SURVEILLANCE OF DEATHS ON BOARD DANISH MERCHANT SHIPS, 1986-93 - IMPLICATIONS FOR PREVENTION

Objective-To describe and analyse the types and circumstances of all n atural and non-natural deaths among seamen on board Danish merchant sh ips. Methods-Data on 147 cases were obtained from maritime authorities , an insurance company, shipping companies, hospitals, death registers , and death certificates in the period from 1986-93. Results-The 53 na tural deaths were dominated by cardiovascular diseases and infectious diseases. Insufficient treatment on board was identified as a contribu ting factor for death in some cases. Medical advice was not always sou ght and the advice given was in some cases insufficient. 73 fatal acci dents were identified. The incidence of accidents of 5.29/10 000 perso n-years was 11.5 times higher than the incidence of 0.46/10 000 for th e Danish male workforce ashore. 23 accidents (31%) were due to maritim e casualties and 26 (36%) were occupational accidents. The remaining 2 4 (33%) were accidents during off duty hours including six self intoxi cations. Rough weather, inadequate awareness of safety, lack of use of personal protection devices, and inexperience were associated with ma ny of the fatal injuries directly related to work. Alcohol played a ma jor part in 12 out of 18 fatal injuries occurring during off duty hour s. Conclusions-The maritime workplace was identified as a high risk wo rkplace and in many aspects differs from the conditions ashore. Acute diseases and serious injuries pose special risks to seamen because of a lack of direct access to professional medical care at sea. Primary p revention of certain diseases is needed and possible. Improved trainin g, improved systems of work, improved safety awareness, and greater us e of personal protection devices are needed to prevent fatal injuries. Medical training of ships' officers providing medical care on board a nd specific training of doctors giving medical advise to ships should be improved to meet the needs.