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Occupational Medicine Advance Access published online on July 25, 2007
Occupational Medicine, doi:10.1093/occmed/kqm053
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Short Report

Maritime health emergencies

Mary Pat McKay

The George Washington University Medical Center—Emergency Medicine, 2150 Pennsylvania Avenue, NW Suite 2B, Washington, DC 20037, USA

Background Commercial ships flying the US flag must conform to Coast Guard standards and have medical care available onboard. Consultation with a physician is required if medication is to be prescribed.

Aim To evaluate the epidemiology of medical contacts for US ships at sea.

Method Retrospective analysis of cases where shipboard caregivers made contact with US emergency medicine physicians for advice.

Results There were 866 cases and 1720 contacts in 48 consecutive months of study. Eighty-eight per cent of cases were men with a mean age of 43.7 years (SD 13.7). Eighty-four per cent of cases were medical, 14% were injuries and 2% were purely psychiatric. Fifty-eight per cent of medical cases, 50% of psychiatric cases and 42% of injury cases were handled with a single contact. Injuries and psychiatric cases required a higher number of contacts per case compared with medical cases (P < 0.01). Five categories of illness accounted for 43% of medical cases (respiratory infections, abdominal problems, genitourinary complaints, rashes and dental issues). Psychiatric cases required the most medication, with 12% requiring four medications. The most common categories of medication given were pain relievers (non-steroidal anti-inflammatory drugs, opiates, heartburn relief) and antibiotics.

Conclusions Even with pre-screening of seafarers and the potential dangers of life at sea, the majority of cases requiring physician advice are not related to trauma. However, cases of injury or acute psychiatric problems required more physician interaction and medication than medical cases.

Keywords      Injuries; maritime; medical advice; radio medical advice; ships

Correspondence to: Mary Pat McKay, The George Washington University Medical Center—Emergency Medicine, 2150 Pennsylvania Avenue, NW Suite 2B, Washington, DC 20037, USA. Tel: +202 741 2911; fax: +202 741 2921; e-mail: mmckay{at}mfa.gwu.edu


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