Olaf Chresten Jensen

Fatal occupational accidents in Danish fishing vessels 1989–2005

The purpose of the study was to study the circumstances and incidence rates of fatal accidents in inspection obligated and non-inspection obligated Danish fishing vessels to identify areas for prevention. Information about the fatalities came from maritime authority reports, including vessel disaster reports, post mortem reports, maritime inquiries and police reports. The person- and vessel years at risk came from the Danish Directorate of Fisheries. During the period 1989–2005, 114 fatalities occurred. Sixty-one of the fatalities occurred in 36 vessel disasters mainly caused by foundering/capsizing due to stability changes in rough weather and collisions; 39 fatal occupational accidents mainly occurred on the larger inspection obligated trawlers during fishing. In the remaining 14 other fatal accidents, the main causal factors were difficult embarking/disembarking conditions by darkness in foreign ports and alcohol intoxication. In the period 1995–2005, the overall incidence rate was 10 per 10,000 fishermen per year with no down-going trend during that period. The fatal accident rates are still too high, despite the efforts to reduce the risk. Increased focus on regular and repeated safety training for all fishermen and improved safety measures are needed, especially in the underscored areas of sea disasters concerning small vessels and occupational accidents on big vessels. Better registration of time at risk for fishermen is needed to validate the effect of the safety measures.

Non-fatal occupational fall and slip injuries among commercial fishermen analyzed by use of the NOMESCO injury registration system

BACKGROUND Fall injuries constitute a significant problem in commercial fishing and such injuries have hitherto not been the subject of closer analysis. METHODS The distribution and the characteristics of 582 occupational injuries among commercial fishermen are described by using data from an emergency department for the period 1990-1997, recorded in a special registration system. RESULTS Consistent with other investigations, injuries from falls made up 25% of all injuries; they were the cause of 28% of all contusions, 32% of all fractures, 61% of all sprains and strains, 40% of all injuries to lower extremities, and 62% of all injuries to the chest. The proportion of fall injuries in different age groups was U-shaped and constitutes around 40% for men both under 20 years and over 50 years of age, and around 20% for those between these ages. Frequent types of injury mechanisms other than falls and slips were: getting caught (22%), contact with objects or persons (28%), foreign body (9%), and cuts (9%). CONCLUSIONS Use of proportionate data gave a detailed description of injuries from falls and slips, showing important areas for prevention. To avoid a possible misclassification of fall injuries in future studies, it is recommended to include an extra specific variable: whether falling or slipping preceded the crash phase of the injury or not.

Self-reported injuries among seafarers Questionnaire validity and results from an international study

International surveys of occupational injuries among seafarers have so far been missing. It was the aim to test the method of self-report of injuries and length of time at risk during the latest duty period and second to study the injury incidence rate among seafarers by use of the method. A pilot study was conducted (n = 1068) in Finland, Denmark, the Philippines, Croatia and Spain using self-completed questionnaires with questions about the person, the ship, the duration of latest duty period and injuries. The duration of the self-reporting duty period was in the Danish part compared with information from the crew register of the Maritime Authority. For seafarers from merchant ships in the Danish sub-study there was acceptable correspondence between the information from the seafarers and the Maritime Authority, but not when referring to ferries and non-specified types of ship. Unadjusted and adjusted injury incidence rates-ratios (IRRs) based on number of injuries per number of work hours were calculated. Adjusted IRRs for ordinary seamen/officers: IRR = 2.43 (95% CI: 1.25-4.72); for age < 35/35+ years: IRR = 1.97 (1.02-3.81); length of tour: 117 days or longer compared with < 117 days: IRR = 0.46 (95% CI: 0.22-0.95); 57-70 working hours per week compared with < 57 h: IRR = 1.26 (0.48-3.29), 71+h compared with < 57 h: IRR = 2.12 (0.84-5.36). Non-significant IRRs >1.00 were found for ships under 10,000 GT compared with larger ships and for own flagged ships compared with ships under flag of convenience. In conclusion, more than 70 h of work per week was related to a higher rate of injuries for seafarers on merchant ships, but the result was not statistically significant. Self-report of the duration of the latest tour of duty is useful for seafarers from merchant ships with short-term employments, but not for ferries and other, non-specified types of ship with other or permanent employment.

Reduction of slips, trips and falls and better comfort by using new anti-slipping boots in fishing

Slips, trips and falls (STFs) are the most common causes of major workplace injury in Britain (Medical News Today, 2010). Fishing is one of the most dangerous industries with falling over-board as one of the main causes of fatal injuries (Petursdottir, Hjoervar, & Snorrason, 2007). In Alaskan commercial fishing, 25% of serious injuries were caused by falls (Lincoln, Husberg, & Conway, 2001; Thomas, Lincoln, Husberg, & Conway, 2001). In Danish fishing, falls accounted for 25% of all injuries, 28% of all contusions, 32% of all fractures, 61% of all sprains and strains, 40% of all injuries to lower extremities and 62% of all injuries to the chest (Jensen, 2000). There are no studies that evaluate the impact, safety or comfort of footwear in fishing. Thus, the objective of this study was to study the fishermen’s experiences as they tested new boots with anti-slipping soles to determine comfort and possible reduction of injury.

Telemedical advice to long-distance passenger ferries

BACKGROUND Radio medical (RM) advice for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyze the data from consultations with passenger ferries to identify areas for possible improvements. METHODS Data from the journals for 1 year from Radio Medical Denmark consultations with the medical officers on passenger ferries were analyzed retrospectively. RESULTS Two hundred fourteen RM records, 73% pertaining to passengers and 27% for crew members, were analyzed. Passenger patients were generally older and more seriously ill than patients among the crew. A high number of potential and life-threatening medical conditions such as angina pectoris was seen among the passengers, and nine of these patients were evacuated by helicopter. Sixty-three percent (n = 135) of the calls related to pain complaints, and more than half of these involved severe or considerable pain. Only acetaminophen (paracetamol) and opioids were in the ferry medicine chest. At least 77 patients would have benefited from use of nonsteroidal anti-inflammatory drugs. CONCLUSIONS The paramedical assistance and the medicine chest contents were considered insufficient in several cases. Passengers and crew members with chronic illnesses should be thoroughly prepared and advised before their travels.

A review of fatigue in fishermen: a complicated and underprioritised area of research

BACKGROUND Fatigue in fishing has been a highly underprioritised area of research, even though fatigue has been found to be the largest single contributing factor in accidents. AIM The aim of this article/paper is to provide an overview of the research conducted on fatigue in fishermen up to date, in order to establish a starting point for further research in this area. MATERIALS AND METHODS The review is mainly based on journal articles from PubMed, Google Scholar, International Maritime Health, Science Direct and some relevant articles links were also followed. RESULTS The research revealed that only 5 articles have been published concerning fatigue in fishermen.The articles all confirmed that fatigue is a serious health and safety issue among fishermen, and that further research therefore is warranted. CONCLUSIONS Only 2 of the 5 studies of fishermens fatigue used objective measures and in one of these, the sample size was small (n = 19), effectively limiting the statistical analysis and its application. Further research using larger samples is needed, preferably with a mix of objective and subjective measures, where of some of the questions should be scenario based and some should be from standardised questionnaires. Greater understanding is also needed to assess how much of the variance in fatigue is attributable to e.g. length of trip, hours of work without rest, and type of job and specific tasks. A greater understanding of the similarities and differences between acute and long-term fatigue is also needed.

Telemedical Maritime Assistance Service (TMAS) to Swedish merchant and passengers ships 1997-2012.

BACKGROUND Telemedical Maritime Assistance Service (TMAS) for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyse and to compare the data from consultations and evacuations from merchant ships and passenger ferries for possible improvements. MATERIALS AND METHODS Data for seafarers from 1997, 2002 and 2007 and for passengers on Swedish ferries for the years 2007, 2009, 2011 and 2012 from the Swedish Radio Medical were studied. Symptoms and diseases were classified according to the International Classification for Primary Care (ICPC-2). The distribution of symptoms, accidents and diseases, treatments/actions taken, evacuations and the communication forms were analysed. RESULTS One thousand ninety-five contacts for seafarers from merchant ships and 651 passenger patients from Swedish ferries were analysed. While the evacuations for the seafarers gradually decreased over the years from 18% in 1997 to 14% in 2007, still 39.5% of the passenger patient contacts were evacuated mainly by helicopters and 70 patients were picked up by an ambulance on the quay. Accidents were 20% for seafarers and 25% for passengers of the contacts. Evacuations for passengers were mainly in the diagnostic groups: unspecific (A), digestive (D), cardiology (K), musculoskeletal (L) and neurology (N). The use of VHF, radio communications and fax machines have been greatly reduced while the use of e-mail and satellite phone increased. CONCLUSIONS No significant differences in reasons for contact or actions over the years have been identified. The evacuations of seafarers decreased over the years but was stable among the passenger patients (39%). The circumstances and reasons behind the evacuations should be analysed for prevention. Standard forms and digital images for documentation can facilitate knowledge exchange and further studies.

Pesticide Residues in Commercial Lettuce, Onion, and Potato Samples From Bolivia—A Threat to Public Health?

Bolivia does not have a surveillance program for pesticide residues in food. The few published studies have suggested that pesticide contamination in food may present a public health problem. Data are lacking for all foods except tomatoes and breast milk. In this study 10 potato, 10 onion, and 10 lettuce samples from La Paz were sampled on August 15, 2015 at a local market and screened for 283 pesticides. Residues of cypermethrin, chlorpyrifos, difenoconazol, or/and λ-cyhalothrin were detected in 50% of the lettuce samples, whereas no pesticides were found in potatoes and onions. In 20% of the lettuce samples, the measurements were above the maximum residue limits, and 2 or 3 pesticides were identified simultaneously. Washing almost halved the pesticide levels, but still 20% of the samples showed measurements above the limits. No samples contained concentrations of pesticides which alone or together would lead to exposures that exceeded the acceptable daily intake or the acute reference dose. To protect consumers from pesticide poisonings and chronic effects, the development of measures for prevention, control, and monitoring of food contamination by pesticides in Bolivia is suggested.

Health status and occupational risk factors in Greek small fisheries workers

BACKGROUND Fishing is an extremely dangerous occupational activity that predisposes to occupational diseases and accidents. Greece, with about 16,000 km of coastline and its unique morphological characteristics with small islands and peninsulas, represents a strong proof of its great tradition in the fisheries sector since ancient times. The aim of the study was to examine the health status and the health risk factors present in Greek fishery workers, by exploring their working environment, thus providing a current baseline for documentation of the needs for prevention and health promotion. MATERIALS AND METHODS An interviewer-administered questionnaire was distributed in 2013 to a random sample of 172 professional small-scale fishermen of the Evros district in North-Eastern Greece. RESULTS Eighty-eight per cent worked in coastal fisheries and 73% were using small fishing vessels, less than 10 m in length overall. Health disorders included musculoskeletal, cardiovascular and visual problems and to a minor degree by hearing, dermatologic and respiratory problems in all age groups. Seventy per cent had experienced at least one occupational accident. Heavy smoking and daily alcohol consumption was seen among nearly half of the fishermen. CONCLUSIONS The health effects observed are causally related to the work process exposures on board and to diet, smoking, and lack of exercise. This in turn relates to the specific working conditions, the culture and level of education in small-scale fishing that need to be taken into consideration together in the prevention programmes.

Pattern of some risk factors of cardiovascular diseases and liver enzymes among Iranian seafarers

Background: Little information is available on the trend in cardiovascular risk factors and hepatic enzymes in Iranian seafarers. The present study aimed at assessing the pattern of obesity, hypertension, diabetes, elevated serum glutamic oxaloacetate transaminase (SGOT), and serum glutamate pyruvate transaminase (SGPT) in Iranian seafarers during 2010 to 2014. Methods: Data on cardiovascular risk factors and hepatic enzymes were extracted from seafarers’ annual health examination of National Iranian Tanker Company (NITC) of 2010, 2012, and 2014. The repeated measure ANOVA was used to compare continuous variables across 3 years. Categorical data were analyzed using Chi-square test. Over weight was defined as BMI (Body Mass Index) >25 kg/m2; obesity was defined as BMI>=30 kg/m2; hypertension was defined as systolic blood pressure (SBP)> 140 mmHg, and diastolic blood pressure (DBP)> 90 mmHg, or a history of antihypertensive drug use. Diabetes (DM) was defined as fasting blood sugar (FBS) > 110 mg/dl, or having a history of oral hypoglycemic agents; and elevated SGOT and SGPT were defined as SGOT > 40 U/L and SGPT > 40 U/L, respectively. Results: The BMI mean±SD values of Iranian seafarers were 24.81±3.07 kg/m2, 25.51±2.96 kg/m2, and 25.96 ± 3.02 kg/m2 in 2010, 2012, and 2014, respectively. A significant difference was observed in BMI over the study period. The mean of systolic and diastolic blood pressure did not significantly increase over time. The SGOT and SGPT means were not significantly different from 2010 to 2014. The prevalence of overweight increased significantly from 46.7% to 60.9% over the study period; however, the prevalence of obesity, hypertension, elevated SGOT, and elevated SGPT did not change significantly. Conclusion: The current survey showed that the obesity problem has increased among Iranian seafarers working on tankers, which is a concerning problem because obesity has negative effects on seafarers’ health.