Jaremin B, Kotulak E, Starnawska M, Mroziński W, Wojciechowski E
Clinic of Occupational and Tropical Diseases, Institute of Maritime and Tropical Medicine, Gdynia, Poland.
Int J Occup Med Environ Health. 1997;10(4):405-16.
Deaths at sea, namely work-related fatal cases, are registered in all fleets throughout the world. Considering the medical and legal aspects, they are subject to notification, inquest, and possible indemnity. The aim of the study was to identify causes, circumstances, and mortality rates among Polish seamen and deep-see fishermen. The group studied comprised 113,260 employees of one shipping company and two fishing enterprises. Out of this number 148 fatal cases (109 seamen and 39 fishermen) registered during the years 1985-94 were investigated thoroughly. Mean annual rates of mortality (130.6) and fatal accidents (67.8) were calculated per 100,000 employees. They occurred to be higher than those among fishermen and the male population of the same age group (20-59 years) employed in various branches of the land economy, yet remaining lower compared to data on British and American seamen and fishermen. The risk of death was particularly high in persons above 40 years of age. It was demonstrated that unlike in the general population, 52% of deaths were due to external causes; primarily sea catastrophes, injuries, poisoning and missing. Among internal causes, circulatory diseases accounted for over 80% of deaths, including one fifth of cases due to acute myocardial infarction. In one third of these cases, cardiac failure had been already diagnosed before the voyage. The following circumstances were specific to deaths occurring during the voyage: deaths at open sea, frequently in the state of being alone in the cabin, no possibility of evacuating sick person to land medical institution, limited access to qualified medical assistance and effective rescue from outside, poor life-saving facilities and difficult communication. It was indicated that in a substantial percentage of fatal cases an adverse effect of the work performed, navigation and weather conditions proved to be hazardous, life-threatening and responsible for the fatal outcome. Sixty per cent of deaths were acknowledged by the shipowners as work-related or equivalent accidents with legal and economic consequences. The countermeasures proposed by the authors to minimize health hazards and life-threat at sea are of rather limited value for both organizational and economic reasons. The ship is still considered as one of the most dangerous workplaces.
海上死亡事故，即与工作相关的致命案例，在全球所有船队中都有记录。从医学和法律角度来看，这些事故需要通报、进行调查并可能给予赔偿。本研究的目的是确定波兰海员和深海渔民的死亡原因、情况及死亡率。研究对象包括一家航运公司和两家渔业企业的113,260名员工。在这一群体中，对1985年至1994年间登记的148起致命案例（109名海员和39名渔民）进行了深入调查。计算出每10万名员工的年均死亡率（130.6）和致命事故率（67.8）。结果发现，这些比率高于渔民以及同年龄组（20至59岁）从事陆地经济各部门工作的男性人口的比率，但与英美海员和渔民的数据相比仍较低。40岁以上人员的死亡风险尤其高。结果表明，与普通人群不同，52%的死亡是由外部原因导致的；主要是海难、受伤、中毒和失踪。在内部原因中，循环系统疾病占死亡人数的80%以上，其中五分之一是急性心肌梗死所致。在这些案例中，三分之一在航行前就已被诊断出患有心力衰竭。航行期间发生的死亡有以下特定情况：在公海死亡，经常是独自在船舱内，无法将病人疏散到陆地医疗机构，获得合格医疗救助和外部有效救援的机会有限，救生设施简陋以及通讯困难。结果表明，在相当比例的致命案例中，所从事的工作、航行和天气状况产生的不利影响被证明具有危险性、危及生命并导致了致命后果。60%的死亡被船东认定为与工作相关或相当于有法律和经济后果的事故。作者提出的将海上健康危害和生命威胁降至最低的对策，由于组织和经济原因，其价值相当有限。船舶仍然被视为最危险的工作场所之一。
