Seafarers' attitudes and chances to improve the nutrition on merchant ships from the crews' and cooks' perspective.

BACKGROUND: Seafarers' diets are often high in fat, sugar and calories, thus contributing to an increased risk of obesity, metabolic syndrome and cardiovascular disease. The multitude of obstacles to healthy eating in the on-board environment on merchant ships makes it essential to find new approaches for health promotion. This study explored seafarers' attitudes, the status quo of support measures and chances to improve nutrition on merchant ships from the perspective of crews and cooks. METHODS: In the course of the EU-funded project "e-healthy ship", European and Southeast Asian seafarers (N = 810) and ship cooks (N = 62) were examined by using two questionnaires on 68 ships of two German shipping companies. RESULTS: Almost all seafarers (98.8%) considered a healthy diet important for their well-being and the majority of seafarers reported being open-minded about changing their eating habits (88.4%). However, European seafarers were less likely to respond that they are willing to eat less meat [OR 0.11; 95%CI (0.07-0.17); p < .001], more vegetables [OR 0.10; 95%CI (0.02-0.49); p = .005] and more fruits [OR 0.11; 95%CI (0.02-0.61); p = .011] than their Southeast Asian colleagues. On the one hand, 82.3% of the ship cooks reported having taken part in at least one cooking course organized by their employer (1: 33.9%, 2: 25.8%, 3: 14.5%, 4 or more: 8.1%), on the other hand, slightly above half stated that the last of these courses had taken place more than 2 years ago. Furthermore, the ship cooks showed a positive attitude towards the use of a tablet-based digital platform that supports the ship cooks in daily and complex tasks (> 85% agreement). CONCLUSIONS: To improve nutrition on board merchant ships, various parameters need to be adjusted, such as ensuring a demand-oriented food supply on board or supporting seafarers' healthy food choices through target group-specific nutrition education. Ship cooks would be able to play a crucial role if they receive support. The development of a tablet-based digital platform that supports the ship cooks in their daily tasks, offers training and empowers them to implement health-promoting measures themselves seems to be an accepted and promising approach.

Systematic Review: Measurement Methods and Concept of Resilience Among Seafarers.

Shipping is considered a demanding environment that can significantly impact seafarers' well-being and mental health. This review aims to examine existing literature on the resilience of seafarers, with a focus on the measurement methods used. Furthermore, this study intends to gain a comprehensive understanding of the current state of research in the field of seafarers' resilience, examining the variations in defining and conceptualizing resilience across different studies and contexts. The review identified 99 studies published between 2003 and 2023, with ten studies being included in the final analysis. These studies employed various measurement methods and provided definitions of resilience. Five questionnaires were identified, with the Dispositional Resilience Scale-15 (DRS-15) being the most commonly used. Two of the selected studies had a longitudinal follow-up, while eight were cross-sectional. Four studies related to tankers, and an additional four studies focused on naval vessels, while two studies did not specify the vessel type. The publications were distributed in the period between 2003 and 2013 (two papers) and between 2013 and 2023 (eight papers). The identified themes encompassed shipboard stressors (three papers), sleep problems (two papers), occupational groups or attitudes (two papers), experiences in war (two papers), and intervention measures (one paper), highlighting the multidimensional nature of resilience within the maritime field. This review suggests a research gap, as it reveals that the topic of resilience in seafaring has been sparsely represented. Despite an increasing interest in recent years, research remains limited, particularly in the civilian maritime sector. Therefore, this review highlights the importance of understanding and promoting resilience among seafarers. While the variety of questionnaires used was limited, achieving consensus and standardization in resilience measurement is essential for more comparable and consistent research findings. Recognizing resilience as a crucial resource can promote the development of targeted interventions and support systems, enhancing seafarers' well-being and mental health.

Exploration of Seafarers' Mobile Proficiency as a Prerequisite for Possible Health App-based Health Promotion on Board.

Numerous health hazards characterize the profession of a seafarer. The job-specific environment may affect the crews' well-being and mental health. The options for health promotion are limited, as seafarers are isolated for long periods and are a difficult-to-reach collective. A digital app-based health management system might offer a promising approach in this regard. This study aims to identify seafarers' technical competencies as a prerequisite for possible health app-based health promotion. A total of 976 seafarers (response rate 75.1%) on 65 ships of a Hamburg shipping company completed the standardized questionnaire MDPQ-16 (Mobile Device Proficiency Questionnaire) that assesses the IT competence in 8 different sub-scales. The results were stratified in respect to occupational groups aboard as well as compared to a reference collective ashore. The seafarers had an MDPQ-16 sum-score of 4.40 (SD 0.84), scoring 0.21 points higher than the land-based reference collective. Significant differences were observed between the ratings and officers in almost every sub-scale and item of the MDPQ-16. The highest sum-score was held by the nautical officers with 4.71. Greater differences between officers and ratings were observed in sub-scales related to rather complex tasks. The seafarers demonstrated a high level of IT proficiency, even surpassing the land-based sample, suggesting that their technical competence is adequate for app-based health promotion. In view of the higher scores of officers, the selection of health apps has to be tailored to the seafarers' different levels of mobile competence in order to maximize the improvement in mental health and well-being. Further research is needed to determine seafarers' needs and interests.

[Virtual staff teamwork during the pandemic - development of digital training formats for community emergency response during the coronavirus pandemic]. / Virtuelle Stabsarbeit in Zeiten der Pandemie ­ Entwicklung digitaler Übungsformate in der zivilen Gefahrenabwehr während der Coronapandemie: Erfahrungen am Beispiel des Projekts ARMIHN.

Background: In the event of emergency response to large-scale incidents, such as a mass casualty incident (MCI) or a mass casualty incident-infectious disease (MCI-ID), regular training is essential in order to have experienced emergency personnel available in the event of an incident. Due to the pandemic drills often had to be cancelled or were only possible with small groups of people. It was often not possible to simulate a large-scale emergency with actors, so that the trainees could not be offered realistic scenarios of a mass casualty or disease incident. As part of two research projects, a digital platform for conducting training was used to avoid the risk of infection between participants during the exercises, so that on-site personnel deployment could be reduced to a minimum. The goal of this work was to evaluate end-user acceptance of the digital solution approaches. Methods: Within the framework of the project "Adaptive Resilience Management in Ports" (ARMIHN), a digital exercise platform was applied and evaluated with the help of participant surveys according to the focal points "implementation", "alternative possibilities", "learning effect" and "usability". The participants used the digital platform to exchange information and to communicate. For this purpose, various collaboration tools were embedded in the platform, which enabled simultaneous exchange of information in real time. Constant video communication with in-house and external authorities/teams was also established. Results: The potential of the digital platform as an alternative to on-site exercises was confirmed by the participating end users in the ARMIHN project with 90% agreement. The increase in subjective skills and knowledge gained during a MCI-ID was also predominantly rated approvingly (up to 70%). Participants who rated the implementation of the online format as well performed were significantly more likely to state that subjectively their ability to handle a MCI-ID had improved (p = 0.016). In contrast, virtual staff teamwork in real crisis situations was viewed critically by about half of respondents. Conclusion: Overall, the evaluation results point to the high end-user acceptance of the developed concept. Even though the aim is to evaluate the system over a longer period with a larger number of participants, the studies already conducted confirm the positive experiences in the respective projects.

Accidents, diseases and health complaints among seafarers on German-flagged container ships.

BACKGROUND: For seafarers on the high seas health hazards are various and due to the setting also specific. The spectrum of job-related health impairments and accidents is mainly influenced by the maritime characteristics. The aim of this study is to assess the kind of accidents and the frequency of diseases and health complaints among seafarers on German container ships by evaluating medical log books. METHODS: A systematic analysis of 14,628 medical entries from 95 medical log books of 58 container ships under German flag from 1995 to 2015 was performed. This monocentric retrospective and descriptive study used information on accidents, diseases and health complaints among different occupational groups and medical treatment procedures for the analysis and evaluation. RESULTS: The analysis showed that more than one third of all consultations with the Health Officer on board are related to internal (33.7%) and surgical (31.3%) symptoms. Almost twenty percent of consultations were due to respiratory infections (19.6%) and accidents (17.9%). Accidents represented the most frequent reason for unfitness for sea service (31.2%). Based on occupational categories, most injuries occurred among deck crew (22.5%), followed by ratings working in the engine room (18.9%). In 106 cases, telemedical contact with a physician ashore was necessary. In total, 15 seafarers had to be evacuated from the ship for further medical treatment onshore. Medicine/drug application was the most common therapeutic measure on board, accounting for 77% of all consultations. CONCLUSIONS: The high proportion of health complaints and accidents among seafarers shows that there is a need to optimize medical care at sea and accident prevention, e.g. by standardized treatment algorithms or improving the medical training of Health Officers. The development and introduction of a digital patient file to record medical treatments on the vessels could also improve medical documentation on board.

Sleep Architecture and Sleep-Related Breathing Disorders of Seafarers on Board Merchant Ships: A Polysomnographic Pilot Field Study on the High Seas.

As seafarers are assumed to have an increased risk profile for sleep-related breathing disorders, this cross-sectional observational study measured (a) the feasibility and quality of polysomnography (PSG) on board merchant ships, (b) sleep macro- and microarchitecture, (c) sleep-related breathing disorders, such as obstructive sleep apnea (OSA), using the apnea-hypopnea index (AHI), and (d) subjective and objective sleepiness using the Epworth Sleepiness Scale (ESS) and pupillometry. Measurements were carried out on two container ships and a bulk carrier. A total of 19 out of 73 male seafarers participated. The PSG's signal qualities and impedances were comparable to those in a sleep laboratory without unusual artifacts. Compared to the normal population, seafarers had a lower total sleep time, a shift of deep sleep phases in favor of light sleep phases as well as an increased arousal index. Additionally, 73.7% of the seafarers were diagnosed with at least mild OSA (AHI ≥ 5) and 15.8% with severe OSA (AHI ≥ 30). In general, seafarers slept in the supine position with a remarkable frequency of breathing cessations. A total of 61.1% of the seafarers had increased subjective daytime sleepiness (ESS > 5). Pupillometry results for objective sleepiness revealed a mean relative pupillary unrest index (rPUI) of 1.2 (SD 0.7) in both occupational groups. In addition, significantly poorer objective sleep quality was found among the watchkeepers. A need for action with regard to poor sleep quality and daytime sleepiness of seafarers on board is indicated. A slightly increased prevalence of OSA among seafarers is likely.

Are there differences between officers and ratings on merchant vessels concerning effort-reward imbalance: a cross-sectional maritime field study.

PURPOSE: Today, measures to economise in the operation of ships can cause either an effort-reward imbalance or health impairments. The goal of this study was to assess the risk of effort-reward imbalance including overcommitment among officers and ratings on merchant vessels during their assignments and to evaluate lifestyle factors of seafarers as well as the health-promoting conditions on board. METHODS: A study sample of 308 male seafarers was examined during a total of 20 sea voyages on German container ships (participation rate 91.9%). RESULTS: Only 11 seafarers were identified as having an increased health risk of an effort-reward imbalance (ER ratio > 1). Officers tended to have a higher risk of an elevated ratio than ratings (4.4% vs. 3.1%) and also showed a significantly higher risk of an ER ratio above the median (58.8% vs. 41.8%; p = 0.022). Compared to land-based populations, the average overcommitment score of seafarers was high (17.9)-particularly among officers (20.3 vs. 16.5; p = 0.031). This corresponded to an elevated risk of overcommitment among officers compared to ratings (OR 2.14; 95% CI 1.78-2.37). This elevated risk remained significant after adjustment for age (OR 2.11; 95% CI 1.76-2.35) and job-related stressors. CONCLUSION: Although an elevated risk of effort-reward imbalance was only observed in few seafarers, this study revealed a high prevalence of overcommitment particularly among officers. In the course of time, overcommitment can lead to mental exhaustion. Therefore, shipboard health-promoting conditions need to be optimised.

Eating behaviour and weight development of European and Asian seafarers during stay on board and at home.

BACKGROUND: Food choices on board merchant ships are limited and seafarers repeatedly described as being at high risk of developing overweight compared to the general population. Up to date, research has not distinguished whether seafarers gain weight on board or at home and whether eating habits differ in both settings. METHODS: As part of the e-healthy ship project, cross-sectional data were collected in two different measurements. In the first investigation on board of three merchant ships of German shipping companies, differences in eating behaviour at home compared to on board ships were assessed for 18 Burmese, 26 Filipino and 20 European seafarers. In a second study, BMI, weight development and location of body weight change of 543 Filipino and 277 European seafarers were examined using an online questionnaire on 68 ships. RESULTS: According to the board examinations, foods and beverages consumed on merchant ships varied widely from seafarers' diets in their home country. Burmese, Filipino and European seafarers equally reported to consume more fruit (z = 4.95, p < .001, r = .62) and vegetables (z = 6.21, p < .001, r = .79), but less coke (z = -5.00, p < .001, r = .76) when at home. Furthermore, culturally different changes were found across all other foods and beverages. The online questionnaire revealed that 45.8% of seafarers were overweight (55.4% Europeans vs. 40.8% Filipinos, p < .001) and 9.8% obese. Moreover, a higher percentage of Europeans compared to Filipinos reported weight gain over the course of their professional career (50.2% vs. 40.7%, p = .007). A sub-analysis of seafarers with weight gain found that more Europeans than Filipinos gained weight at home (43.9% vs. 23.1%, p < .001). CONCLUSIONS: Both, home and working on board merchant ships, represent very different living environments which may affect seafarers' lifestyle and eating habits in various ways and thus could favour or inhibit weight gain. From our results, it appears that the body weight and eating habits of Asian seafarers in particular are adversely affected by the working and living conditions on board. Further prospective studies are required to prove this hypothesis.

A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts.

BACKGROUND: The project "ARMIHN" (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, previous MCI-ID were especially caused by pathogens such as Influenza virus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the associated interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes. METHODS: A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed. RESULTS: The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 min. Based on their specialist expertise, 14 of the 31 listed clinics were selected. CONCLUSION: The purpose of the study was to provide an analysis of the current situation and show how involved parties would cope an MCI. A description of processes and resources at the Port of Hamburg will be used when designing a management plan for responding to an MCI-ID.

[Prevention and management of COVID-19 outbreaks on merchant ships]. / Prävention und Management von COVID-19-Ausbrüchen auf Handelsschiffen: Technische, organisatorische und persönliche Schutzmaßnahmen zur Risikominimierung in einem besonderen Arbeitsumfeld.

BACKGROUND: A pandemic is a particular medical challenge for seafarers traveling without a physician on board. At the same time the global fight against the coronavirus disease 2019 (COVID-19) pandemic has to rely on resilient merchant shipping in order to maintain the flow of goods. For infection prevention and management on board, those responsible need a portfolio of protective measures that can be used on ships. RESEARCH QUESTIONS: The overview examines the question of which technical, organizational and personal protective measures can be used on a merchant ship in order to prevent or cope with COVID-19 outbreaks on board. MATERIAL AND METHODS: Guidelines, information and occupational health and safety standards from the maritime setting, but also from many other work areas, were examined in order to facilitate a variable use by those responsible (e.g. according to ship size, equipment, weather, operating status, work requirements, contact with external persons, medical problems). RESULTS: A handout was compiled that contains specific technical, organizational and personal protective measures for crews, explaining their use in a maritime context. Possible safety barriers, options to combine them and an appropriate timing are explained in a target group-oriented manner. CONCLUSION: A great variety of protective measures derived from occupational medical literature and the experience of the port medical service in Hamburg can also be implemented on the high seas. In pandemic times, merchant ships should be equipped with foresight (e.g. with rapid diagnostic tests) and those responsible should be authorized to use effective infection control measures adapted to the situation on board. Seafarers should receive priority vaccination offers regardless of their national origin.

Online survey among maritime pilots: job-related stress and strain and the effects on their work ability.

BACKGROUND: Maritime pilots often navigate ships through challenging waterways. The required 24 h standby rotation system (ROS) poses a stressful working situation. This study aims to describe the current job-related stress and strain among maritime pilots and the effects on their work ability, taking into account the different rotation systems. METHODS: Within a cross-sectional survey, pilots of all German pilots' associations were asked to complete an online questionnaire. The 1-week ROS (port pilots) was compared with the 4-month ROS (sea and canal pilots). The pilots' subjective perception of stress and strain was assessed using an established ship-specific questionnaire. Daily sleepiness and work ability were examined respectively using the Epworth Sleepiness Scale (ESS) and the Work Ability Index (WAI). RESULTS: The study group consisted of 401 male German pilots with an average age of 48.5 years (participation rate 46.9%). More than 50% of the pilots evaluated irregular working hours as the main stressor in their job. 79.8% of the pilots (especially 4-month ROS) experienced high psychological demands in their workplace. 83.3% stated having regularly neglected their private obligations due to job assignments. Pilots from the 4-month ROS experienced insufficiently predictable free time and long operation times at a stretch as stressors (p < 0.001 and p = 0.037). Elevated daily sleepiness was found in 41.9% of the pilots. The overall evaluation of the WAI questionnaire showed good to very good work ability at 77.3%. Additionally, no significant differences in the daily sleepiness or the work ability were observed between the pilots of the different two ROS. CONCLUSIONS: Due to their subjectively higher job-related mental demands, their disturbed work-life balance, and their long operation times at a stretch, it is likely that pilots from the 4-month ROS have significantly higher job stress compared to those in the 1-week ROS. However, this does not lead to more sleepiness or reduced work ability, which suggests that the pilots of this ROS are highly adapted to their working situation. Nevertheless, intervention measures with shortened ROS amongst sea and canal pilots' associations should be tested in respect of benefit, practicability and acceptance by the pilots.

Global overview of dietary outcomes and dietary intake assessment methods in maritime settings: a systematic review.

BACKGROUND: Seafaring is a risky occupation with high prevalence of risk factors for non-communicable diseases. Food intake and eating habits are important cornerstones regarding health and health promotion. The aim of this study was to provide an overview of dietary intake and dietary intake assessment methods of seafarers and suggestions for applicable assessment tools. METHODS: We systematically searched PubMed and NLM Gateway (for MEDLINE), Web of Science, and SCOPUS up to February 2020 using standard keywords including nutrition OR diet OR meal AND maritime settings. Two independent reviewers extracted the data. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal checklist. RESULTS: From 4449 studies initially identified, 26 articles were included in the final review. Qualitative data (e.g. on unhealthy eating) had been gathered using in-depth individual or group interviews, participant observations, and phone-based chats. Composition of menu analysis, 24 h dietary recall, food diaries/ diet records, dietary habits questionnaire, food stores and food waste of the ship were used to assess the quantitative outcomes (e.g. dietary intakes). Access to meat, processed meat and egg, frozen and canned food items, sugary drinks, alcohol, greasy and salty food was high. In contrast, consumption of fruit, vegetables, dairy products, and cereals was lower than recommended. CONCLUSIONS: Eating habits and dietary intakes in maritime settings are unhealthy. Subjective dietary assessment methods combining menu analysis with new technologies (e.g. mobile-based) might be an applicable method in this hard to reach setting which is the vessels.

Systematic Review on Outbreaks of SARS-CoV-2 on Cruise, Navy and Cargo Ships.

The confined environment of a ship promotes the transmission of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) due to close contact among the population on board. The study aims to provide an overview of outbreaks of SARS-CoV-2 on board of cruise, navy or cargo ships, to identify relevant outbreak management techniques, related problems and to derive recommendations for prevention. Four databases were searched. The study selection included reports about seroprevalences or clinically/laboratory confirmed infections of SARS-CoV-2 on board ships between the first of January, 2020 and the end of July, 2020. A total of 37 studies were included of whom 33 reported outbreaks of SARS-CoV-2 on cruise ships (27 studies referred to the Diamond Princess). Two studies considered outbreaks on the Grand Princess, three studies informed about Nile River cruises and one study about the MS Westerdam (mention of multiple outbreaks possible in one study). Additionally, three studies reported outbreaks of SARS-CoV-2 on navy vessels and one study referred to a cargo ship. Problems in handling outbreaks resulted from a high number of asymptomatic infections, transportation issues, challenges in communication or limited access to health care. Responsible operators need to implement infection control measures which should be described in outbreak management plans for ships to prevent transmission risks, including, e.g., education, testing strategies, communication lines, social distancing and hygiene regulations.

Objective and subjective measures to assess stress among seafarers.

BACKGROUND: Working and living on board merchant vessels often constitute high psychophysical stress for the crews. In this study, the current stress of seafarers is examined by using observation-based and subjective measures. MATERIALS AND METHODS: The workplaces of 70 crew members on board 11 container ships were analysed and evaluated using the objective instrument for the situational screening of mental workload (SMW-S). In addition, standardised interviews were carried out with 198 seafarers about their subjectively experienced stress. RESULTS: According to SMW-S, nautical and technical officers experience psychological strain due to their limited decision latitude, risky work situations and the physical and psychosocial working conditions. Among the ratings, psychological distress is more likely due to the limited decision latitude, physical and psychosocial working conditions and low qualification requirements (and, for the engine room ratings, given the low complexity and variability in their work). The interview results show that the irregular work is stressful for 79% of seafarers, the long working periods for 77%, the long working hours per day for 69% and working under time pressure for 62%. Additional psychosocial burdens are present for 95% of seafarers due to family separation and for 65% due to existing social differences in a multicultural occupation. CONCLUSIONS: Considering the stressful work on board, particular attention must be paid to shipping-specific conditions such as long working times, family and socio-cultural separation and living together in a heterogeneous crew.

Measurement Methods of Fatigue, Sleepiness, and Sleep Behaviour Aboard Ships: A Systematic Review.

Since seafarers are known to be exposed to numerous job-related stress factors that can cause fatigue, sleepiness, and disturbed sleep behaviour, the aim of this review was to provide an overview of the subjective and objective measurement methods of these strains. Using a systematic review, 166 studies were identified within the period of January 2010 to December 2020 using the PubMed database. Of the 21 studies selected, 13 used both subjective and objective measurement methods. Six studies used only subjective and two studies only objective methods. For subjective assessment, 12 different questionnaires could be identified as well as activity and sleeping logs. Actigraphy and reaction time tests (RTT) were the most common objective methods. In single cases, electrooculography (EOG), pupillometry and ambulatory polysomnography (PSG) were used. Measurement-related limitations due to vessel-related impacts were less often reported than expected. No restrictions of daily routines on board were described, and only single-measurement disturbances due to ship movements were mentioned. The present literature review reveals that there are various routines to measure fatigue, sleepiness, and sleep behaviour on board. A combination of subjective and objective methods often appears to be beneficial. The frequent use of actigraphy and RTT on board suggests good feasibility and reliable measurements with these methods. The use of ambulatory PSG in maritime-like contexts suggests that this method would also be feasible on board.

Training seafarers to deal with multicultural crew members and stress on board.

BACKGROUND: The present study describes the intercultural differences in the perception of stress and the preparation of seafarers. MATERIALS AND METHODS: Three hundred twenty-three seafarers (156 [48.3%] Europeans and 167 [51.7%] Southeast Asians) were interviewed about their subjective stress on board. RESULTS: According to the interviews with ship's officers, mostly represented by Europeans, mental stress was most often due to high responsibilities (82.0%), extensive administrative tasks (81.1%) and lack of qualification of seafarers (64.8%). Subjectively, the Europeans questioned were significantly more likely to experience mental stress on board than the Southeast Asians (74.2% vs. 56.3%), whereas the latter were more prone to being physically stressed. 43.1% of the Southeast Asian seafarers often felt lonely on board compared with 26.2% of the Europeans. Preparation for maritime-specific stress in the form of specific training units is only provided in 1 of the 5 universities surveyed. The most important reason for this is a lack of time. Intercultural leadership training was also only offered at one university. CONCLUSIONS: In view of the many psychophysical stressors in daily life on a ship and the lacking respective education, it is recommended to integrate stress management and diversity training in intercultural communication in the higher education of future superiors on board.

Physical influences on seafarers are different during their voyage episodes of port stay, river passage and sea passage: A maritime field study.

INTRODUCTION: During a sea voyage, crew members of vessels are permanently exposed to physical stress caused by noise, vibration and heat. This study aims to describe the extent of the physical influences on board container ships and the resulting stress. METHODS: Up to four scientific investigators accompanied six sea voyages on container ships under German management. Workplace and person-related measurements for noise, vibration and climatic parameters were carried out on the vessels during the three different voyage episodes (port stay, river passage and sea passage). RESULTS: The interviewed seafarers reported, in decreasing order, the level of psychological stress due to vibration (80.6%), noise (71.8%) and, much less, heat (45.7%) in the workplace. In terms of workplace-related physical measurements, the highest noise levels were found in the engine room (104 dB (A)), in the workshop (81 dB (A)) and on deck (77 dB (A)), irrespective of the voyage episode. Some noise measurements in the recreational area revealed levels above the threshold. All measured 180 vibration values were below the relevant threshold limits-with the highest values in the engine room (62 mm/s2), followed by the workshop (37 mm/s2) and the engine control room (34 mm/s2). In terms of thermal comfort, none of the measured climatic parameters differed significantly between the voyage episodes. According to the person-related physical measurements, the noise exposure was particularly pronounced among the engine room personnel with an average noise level of 96 dB (A) (often during cleaning, painting and repair work). In contrast, the deck crew and nautical officers were respectively exposed to an average level of 83 dB (A) and 77 dB (A) at work. DISCUSSION: A relevant stress level due to physical loads was detectable in the present study. As ship crews are exposed to the physical influences on board for 7 days a week over several months, further research is recommended to assess the long-term health effects for seafarers.

Reply to Comment on Oldenburg, M., Jensen, H.J. Stress and Strain among Seafarers Related to the Occupational Groups. Int. J. Environ. Res. Public Health 2019, doi:10.3390/ijerph16071153.

In respect of the above mentioned manuscript [...].

Work profile of maritime pilots in Germany.

Long and irregular shifts, unforeseeable operations and high responsibility are still prominent in the job of a pilot and pose high psycho-physical demands. Furthermore, there is a disturbed work-family balance. Working hours of pilots are highly variable and not bound by regulations due to irregularities of vessel traffic. The pilots have to work in a shifting rotation system. This paper demonstrates the stressors during their work routine and shows the usual working profile of a pilot during their service.

Prevalence of alcohol consumption among seafarers and fishermen.

BACKGROUND: Over the decades, several published studies showing the relevance of alcohol use among seafarers/fishermen have highlighted the dangers of alcohol consumption during working time. The present study aims to provide an up-to-date overview of the prevalence of alcohol consumption among seafarers/fishermen. It also points out their consumption behaviour, depending on socio-demographic and job-related factors. MATERIALS AND METHODS: To detect relevant studies for this systematic review, the electronic database PubMed was searched. All identified studies published between January 2014 and September 2019 were included using the subsequent terms: (alcohol OR ethanol) AND (seafarer OR fishermen OR ship crew OR merchant ship). RESULTS: According to the applied search string, 18 studies were identified. Thirteen of them were selected for this review. The results of the studies about alcohol consumption among seafarers and fishermen showed a wide range of prevalence, from 11.5% to 89.5% (median 53.0%). Concerning seafarers no stratified data were available for further analyses. Among fishermen alcohol consumption has decreased over the period examined (56.9% [2010-2014] vs. 42.3% [2015-2018]). The evaluation of socio-demographic factors showed alcohol consumption was less prevalent in fishermen > 60 years (15.0%). Furthermore, a higher prevalence of alcohol intake was found in those with a lower education (63.9%). In respect of job-related data, 61.0% of the alcohol consuming fishermen reported they had been involved in an accident due to alcohol consumption. CONCLUSIONS: The consumption of alcohol among fishermen has declined over time. Compared with the landbased European population, seafarers and fishermen show a lower prevalence of alcohol use, at least during their stay on board. Due to the limited data available - especially concerning seafarers - further studies on the prevalence of alcohol consumption among shipboard crews are recommended. In particular, these should provide more data on alcohol consumption related to socio-demographic and job-related factors.