Crew referrals to dentists and medical specialist ashore: a descriptive study of practice on three passenger vessels during one year.
OBJECTIVE
To study crew referrals to out-patient port services from 3 passenger ships during 12 months (2004), with focus on dentist appointments. The median number of crew on Ship A was 561, on Ship B 534 and on Ship C 614.


METHODS
Crew referrals were registered continuously and after each cruise segment recorded in the ship's doctor's medical cruise report, from which the data were retrieved and reviewed.


RESULTS
During 2004 the doctors of the 3 sister ships had a total of 8888 crew consultations (Table 1). Mean number of doctor consultations for crew was 17.5 a day. On Ship A 50%, on B 59% and on C 70% of the port referrals were dentist appointments. A crew member was referred to a dentist every 7 (Ship C) to 10 days (Ships A + B). Among the specified dental referrals, 18% were extraction requests.


CONCLUSIONS
The ship's doctors had a busy crew practice, but were neither trained nor equipped to do elective dentistry aboard. Crew referral rate to services ashore was low, but 50-70% of the referrals for out-patient port services concerned dentistry. Inadequate health insurance caused low-wage crew to request free extractions instead of expensive repair in high-cost ports. As dentistry in local ports is a poor substitute for the person's own dentist, doctors performing seafarer examinations should ensure that dental problems are solved before sign-on.
Dahl
Eilif
E
Surgical Department, Rikshospitalet-Radiumhospitalet Medical Center, 0027 Oslo, Norway. eilifdahl@hotmail.com
D003813:Dentistry; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008511:Medicine; D009326:Naval Medicine / Q000706:statistics & numerical data*; D009664:Norway / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012767:Ships; D013038:Specialization