International Maritime Health最新文献

{"title":"Septic arthritis attributed to a spider bite - a case report and review of the literature.","authors":"Kamil Kosal, Agata Tomaszewska, Klaudia Julia Kościelecka, Malgorzata Maria Paul","doi":"10.5603/imh.111376","DOIUrl":"https://doi.org/10.5603/imh.111376","url":null,"abstract":"<p><p>Individuals who travel to tropical or subtropical areas are exposed to various infectious, environ-mental, and climatic risk factors, as well as traffic accidents, security problems, natural disasters, and direct contact with potentially dangerous plants or animals. Accidental bites by venomous spiders during long journeys are always dangerous to health and life, but it is not usually recognized that nonvenomous spiders also pose such a substantial threat to the lives of local inhabitants and travelers. Here, we present an unusual case of a 41-year-old male patient who was admitted to the University Hospital after a tourist trip to Kenya with skin lesions and abscesses located in the gluteal region and the lower limb, caused by a tropical spider bite. As a severe complication, the patient developed sepsis and septic arthritis of the hip, contralateral to the primary skin lesions. Microbiological evalua-tion of peripheral blood, synovial fluid, and pus from subcutaneous abscesses consistently identified methicillin-sensitive Staphylococcus aureus (MSSA) as the cause of sepsis. This case is unusual and exceptional, as it illustrates the possibility of a serious complication in the form of generalized bacterial superinfection accompanying a spider bite in an immunocompetent person. It was also the first documented report of staphylococcal septic arthritis directly related to a nonvenomous spider bite. In this publication, we present our diagnostic and treatment approach, compare it with other similar cases from the available literature, and discuss spider bites as a common and often downplayed complaint in patients returning from tropical areas in daily medical practice.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of health conditions, lifestyle factors, and stress on seafarers' self-rated health - a cross-sectional study.","authors":"Rebecca Hayes-Mejia, Jack Palmieri, Martin Stafström","doi":"10.5603/imh.111721","DOIUrl":"https://doi.org/10.5603/imh.111721","url":null,"abstract":"<p><strong>Background: </strong>Self-rated health (SRH) is a validated holistic indicator of health, yet evidence among seafarers is limited. We examined how health conditions and lifestyle factors relate to poor SRH and whether perceived stress modifies these associations in active-duty seafarers. A total of 22,432 international seafarers who were on board were included in the analysis of an electronic survey distributed via 52 shipping and manning companies in February-March 2024.</p><p><strong>Material and methods: </strong>An 82-item questionnaire assessed SRH, self-reported health conditions, lifestyle factors (physical activity, sleep/feeling rested, smoking, alcohol risk, loneliness, screen time), and perceived stress. Cross-sectional analyses used descriptive statistics and logistic regression. Models were adjusted for age, sex, rank, and time on board; stress was added as an independent predictor. Additive interactions between stress and lifestyle factors were evaluated using relative excess risk due to interaction (RERI).</p><p><strong>Results: </strong>Poor SRH was strongly associated with multimorbidity and selected conditions, particularly depression/anxiety, gastrointestinal issues, and musculoskeletal issues. In fully adjusted lifestyle models, sedentary behavior, not feeling rested, smoking, loneliness, and excess screen time remained associated with poor SRH, while alcohol risk was not. Stress was independently associated with poor SRH and amplified the effects of not feeling rested, loneliness, and excess screen time. Self-rated health captured a combined burden of physical and mental symptoms as well as recovery--related and psychosocial factors relevant to life at sea. The stress-sensitive clustering of poor sleep/rest, loneliness, and high screen time suggests that interventions may be most effective when stress management is integrated with fatigue and social-connection measures.</p><p><strong>Conclusions: </strong>Health conditions and modifiable lifestyle/psychosocial factors were associated with seafarers' SRH, and perceived stress acted as both an independent predictor and an effect modifier. Targeting sleep, stress, social well-being, and sedentary recovery patterns may improve perceived health and potentially safety on board.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reverse sinus barotrauma with periorbital emphysema as an occupational hazard - a case report.","authors":"Serkan Ergözen, Ozan Gökdoğan, Nisa Örmeci, Çiğdem Karagöz","doi":"10.5603/imh.110399","DOIUrl":"https://doi.org/10.5603/imh.110399","url":null,"abstract":"<p><p>Sinus barotrauma is the second most common diving injury among divers. It results from an imbalance between the pressure within the sinuses and the ambient pressure. It may occur not only as \"barotrauma of descent\" but also as \"barotrauma of ascent/reverse barotrauma,\" which is less common. Here, we describe a professional diver who had worked at a fish farm for nearly 3 years, diving with SCUBA equipment, and developed reverse sinus barotrauma with periorbital emphysema. This diving injury is preventable. To help prevent it, divers must have adequate education and knowledge of diving physics, physiology, and injuries. They should also be aware of their health status and whether they are fit to dive on a given day. If in doubt, they should cancel the dive. If they are unable to equalize the pressure difference and/or experience sinus pain, they should stop descending, abort the dive, and seek medical evaluation and treatment.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Evaluating of the readability of ChatGPT-generated responses on travel health risks\".","authors":"Lyka Jane Castillote Ang","doi":"10.5603/imh.108831","DOIUrl":"https://doi.org/10.5603/imh.108831","url":null,"abstract":"<p><p>None.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue-specific gradient factors to address undeserved decompression sickness.","authors":"Sergio Angelini, Attilio Piacente","doi":"10.5603/imh.112305","DOIUrl":"https://doi.org/10.5603/imh.112305","url":null,"abstract":"<p><strong>Background: </strong>\"Undeserved hit\" is a term used to define a case of decompression sickness (DCS) when the diver has adhered to the limits set by a dive computer. In a recent study, Divers Alert Network (DAN) Europe has analyzed over 39,000 dives with 295 undeserved hits. These 295 dives, and an additional 22 that were borderline or above accepted safe limits of decompression, were processed to determine the inert gas load at the end of the dive, expressed in terms of gradient factors (GF) in a ZH-L16C framework. The data show that DCS was observed with GF values as low as 70, but mostly involved the intermediate tissues (27-minute half-time and higher).</p><p><strong>Material and methods: </strong>We propose a variation of the Bühlmann algorithm to incorporate this evidence in a way that does not penalize a recreational diver when not needed.</p><p><strong>Results: </strong>Our simulations show that by applying tissue-specific gradient factors (TSGF), the algorithm can automatically become more conservative as the severity of the dive profile increases and as the effect of repetitive dives becomes more pronounced.</p><p><strong>Conclusions: </strong>Tissue-specific gradient factors can be used to increase the conservatism of the ZH-L16C algorithm for extreme exposures and repetitive dives, without being too limiting for the recreational diver.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diatoms in seas: a risk of silicosis for mariners ?","authors":"Richard Pougnet, Jean-Dominique Dewitte, Brice Loddé","doi":"10.5603/imh.109989","DOIUrl":"https://doi.org/10.5603/imh.109989","url":null,"abstract":"<p><p>In a recent article, it was highlighted that ocean waters contain a high concentration of diatoms [1]. Diatoms are algae whose properties are well known in occupational health, because one form of occupational exposure to silica comes from the use of diatomaceous earth. Some workers developed silicosis. Some mariners therefore wondered whether they themselves might be at risk of silicosis by navigating and working on these seas.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lip health among maritime workers in the Baixada Santista Port Region - clinical evaluation and development of a protective moisturizer.","authors":"José Sani Neto, Jessica Caroline Machado, Ana Paula Taboada Sobral, Nycolas Gomes Da Cunha Carvalho, Sandra Kalil Bussadori, Carolina Mayumi Iegami, Juliana Maria Altavista Sagretti Gallo, Ana Luiza Cabrera Martimbianco, Elaine Marcílio Santos, Gustavo Duarte Mendes, José Cássio de Almeida Magalhães, Marcela Leticia Leal Gonçalves","doi":"10.5603/imh.109933","DOIUrl":"https://doi.org/10.5603/imh.109933","url":null,"abstract":"<p><strong>Background: </strong>Fishermen are among the occupational groups with substantial sun exposure and are prone to dehydration, sunburn, photoaging, actinic cheilitis, and oral cancer. The objective of this study was to evaluate the dermatological condition of the lips of fishermen in the Guarujá/Santos port region, investigate whether they use preventive measures to avoid such lesions, and develop a suitable product for lip protection.</p><p><strong>Material and methods: </strong>Thirty participants underwent an initial clinical examination and photo-graphic documentation. All 30 participants received the developed lip protector, which contained UV filters and moisturizing agents. At re-evaluation one month later, 17 participants returned, corresponding to a loss to follow-up of 43.40%.</p><p><strong>Results: </strong>All fishermen were male, with a minimum age of 23 and a maximum age of 74. When asked about lip balm use, only 1 of the 30 participants reported using it. At follow-up, among the 17 participants, only 1 reported using the provided lip balm and reapplying it during the day; this use was described as \"sporadic.\"</p><p><strong>Conclusions: </strong>The findings highlight the need for educational strategies to promote lip protection and prevent potentially malignant lesions among outdoor workers exposed to ultraviolet radiation.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncharted territory - an audiometric surveillance program for seafarers.","authors":"Imogen Stilz, Molly Cahill, Stewart Milne, Sarah Quayle, Marc Rudd","doi":"10.5603/imh.109117","DOIUrl":"https://doi.org/10.5603/imh.109117","url":null,"abstract":"<p><strong>Background: </strong>Occupational noise exposure causes noise-induced hearing loss (NIHL). The International Maritime Organization Code on Noise Levels on Board Ships includes audiometric surveillance as an optional measure for monitoring auditory thresholds over time. The Occupational Safety and Health Administration (OSHA) standard threshold shift (STS) criterion is widely used for surveillance. A standard threshold shift can occur due to aging, illness, cumulative exposure to noise and ototoxic agents, or test-retest variability. To the authors' knowledge, this is the first service implementation and evaluation study of an audiometric surveillance program among seafarers in marine transport.</p><p><strong>Material and methods: </strong>In addition to pre-existing noise controls compliant with industry standards, an audiometric surveillance program was implemented across a fleet of hydrocarbon transport ships for a multinational population of 745 noise-exposed seafarers. Audiometry was conducted during seafarers' periodic fitness examinations, and the OSHA STS criterion was used to identify threshold shifts.</p><p><strong>Results: </strong>After 1 year, 542 seafarers had baseline audiograms, and 85 had both a baseline audiogram and at least one subsequent audiogram. Nine cases of STS were detected (11%).</p><p><strong>Conclusions: </strong>Audiometric surveillance in international marine transport is feasible and can be used to verify the effectiveness of risk controls for NIHL among seafarers. The observed incidence of STS is unlikely to reflect true hearing loss over the short follow-up period, and is more likely caused by test-retest variability. It is at the upper end of the predicted variability from clinical and industrial audiometry studies, although higher test-retest variability and STS rates have been reported in naval operations. High test-retest variability in an itinerant workforce presents a challenge when verifying the effectiveness of noise controls. Although individual audiometric surveillance remains important, aggregate population-level surveillance data may provide a more robust indicator of risk control effectiveness across the workforce. Further research on the epidemiology of NIHL and the performance of audiometric testing among seafarers is needed.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of artificial intelligence in advancing health for seafarers.","authors":"Glenn J Pulvera","doi":"10.5603/imh.111120","DOIUrl":"https://doi.org/10.5603/imh.111120","url":null,"abstract":"<p><p>The maritime industry is undergoing rapid digital transformation, with artificial intelligence (AI) increasingly influencing the delivery and governance of health services for seafarers. This short communication explores the potential role of AI in addressing persistent occupational health challenges faced by maritime workers, including limited access to healthcare, fatigue, and mental health risks. AI-enabled applications in telemedicine, clinical decision support, and predictive analytics offer opportunities to enhance prevention, early detection, and continuity of care at sea. However, effective integration requires robust ethical safeguards to ensure data privacy, transparency, and equitable access. Advancing responsible AI use may contribute to safer and more resilient maritime health systems.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Brugmansia</i> poisoning - a case report highlighting a preventable port call hazard for seafarers and travelers.","authors":"Alejandro Martínez, Jacobo Pardo, Gabriel Fernando Fallas","doi":"10.5603/imh.111342","DOIUrl":"https://doi.org/10.5603/imh.111342","url":null,"abstract":"<p><strong>Background: </strong>Recreational ingestion of toxic plants poses a significant and preventable health risk.Brugmansiasp. (Angel's Trumpet), common in tropical regions, contains potent anticholinergic alkaloids. This case highlights that such intoxication represents a specific hazard for maritime travelers and workers in port regions.</p><p><strong>Case presentation: </strong>A 16-year-old male with a history of substance abuse presented to the emergency service three hours after ingesting a tea made fromthe flowers of Brugmansiasp. for recreational purposes. He exhibited a classic anticholinergic toxidrome: agitated delirium, visual hallucinations, incoherent speech, mydriasis, tachycardia, and dry mucous membranes. Management required prolonged sedation with intravenous benzodiazepines (diazepam) and the use of physical restraints for over 36 hours. After resolution of the acute delirium, he expressed suicidal ideation, leading to a psychiatric referral, during which underlying impulse-control issues were diagnosed.</p><p><strong>Conclusions: </strong>This case of severeBrugmansiapoisoning underscores a dual public health challenge. First, it is a clinically significant toxicological emergency requiring recognition and supportive management. Second, it exemplifies a preventable risk for maritime populations - both seafarers on shore leave and cruise tourists - who may experiment with locally available psychoactive plants. Enhanced awareness and targeted education in port communities and among travelers are crucial preventive measures in maritime health.</p>","PeriodicalId":45964,"journal":{"name":"International Maritime Health","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}