International maritime health [journal]
- ANNOUNCEMENT. [Journal Article]
- Int Marit Health 2016; 67(2):126.
- Zika virus infection: what should we not forget? [Journal Article]
- Int Marit Health 2016; 67(2):125.
- "Christ offered salvation, and not an easy life": How do port chaplains make sense of providing welfare for seafarers? An idiographic, phenomenological approach analysis. [Journal Article]
- Int Marit Health 2016; 67(2):117-24.
The shipping industry has historically leaned towards a biomedical model of health when assessing, treating and caring for seafarers. In recent years there has been more concern for the mental health of seafarers in both the academic literature and the commercial world, however, the psychological and emotional well-being of seafarers still largely falls on the shoulders of the port chaplains. The aim of the study was to explore how port chaplains make sense of providing welfare for seafarers by taking an idiographic, phenomenological approach (IPA).Six male participants working as chaplains in United Kingdom ports took part in recorded face-to-face, semi-structured interviews covering three areas of questioning: role, identity and coping. Interviews were transcribed verbatim, and data analysed using interpretative phenomenological analysis.Three super-ordinate themes were identified from participants accounts; "We walk a very strange and middle path", "Exploited" and "Patching up". Rich data emerged in relation to the personal impact chaplains felt they made, which was facilitated by the historical role of the Church; this led to the second super-ordinate theme of how chaplains felt towards seafarers. Lastly, the analysis demonstrates how chaplains adapt to the limitations forced upon them to provide welfare, and a degree of acceptance at the injustice.Results were discussed in reference to theoretical models, including self-efficacy, empathic responding and the transactional model of stress and coping. Chaplains in ports perform their role autonomously with no input from healthcare professionals. Recommendations are made for a biopsychosocial model of health involving primary care, benefiting the health and well-being of seafarers and providing support and guidance for port chaplains at the frontline of welfare for seafarers.
- Environmental and health impact assessment for ports in Thailand. [Journal Article]
- Int Marit Health 2016; 67(2):112-6.
Port development in Thailand is an essential part of the national maritime interest in connection with ship and shore activities. The growth of maritime industry and transportation has led to the expansion of ports' areas and capacity. Each port type causes different environmental impacts. Therefore, the Port Authority of Thailand has set up guidelines on ports' environmental management. This is divided into 3 major phases; namely, planning, construction and operation commencement periods. The Report of Environmental and Health Impact Assessment (EIA, HIA and EHIA) is regarded as the environmental management process in the planning period. It is a key tool to anticipate and prevent any adverse effects that might occur on the environment as well as community health resulting from the project implementation. This measure, in turn, creates advance preparation on both the preventive and problem-solving means before the project gets off the ground. At present, the majority of new projects on port development have still been in the process of information gathering for EHIA submission. Some cannot start to operate due to their EHIA failure. For example, the Tha-sala port which did not pass EHIA, mainly because emphasis had been focused on adhering to legal regulations without taking into consideration the in-depth analysis of data being conducted by community entities in the area. Thus caused the project to be finally abolished. Impact assessment on environment and health should be aimed at detailed understanding of the community in each particular area so that effective data of objective achievement in preventing environmental problems could actually be carried out and welcomed by the concerned society.
- Thermophysiological responses and work strain in fishermen on deep-sea fishing vessels. [Journal Article]
- Int Marit Health 2016; 67(2):104-11.
Fishermen working on deep-sea vessels in the Barents and Norwegian Sea are exposed to low air temperatures, strong winds, high humidity, rain, snow and work at different intensities. Few studies have investigated the effect of environmental work factors on the physiology of this occupational group. The aim of the study was to investigate work strain and thermophysiological responses of fishermen on the trawl and factory decks of deep-sea vessels.Twenty-five professional male fishermen (age 39 ± 13 years) were recruited to the study which was performed on three trawlers in the Norwegian Sea in April, June and August 2014. During a six-hour shift, heart rate (HR), core (Tc) and mean skin (Ts) temperatures were recorded, and questions about subjective thermal sensation and comfort were answered.Short periods of hard (above 86% of HRmax) work raised Tc by 0.8°C to 37.8°C and decreased Ts by 2.3°C to 29.8°C during work on the trawl deck, and subjects reported being warm and sweaty. On the factory deck long periods of fairly light (between 52% and 66% HRmax) work, Tc of 37.4°C and Ts of 30.9°C were measured.Fishermen experience intermittent periods of heavy work on the trawl deck shown with elevated core temperature and HR. Work on the factory deck includes long periods of repetitive work with light to moderate work strain. A better understanding of work strain and environmental challenges during work on Norwegian deep-sea vessels will help identify exposure risks during work in the cold and heat.
- The workload of fishermen: a cross sectional survey among Danish commercial fishermen. [Journal Article]
- Int Marit Health 2016; 67(2):97-103.
Fishery has always been perceived as a physically demanding industry of a manual character. In recent years the physical work environment has developed positively and consequently the current situation in not fully described in the existing literature. This study aims to describe the work environment of Danish fishermen with regard to their physical workload and ergonomic factors.A cross sectional study was performed on a random sample of active Danish commercial fishermen (response rate: 28%) by means of a questionnaire on demographic and self-reported occupational and health data. Questions covering the physical workload were related to seven different work situations and a score summing up the workload was developed for the analysis of the relative impact on different groups of fishermen.Almost all fishermen (96.2%) were familiar to proper lifting techniques but only 55.4% used them in their daily work. Standing work was the most applied work position (81.8%), while repetitive hand and finger movements and twisting and bending in the back were other frequent work situations. Deckhands had higher workload scores than skippers, while crew on Danish seiners had higher workload scores than fishermen in other vessel types.Despite improved work environment in the Danish fishing industry, fishermen still experience high levels of workload and suboptimal ergonomic conditions, which are known to cause pain and impair musculoskeletal health. To address the specific areas of fishing with the highest workload, future investments in assistive devices to ease the demanding work and reduce the workload, should particularly address deckhands and less mechanized vessels.
- Prevalence of cannabis and cocaine consumption in French fishermen in South Atlantic region in 2012-2013 and its policy consequences. [Journal Article]
- Int Marit Health 2016; 67(2):88-96.
The aim of the study was to evaluate the use of cannabis and cocaine among fishermen followed in occupational medicine in the ports of Aquitaine and Charente-Maritime (Direction interrégionale de la mer Sud-Atlantique [DIRM-SA]).Thousand fishermen could be recruited during medical regulatory examination by the occupational physicians and nurses of Occupational Health Department for Seamen.About 20% of fishermen were former smokers. A third of the fishermen are at risk for excessive drinking according to the AUDIT-C. The prevalence of cannabis experimentation was estimated at 58%. The prevalence of positive urine test for cannabis was 28%. The prevalence of experimentation with cocaine was about 16%. The prevalence of positive urine test for cocaine was 4.5%.In accordance with its objectives, this study allows objectifying cannabis and cocaine consumption among fishermen. The national rules for fitness at sea have to be modified by introducing the use of urinary tests by occupational physician.
- Benefits of photograph transmission for trauma management in isolated areas: cases from the French tele-medical assistance service. [Journal Article]
- Int Marit Health 2016; 67(2):83-7.
French maritime tele-medical assistance is currently performed by a telephone consultation associated with complementary transmission of data (photographs, electrocardiograms, etc.) over the internet. Five case reports are presented to illustrate how photo transmission is useful to managing initial care and monitoring isolated patients. Case reports included: Case 1: management of a hand burn; Case 2: management of a finger wound; Case 3: management of an ocular foreign body; Case 4: management of a subungual haematoma; Case 5: management of phlegmon. In conclusions, photo transmission improves our practice of maritime tele-medical medicine. New high-definition technologies will help in the development of videoconferences on ships.
- Bleeding management in remote environment: the use of fresh whole blood transfusion and lyophilised plasma. [Journal Article]
- Int Marit Health 2016; 67(2):79-82.
To mitigate medical risks in remote environments, the authors have implemented an innovative integrated medical support solution for bleeding management on board ships since 2013. Fresh whole blood transfusion (FWBT) and lyophilised plasma were put in place to address life threatening haemorrhages in maritime operations in the Arctic and Antarctica. The authors are illustrating the bleeding risks with an actual case occurring in Antarctica prior to the implementation of these procedures. They are presenting the different steps involved in the complex process of FWBT, from blood donors' qualifications to actual transfusions. The pros and cons of blood transfusion in extreme remote environment are discussed, including the training of health care professionals, equipment requirements, legal and ethical issues, decision making in complex blood group matching, medical benefits and risks.
- Development of software for handling ship's pharmacy. [Journal Article]
- Int Marit Health 2016; 67(2):72-8.
Ships are required to carry a given amount of medicinal products and medications depending on the flag and the type of vessel. These medicines are stored in the so called ship's "medicine chest" or more properly - a ship pharmacy. Owing to the progress of medical sciences and to the increase in the mean age of seafarers employed on board ships, the number of pharmaceutical products and medical devices required by regulations to be carried on board ships is increasing. This may make handling of the ship's medicine chest a problem primarily on large ships sailing on intercontinental routes due to the difficulty in identifying the correspondence between medicines obtained abroad with those available at the national market. To minimise these problems a tool named Pharmacy Ship (acronym: PARSI) has been developed.The application PARSI is based on a database containing the information about medicines and medical devices required by different countries regulations. In the first application the system was standardised to comply with the Italian regulations issued on the 1st October, 2015 which entered into force on the 18 January 2016.Thanks to PARSI it was possible to standardize the inventory procedures, facilitate the work of maritime health authorities and make it easier for the crew, not professional in the field, to handle the 'medicine chest' correctly by automating the procedures for medicines management. As far as we know there are no other similar tools available at the moment. The application of the software, as well as the automation of different activities, currently carried out manually, will help manage (qualitatively and quantitatively) the ship's pharmacy.The system developed in this study has proved to be an effective tool which serves to guarantee the compliance of the ship pharmacy with regulations of the flag state in terms of medicinal products and medications. Sharing the system with the Telemedical Maritime Assistance Service may result in avoiding mistakes in drug administration. Last but not least the availability of PARSI could help reduce/ avoid problems with maritime health authorities in case any of the required medicinal products are missing.