title: Occupational accidents in the Danish merchant fleet and the nationality of seafarers.
abstract: BACKGROUND
  The aim of the study was to examine occupational accidents reported from non-passenger merchant ships registered in the Danish International Ship Register in 2010-2012, with a focus on analysing nationality differences in the risk of getting injured in an accident.
  
  
  METHODS
  Data about notified occupational accidents were collected from notifications sent to the Danish Maritime Authority and from records of contact with Danish Radio Medical. Events were matched by personal identification and accident data to create a unified database. Stratified cumulative time spent on board by seafarers was used to calculate accident rates. Incidence rates of different nationalities were compared by Poisson regression.
  
  
  RESULTS
  Western European seafarers had an overall accident rate of 17.5 per 100000 person-days, which proved to be significantly higher than that of Eastern European, South East Asian and Indian seaman (adjusted incidence rate ratio 0.53, 0.51 and 0.74, respectively), although differences decreased over the investigated period. Smaller but in most cases still significant discrepancies were observed for serious injuries. The back injury rate of Western European employees was found especially high, while eye injuries seem to be more frequent among South East Asian workers.
  
  
  CONCLUSIONS
  The study identified substantial differences between nationalities in the rate of various accidents reported from merchant ships sailing under the Danish flag. The differences may be attributed to various factors such as safety behaviour. Investigation of special injury types and characterisation of effective elements of safety culture can contribute to the improvement of workplace safety in the maritime sector.
authors.affiliation: Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark ; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
authors.forename: Balázs
authors.initials: B
authors.lastname: Adám
authors.affiliation: Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark.
authors.forename: Hanna Barbara
authors.initials: HB
authors.lastname: Rasmussen
authors.affiliation: Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark.
authors.forename: Randi Nørgaard Fløe
authors.initials: RN
authors.lastname: Pedersen
authors.affiliation: Centre of Maritime Health and Society, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9-10, Esbjerg, DK-6700 Denmark.
authors.forename: Jørgen Riis
authors.initials: JR
authors.lastname: Jepsen
keywords: Injury rate; Maritime health; Nationality differences; Occupational safety; Safety culture