Health status of a sample of Beninese seafarers examined on the occasion of medical fitness for work at sea

Background: In view of the considerable risks involved in maritime work, the medical fitness of seafarers is of paramount importance. A study carried out in May 2018 in Benin made it possible to describe the health profile of seafarers who received a medical examination before boarding and to identify the diseases likely to hinder their medical aptitude for this profession. Materials and methods: This is a retrospective cross-sectional study that was based on 125 medical files registered from 2013 to 2017 and selected on the basis of the criteria of completeness, readability and non-overload of the entries. Results: The results showed that more than half (63.2%) of the seafarers in our series are over 40 years old. The prevalence of high blood pressure was 28.4% in the seafarer population. Obesity was detected in 21.5% of subjects. Of the moderate cases of hearing loss found, 4 out of 5 worked at the machine station. The unrestricted fitness level was 86.4%. One (0.8%) case of physical restriction and 12.8% of cases of mandatory wearing of medical glasses at work were reported. The “healthy worker effect” may underestimate the risk of marine activity to the health of seafarers when referring to the general population. Conclusions: The study provides opportunities to improve the seafarers’ health situation in accordance with international provisions such as the Maritime Labour Convention, 2006 (MLC, 2006) ratified by Benin in June 2011

Cardiovascular risk factors in seamen and fishermen: review of literature

Background and aim: The aim of this study was to evaluate the prevalence of risk factors for cardiovascular disease among sailors and their evolution over time.Materials and methods: This study is a review of the literature from Medline® database and the Medicina Maritima journal. With prevalence studies, the overall prevalence was calculated; 2 groups were created according to the study period (1990s vs. 2000s) and compared by c2 test with Mantel-Haenszel correction.Results: Eighteen articles were selected (total: 57,473 European sailors and 327 non-European sailors). Smoking prevalence varied between 37.3 and 72.3%; overweight prevalence between 27.9 and 66.5%; hypertension was between 8.2 and 49.7%; hypercholesterolaemia (“high blood level of cholesterol”) variedbetween 25.1 and 42% of the populations studied; between 3.3 and 9.3% of the populations studied suffered from diabetes. Two studies showed a 10-year cardiovascular risk comparable to that of the general population. After calculating with similar studies, the prevalences were 61.4% for smoking, 60.9% for overweight, 30.1% for hypertension, 34.6% for high cholesterol, and 3.6% for diabetes. Smoking prevalence was significantly lower in 2000s (45.4% vs. 61.3%, p < 0.01), those of overweight, hypertension and hypercholesterolaemia were higher (64.1% vs. 47.1%, p < 0.01, and 42.1% vs. 14.8%, p < 0.01, 42.0%vs. 33.9%, p = 0.02).Conclusions: Modifiable risk factors are the most studied. Smoking tended to decrease in the 2000s

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

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.

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

Comments to Nordmo et al.’s article: effect of hardiness

We would like to comment on Nordmo et al.’s article on hardiness among Norwegian Royal Navy seamen. The article is very interesting. Understanding the sleep disorders of the military can indeed make it possible to favour the preservation of their health and their competencies. The authors have highlighted the limitations of their study. They will take into account the sleep disorder factors already described in literature, such as: noise, comfort on board, shift organisations, etc. We would like to make two comments: on the one hand, highlight another limit to help future studies; on the other hand, open another perspective of prevention, not described in this article

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