title: Telemedical Maritime Assistance Service (TMAS) to Swedish merchant and passengers ships 1997-2012.
abstract: BACKGROUND
  Telemedical Maritime Assistance Service (TMAS) for seafarers and traveling passengers is important and can be crucial for the optimal medical treatment on board ships. The aim of this study was to analyse and to compare the data from consultations and evacuations from merchant ships and passenger ferries for possible improvements.
  
  
  METHODS
  Data for seafarers from 1997, 2002 and 2007 and for passengers on Swedish ferries for the years 2007, 2009, 2011 and 2012 from the Swedish Radio Medical were studied. Symptoms and diseases were classified according to the International Classification for Primary Care (ICPC-2). The distribution of symptoms, accidents and diseases, treatments/actions taken, evacuations and the communication forms were analysed.
  
  
  RESULTS
  One thousand ninety-five contacts for seafarers from merchant ships and 651 passenger patients from Swedish ferries were analysed. While the evacuations for the seafarers gradually decreased over the years from 18% in 1997 to 14% in 2007, still 39.5% of the passenger patient contacts were evacuated mainly by helicopters and 70 patients were picked up by an ambulance on the quay. Accidents were 20% for seafarers and 25% for passengers of the contacts. Evacuations for passengers were mainly in the diagnostic groups: unspecific (A), digestive (D), cardiology (K), musculoskeletal (L) and neurology (N). The use of VHF, radio communications and fax machines have been greatly reduced while the use of e-mail and satellite phone increased.
  
  
  CONCLUSIONS
  No significant differences in reasons for contact or actions over the years have been identified. The evacuations of seafarers decreased over the years but was stable among the passenger patients (39%). The circumstances and reasons behind the evacuations should be analysed for prevention. Standard forms and digital images for documentation can facilitate knowledge exchange and further studies.
authors.forename: Karin
authors.initials: K
authors.lastname: Westlund
authors.forename: Stig
authors.initials: S
authors.lastname: Attvall
authors.forename: Ralph
authors.initials: R
authors.lastname: Nilsson
authors.affiliation: Centre of Maritime Health and Society, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark. ocj@health.sdu.dk.
authors.forename: Olaf C
authors.initials: OC
authors.lastname: Jensen
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009326:Naval Medicine; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D060051:Occupational Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D058996:Quality Improvement; D012767:Ships; D013548:Sweden / Q000453:epidemiology; D017216:Telemedicine / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*
keywords: Radio Medical; evacuation; passenger; repatriation; seafarer; shipping; telemedical