title: Major differences in rates of occupational accidents between different nationalities of seafarers.
abstract: OBJECTIVE
  Earlier studies and statistics have shown that merchant seafarers from the South East Asia had considerable lower accident rates when compared with seafarers from Western Europe. The purposes of the study were to investigate whether the earlier observations were sustained if further sources on occurrence of accidents were used and to identify specific causes of excess accident rates among certain nationalities.
  
  
  METHODS
  Occupational accidents aboard Danish merchant ships during one year were identified from four different sources. These included accidents reported to the maritime authorities, accidents reported to a mutual insurance company, files on medical costs reimbursed by the government and finally, accidents in which there has been contact to the radio medical service. Time at risk aboard was obtained from a register on all employment periods aboard merchant ships.
  
  
  RESULTS
  A total of 943 accidents causing personal injury to a seafarer directly caused by work aboard were identified. Among these accidents, 499 had taken place aboard cargo ships in international trade. Only these were used in the detailed analysis. The accident rate for all identified accidents aboard cargo ships were 84 accidents per 1,000 years aboard. The crude incidence rate ratio (IRR) for East European seafarers was 0.88 and for South East Asians 0.38 using West European seafarers as reference. In a Poisson regression analysis, the IRR for South East Asians was 0.29 (0.22-0.38). In an analysis including only more serious accidents, IRR for South East Asians rose to 0.36 (0.26-0.48).
  
  
  CONCLUSIONS
  This study indicates that seafarers from South East Asia, mainly the Philippines, may have a genuine lower risk of occupational accidents in comparison with seafarers from Western and Eastern Europe. Differences in approach to safety and risk taking between South East Asian and European seafarers should be identified and positives attitudes included in accident preventing programmes. Main messages Seafarers from South East Asia, mainly the Philippines, seem to have a genuine lower risk of occupational accidents in comparison with seafarers from Western and Eastern Europe.
  
  
  CONCLUSIONS
  Differences in approach to safety and risk taking between South East Asian and European seafarers should be identified and positives attitudes included in accident preventing programmes.
authors.affiliation: Medical Office of Health, National Board of Health, Region Southern Jutland, Ribe, Denmark hlhansen@dadlnet.dk
authors.forename: Henrik L
authors.initials: HL
authors.lastname: Hansen
authors.forename: Lise Hedgaard
authors.initials: LH
authors.lastname: Laursen
authors.forename: Morten
authors.initials: M
authors.lastname: Frydberg
authors.forename: Soeren
authors.initials: S
authors.lastname: Kristensen
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control / Q000706:statistics & numerical data*; D002423:Cause of Death; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010679:Philippines / Q000453:epidemiology; D012767:Ships / Q000706:statistics & numerical data*; D016526:Workload; D017132:Workplace