Marcus Oldenburg

Occupational risks and challenges of seafaring.

Occupational Risks and Challenges of Seafaring: Marcus Oldenburg, et al. Department of Maritime Medicine, Institute for Occupational and Maritime Medicine, Germany—Seafarers are exposed to a high diversity of occupational health hazards onboard ships.

Estimating the Risk of Communicable Diseases aboard Cargo Ships

BACKGROUND International travel and trade are known to be associated with the risk of spreading communicable diseases across borders. No international surveillance system for infectious diseases on ships exists. Outbreak reports and systematic studies mainly focus on disease activity on cruise ships. The study aims to assess the relevance of communicable disease occurrence on cargo ships. METHODS Retrospective analysis of all documented entries to 49 medical log books from seagoing cargo ships under German flag between 2000 and 2008. Incidence rates were calculated per 100 person-years at sea. Case series of acute respiratory illness, influenza-like illness, and infectious gastrointestinal illness affecting more than two persons within 1 successive week were classified as an outbreak. Attack rates were calculated based on number of entries to the medical log book in comparison to the average shipboard population during outbreak periods. RESULTS During more than 1.5 million person-days of observation, 21% of the visits to the ships infirmary were due to presumably communicable diseases (45.8 consultations per 100 person-years). As many as 33.9 patients per 100 person-years sought medical attention for acute respiratory symptoms. Of the 68 outbreaks that met predefined criteria, 66 were caused by acute respiratory illness with a subset of 12 outbreaks caused by influenza-like illness. Attack rates ranged between 3 and 10 affected seafarers per ship (12.5&-41.6% of the crew). Two outbreaks of gastrointestinal illness were detected. DISCUSSION Respiratory illness is the most common cause of presumably communicable diseases aboard cargo ships and may cause outbreaks of considerable morbidity. Although the validity of the data is limited due to the use of nonprofessional diagnoses, missing or illegible entries, and restriction of the study population to German ships, the results provide guidance to ship owners and to Port Health Authorities to allocate resources and build capacities under International Health Regulations 2005.

Health Risks Due to Coffee Dust

OBJECTIVE This study assessed current health risks due to occupational exposure to coffee dust. METHODS We performed a cross-sectional study in a coffee haulage company (n = 24), a coffee silo (n = 19), and a decaffeinating company (n = 17). Cross-shift and cross-week case histories of these employees as well as lung function values were recorded. During the handling of green coffee, measurements of airborne dust were conducted. RESULTS The employees in these workplaces were mainly affected by erythematous and rhinoconjunctival symptoms. They occurred especially in subjects exposed to a high dust load (> 10 mg of inhalable dust per cubic meter of air; n = 28) [Pearson chi(2) test, p = 0.020 and p = 0.023]. IgE antibodies to green coffee and castor beans were detected in 3 workers and 10 workers, respectively. The majority of them (two employees and six employees, respectively) had shown respiratory symptoms during the past 12 months. The preshift lung function values were below average but were not dependent on the level of the inhalable coffee dust exposure. Employees with a coffee dust load > 10 mg/m(3) of air showed higher unspecific bronchial responsiveness more frequently than those with lower exposures. CONCLUSION During the transshipment (especially during unloading) of green coffee, a high and clinically relevant exposure to irritative and sensitizing dust occurs. Therefore, efforts to reduce these dust exposures are generally recommended.

Cof a 1: identification, expression and immunoreactivity of the first coffee allergen.

Background: Over the past years, dust of green coffee beans has become known to be a relevant cause for occupational type I allergies. Up to now, allergy diagnostics is based on native green coffee bean extract which exhibits insufficient specificity due to interfering substances as well as batch-to-batch variations. No coffee allergen has been described on the molecular level so far. The aim of this study was to identify the first allergen of green coffee. Methods: The allergenicity of native green coffee bean extracts was analyzed by means of ImmunoCAP in sera of 17 symptomatic coffee workers. A Coffea arabica pJuFo cDNA phage display library was constructed and screened for IgE binding to coffee proteins with 2 sera from allergic coffee workers. By sequence analysis, a new coffee allergen (Cof a 1) was identified, expressed in Escherichia coli, and evaluated by Western blots. The frequency of sensitization was investigated by ELISA screening. Results: The Cof a 1 cDNA encoded a 32-kDa C. arabica class III chitinase. Serum IgE antibodies to the recombinant allergen were found in 3 out of 17 symptomatic coffee workers (18%), whereas only 2 of them reacted to the commercial allergy test. Conclusions: A class III chitinase of C. arabica was identified to be the first known coffee allergen Cof a 1. It may have a relevant potential for the specific diagnosis of coffee sensitization.

The rescue of refugees: a challenge for the merchant fleet.

InTrODucTIOn On the 6th of July 2015 a kick-off meeting on the topic “Rescue of refugees from distress at sea” took place at the seamen’s club “Duckdalben” in Hamburg. The focus was on the challenge for the merchant shipping fleet and the stress for the seafarers caused by the rescue operations. The meeting was initiated by the Institute for Occupational and Maritime Medicine (ZfAM) and the Hamburg Port Health Centre, both facilities of the Authority for Health and Consumer Protection Hamburg, and extensively supported by the German Shipowners’ Association. The kick-off meeting was supposed to be the beginning of a professional exchange of all involved parties; therefore presentations and a panel discussion were planned. The intention was to offer support to those involved in the rescue of refugees and to work on common assisting documents and programmes. Mainly invited were representatives of German ship-owner companies to inform themselves about the current situation and bring in their experience. At the beginning the participants were greeted by Ms. Prüfer-Storcks (Senator for Health and Customer Protection), Prof. Dr Harth (Institute for Occupational and Maritime Medicine), Dr Kröger (German Shipowners’ Association) and Mr. Geitmann (ver.di). In their introductions they pointed out the current dramatic situation in the Mediterranean Sea. According to United Nations High Commissioner for Refugees (UNHCR). Europe is experiencing a refugee crisis of historical dimension with approx. 140,000 refugees at the moment arriving since the beginning of the year. While in public and political discussions the focus is on the accommodation and the care of the refugees, the current situation in the Mediterranean Sea is also an immense challenge for the merchant shipping fleet and therewith also for the seafarers. The difficulties for merchant ships in a rescue operation stem from technical reasons as well as from the small crews of these ships. The dramatic and to some extent perilous rescue operations lead to psychologically stressful events for the seafarers. Especially since the operation “Mare Nostrum” was shut down the involvement of merchant ships heavily increased. “Mare Nostrum” was an operation of the Italian navy and coast guard established in October 2013 after the drowning of approx. 400 refugees within a few days. The mission ended in October 2014, approx. 150,000 people were rescued by the operation according to the International Organisation for Migration. Subsequent to “Mare Nostrum” operation “Triton” was established in November 2014. “Triton” is an operation of the European agency Frontex originally designed for the surveillance of Italian coastal waters and parts of the Italian search and rescue area. The additional assignment of Navy Ships as well as the extension of the “Triton” mission area of operation are indeed a relief, but merchant ships are still regularly involved in rescue operations. Civil vessels ability for the rescue and adequate accommodation of the refugees are very limited and the crews are not trained for these operations. This often leads to a mismatch of the will to help and the ability to help. The experiences have to be psychologically handled by the seafarers.