Recent Research Activities from the EOM Working Groups

Surveillance of maritime deaths on board Danish merchant ships, 1986 - 2009

Daniel F. Borch, Henrik L. Hansen, Hermann Burr, Jørgen R. Jepsen

Int Marit Health, 2012; 63, 1: 7–16        

Background: A previous study demonstrated a high death rate among seafarers signed on Danish ships during the years 1986–1993. This study aimed to examine and analyse the subsequent development until 2009.

Material and methods: A total of 356 fatalities were identified from data supplied from the Danish Maritime Authority, an insurance company, and other sources. Maritime deaths among seafarers signed on Danish ships comprise deaths from 1) accidents, suicides and homicides; and 2) disease on board. Deaths due to 2) occurring ashore within 30 days after signing off were included. The overall and mode-specific death rates were calculated for three eight-year observation periods. The rates for work-related fatal accidents were compared with the rates for landbased trades.

Results: All categories of maritime deaths were significantly reduced from 1986 to 2009 — in particular during the last eight-year period (Accidents 1986-1993: 66.6 per 100,000 person years, 2002–2009: 27.0 per 100,000 person years, diseases 49.5–26.1, suicides 14.4–7.8). In spite of the remarkable improvement since 1986, seafarers remain in 2002–2009 more than six times more likely to die from occupational accidents (including shipwrecks) than do workers ashore.

Conclusions: The favourable trend of maritime deaths in the Danish merchant fleet may be due to 1) preventive measures — e.g. interventions relating to vessel safety, work environment, and improved medical care on board — and to 2) technological and organizational changes — e.g. newer and larger vessels in the Danish merchant fleet, changed composition of the workforce, and reduced shore leaves. The persisting excess risk warrants further preventive actions.

Muscle Testing in the Diagnosis of Work-Related Upper Limb Complaints

Jørgen Riis Jepsen and Carl-Go ran Hagert

ENJ 2010; 2:(2). Month 2010

Patients with work-related upper limb conditions frequently present a triad of neuropathic symptoms like pain, weakness, and numbness/tingling that suggests involvement of the peripheral nerves. Consequently, the physical examination must be able to identify or rule out an impaired function of these. Here we propose an examination technique based on a recognized classical paradigm, namely that impaired function of a peripheral nerve leads to reduced strength of the muscles it innervates. We have previously validated an extensive physical examination of the upper limb nerves and found that it enabled us to accurately identify and locate nerve afflictions in a high proportion of patients and occupationally exposed subjects. This relatively extensive approach may be regarded as complicated and time consuming. Therefore, we review the technique and interpretation of an easy and rapid assessment of three antagonist muscle pairs (Pectoral*Posterior deltoid, Biceps*Triceps, Flexor carpi adialis*Extensor carpi radialis brevis) and three additional individual muscles (Extensor carpi ulnaris, Abductor pollicis brevis, Abductor digiti minimi). This examination enables clinicians to identify patterns of weakness in accordance with specific locations of peripheral nerve afflictions. These patterns are present in a major proportion of work-related upper limb disorders, including the so-called ‘‘non specific’’ disorders that are currently uncovered by diagnostic criteria because a conventional physical examination cannot demonstrate physical abnormalities. We propose testing of these nine muscles to be routinely integrated in the physical upper limb examination.