Does long-term length of stay on board affect the repatriation rates of seafarers?

Background: The length of seafarers’ contract has undergone scrutiny regarding the health, welfare, and fatigue of the crew. This study investigates whether a stay of more than 200 days can increase the risk of medical repatriation among Filipino seafarers. Materials and methods: We reviewed the number of medical repatriations from January 2014 to December 2016, specifically those who were repatriated after more than 200 days on board. We used WHO ICD-10 classification to categorise diseases and medical events that cause the repatriation, and classified them under “Injury” or “Illness” as defined by the Occupational Injury and Illness Classification Manual. We also separated those who worked on cargo vessels as well as those who worked on passenger ships. We requested for the total number of seafarers who worked longer than 200 days on board. After calculating a repatriation rate for this specific group of long-term workers, we then compared this with a previous study. Chi-square analysis and regression analysis were applied to analyse the data comparing the passenger versus cargo ships repatriation rates. Results: There were a total of 840 cases of long-term repatriations in this study for the 3 year period. The total number of crew who had stayed for more than 200 days was 51,830. The different causes of repatriation are presented. Repatriation rates are also shown and a study of the regular stay and long term contracts are also compared. Conclusions: There are various disease entities significantly higher in the long term work group. We offer some possible explanations for some of these differences in repatriation rates. This data could be useful in planning of schedules, work hours and contracts as well as the prevention of disease in seafarers

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 aimof the study was to follow up on the previous 2010–2014 study using data from 2015–2019 to evaluatethe epidemiology of medical repatriation among Filipino seafarers.Materials and methods: Data from medical repatriation records of Filipino seafarers from January 2015 toDecember 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 periodresulted in a medical repatriation rate calculated at 1.4%. We used the 10th revision of the InternationalStatistical Classification of Diseases and Related Health Problems (ICD-10) to determine the most commoncauses 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 continuedprofiling of health issues should lead to better health protocols and controlling medical costs. Itshould also lead to better prioritisation of health protection and care on board ships. Within the present10-year database of medical repatriations coinciding with the implementation of Maritime ConventionLabour Convention 2006, there is a compelling need to compare the two data sets to have an objectiveevaluation of the convention’s projected goals

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The Pierre Auger Observatory: Contributions to the 33rd International Cosmic Ray Conference (ICRC 2013)

Contributions of the Pierre Auger Collaboration to the 33rd International Cosmic Ray Conference, Rio de Janeiro, Brazil, July 201