Occupational allergic diseases among harvesting fishermen on the open sea: A systematic review.

BACKGROUND: Nearly 60 million people work in the fishing and aquaculture sectors worldwide and are exposed to specific allergens. Some reviews have been published in occupational allergic diseases in seafood workers but none in fishermen. OBJECTIVE: To describe the morbidity and main causal agents of allergic diseases among harvesting fishermen. METHODS: A protocol with predefined objectives and inclusion criteria was used in accord with the Preferred Items for Reporting Systematic Reviews and Meta-analyses-Protocols statement. Population was defined as harvesting fishermen, and the conditions of interest were allergic pulmonary diseases, occupational allergic rhinitis, and allergic dermatologic disease. A literature search was carried out in EMBASE, MEDLINE, Web of Science, and PASCAL databases. After the title-abstract and full-text selection of eligible studies, data were extracted and synthesized qualitatively. RESULTS: A total of 25 studies were selected, 15 articles on occupational asthma (OA) and 10 on dermatologic diseases. Most studies were case reports and case series from European countries. Most OAs were sensitizer induced, with common crab, Anisakis simplex, red soft coral, and cuttlefish as causal agents. Irritant-induced OA because of metabisulfites was also described. Occupational eczema caused by bryozoans was the most common of the cases among fishermen working in the North Sea and the Channel. CONCLUSION: Occupational allergic diseases in harvesting fishermen are described in well-resourced countries, but there are few studies from countries with a high number of fishermen, such as in Asia, and these mostly include immunoglobulin E-mediated diseases. The presence of the healthy worker effect is probable. Atmospheric allergen concentration is a major risk factor for OA. Specific conditions, including cold air, fish-juice contact, and salt-water contact, are other risk factors. There is a need to investigate occupational allergic disease in all countries and develop specific studies in fishermen.

Port Workers' Use of Medical Services in a Maritime Container Terminal in Costa Rica.

Supervised by three or four medical doctors and one nurse in rotating shifts, the medical clinic in Costa Rica's Moín Container Terminal is open 24/7 for visits from port workers. In our study, we aimed to identify the sociodemographic and clinical characteristics of a consecutive series of patients who attended the medical clinic for outpatient services during an 8-month period. Our descriptive study involved collecting patient records from the medical clinic during the first 8 months of 2021 (i.e., 1 January-31 August 2021), during which 3050 visits from 1301 port workers were registered. Terminal tractor drivers, crane operators, and stevedores were the most frequent job categories among the patients. Doping (i.e., ICD-10 Z03.6) was observed in 64% of the visits. The top ICD-10 codes among all other patients not observed to have engaged in doping (n = 469) were diseases of the musculoskeletal system (7.2%) and abnormal clinical and laboratory symptoms (6.2%). Problems with the musculoskeletal system were primarily back pain (36.0%), muscle contracture (30.1%), and secondary headache (25.2%). Two-thirds of the visits were due to screening for alcohol and drugs or doping; however, inconsistency in the coding system complicates the analysis of data, and a dropdown menu in the registration is therefore needed to prevent errors. Relative risk calculations are impossible due to a lack of data about the at-risk population but should be pursued under different circumstances in future studies. In the support chain of goods, the medical clinic in the port plays a key role in saving time in shipping, which means that the injured or sick employees in most cases can continue working. For the shipping industry, quick un- and offloading is very important to stay competitive in the market for transport.

Rethinking the use of urine dipstick for early diagnosis of Type 2 diabetes mellitus.

Transport workers, seafarers and fishers have biannual mandatory fit-for duty medical examinations. Urinedipstick is used for early diagnosis of Type 2 diabetes mellitus. Due to low sensitivity with more than 80% false negatives the method should be replaced by highly sensitive blood tests, Hb1Ac or similar for diagnosis of Type 2 diabetes mellitus to pursue the UN Global Sustainable Goals, especially Goal 3: Good health and well-being for all workers and Goal 8: Decent Work and Economic Growth.

Early diagnosis of T2DM using high sensitive tests in the mandatory medical examinations for fishers, seafarers and other transport workers.

Transport workers like seafarers, truck-, bus-, train- and taxi drivers and fishers have a known great inequity in health at work including high risk of developing type 2 diabetes. Their routine mandatory medical examinations use urine glucose for diabetes check with more than 50% false negatives, which should be replaced by high sensitive tests for diabetes-2, like A1C, Fasting Glucose (FPG) or Oral Glucose Tolerance Test (OGTT).

Risk Assessment in Artisanal Fisheries in Developing Countries: A Systematic Review.

INTRODUCTION: Artisanal fisheries generally do not have injury prevention plans and safety or quality management systems on board, thus making them prone to more fatal and nonfatal injuries. The objective of the study is to systematically review and synthesize the literature to identify the risks of injuries (fatal and nonfatal) and health problems in artisanal fisheries in developing countries. METHODS: A systematic literature search was carried out from December 2019 to March 2020. Articles were included with at least 1 outcome of interest (fatal injuries, nonfatal injuries, health problems, causal factors). In all, 18 articles on occupational safety and health aspects in artisanal fisheries from developing countries were kept for final analysis. RESULTS: Of the 4 studies on fatal injuries, only 1 reported fatal incidence rates (14 per 1,000 person-years). Vessel disasters were the most common cause of fatal injuries, with 14.3%-81% drownings. The prevalence of nonfatal injuries was between 55% and 61%. The most common causes were falls on the deck or into the sea/river, blows from objects/tools, punctures and cuts by fishhooks/fish rays and fishing equipment, and animal attacks or bites. Health problems included eye, ear, cardiovascular (hypertension), respiratory (decompression sickness), dermatological, and musculoskeletal problems. DISCUSSION: There is a serious gap of health and safety information in artisanal fishery, which is more extensive in developing countries. Epidemiological studies are needed with comparable incidence and prevalence rates. For adequate prevention and compliance with the UN sustainable goals, there is an urgent need to establish a health information system in the countries to register the relevant demographic and epidemiologic characteristics of the population.

Global occupational health research methods education.

Occupational and Public Health Research has been developed gradually over the last century, unfortunately not to the same levels in all continental parts of the globe. The aim is to supply an open modular educational program in Occupational- and Public Health research methodology for research of the risk indicators for the prevention of workers' health and safety globally. The modular educational program in research methodology is based on the Humboldtian university model with unity of research and teaching. Research data for the students comes from the research part of the "Maritime Education and Research Network" for all types of industries. The modules constitute the basic education in occupational health science research methodology. The proposal for Master of Science for medical doctor's specialization in occupational medicine with an emphasis on research includes 3 theoretical and a clinical module. The huge difference in research methodology globally indicates inequity in relation to the UN17 goals that need to be taken hand on. Global collaboration in teaching health research methodology is needed to reach the goals of equity in health science education. The aim is to reduce the inequity in global health by strengthening the education in health science research methodology.•Open access educational program for health science research methodology to reach the UN17 goals.•The modules constitute the education in research methodology for Public- and Occupational health.•Global education in health research methodology is needed to eliminate the inequity in global health.

The costs of repatriating an ill seafarer: a micro-costing approach.

Seafarers sail the high seas around the globe. In case of illness, they are protected by international regulations stating that the employers must pay all expenses in relation to repatriation, but very little is known about the cost of these repatriations. The objective of this study was to estimate the financial burden of repatriations in case of illness. We applied a local approach, a micro-costing method, with an employer perspective using four case vignettes: I) Acute myocardial infarction (AMI), II) Malignant hypertension, III) Appendicitis and IV) Malaria. Direct cost data were derived from the Danish Maritime Authority while for indirect costs estimations were applied using the friction cost approach. The average total costs of repatriation varied for the four case vignettes; AMI (98,823 EUR), Malignant hypertension (47,597 EUR), Appendicitis (58,639 EUR) and Malaria (23,792 EUR) mainly due to large variations in the average direct costs which ranged between 9560 euro in the malaria case and 77,255 in the AMI case. Repatriating an ill seafarer is a costly operation and employers have a financial interest in promoting the health of seafarers by introducing or further strengthen cost-effective prevention programs and hereby reducing the number of repatriations.

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.