Apart from accidents and work related injuries caused by external factors, being the primary cause of death at sea and repatriation of seamen and fishermen from ship to hospital on shore, acute cardiovascular incidents are the main internal causes of their death, both at sea and on land, as well as of long lasting sick leave and disability (14).
In the regulations on health requirements for persons working on sea-going ships and in inland navigation (orders of the Ministry of Health 1993, 1996, 2003, guidelines (39), EU directives and other national regulations) and in the register of diseases and conditions disqualifying from such an employment (EU directive, annex to the order of the Ministry of Health 1993, European Commission (32,33), ILO/WHO guidelines(39), cardiovascular diseases are only generally mentioned. The minimal scope of examinations is recommended for seafarers in age up to 50 years, and for older seafarers, but without the assessment of their occupational risk. This gives rise to ambiguities in interpretation at the time of issuing their health certificates, and also in judicature when analyzing cause-and-effect relationship between the occurrence of an acute cardiovascular incident during the ship’s voyage and conditions of the work at sea.
Principles, possibilities and benefits are discussed in this paper, which may be expected from the general assessment of cardiovascular diseases risk at the time of the health assessment for the work at sea. The risk forecasting, health certification and the question of choosing primary preventive methods are included in this presentation.
Dr Elżbieta Rosik, MD. Outpatient Clinic of the Academic Centre for Maritime and Tropical Medicine, Autonomous Public Clinical Hospital of the Medical University of Gdańsk
Dr Bogdan Jaremin, MD, PhD, Head of the Clinic
Dr Kinga Szymańska, MD, Clinic of Occupational and Internal Diseases of the Academic Centre, Medical University of Gdańsk
Outpatient Clinic of the Academic Centre for Maritime and Tropical Medicine,
Autonomous Public Clinical Hospital of the Medical University of Gdańsk
Address for correspondence:
Dr Elżbieta Rosik,
Outpatient Clinic, Academic Centre for Maritime and Tropical Medicine,
Powstania Styczniowego 9b, 81-519 Gdynia, Poland
Fax: 048-58-622 3354