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

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

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

Can a transgender person be an occupational diver? Demonstration from a case report

This is the first case report about a transgender professional diver. The purpose of this article is to show the professional adaptations to help him to continue occupational dive and to raise the question of the impact on diving risks of hormonal treatment in this case. He was a 39-year-old man when he began his transition. He had worked as a diver for 9 years before his transition. When he changed to look like a woman, there were a few difficulties in continuing his professional activity. The main difficulty was that he looked like a woman while working with men. Modesty was a crucial issue in the enterprise. There were other problems such as the organisation of premises, the physical workload and the interaction between treatments and diving. There is a lack of a law to guide the employer. French legislation does not address the issue of transsexuals for this profession. The medical recommendations do not specify contraindications or adaptations for diving safely. Because of his transition, he lost muscle mass. The occupational physician helped to adjust his activity: decreasing the weight of his diving suit, creating a female-like locker room etc. Finally, the question of the risk of decompression illness arose. Legal hormonal medication seems not to significantly increase the risk of decompression illness, but this diver was taking illicit treatment to speed up the transition. The occupational physician recommended taking the legal hormonal medication

Occupational asthma in the commercial fishing industry: a case series and review of the literature

We present a case series of snow crab-induced occupational asthma (OA) from a fishing and processing vessel, followed by a review of OA in the commercial fishing industry. OA is typically caused from an IgE-mediated hypersensitivity reaction after respiratory exposure to aerosolized fish and shellfish proteins. It more commonly occurs due to crustaceans, but molluscs and fin fish are implicated as well. Standard medical therapy for asthma may be used acutely; however, steps to reduce atmospheric allergen concentrations in the workplace have proven to be preventive for this disease. Int Marit Health 2010; 61, 1: 13-1