波兰海员工作场所的心肌梗死。职业因素的风险及影响。

Myocardial infarction (MI) at the work-site among Polish seafarers. The risk and the impact of occupational factors.

作者信息

Jaremin Bogdan, Kotulak Ewa

机构信息

Medical University of Gdansk, Inter-Faculty Institute of Maritime and Tropical Medicine, Powstania Styczniowego 9 B, 81-519 Gdynia, Poland.

出版信息

Int Marit Health. 2003;54(1-4):26-39.

PMID:14974775

Abstract

OBJECTIVES

To study the incidence of myocardial infarction (MI) on board ship, the impact of conditions of work on the mortality and survival rate, to analyze the recommendations and possible preventive interventions to reduce the loss of life at the work-site among Polish seafarers and deep-sea fishermen.

METHODS

To use various sources of information for the retrospective study of the MI incidence among 11,325 Polish seamen and deep-sea fishermen. To analyse the impact of the marine environment and work-related factors on the course, treatment and prognosis of MI. The results were compared with the incidence and mortality rate of MI among general male workers population in Poland.

RESULTS

In this retrospective study, 106 cases of the MI at sea were included. Their diagnosis was based on the medical documentation and legal investigation of cases. The most significant findings seem to indicate that the incidence of MI at the work-site among Polish seafarers was not higher than among general population of Polish males in the same decade, probably due to the "healthy worker" effect. However, the pre-hospital and one-month mortality due to MI were higher in the group of seafarers as compared to the group of general male population. The analysis of conditions of seafarers' work and life and the possibility of treatment at sea in a case of the MI on board strongly suggest that the work-related factors had significant impact on the loss of life among them. The preventive measures, very complex and difficult from the organizational and economic point of view, are still far from being recommended and implemented in the shipping industry.

CONCLUSIONS

The study has confirmed that seafarers are at high risk of death in case of a MI on board. The impact of their work environment and work-related factors reduce significantly the chance of survival at sea in such cases. The preventive measures are difficult to implement.

摘要

目的

研究船上心肌梗死（MI）的发病率、工作条件对死亡率和生存率的影响，分析相关建议以及可能的预防干预措施，以减少波兰海员和深海渔民在工作场所的生命损失。

方法

利用各种信息来源对11325名波兰海员和深海渔民的MI发病率进行回顾性研究。分析海洋环境和工作相关因素对MI病程、治疗及预后的影响。将结果与波兰普通男性工人人群的MI发病率和死亡率进行比较。

结果

在这项回顾性研究中，纳入了106例海上MI病例。其诊断基于病历记录和案件的法律调查。最显著的发现似乎表明，波兰海员在工作场所的MI发病率不高于同一十年中波兰男性普通人群，这可能是由于“健康工人”效应。然而，与普通男性人群相比，海员组因MI导致的院前和1个月死亡率更高。对海员工作和生活条件以及船上发生MI时海上治疗可能性的分析强烈表明，工作相关因素对他们的生命损失有重大影响。从组织和经济角度来看，预防措施非常复杂且困难，在航运业中仍远未得到推荐和实施。