Fréttir | Sjómannaheilsa
 

Fréttir

"Íslendingar eru eftirbátar annarra landa þegar kemur að reglum og stöðlum er varða kröfur um heilsufar og líkamsburði sjómanna. Þetta skýtur skökku við þar sem Íslendingar hafa jafnan talið sig mjög framarlega hvað varðar sjósókn og veiðar".

Í Fiskifréttum þann 18. desember 2014 er ýtarleg umfjöllun um þessi mál, þar sem Guðni Arinbjarnar Sjómannalæknir og Svanlaug Inga Skúladóttir hjúkrunarfræðingur hjá Sjómannaheilsu ræða þessi málefni og tala um nýja alþjóða reglugerð á þessu sviði sem kveður m.a. á um að allir sjómenn skuli gangast undir ítarlega læknisskoðun áður en þeir eru ráðnir í áhöfn skipa.


Hér er hægt að skoða greinina:  

"Læknisskoðun sjófarenda verði ófrávíkjanleg regla"
 

Janúar 2015 Guðni Arinbjarnar



Influensu - bólusetningar 2018
 

Nú standa yfir bólusetningar hjá Sjómannaheilsu, 
en opnir tímar verða eins og hér segir:

 

Opnir tímar í bólusetningar í haust.

Við viljum biðja starfsmannastjóra - og skipstjóra um að koma þessum upplýsingum til sjómanna á skipunum og þeirra sem eru í landi.

Ef þið komist ekki í bólusetningu þegar við komum á starfsstöðina ykkar þá eruð þið velkomin í opna tíma sem eru sem hér segir.


Kópavogur:  Holtasmári 1 - 7. hæð (Læknaráð) 
  • Mánudaginn      1. Október  klukkan 13.00 - 14.00
  • Fimmtudaginn   4. Október klukkan  13.00 - 14.00
  • Mánudaginn      8. Október klukkan  10.30.- 11.00
  • Miðvikudaginn 17. Október klukkan  09.00 - 09.30


Akranes - á kaffistofu 2 hæð í Skipaverkstæði
  • Þriðjudaginn  25. September  klukkan 15.00 - 15.45


Akureyri:  Læknstofur Akureyrar - Glerártorg 2 hæð
  • Fimmtudaginn   27. September klukkan 12.30 - 13.00
  • Þriðjudaginn          2. Október        klukkan12.30 - 13.00
  • Fimmtudaginn   11. Október      klukkan 10.00 - 10.30
  • Miðvikudaginn   31. Október     klukkan 12.30 - 13.00


Ef starfsfólk kemst ekki í neitt af þessum tímum - þá verið í sambandi við undirritaða.
 

Svanlaug Inga Skúladóttir
Framkvæmdastjóri og hjúkrunarfræðingur

svanlaug@centrum.is
s. 894 0003
Holtasmári 1 - 7 hæð
201 Kópavogur

sjomannaheilsa.is

 



Kópavogur ágúst 2013

Sælt veri fólkið

Hér geti þið lesið ykkur til um TELEMEDICINE - fjarlækningar

 

  • Við hjá Akkilles / sjómannaheilsu höfum verið að kynna okkur Telemedicine eða ráðgjöf um heilsufarsvandamál til yfirmanna skipa. Alltaf hefur verið eitthvað um ráðgjöf til skipstjóra og annarra yfirmanna en nú viljum við fara að gera betur og hafa ákveðna verkferla um þessa ráðgjöf og góða skráningu.
  • Þegar um er að ræða heilsufarsvandamál sem koma upp þegar skip eru á hafi úti geta skipstjórar eða aðrir yfirmenn verið í sambandi við Guðna Arinbjarnar bæklunarskurðlækni og sjómannalækni og leitað eftir ráðleggingum. Ef vandamálið er ekki innan sérsviðs Guðna leitar hann til annarra sérfræðinga. 
  • Mynd segir þúsund orð – í mörgum tilfellum er gott að senda með mynd til að lýsa vandamálinu betur og eru þá myndir teknar á snjallsíma eða stafræna myndavél og sendar til Guðna með tölvupósti.

ATHUGIÐ: í neyðartilfellum skal alltaf fylgja venjulegum verkferlum um neyðartilfelli.
  • Verklagsreglurnar verða sendar til þeirra útgerðarfélaga sem eru í þjónustu hjá Akkilles slf.
 

 

Guðni Arinbjarnar
 



Kópavogur febrúar 2013

Sælt veri fólkið

>> Hér kemur úrdráttur úr rannsókn minni sem ég gerði haustið 2012, á þyngd íslenskra sjómanna.
 

Þyngd Íslenskra Sjómanna
 

Úrdráttur úr Rannsókn sem gerð var haustið 2012 á þyngd íslenskra sjómanna á fiskiskipum sem eru 500 brúttótonn og stærri.

 

  • Sjómenn á Íslandi vinna oft við mjög erfið skilyrði. Veður geta orðið mjög slæm, vinnuaðstaðan getur verið varhugaverð vegna bleytu, hálku, þrengsla og vegna stöðugrar hreyfingar á vinnusvæðinu. Sjómennirnir eru oft lengi að heiman frá fjölskyldum sínum, þeir eru oft þreyttir vegna mikillar vinnu og lítils svefns og stór hluti þeirra stundar ekki reglulega hreyfingu um borð utan vinnunnar.  Þetta getur leitt til óheilbrigðs matarræðis sem getur leitt til ofþyngdar
 
  • Það eru engin lög eða reglugerðir á Íslandi fyrir sjómenn aðra en yfirmenn um kröfur til sjómanna um líkamlegt atgervi til starfa á sjó.  Það er mjög mikilvægt fyrir öryggi um borð í fiskiskipum sem og öðrum skipum um að áhöfnin sé  heilbrigð og hafi líkamlegt atgervi til að sinna vinnu sinni og takast á við þær hættur sem geta steðjað að.
 
  • Tilgangur þessarar rannsóknar sem unnin var í tengslum við meistarnám undirritaðrar í sjómannaheilsu (Mater of Maritime Health) við Háskólann í Cadiz á Spáni var að skoða einungis einn þátt líkamlegs atgervis það er þyngd. Og í framhaldi að skoða hversu margir sjómenn á Íslandi ættu í vandræðum með að standast þær alþjóðlegu kröfur sem gerðar eru mjög víða erlendis til líkamlegs atgervis sjómanna
 
  • Gögnum var safnað um borð skipum og í heilsufarsskoðunum. Sjómennirnir vigtuðu sig sjálfir og svöruðu spurningalista. 405 spurningalistar voru nothæfir í rannsóknina sem er um það bil 20% af fjölda íslenskra sjómanna sem vinna á  skipum sem eru  500 brúttótonn og stærri.
 
  • Niðurstöðurnar sýndu að meðalaldur sjómannanna var 41,8 ár og meðalþyngdin var 90 kíló.  Aldur hafði ekki tölfræðilegt gildi þegar hann var borinns aman við líkamsþyngd.  Meðal líkamsþyngdarstuðull (Body Mass Index BMI) var 27,7 og var hann frá  20,4 – 42,6.  Nær 24 % sjómannanna voru í offituhóp (BMI yfir 30) og af þeim voru 6 % með BMI yfir 35. Þetta segir okkur að um 120 sjómenn á íslenskum fiskiskipum 500 brúttótonn og stærri fengju t.d. ekki leyfi norskra yfirvalda til að stunda sjómennsku vegna þyngdar.
 
  • Þegar þessar niðurstöður eru bornar saman við niðurstöður annarra rannsókna innlendra og erlendra þá kemur í ljós að ofþyngd og offita er vandamál sem fer vaxandi meðal sjómanna sem og annarra.  Mjög mikilvægt er að sporna við þessari þróun sem allra fyrst. 

 

Umræða:

  • Aðeins 25 % sjómannanna voru í kjörþyngd.  Þetta hlutfall er allt of lágt og er mjög umhugsunarvert. Sjómenn vinna erfiðisvinnu og mikið af þeim eru mjög stæltir og vöðvamiklir og ekki er víst að líkamsþyngdarstuðullinn BMI endurspegli raunverulega líkamsfitu.  En þetta er ekki næstum alltaf raunin – erfiðisvinna um borð hefur minnkað með aukinni tæknivæðingu um borð.
 
  • Þegar niðurstöðurnar eru bornar saman við niðurstöður annarra rannsókna kemur í ljós þyngdarvandamál íslenskra sjómanna er aðeins minna en sjómanna í Danmörku.  Ef við skoðum rannsókn á þyngd íslenskra sjómanna sem gerð var 2004 þá eru sjómenn að þyngjast og vandamálið að verða stærra.
 
  • Eitthvað þarf að gera til að sporna við þessari þróun og kemur ýmislegt upp í hugann. Skoða þarf mataræðið um borð – einn sjómaður sagði mér að í túr sem var rúma 30 dagar þá voru franskar kartöflur á matseðlinum 18 sinnum – þetta er hvorki hollt né gott fyrir neina manneskju. Margir standast ekki franskar kartöflur ef þær eru á boðstólnum og því er mikilvægt að matsveinar bjóði ekki upp á franskar kartöflur nema til hátíðabrigða. Það er mjög mikilvægt að áhöfnin komi saman og ræði um það hverskonar fæði ætti að vera um borð. Við heyrum mikið frá sjómönnum að þeir þyngjist því kokkurinn eldi allt of fitandi og óhollan mat og svo þegar við tölum við kokkana þá segjast þeir elda akkúrat það sem áhöfnin óskar.  Þessu ætti að vera auðvelt að breyta með því að áhöfnin hittist og ræði saman um mataræðið um borð.
 
  • Matsveinarnir þurfa að læra mikilvægi þess að elda hitaeiningasnauðari máltíðir og hollari.
 
  • Eitt atriði er líka sjoppurnar sem eru um borð í mörgum skipum og selja gos og sætindi. Áhafnirnar reka sjálfar þessar sjoppur og mikið af mönnum – kanski helst þeir sem ekki mega við því – nota mikið þessar sjoppur.  Heillavænlegra væri að menn þyrftu sjálfir að bera um borð allt það gos og sælgæti sem þeir ætla að neyta í túrnum – eflaust bregður mörgum í brún við magnið.
 
  • Regluleg hreyfing fyrir utan vinnunna er líka atriði sem mikilvægt er að skoða -  flest skip hafa einhverja líkamsræktaraðstöðu um borð – mis góða þó. Þessa aðstöðu er mikilvægt að gera aðlaðandi og hafa þar líkamsræktartæki sem er hentugt að nota um borð í skipum. Þeir sjómenn sem vinna á 8 tíma vöktum virðast nota líkamsræktaraðstöðuna frekar en þeir sem vinna á skipum með 6 tíma vaktir.  Verðugt væri að skoða þetta betur.
 
  • Mjög mikilvægt er að gera sjómenn meðvitaðri um eigin heilsu og líkamlegt atgervi með heilbrigðisfræðslu og ráðgjöf. Mjög gott tækifæri til þess er þegar sjómenn koma í heilsufarsskoðun þar sem hjúkrunarfræðingar fara í gegnum heilsufar, sjúkrasögu, lífsstíl og gera ýmsar mælingar og teknar eru blóð- og þvagprufur.  Sjómennirnir fá ráðleggingar varðandi eigin heilsu og setja sér markmið. Árangurinn er síðan skoðaður í næstu skoðun.
 
  • Það er mikilvægt að útgerðirnar axli líka ábyrgð á þeim breytingum sem mikilvægt er að gera til að sporna við ofþyngdarvandamálinu með því að styðja og hvetja tilbreytinga um borð sem stuðla að bættu heilbrigði og mataræði áhafnarinnar.
 
  • Í þessari rannsókn var aðeins einn hluti af líkamlegu atgervi skoðaður það er líkamsþyngd íslenskra sjómanna. Það er mikilvægt að skoða líka fleiri þætti eins og sjúkdóma, lyfjanotkun, heyrn, sjón, í hverskonar formi menn eru og margt fleira.  Ef alþjóðlegum reglum um kröfur til líkamlegs atgervis sjómanna verður komið á hér á landi eins og vonandi verður á næstunni þá er mikilvægt að kynna þessar reglur fyrir sjómönnum og þeir þurfa að hafa einhvern aðlögunartíma.
 >> Rannsóknina í heild á ensku má skoða hér fyrir neðan.

 

Svanlaug I Skúladóttir Hjúkrunarfræðingur
 


 

Kópavogur febrúar 2013

Sælt veri fólkið

Hér kemur rannsóknin í heild sinni á ensku;


 

The Weight of Icelandic Fishermen
Research Project

University og Cádiz Master of Maritime Health

Svanlaug Inga Skúladóttir October 2012


 

Abstract.

Fishermen in Iceland working on larger fishing ships, often work under extreme conditions. They can experience very bad weather and their work space is often wet, slippery, crowded, full of hazardous gear and equipment and in constant motion. They are often away from home and their families for a long time; they are often tired, they do not often conduct regular exercises and are often deprived of a full sleep. This often leads to unhealthy diet choices which can lead to weight problems.

There are no rules and regulations in Iceland for crew members other than officers regarding certification of fitness to work on board fishing ships. It is important for safety on board to have a crew that is healthy and has the physical fitness to work and survive under extreme conditions.

The aim of this study was to look at one aspect of physical fitness concerning weight and try to find out if many fishermen in Iceland would have trouble passing a health examination because of weight problems.

Data was gathered on board the ships and in health examinations. The fishermen filled out the questionnaire themselves. A total of 405 questionnairies were useable for the study which represents about 20 % of fishermen in Iceland working on fishing ships that are 500 GT and larger.

The results showed that the average age was 41.8 years and the average weight was 90 kg. Age was not a statistically significant variable. Average Body Mass Index (BMI) was 27.7 with a range of 20.4 – 42.6. Nearly 24% were obese with 6% of the fishermen with BMI of 35 or more. 6% or nearly 120 Icelandic fishermen would not get their license to work on board fishing ships due to weight problems.

When these results are compared with older studies an increase in overweight and obesity can be seen. This is not good and something has to be done to change this trend.

 

 

In Iceland there are no laws or regulations regarding physical fitness of fishermen as there are in our neighbour Nordic countries and very many other countries. The Captain, the First Mate and the Mechanical Engineer have to have their license renewed every 5 years and they need to pass some physical fitness standards mostly regarding eyesight and hearing. Deckhands and others on board do not require any physical examination or any license.

All stakeholders in Iceland that is the Federation of Icelandic Fishing Vessel Owners, The Icelandic Seamen Association, the Icelandic Union of Marine Engineers and Metal Technicians, The Officers Association and The Icelandic Directorate of Health have all shown interest in adopting the new Guidelines on the medical examination of seafarers. But this will take some time and work to implement and get through Parliament.

In the meantime it is important to look at the physical fitness of our fishermen. Do they need a long adaptation time before the implementaion of the new guidelines or are most of them physically fit for work on board. The aim of this study was to look only at one part of physical fitness that is weight and try to find out if many Icelandic fishermen would not pass medical examination because of weight problems. Further studies are needed to look at other aspects of physical fitness of Icelandic fishermen.
 

Research question.

Several research questions where stated.
1. What is the weight of Icelandic fishermen?
2. What is the Body Mass Index (BMI) of Icelandic fishermen?
3. Does age have effect on weight and BMI?
4. Do Icelandic fishermen see themselves as overweight – underweight or of

the right weight?
5. Have Icelandic fishermen gained weight, lost weight or is their weight the

same as 5 years ago?
6. How many Icelandic fishermen should not have license to work on board

fishing ships due to weight problems?
 

Data collection.

Information regarding the study and a sample questionnaire was sent to 26 trawlers and fishing ships that were 500 GT and bigger before data gathering started. Permission for the questionnaire was sought from the fishing companies.

Nurses went on board fishing ships before they went to sea and asked all on board to weigh themselves and write the weight on the questionnaire and to answer a few questions at the same time. At the same time the nurses were offering vaccination to the fishermen. Data was also gathered during health examinations that are voluntary. No information regarding name, personal number, ship, position or company was asked. Data was gathered from August to October 2012 from many different places around Iceland. Very few fishermen refused to participate in the study and I am very thankful to all who participated for their help.
 

Weight.

Obesity has become a major health problem in many parts of the world especially in the Western World. The consequences of overweight are well known and include an increased risk of e.g. cardiovascular disease, stroke and diabetes. It is costing taxpayers and industries enormous amounts of money in the form of sick days and bad health. (1)

Body Mass Index (BMI) is a number calculated from a person's weight and height. BMI is a fairly reliable indicator of body fatness for most people. BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat, such as underwater weighing and dual energy x-ray absorptiometry (DXA). (2.3) BMI can be considered an alternative for direct measures of body fat. Additionally, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems. (4)

It is important to remember that although BMI correlates with the amount of body fat, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as overweight even though they do not have excess body fat. (4)
 

With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared.

Example: Weight = 68 kg, Height = 165 cm (1.65 m) Calculation: 68 ÷ (1.65)2 = 24.98
 

The BMI ranges that are commonly used can be seen in table 1.
 

Table 1.

Research has shown that as weight increases to reach the levels of overweight (BMI 25 – 30) and obesity (BMI over 30) the risk of certain diseases increases, these are:

Coronary heart disease Diabetes Type 2 Cancers (endometrial, breast and colon) Hypertension High total cholesterol and/or high levels of triglycerides Stroke Liver and gallbladder disease Sleep apnea and respiratory disease Osteoarthritis (5)

 

An Icelandic research looked at how obesity in Iceland has evolved from 1990 to 2007. The results showed that BMI has increased considerable. In 1990 7.2 % of Icelandic males suffered from obesity, but in 2007 this number had increased to 18.9%. 66.6 % of Icelandic males were over normal weight in 2007. (6)

Overweight is a problem amongst fishermen and has been for some time, it is a growing problem as research shows. Two Danish studies were conducted; the first in 2001 / 2002 and it ́s results showed that there were more statistically significant overweight seafarers in all age groups compared to a reference group ashore. Among those between 45 and 66 years of age 0.7% had a weight below normal, 22.7% had normal weight and 76.6% had a weight above normal while 30.9 % of this group was obese. (7) In 2010 this research was in part duplicated and the results then showed that Danish merchant seafarers had a major and significantly increasing overweight problem. Among fishermen the overweight problem was even more frequent. Overweight constitutes a threat not only to their health, but also to their career at sea. (8)

74 fishermen were examined in an Icelandic study conducted in 2004 and the results showed that 35 % had a BMI that was normal, 46% were overweight and 19% were obese. (9)

The aim of a study done in 2009 was to identify how satisfied Icelanders 18 – 79 years of age were with their body weight. The research was based on answers from 5832 individuals. The results indicated that 35% of Icelandic males 18 – 79 years old were dissatisfied with their body weight and close to 63% of males believed they had to loose some weight. Males are most satisfied proportionally with their body weight in the youngest (18-25 years) and the oldest (66-79 year old) age groups. (10)
 

Physical fitness and fishing as an occupation.

It has long been known that fishing is one of the most dangerous occupations. Fishermen have a risky working environment, they work and live in the same confined spaces, they live and work on board ships that are constantly moving often in many directions at the same time, the weather is often bad especially in the northern seas, they work long irregular hours, their work is often hard labor, there is much noise and vibration, there are all kinds of stress factors and they are often far away from their homes and their families for a long time. They are also often far away from the health care system that people ashore are used to and also often far away from any help if there is an emergency. For these and other reasons it is very important for fishermen to be physically fit. They need to be able to thrive in this environment and be able to meet the requirements their jobs demand of them. And this is not enough, they have to be able to save themselves and others in case of emergency and they cannot have diseases that can deteriorate rapidly and put them in dire need of immediate help of advanced health care.

Research has shown that both the mortality rate and morbidity rate is higher for fishermen than for people in other occupations. In recent years a lot has been done to increase safety and decrease hard labor in fishing ships both in Iceland and elsewhere and mortality rate and morbidity rate has declined but more is needed. (11,12,13,14,15,16)

Health promotion and lifestyle changes is a big issue that needs to be emphasized and being overweight is one of the factors that needs to be worked on. (17)

There is research that has looked at how overweight interferes with performance of seamen. One research showed that the time taken to exhaust the air supply in self- contained breathing apparatus is shorter in those who are overweight. (18) Another showed that those seafarers that are overweight are both more at risk in a hostile atmosphere as well as being less capable of performing their duties than other crew members. (19)

An example of incidence investigations that link obesity to safety risks include problems with entry into confined spaces and rescue from them, the safe use of rescue chutes, and slowed ship evacuation when vessels have had to be abandoned. (19)

Our fishermen are aging – before, work on board was just for young and very fit persons but with increased technology and less hard labor fishermen are able to lengthen their careers at sea. One research showed that work ability declines with age and an increased body mass index has a deleterious effect on the ability of older seafarers to do even moderate levels of work. (20)
 

Diet onboard.

Research has indicated that being overweight is a major concern in the maritime industry. Among possible explanations for increased frequency of weight problems is the easy access to abundant quantities of food and high caloric diet that is served on board many ships. (8) The hard labor of the work on board has diminished with increased technology and the crew is often burning fewer calories. Even though there have been changes regarding the diet on board many ships, it is not true for all. The reason for the high caloric diet on board many ships is hard to point out. It seems there is often a conflict between the crew members and the cook. When the cook is asked he/she states that he serves what the crew wants and most often the crew has choices for example between boiled potatoes and french-fries. And if the crew is asked the answer is often that the cook has too much high caloric food on board.

More vegetables and fruit need to be on the table for fishermen. In a study of health and lifestyle of Scottish fishermen the results showed that only 23% of fishermen reported eating fruit and vegetable more than once a day at sea and only 29% at home. (17)
 

Guidelines on the medical examination of seafarers.

The new Guidelines on the medical examination of seafarers have been endorsed by the main stakeholders that is The International Labour Organization (ILO) and The International Maritime Organization (IMO). Many countries have adopted these guidelines as the tool to use for fair examination of physical and medical fitness of seafarers. (21)

 

The aim of the medical examination is to ensure that the seafarer being examined is medically fit to perform his or her routine duties at sea and is not suffering from any medical condition likely to be aggravated by service at sea, to render him or her unfit for service or to endanger the health of other persons on board. (21)

In the guidelines in Appendix C physical capability requirements are discussed. There it is stated that the requirements for work at sea vary widely and have to take account of both routine and emergency duties. The functions that may require assessment include among others – size – compatible with entry into confined areas. It is also stated that medical conditions and physical capabilities limitations may arise from conditions, such as high or low body mass / obesity. (21) It is further stated that for the ICD codes E65-68 the condition of obesity / abnormal body mass – high or low is due to accidents to oneself, reduced mobility and exercise tolerance for routine emergency duties. Increased likelihood of diabetes, arterial diseases and arthritis. (21) The limitations can be temporal if the seafarer is likely to show improvements but otherwise permanent. The limitations can also be time limited and restricted to near coastal waters.

The guidelines do not state a specific BMI for a seaman to pass. But some nations do have a specific BMI as a norm. In Norway there are rules regarding endocrine diseases and there it is stated that for serious obesity with a BMI of 35 or over there is an absolute restriction to serving on board both for bridge functions as for other functions. A BMI of 30 – 35 is a relative restriction and has to be examined further. (22)
 

Results.

418 fishermen answered the questionnaire - 13 were excluded. The reasons being; only three were female and in 10 questionnaires crucial data such as age, height or weight was missing. This left 405 questionnaires that were used in the study.

All the participants are fishermen working on fishing ships that are 500 GT and over. The total number of fishermen in Iceland is around 5200. It was very difficult to find an exact number of fishermen working on ships that are 500 GT and over. After phoning all the fishing companies around Iceland to enquire about the number I found out that there are ca. 1900 men and women working on fishing ships of 500 GT or larger in Iceland. This means that the sample is over 20% and is therefore representable.
 

The average age of the fishermen was 41.8 years with a range of 18 – 69 years; the age distribution can be seen in table 2.


 

Table 2.

 

Weight was measured in kg and the fishermen had their clothes on – except for shoes and overcoat. Most were wearing trousers, t-shirt and a sweater to compensate for these clothing 1.5 kg was subtracted from the total weight of each fishermen.
 

Average weight was 90.0 kg with a range from 61.5 – 148.5 kg; the average weight distribution according to age can be seen in table 3.


 

Table 3.
 

Body Mass Index (BMI) was calculated by using weight in kilograms divided by height in meters squared. For this research overweight is defined as BMI of 25 – 29,9 and obesity is defined as BMI of 30 and over.

Average BMI was 27.7 with range of 20.4 – 42.6. The distribution of BMI can be found in table 4.


 

Table 4
 



 

Diagram 1

 

To see if there was a statistical significance between age and weight and age and BMI the participants were divided into 5 age groups as can be seen in table 2. A statistical test ANOVA was then used to look at the difference. Results showed that there was not a statistical significance between age and weight (F (2.404) = .712; p = .584). Neither was there a statistical significance between age and BMI (F (2.404) = 1.324; p = .260).

 

The fishermen were asked to answer a question about what they think of their own weight i.e. do they think they are too heavy, too skinny or the right weight. Their answers can be seen in diagram 2. 50% state that they think they are overweight whish is similar to a study done in Iceland in 2009 where 63% of males thought they needed to loose weight and 35 % were dissatisfied with their weight. (10)



Diagram 2

 

They were also asked if they had lost weight, gained weight or were of the same weight as 5 years ago. The answers are in diagram 3.

  
 

Diagram 3
 

To explore if there is a statistical significance between age and the two questions above a Pearson Chi-square was used. For the first question about how they perceive them selves the Chi-square results were (x2(8,N=405)=10.631; p=.224) i.e. there is no statistical significance between age and how the fishermen perceived their own weight. Neither was there a statistical significance between age and whether the fishermen had been gaining or loosing weight in the last 5 years, Chi-squares (x2 (8, N=405)=6,991 ; p=.538).
 

Six research questions were stated in the beginning and here are their answers. 1. What is the weight of Icelandic fishermen - Average weight was 90.0 kg

with a range from 61.5 – 148.5 kg

2. What is the Body Mass Index (BMI) of Icelandic fishermen - Average BMI was 27.7 with range of 20.4 – 42.6.

3. Does age have effect on weight and BMI - Age is not a statistically significant variable for weight and BMI of the fishermen in the sample.

4. Do Icelandic fishermen see themselves as overweight – underweight or of the right weight – 50% of the fishermen thought they were overweight, 46% of the right weight and 4% thought they were underweight.

5. Have Icelandic fishermen gained weight, lost weight or is their weight the same as 5 years ago – 57% stated that they were of the same weight as 5 years ago, 34% had gained weight and 9% had lost weight.

6. How many Icelandic fishermen should not have license to work on board fishing ships due to weight problems – 6% of the fishermen had a BMI of over 35 and according to Norwegian rules these should absolute not get their license to work on board fishing ships.
 

Discussion.

Only 25% of Icelandic fishermen on board fishing ship’s that are 500 GT or larger are of optimal weight. This proportion is too low and it is a great concern. Fishermen do work hard labor and a lot of them are well muscled and their BMI does not always mirror their actual body fat. But that is not always the fact – hard labor on board has diminished with increased machine work and technology.

The aim of this study was to find out if many fishermen in Iceland would have trouble passing a health examination because of weight problems. In the study group 24% are in the obese group and 6% of these have a BMI of over 35 and should not be working on board a fishing ship. This means that in the whole fleet there are probably over 120 men that should not have license to work on board fishing ships if we use guidelines from Norway.

These results are similar to research results from Denmark (7.8) though the Icelanders are slightly less overweight than their neighbors from Denmark. If we look at similar studies of fishermen in Iceland (9) from the year 2004, we can see that overweight is increasing among fishermen.

Something needs to be done to diminish this pending epidemic of being overweight amongst seafarers. The diet on board is one thing that needs to be looked at. One seafarer told me that on a tour of 35 days french-fries where served 18 times – this is neither healthy nor good for anyone. It is necessary to educate the chefs on board of the importance of diminishing calorie intake and how they can cook more healthy food.

One issue is the small convenience stores on board many ships that sell soda drinks, chocolate bars and sweets. The crews themselves run these stores and a lot of men are using them frequently. It would be better for everyone to close these down and let every person carry on board the dozens after dozens of sodas and sweets they will

10

Master of Maritime Health Svanlaug Inga Skúladóttir University of Cádiz

consume on one tour for themselves. I am sure they themselves would be surprised by the amount they are consuming.

Another issue is regular exercises – most ships have some sort of exercise room on board but these are often stacked with all kinds of boxes. These rooms need to be inviting and with good fitness equipment that are appropriate for usage on board ships.

Fishermen often lead a potentially unhealthy lifestyle where there is not much time or opportunity for regular exercises, they are often sleep deprived and are far away from their families. This often leads to unhealthy diet choices. A study was done in Iceland in 2008 (23) where a physical activity and nutrition intervention was undertaken to increase awareness and facilitate a healthier lifestyle among fishermen at sea. The intervention was successful, leading to weight loss amongst other positive health changes.

Health promotion is a must for fishermen to increase their awareness of their own health. It is necessary for health personnel to always use health promotion when possible especially while conducting health examination whether they are mandatory or voluntary and in all one on one contact. The whole crew also needs to be educated about healthier dietary choices because it is often difficult for the chef to do some healthy changes when they get disapproval from the crew. The fishing companies need to share the responsibility and the changes have to be initiated from the top by supporting healthier lifestyle on board in every way possible.

This study only looked at only one aspect of physical fitness that is weight of Icelandic fishermen working on fishing ships of 500 GT and larger. It is very important to look at other aspects such as diseases, medications, hearing, vision, fitness and more. If international rules and regulations regarding medical examination of seafarers are to be adopted in Iceland as hopefully they will be in the near future, it is important to introduce these to all seafarers and it is necessary to give them some adaptation time.


 

References.

1. WHO. Obesity and overweight. Fact sheet N° 311, September 2006. Available at http://www.who.int/mediacentre/factsheets/fs311/en

2. Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. American Journal of Clinical Nutrition 2002;7 597–985.

3. Garrow JS and Webster J. Quetelet's index (W/H2) as a measure of fatness. International Journal of Obesity 1985; 9:147–153.

4. Centers of Disease Control and Prevention. Assessing your weight. (Internet) Updated 2011 August 17, cited 2012 October 20. Available from: http://www.cdc.gov/healthyweight/assessing/index.html

5. NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf (PDF-1.25Mb)

6. Valdimarsdóttir M, Jónsson SH, Þorgeirsdóttir H, Gísladóttir E, Guðlaugsson JÓ, Þórlindsson Þ. Líkamsþyngd og holdafar fullorðinna Íslendinga frá 1990 – 2007. September 2007. Lýðheilsustöð (The public Health institute of Iceland)

7. Hoeyer JL, Hansen HL. Obesity among Danish seafarers. Int. Marit. Health. 2005;56(1-4):48-55.

8. Hansen HL, Hjarnoe L, Jepsen JR. Obesity continues to be a major health risk for Danish seafarers and fishermen.

9. Sólarplexus. Hvíld sem áhrifaþáttur á heilsu og öryggi sjómanna. Rannsókn gerð á íslenskum sjómönnum: Á vegum samgönguráðuneytisins. Sólarplexus ehf. 2004. Reykjavík.

10. Matthiasdóttir E. Sátt íslendinga á aldrinum 18-79 ára við eigin líkamsþyngd. 2009. Meistaraverkefni Háskólinn í Reykjavík, Kennslu og lýðheilsudeild.

11. Moore SRW. The mortality and morbidity of deep sea fishermen sailing from Grimsby in one year. Brit. J. industry. Med., 1969, 26: 25-46

12. Matheson C, Morrison S, Murphy E, Lawrie T, Ritchie L and Bond C. The health of fishermen in the catching sector of the fishing industry: a gap analysis. Occup. Med. 2001.51:5: 305-311.

13. Roberts SE. Occupational mortality in British commercial fishi