Seafaring stressors aboard merchant and passenger ships

Objectives:  The aim of this study was to identify stressors in seafaring aboard merchant and passenger vessels. Furthermore, their dependence on occupational and non-occupational factors was assessed. Methods:  A total of 134 male seafarers sailing under Germanflagged vessels were interviewed (response 81.3 %). The seamen rated the individual stress level of 23 different stressors aboard. Results:  Separation from their family (named 48 times), time pressure (30 times), long working days (28 times), heat in workplaces (24 times), and insufficient qualification of subordinate crew members (16 times) were regarded as the most important stressors aboard. In comparison to non-officers, officers stayed on board for considerably shorter periods (4.8 vs. 8.3 months) but had significantly more often an extremely high number of working hours (63.5 % vs. 21.1 %, Chi-square-test: p < 0.001). Correspondingly, officers complained more frequently of a higher stress level due to time pressure (52.4 % vs. 36.6 %). Conclusions:  Particular attention should be paid to preventive organizational measures such as avoiding long-time separation from family, time-pressure, extremely long working days, and a long stay on board. Submitted: 10 August 2007; revised: 25 September 2008, 16 December 2008; accepted: 23 January 2009     

中国海员截缩简略寿命表（1979—1983年）

本文报告了1979～1983年期间的中国海员截缩简略寿命表。研究结果表明:海员在15周岁时平均预期寿命为57.87岁,较同期居民低0.5岁;年龄在35岁以上的海员,健康水平有所下降,提示长期航海工作可能导致死亡危险性的增高;海员死亡年龄中位数为56.56岁,其死亡模式之特征不是以老年人口为主。据此,笔者认为海员在岗工作年限不宜过长,如能在45岁以后改为岸上作业,可望延长寿命。     

膳食对船员营养和免疫状况的影响(论著)

目的：了解改善膳食对船员航海期间营养与免疫状况的影响。方法：检测了５６名航海船员膳食改善前后的营养素摄入量，以及维生素Ａ、Ｂ１、Ｂ２、Ｃ和尼克酸体内含量，血清免疫球蛋白、补体Ｃ３水平和外周血Ｔ淋巴细胞亚群等营养与免疫指标。结果：膳食改善前，船员补体Ｃ３，Ｔ淋巴细胞ＣＤ４亚群，维生素Ｂ２和Ｃ的４小时负荷尿含量分别为０．８８±０．３０ｇ／Ｌ，３７．０６％±５．４９％，３０７．９０±１４８．４０μｇ和１．８０±０．９０ｍｇ。膳食改善后依次增加到１．１３±０．３３ｇ／Ｌ，４１．１８％±５．９７％，５１２．６０±１０３．９０μｇ和４．７０±１．０１ｍｇ。各指标膳食前后差别有显著性意义（Ｐ＜０．０５）。结论：改善膳食可增强船员免疫功能和营养状况。     

北方海域航海人员血压调查及影响因素分析

目的 了解北方海域航海人员高血压发病情况及影响因素。方法 对北方海域航海人口（数千名）按统一方法测量血压。结果 （1）高血压总患病率为10．36％。（2）＜35岁者患病率（9．54％）显著高于1991年全国血压抽样调查的同龄男性（5．5％）（P＜0．001）。（3）相关与回归分析表明,对血压有明显并呈正相关的因素为：年龄、体重指数（BMI）、海龄、食盐量、饮酒、心率和高血压家族史（P＜0．01）。结论 北方海域航海人员的高血压患病率偏高,应采取切实可行的方法进行防治。     

船员梅毒患病情况调查分析

目的 :分析远洋船员梅毒的患病情况 ,重视船员性健康教育。方法 :对 2 0 0 0～ 2 0 0 1年上远洋船舶的船员进行血清梅毒检测 ,并作梅毒螺旋体明胶凝集试验 (TPPA)确诊。结果 :3 877名船员中 ,梅毒阳性者 18例 ,患病率为0 46%。 5 2岁以上年龄段船员患病率明显低于其它年龄段。大专以上的船员患病率明显低于初中、高中、技校和中专船员。远洋船员患病率明显低于国内航线船员。均以早期潜伏梅毒为主。结论 :船员梅毒的患病率明显高于一般人群 ,应引起社会及有关方面的重视     

Symptoms, lung and liver function, blood counts, and genotoxic effects in coastal tanker crews

 Objective The deck crew on tankers can be exposed to high concentrations of benzene and other chemicals during loading, unloading and tank-cleaning operations. The objective of this study was to investigate whether genotoxic or other early health effects of cargo vapour exposure could be detected in coastal tanker crews. Methods The association between exposure to cargo vapours and clinical symptoms and signs, spirometry, blood cell count, blood tests for liver function, and the frequency of micronuclei and sister chromatid exchanges in peripheral lymphocytes was studied in a cross-sectional investigation of 107 male crew members (66 deck crew and 41 others) on ten coastal tankers. Results Seven of the tankers had automatic cargo level gauging systems but some of the ships still had open hatches during loading and unloading operations. Acute symptoms such as headache, nausea, vertigo, fatigue and dizziness after loading or tank-cleaning operations were reported by 56 of the 66 deck crew members (85%). Irritation of the mucous membrane in eyes and upper respiratory tract by cargo vapours were also common in this group. Obstructive symptoms were more common in the group with the highest exposure to cargo vapours but persistent effects on lung function (vital capacity and forced expiratory volume in l s), nervous system, liver enzymes or blood counts were not found. The frequency of micronuclei after mitotic stimulation with phytohaemagglutinin was higher among the deck crew (mean 4.2, SEM 0.40) than in other crew members (mean 3.6, SEM 0.35), although the difference was not statistically significant. We found no association between exposure and the frequency of sister chromatid exchanges or micronuclei after stimulation with pokeweed mitogen. Conclusion This study indicates that exposure to cargo vapours in coastal tanker crews may cause symptoms in the respiratory and nervous systems. Received: 24 July 1996/Accepted: 20 September 1996     

北方海域航海人员正常高限血压的发生率及因素分析

目的　了解北方海域航海人员正常高限血压 (HNBP)的发生率及影响因素。方法　对4 0 72名北方海域的航海人员按统一方法进行血压测量与问卷调查。结果　 (1) HNBP发生率为17.88%。 (2 ) HNBP组与除外 HNBP的正常血压组相比 ,饮酒、家族史及体重超重的人数比例明显增高(P<0 .0 5 ) ,HNBP组年龄、海龄、心率、食盐量、A型行为均值与焦虑均值均明显高于正常组 (P<0 .0 5 )。结论　血压在正常高限的北方海域航海人员中存在多种高血压的相关因素 ,对该组人群应注意随访观察 ,加强防护措施。     

船员屈指肌腱损伤的治疗

目的探讨船员屈指肌腱损伤的特点和治疗方法。方法对本院收治的５２例船员屈指肌腱损伤临床资料进行总结并着重对治疗效果进行分析。结果本组Ⅰ期修复４３例１６８条,Ⅱ期修复９例２４条。术中用套圈缝合法或改良Ｋｅｓｓｌｅｒ法缝接肌腱,Ⅱ期行粘连肌腱松解术８例２５条,术后２４小时开始功能锻炼。治疗效果经对４３例１４６条随访３个月～３年（平均１年６个月）,根据ＴＡＭ疗效标准评定为：锐割伤５７条中,优４７条,良８条,中２条,优良率为９６．５％;缆绳绞轧伤３６条中,良２１条,中９条,差６条,优良率为５８．３％;压榨断开伤５３条中,优２９条,良１６条,中６条,差２条,优良率为８４．９％。结论屈指肌腱损伤疗效与损伤类型关系密切。锐器切割伤疗效最佳,缆绳绞轧伤最差。对缆绳绞轧伤应积极创造条件,采取相应措施,以提高其疗效     

应激对海员心理及血清甲状腺素、睾酮和皮质醇含量的影响

目的　研究海员应激对心理、神经、内分泌免疫的影响。方法　海员 85人为海员组 ,同地区码头作业人员 75人为对照组 ,采用症状自评量表 (SCL- 90 )、匹兹堡睡眠质量指数量表 (PSQI)进行测评。同时测定海员组、对照组的血清总甲状腺素 (TT4 )、总三碘甲状腺原酸 (TT3)、睾酮 (Testo)及皮质醇(Cortisol)水平。结果　海员组较明显的心理不良反应为人际敏感、抑郁、躯体化、敌对、偏执等。海员组除抑郁因子分、恐怖因子分与军人常模无明显差异外 ,其余各项因子分、阳性项目数均明显高于军人常模 (分别 P<0 .0 5～ <0 .0 0 1) ;海员组与对照组比较 ,除恐怖因子分外 ,其余各项因子分、阳性项目数均明显高于对照组 (均 P<0 .0 0 1) ;海员组 4 2 .4 %存在睡眠质量问题。与对照组比较 ,海员组 TT3、Testo、Cortisol的水平显著增高 (均 P<0 .0 0 1)。TT4 两组差异不显著 (P>0 .0 5 )。结论　海员面临多种应激源 ,有不同程度的心理不良反应 ,心理应激反应影响神经、内分泌及免疫系统的变化。     

吲哚美辛治疗海员中牙龈炎的疗效观察（论著）

目的：观察海员中牙龈炎应用吲哚美辛（消炎痛）治疗的临床疗效，并与灭滴灵治疗作比较，探讨其对牙龈炎优良效用的机理。方法：选口腔科门诊患牙龈炎的海员１８９例，主要以牙龈指数（ＣＩ）为观察指标。实验分吲哚美辛组（６４例）、灭滴灵组（６３例）和对照组（６２例），各组分别治疗１周后进行治疗前后与组间比较。结果：吲哚美辛和灭滴灵组的ＧＩ与治疗前比均非常明显降低（Ｐ＜０．０１），同时此两组与对照组比均有非常显著性差异（Ｐ＜０．０１），而吲哚美辛组与灭滴灵组间无显著性差异。吲哚美辛组中不同年龄和不同类型龈炎的ＧＩ于治疗后均明显降低，而边缘性龈炎的ＧI比肥大性龈炎者降低更明显，但各年龄组间的ＧＩ相比无显著性差异。结论：吲哚美辛对海员龈炎有较好的疗效，对边缘性龈炎的作用优于肥大性龈炎；吲哚美辛用途广、携带使用方便，可作为海员远航的备用药物。