Five-year (2015-2019) follow-up study of 6,526 cases of medical repatriation of Filipino seafarers.

BACKGROUND: There is a limited number of studies on the medical repatriation of seafarers. The aim of the study was to follow up on the previous 2010-2014 study using data from 2015-2019 to evaluate the epidemiology of medical repatriation among Filipino seafarers. MATERIALS AND METHODS: Data from medical repatriation records of Filipino seafarers from January 2015 to December 2019 were collected from various claims departments of different manning agencies in Manila, Philippines. RESULTS: Data from a total of 6,526 medical repatriation cases and 464,418 deployments in a 5-year period resulted in a medical repatriation rate calculated at 1.4%. We used the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) to determine the most common causes of repatriation. We found that these were musculoskeletal disorders, gastrointestinal problems, and traumatic injuries. The distribution of the specific illnesses per organ system is presented. CONCLUSIONS: Filipinos continue to represent the most numerous group of seafarers in the world. The continued profiling of health issues should lead to better health protocols and controlling medical costs. It should also lead to better prioritisation of health protection and care on board ships. Within the present 10-year database of medical repatriations coinciding with the implementation of Maritime Convention Labour Convention 2006, there is a compelling need to compare the two data sets to have an objective evaluation of the convention's projected goals.

Emollient prescribing formularies in England and Wales: a cross-sectional study.

OBJECTIVE: To identify and compare emollient formularies across all clinical commissioning groups (CCGs) and local health boards (LHBs) in England and Wales. DESIGN: Formularies were retrieved via CCG/LHB websites or Google search (October 2016-February 2017). Data on structure and content were extracted, and descriptive analyses were undertaken. SETTING: 209 English CCGs and 7 Welsh LHBs. MAIN OUTCOME MEASURES: Number and structure of formularies; number, type and name of emollients and bath additive recommendedandnot recommended; and any rationale given. RESULTS: 102formularies were identified, which named 109 emollients and 24 bath additives. Most were structured in an 'order of preference' (63%) and/or formulation (51%) format. Creams and ointments were the most commonly recommended types of emollients, and three ointments were the most commonly recommended specific emollients (71%-79% of formularies). However, there was poor consensus over which emollient should be used first line and 4 out of 10 of the most recommended lotions and creams contained antimicrobials or urea. Patient preference (60%) and/or cost (58%) were the most common reasons given for the recommendations. Of the 82% of formularies that recommend the use of bath additives, 75% did not give any reasons for their recommendation. CONCLUSIONS: Emollient formularies in England and Wales vary widely in their structure, recommendations and rationale. The reasons for such inconsistencies are unclear, risk confusion and make for inequitable regional variation. There is poor justification for multiple different, conflicting formularies.