A systematic review on the impact of ship movements on lower back among maritime workers.

Purpose: Working on a ship is challenging for maritime workers. Ship movements and high physical workload on board are straining their musculoskeletal system, which can particularly lead to lower back pain (LBP). The purpose of this study is to review recent studies about the impact of moving environments on the lower back both of seafarers and fishermen and the frequency of related health complaints.

Methods: Using a systematic review in the PubMed database, 384 studies about musculoskeletal issues among maritime workers were identified in the period 2000 to 2021. Evaluation of studies was done according to the PRISMA statement.

Results: The review revealed 13 studies focusing on musculoskeletal issues of the lower back among maritime workers. Four studies used biomechanical modeling to examine the physical load on board. They all described high physical strain when performing heavy working tasks in moving environments and 2 described the need for compensational efforts due to ship movements. Ten studies examined the musculoskeletal health of seafarers or fishermen and pointed out that particularly fishermen suffer from increased rate of LBP. A comparison of the data of four studies, which comprise prevalence of LBP, depict higher prevalences on fishermen (between 60.95; 95% CI 51.62-70.28 and 82.13; 95% CI 77.23-87.03) than data from land-based population (48.63; 95% CI 46.62-50.64), while the study concerning seafarers showed lower prevalence (28.42; 95% CI 24.74-32.10).

Conclusions: The high prevalence of LBP among fishermen suggests that heavy physical work (e.g., operating of fishing nets, filleting process) during ship motions is a strong risk factor. Further studies should evaluate effects of ship movements on the lower back among maritime workers, considering the different activities on board of vessels. As in most physically challenging jobs with repetitive activities, consequent prevention might be a key to lower the morbidity.