Mortality from disease among seafarers in British merchant shipping (1976-1995).
OBJECTIVE
To establish the cause and circumstances of all deaths from disease among seafarers who were working in British merchant shipping between 1976 and 1995. Further aims were to discuss implications for reducing mortality and for maritime health care.


METHODS
A retrospective study of occupational mortality, based upon official mortality files, with a population of 983,119 seafarer-years at risk.


RESULTS
Out of a total of 600 deaths from disease, 427 (71%) were caused by cardiovascular disease; 247 of the 427 (58%) were taken ill at sea and 180 (42%) in port. Over 60% of the 427 who died from cardiovascular disease were off-duty at the time of onset and over 40% were found dead. Rates of evacuation to hospital before death from cardiovascular disease were 7% at sea and 9% in port. Fifty-five deaths from gastro-intestinal disease (9% of all deaths) were largely due to liver cirrhoses and stomach ulcers (14 each) and acute pancreatitis (seven). Trends in crude mortality rates for both cardiovascular and non-cardiovascular disease declined between 1976 and 1995.


CONCLUSIONS
Seafarers are at special risks from acute illnesses since they lack direct access to specialist medical care. Prevention should be aimed at improvements in the use of radio-medical advice and in medical training for ship's officers. Also, since many deaths were linked to lifestyle factors such as smoking, obesity and heavy alcohol consumption, primary preventative advice would be of benefit.
Roberts
Stephen E
SE
Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road, Oxford OX3 7LF, UK. stephen.roberts@uhce.ox.ac.uk
D000428:Alcohol Drinking; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D005767:Gastrointestinal Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D008889:Military Personnel / Q000706:statistics & numerical data*; D009026:Mortality / Q000639:trends; D009765:Obesity; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D012767:Ships; D012907:Smoking; D006113:United Kingdom / Q000453:epidemiology