Textbook of Maritime Medicine

Seafaring has always been considered a dangerous occupation. Crews of merchant ships are exposed to extremes of weather, hazards connected with the operation of mechanical equipment, toxic cargoes and toxic substances used aboard. Seamen are swept overboard by heavy seas, and die as a result of vessel casualties (such as foundering, capsizing, explosions, fires).

Their health is affected by noise, vibration, smoke inhalation, fatigue, overwork, and other exposures described in the chapters of this book.

Travel to the tropics is connected with exposure to exotic diseases including malaria.

In case of sudden illness or an accident and injury during the ship’s voyage, the chances of receiving proper and effective treatment is not as good for seafarers as for workers on shore because of lack of direct and prompt access to qualified medical assistance. Seafaring is therefore a dangerous occupation with a higher morbidity and mortality rate than in most occupations onshore.

Statistical data on morbidity and mortality among seafarers have been regularly collected , analyzed and compared in many countries. Numerous papers have been published on this subject in the medical literature. A good source of information is data published by the International Labour Organization (ILO). The problem is that various methodologies were used in these studies, and therefore data may not always be comparable.

Even more dangerous is the occupation of fishermen. Data on their morbidity and mortality have also been published since decades, including the classical papers by Schilling in the UK ( R.S.F.Schilling, 1971, Hazards of deep-sea fishing. Brit Journ Industr Med 28,27).

Numerous papers published by the ILO, in the International Maritime Health Journal, British Journal of Industrial Medicine, Journal of Occupational Medicine, and many other scientific journals provide a wealth of statistical data and analyses on the work-related morbidity and mortality among seafarers and fishermen. Due to this quantity, it would be not possible to refer to them in this chapter. The reader is therefore directed for instance to the web page www.ilo.org/safework_bookshelf and to other database for detailed and actual information on the subject.

Regarding the accidents and injuries of seafarers, they have generally been recorded more frequently on older than on newly constructed ships, on smaller than on large ships; on general cargo than on tanker ships.

Regarding the work-related mortality among fishermen in various countries, published data from Denmark indicated that it was 25-30 times higher than in workers on shore. In the USA it was 8 times higher than in truck drivers, 16 times higher than in policemen, and 40 times higher than in general population of the country.