Pattern of passenger injury and illness on expedition cruise ships to Antarctica.
BACKGROUND
Expedition ships to Antarctica travel to remote areas with limited medical support.


OBJECTIVE
This study determines the rate and patterns of passenger illness and injuries among those traveling on expedition ships to Antarctica. We hypothesize that severe medical conditions are encountered that require physicians serving on these ships to be skilled enough to care for critically ill or injured patients.


METHODS
We performed a retrospective analysis of the medical records of all passengers who were provided medical care on 26 Antarctica voyages from October 2010 to March 2011 (four different expedition ships). A structured system was used to categorize the diagnoses from each patient encounter. The pattern of traumatic injuries was noted, including location of occurrence. Treatments rendered including patient evacuations were documented. The population is described with incidence rates.


RESULTS
A total of 2,366 passengers traveled on 26 trips, for a total of 34,501 person-days. In all, 680 physician visits were done, including 150 consultations for motion sickness preventive care, leaving 530 visits (15.4 visits per 1,000 person-days) for active medical care. Median age was 50 (range 10-90) years and 51% were females. Incidence rates per 1,000 person-days for the most common processes include motion sickness (4.2), infections (3.5), and injury (2.0). Injuries were more likely to occur on the ship (66%, 95% CI: 54-77%) compared to off the ship (34%, 95% CI: 23-46%). Four subjects (0.12/1,000 person-days) were evacuated (three due to traumatic conditions and one due to medical complications) and one person died (medical complication).


CONCLUSIONS
Passengers on expedition ships to Antarctica may experience significant illness and injury. Ship physicians should be aware of the patterns of injuries and illnesses that occur on expedition ships and should have appropriate training to treat various medical and traumatic conditions including life-threatening illnesses.
Department of Emergency Medicine, University of California at Davis School of Medicine, Sacramento, CA, USA.
Lusana
L
Schutz
Dan
D
Zak
James F
JF
Holmes
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001110:Arctic Regions; D002648:Child; D004638:Emergency Treatment / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009041:Motion Sickness / Q000453:epidemiology* / Q000628:therapy; D012307:Risk Factors; D012767:Ships / Q000706:statistics & numerical data*; D014195:Travel / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult