Background - Work in commercial fishing is physically demanding and hazardous, but unlike merchant seamen, fishermen are not required to hold a certificate of medical fitness. <br/><br/>Aims - To investigate the case for regulatory medical standards for commercial fishermen and to identify priorities for the prevention and management of occupational injuries at sea. <br/><br/>Methods - We surveyed a convenience sample of fishermen at three major fishing ports in South West England using a standardized interview-administered questionnaire. <br/><br/>Results - Interviews were completed by 210 (68%) of 307 fishermen approached. Over their careers, 56 subjects (27%) had been returned to shore as an emergency for medical reasons, a rate of 14.6 (95% confidence interval 11.5–18.2) per 1000 man-years. Most emergency evacuations were for acute injuries, and only five were for illness. A few participants suffered from chronic disease that would call into question their fitness to go to sea. Fifty-five fishermen had suffered injuries in the past 12 months, including 12 that had caused loss of more than 3 days from work. Subjects had self-stitched 4 of 15 reported hand lacerations, while others had been bound with ‘gaffer’ tape. <br/><br/>Conclusions - Prevention of hand lacerations should be a high priority, with first-aid training and equipment for fishing crews to improve their care when prevention fails. No firm conclusions can be drawn about the value of regular medical screening for commercial fishermen, but such screening should be considered a lower priority than accident prevention<br/
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