Don’t forget about seafarer’s boredom

Background: The question we asked was whether it is worthwhile screening for seafarers who are prone to boredom, and whose mental health might deteriorate on board because of the particular character of life at sea. Materials and methods: We used the Farmer and Sundberg Boredom Proneness Scale (BPS), validated in French, as well as the Zigmond and Snaith Hospital Anxiety and Depression Scale (HADS). The survey was voluntary and responses were collected by means of questionnaires which were returned by post.  Results: Eighty seafarers (40 officers and 40 crew) as well as 63 office staff from the same shipping company were included in the survey. We found a significant difference between officers and operational personnel: average score of 8.4 ± 5 (median = 7) for officers and 10.2 ± 4.8 (median = 10) for operational personnel. 21% of the officers have scores greater than or equal to 12 compared with 41% of the crew. There is a significant correlation between the BPS and HADS test scores, in terms of depression, for the office staff and the seafarers taken as a whole; this correlation being highly significant among officers (r = +0.85), but only marginally significant among crew members (r = +0.54).  Conclusions: The BPS may be useful in screening for seafarers prone to boredom and depression for their fitness for embarkation.

Deaths on board: medical and legal implications for the maritime physician

When death at sea occurs many people are implicated. The assignees of victims often look for detailed circumstances of deaths at sea, and the doctor, besides his preventative role, has to certify the death on board and try to determine the circumstances with a view to a legal investigation if it proves necessary. In this work are presented the main causes, facts, and characteristics of human deaths at sea, and the responsibility of the ship's doctor in case of death on board. Int Marit Health 2010; 61, 1: 24-2

Occupational asthma in maritime environment

In the maritime environment, characterized by a great biodiversity, employees can be during their work exposed to chemical and above all biological substances. Some of them are the cause of occupational asthma. This is the case for some fished products such as crustaceans and mollusks and also for some products carried as cargo like cereals or chemicals used in the maintenance of ships. This article is a review of known etiological factors of occupational asthma (OA) to which seafarers and other maritime workers are likely to be exposed

Evaluation of the sensitisation to grains and its pulmonary impact in employees of the port of Brest silos

Background: Evaluation of the sensitisation and levels of exposure to grains and its pulmonary impact ina population of Brest port silo employees.Materials and methods: We included exposed workers. The study consisted of clinical examination witha standardised questionnaire, blood samples, prick-tests, and spirometry tests. The atmospheric concentrationof total dust in the workplace was also associated.Results: Eight workers were included in the study. No case of occupational asthma was found, but 3 casesof occupational rhinitis were noted and occupational prick-tests were positive in 4 cases. The mean totaldust concentration in the three atmospheric samples was 4.87 mg/m3 for 8 hours but it was under thedetection limits for alveolar fractions.Conclusions: Port silo workers are exposed to total dust concentrations below the French legal limit(10 mg/m3) but higher than Canadian and American recommendations. Levels of exposure in our studyare similar to other studies developed in port silos. Symptoms developed by workers may be due to highexposure to dust with an irritant effect rather than an allergic effect. Despite this fact, a specific medicalsurvey is needed, and ventilation and respiratory masks have to be promoted for prevention

Occupational asthma in maritime environments: an update

In 2006 we published our first review based on the available literature on occupational asthma in maritime environments in the “International Maritime Health” journal. Since then, we have obtained a great deal of new knowledge on asthma in seafood workers and fishermen and on the impact of exposures from sulphites preservatives, container fumigants etc. in maritime workers. This review aims to provide an update of the current knowledge base about occupational asthma in a maritime context and to provide recommendations regarding medical surveillance of workers at risk

A case of occupational asthma from metabisulphite in a fisherman

Background. The objective was to describe a case of occupational asthma in a fisherman linked to the inhalation of metabisulphites, then to discuss the history and actions for prevention. Material and methods. We report the case of a fisherman fishing for Dublin bay prawn (Nephrops), who suffered from asthma after being exposed to metabisulphites. This case is compared with other cases in the occupational medical literature. He was a 53-year-old male and a former smoker, who presented with dyspnoea and a very productive cough, due to both chronic exposure to metabisulphites and acute exposure to contamination due to the breakdown of the ventilation system in the trawler on which he was fishing. The symptoms appeared to be occupational. Tests carried out in the following months revealed reversible airway obstruction with non-specific bronchial hyperreactivity, while allergy tests were negative. A visit to the trawler allowed us to determine the unusual cause of exposure in the case. Other reported cases concern normal working processes causing reversible airway obstruction. Discussion. Metabisulphites are antioxidants and preservatives used in the food industry which have been identified as the causative agent in occupational asthma since the 1980s. Only two other cases have been previously reported in fishermen, however. The clinical presentation of our subject was notable for the productive nature of his cough. The appearance of symptoms after combined acute and chronic exposure made us consider an irritative pathophysiology in this asthma, as opposed to sensitization. The negative allergy testing in this subject was similar to other cases reported in the literature. Our subject alone was submitted to patch testing, which was also negative. Conclusions. Our case represents occupational asthma caused by metabisulphites with clinical signs notable for the productive nature of the cough. Few cases have been reported amongst fishermen despite the significant use of this substance with irritant and sensitizing characteristics in the workplace

Occupational poisoning by carbon monoxide aboard a gas carrier. Report on 8 cases

Objectives - To determine the accidental factors and the clinical symptoms in eight cases of occupational poisoning of port workers by carbon monoxide. - To consider the primary prevention of this serious pathology occurring at work. Methods - To analyze the circumstances of the exposure to carbon monoxide in the employees in the naval repair sector. - To indicate the systemic failures causing this accidental poisoning, the means for early diagnosis and appropriate treatment, and to discuss the prevention of such accidents. Results. The poisoning occurred in eight mechanics and electricians working without any protective means in a gas carrier tank in dry dock. The employees, unaware of carbon monoxide exposure, stayed for 45 minutes in an atmosphere polluted with carbon monoxide concentrations of over 500 ppm. The main complaints were of headache, muscular weakness, and drowsiness. No post-interval syndrome was found three weeks after poisoning. The levels of carboxyhaemoglobin varied from 1.8 to 31.2%. Early normal pressure oxygen therapy reduced the symptoms. No delayed syndrome was found three weeks after poisoning. Conclusions. The inclusion of poisonous gas in gas-free certification, adherence to maritime harbour regulations, greater respect for working instructions in hazardous environments, and the use of detectors appropriate to the conditions for each ship would avoid exposure and decrease the risk of poisoning

Stress in seamen and non seamen employed by the same company

Objectives: The aim of this survey was to compare the level of professional stress among seamen – crew members - who work on French oceanographic vessels to the one of technicians and engineers from the oceanographic institute, who board the ships to operate special equipment during sea voyages. Results: two groups of subjects were included: 74 seamen and 74 non seamen, males of comparable ages were questioned. Results showed that there was no significant difference in strain at work and social support between them (41 seamen and 50 non seaman professionals who filled in the questionnaires). There was a very significant difference in the decision latitude: much lower level for seamen as compared to non seamen. 17% compared to zero percent of non seamen were ranked in the heavy strain/low decision latitude category regarded by Karasek as a high risk of stress (compared to 0% of non seaman professionals). 33% of seamen in this group reached a score that indicated psychical stress according to Langner’s total health test. Conclusion: The results of the survey show that the occupation of seamen includes specific elements regarded by Karasek as leading to a risk of stress. Method: Two questionnaires were used for collecting data: - Langner’s total health test (22 items) that investigates the level of psychical stress, - Karasek’s "Job Content Questionnaire" (38 items) used for investigation of strain at work, psychological pressure, decision latitude and social support. Data were processed by a statistical software : Sphinx, using Chi² test. Results: two groups of subjects were included: 74 seamen and 74 non seamen, males of comparable ages were questioned. Results showed that there was no significant difference in strain at work and social support between them (41 seamen and 50 non seaman professionals who filled in the questionnaires). There was a very significant difference in the decision latitude: much lower level for seamen as compared to non seamen. 17% compared to zero percent of non seamen were ranked in the heavy strain/low decision latitude category regarded by Karasek as a high risk of stress (compared to 0% of non seaman professionals). 33% of seamen in this group reached a score that indicated psychical stress according to Langner’s total health test. Conclusion: The results of the survey show that the occupation of seamen includes specific elements regarded by Karasek as leading to a risk of stress

Temporary and permanent unfitness of occupational divers. Brest Cohort 2002–2019 from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P)

Background: In France, the monitoring of professional divers is regulated. Several learned societies (French Occupational Medicine Society, French Hyperbaric Medicine Society and French Maritime Medicine Society) have issued follow-up recommendations for professional divers, including medical follow-up. Medical decisions could be temporary unfitness for diving, temporary fitness with monitoring, a restriction of fitness, or permanent unfitness. The aim of study was to point out the causes of unfitness in our centre. Materials and methods: The divers’ files were selected from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P). Only files with a special medical decision were selected, between 2002 and 2019. Results: Three hundred and ninety-six professional divers are followed-up in our centre and 1371 medical decisions were delivered. There were 29 (7.3%) divers with a special medical decision, during 42 (3.1%) medical visit. Twelve (3.0%) had a permanent unfitness. The leading cause of unfitness was pulmonary diseases: emphysema (3), chronic obstructive pulmonary disorder (2), asthma (2). Sixteen (4.0%) divers had temporary unfitness. The leading causes were cardiovascular (4 times) and neurological (6 times). Twelve (3.0%) divers had had at least one decompression sickness. Conclusions: Judgments of permanent unfitness for diving were rare (3.0% of divers), but were because of life-threatening disease. Medical follow-up of occupational divers was justified to decrease the risk of fatal event during occupational dives