Summary:
ABSTRACT
Introduction:
Fishing is an extremely dangerous occupational activity, which predisposes to
occupational
diseases and accidents. Greece is a small country however, the country’s unique
morphological
characteristics, (16,000 km of coast line, numerous small islands, small
peninsulas, etc), represents
a strong proof of its great tradition in the fisheries sector since ancient
times. The country lacks
registries with data concerning fishermen’s health and safety. Fishermen
themselves do not ask for
health services, unless becoming severely ill or injured. Thus, occupational
accidents are without
any doubt under-reported and occupational diseases are not reported at all.
Fishermen are very
closely bounded to their working environment which varies according to the type
of fishing tool,
vessel characteristics (type, length, engine power, etc). They are also exposed
to different risk
factors according to their position of duty. This study represents the
continuation of a pilot study,
the first occupational health study in Greek fisheries sector
Aim : Aim of the study is to determine the risks for health and safety in Greek
fisheries workers,
by exploring their health status and occupational risk factors present in their
working environment,
thus providing a current baseline for documentation of the needs for prevention
in this sector and
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risk control by the occupational medicine services of the country. It explores
the effects of purely
occupational characteristics present in the field of fisheries ( type of
fishing gear, etc) but also of
other factors, in some way related to the working conditions, which predispose
to a certain
lifestyle of fishermen (smoking, alchol consumption, unhealthy dietary
selections, insomnia,
anxiety, depression, limited physical activity) all measured by proper scales,
so that their effect to
be quantitatively interpreted and studied from the point of view of causing
factors for occupational
accident or disease in the population of fishermen in Greece.
Methods
A cross-sectional study was carried out in the population of fishermen of the
Evros district
(including the island of Samothraki) in North-Eastern Greece. 161 professional
fishermen
participated in the study, out of 172 fishermen found in the registries.
Fishermen were interviewed
by an interviewer using an original questionnaire, containing questions about
data of
demographic, occupational history, medical history, working characteristics in
fisheries, dietary
habits, smoking and alcohol consumption, scales measuring anxiety, depression,
fitting to the
Mediterranean diet, physical activity and insomnia. The data collected were
statistically analyzed
with single and multiple analysis of all variables in order to assess the
probability of occurrence of
an accident and disease due to fishery work.
Results: Fishermen of the sample work mainly in the coastal fisheries (87,57%).
For the great majority of
them fisheries represent their main and only occupational activity (95,65% and
91,3% respectively).
Mean age of starting work in fisheries sector is the age of 25. The mean of
years working in fisheries is
33,66 years. Educational levele for the majority of the sample (52,17%) is low
(primary school), and only
4,35% of the sample possess a higher degree. Most of the fishermen (93,8%) work
in fisheries during 12
months /year by a mean of 10,88 hours per day. 72,7% of fishermen work in a
fishing vessel of less
than 10 m length and 37,3% of an engine power only greater than 50kw. 44,1% of
the sample states that
smokes having started at the age of 18. Mean number of cigarettes per day is 36
and 52.7% of the
sample exceeds the level of 60 pack-years.
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Study’s sample seems to adjust to the Mediterranean diet model moderately (32.
69 +/- 5.075). Alcohol
consumption is on everyday basis with quantities equal or greater than 300ml
for 33.5% of the sample.
It is important to note that 18.6% reports alcohol consumption of 500ml or more
daily. According to the
results of the data analysis concerning fishermen’s health, an exceeding of BMI
normal levels,
cardiovascular problems, dermatological, respiratory, hearing problems and
depression are the major
problems found in the sample, without reporting fishermen with serious or
severe depression (DRScore
Zung >70). High level of anxiety were not found.. Occupational risk factors for
fishermen’s health are
considered to be alcohol consumption, smoking, inadequate sleep and fatigue.
Relative probability of
cardiovascular diseases occurrence in male fishermen is greater than female
fishermen given that they are
of the same age. (b=-1,932). However, the sample’s fit to the Mediterranean
diet (exp of 1,936) and the
absence of high level of depression (exp of 0,048) have a protective effect on
the cardiovascular disease
occurence in fishermen. As far as it concerns safety in greek fisheries sector,
fishermen of the sample
report an occupational accident experience by 69.6%. Main causes of the
accidents were fall due to
slippery deck or obstacles like nets. Also, the process of hauling fishing gear
(mainly the nets or
longlines) is a very dangerous one, predisposing to accidents. Other important
causes of accidents are
fatigue, enter/exit the vessel, walking along the deck on board, bad weather
conditions, bad maneuvers
during throwing the nets or longlines. The most frequent anatomical sites of
injuries are the digits of the
hand. The most frequent types of injuries reported are contusions, lacerations,
joint dislocation, strain,
cerebral injury, episode of near drowning (related to fall either on the deck
or in the sea) and myocardial
infarction, an episode of loss of consciousness, hemorrhage of ophthalmic
vessel, herniated intervertebral
disc, meniscal tear, traffic accident due to fatigue while returning home
(related to fatigue due to
musculoskeletal overload, sleep deprivation, etc.) 4.8% of the sample reports
an experience of a fall in the
sea and an episode of near drowning. The vessel’s prow seems to be the part of
the vessel where the
majority of the accidents occur which may be related with the fact that the
pulley for helping the hauling
of the nets which is a risky process by multifactorial points of view. 34.4% of
occupational accidents
occurred under bad weather conditions. Fishing vessels of smaller size (small
vessels or boats) are more
prone to accidents compared to bigger fishing vessels. 8.1% of occupational
accidents have provoked
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some kind of disability. For 49.4.0% absence from work due to an accident was
more than 1 day long.
The probability of an occupational accident is positively related with the
duration of coastal experience
and level of depression (Score Kλίμακας ZUNG) and negatively related with age,
and having experience
in deep sea and overseas fisheries. Probability of occupational accident
increasesas higher the level of
depression, which is a finding absolutely compatible with the nature of
depression’s symptoms which
create a very risky background of accident provocation during emergency
situations while on board. On
the contrary, the bigger the age of fisherman and the experience in deep sea
and overseas fisheries, the
smaller the probability of an occupational accident. More specifically, if a
fisherman has greater
experience in overseas fisheries by one year then the relative probability of
occupational accident
decreases (Exp of 1,8) given that costal experience, deep sea experience and
depression level (measured
by Zung score), do not change. Respectively, if the age of a fisherman
increases by one then the relative
probability of occupational accident occurrence decreases (exp of 0,078) given
that the values of the rest
variables remain constant.
Conclusion: Working as a fisherman in the Greek Prefecture of Evros increases,
with adjustment to age
and the exposure to other factors, in a statistically significant manner, the
likelihood of cardiovascular
diseases and occupational accident. The health effects observed are causally
related to smoking, alcohol
consumption and fatigue, which in turn relate to the specific working
conditions and culture in small scale
fishing. Working in the coastal Greek fisheries sector is more dangerous than
working in the deep sea and
overseas fisheries. Fishermen are lacking education on health and safety
matters and occupational
medicine services. Working conditions at sea often represent a field with
difficulties in implementation of
programs able to help the fishery workers, thus there is a great need for
introduction of specific health &
safety strategies, carefully adapted to the special working environment
conditions. Some careful studies,
based on real time monitored conditions, should be done in order to design the
proper preventive
measures and behaviours as effectively as possible before addressing some
strict preventive measures to
the overloaded and frequently eager for survival fishermen. These conclusions
need to be taken into
consideration by the country’s authorities and occupational medicine services
for the implementation of
prevention programs and risk control for the benefit of the country’s work
force in fisheries sector.
