To study crew sick leave aboard and medical sign-off during one year (2004) among crew on a passenger ship doing worldwide cruising.
Patient data were registered continuously during the year and reviewed afterward.
There was an average of 612 crew members (22% women) aboard. There were 6,378 recorded crew visits (= 17.5 per day), 3,705 of which directly involved the doctor (= 10.2 per day). Four-hundred-and-fifty-one crew were on sick leave aboard for a total of 829 days. One-hundred-and-thirty-eight crew were isolated for a total of 268 days (= 32% of all sick leave) to prevent spreading of gastroenteritis. Among the 142 reported injuries, 77 (54%) led to sick leave on board for a total of 182.5 days (= 22% of all sick leave). Fifty-six crew were referred to dentists and 18 to medical specialists in port. Twenty-eight crew were medically signed off, 16 (57%) of them following injuries, and 7 (25%) for pre-existing conditions. Three crew were hospitalized in port prior to repatriation.
Crew consultation rates were high and sick leave rates low. Many factors aboard promoted sick presenteeism, minimized absenteeism, prevented malingering and reduced the length of sick leave. A substantial part of the sick leave was imposed by management and doctor, and if it was up to the crew, the number of sick leave days would have been even lower. The crew was eager to work, and their work morale was high.
Prof.Dr Eilif Dahl, MD, MHA, PhD, Medical Consultant
Surgical Department, Rikshospitalet- Radiumhospitalet Health Enterprise,
0027, Oslo, Norway,
Phone: +47 22 56 23 24,
Fax: +47 22 56 31 12
Potential conflict of interest:
The author has worked part time for a number of cruise companies as an independent maritime medical consultant and as a ship surgeon