Maritime Health Research and Education-NET

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UN Sustainable Development Goals (Lima, Peru)
Filipino seaman throwing heaving line with monkey fist.
Seemannsclub Oase, Stade, Germany 2020
Health and safety training of Fishermen in Panamá
Tanker in the Atlantic 2005
Oil platform P-51 Brazil 2005
Dockworkers Pearl Harbor Hickam in Hawaii 2015
Wreckless divers at Kellys anchor, Whittle Rock 2020


Links to other languages[edit | edit source]

Spanish, French, Portugues, Danish,Icelandic, Chinese, Russian, Tagalog , Thai, Persian, Japanese, تحقیقات و آموزش بهداشت دریایی-NET Hindi

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1. Introduction[edit | edit source]

The Maritime Health Research and Education-NET (MAHRE-Net) is a non-profit network of students and researchers to collaborate within the OMEGA-NET Cohorts. The study target populations include maritime students, seafarers, fishermen, port workers, offshore workers, divers and their social relations. We join the OMEGA-NET movement that aims to optimise and integrate occupational, industrial, and population cohorts at the European level but also outside Europe. The aim is to provide a foundation for an enhanced evidence base for the identification of health risks and gains related to occupation and employment to foster safe and healthy preventive strategies and policies. We will follow and support the young people from the maritime schools in their carrier. The method is that we ask the classes of maritime students to fill out a short questionnaire about their health and wellbeing in the beginning of their studies. When they start their practice times at sea, they answer the same questions to identify the influence on their well-being on board. We measure how many of them leave the sea profession and we ask them how they think the profession can continue to be attractive to the young people. It is intended to suggest and assist in the implementation of preventive measures based on the results. Later, we continue to ask them at some year intervals with the same questionnaires to assess whether the efforts have helped. We give the same questionnaires to the maritime students in other countries for comparison and to learn from their proposals on how to get the best working conditions. Also we ask what is needed of teaching to help the industry to give them the best conditions so they can stay safe in the job. Different cohort data sources like pre-employment medical health examination data can be tried out for feasibility and validity (see 5.3) A "Cohort" is defined in the epidemiological science as a group of people who share the same characteristic, in this case more or less the same birth years and we take several contacts to them over their life. Cohorts are also started with maritime workers through their union and other organisations and the shipping companies. The outcome of the research, the enhanced evidence base is used together with other evidence from review studies for the permanent updated teaching materials and teaching in the prevention plans as mentioned below.

2 BACKGROUND - open[edit | edit source]

3 OBJECTIVES[edit | edit source]

  1. International prospective exposure and health risk cohort studies with maritime students and workers
  2. Using the standard protocols with different themes
  3. Harmonise exposure and outcome information by using standard questionnaires
  4. Objective and subjective assessments of workplace hazards exposures
  5. Develop and validate Job-exposure Matrices
  6. Systematic reviews and pooled studies from the cohort rounds
  7. Cohort-Linkage to pre-entry and follow-up health exams and other health registers
  8. Propose and help with prevention measures based on the results:
  9. Make training materials based on the cohort study outcomes and other scientific sources
  10. OHS training to maritime doctors, seafarers, fishermen, students and others
  11. Integrate research methodology in the supervision of student’s thesis work
  12. Adapt to the OMEGA-NET on data sharing and reporting cohort meta-data
  13. Keep the Excel data file copies safely (producing country and supervisor)

4. METHODS[edit | edit source]

Data will be collected with questionnaires to be answered electronically, by interview or self-contained. The questions will consist of three parts,

  1. One permanent introduction with the demographic informations about the person and the ship/workplace
  2. The second and main part will be selected from the list of standard questionnaires below
  3. Some extra questions due to specific wishes

Design[edit | edit source]

Repeated cross-sectional rounds in a prospective dynamic cohort design. The follow up with analysis of any changes in the overall answers will be analysed for more than one time responders. In each questionnaire round the first time respondents will constitute a new cohort.

Follow-up of the cohorts[edit | edit source]

For each of the questionnaire rounds there will be a question about completion of a similar questionnaire before. And thereby comparison by groups of workers like specific job positions, type of ship etc. The objective is to identify trends of risky work indicators, wellbeing and health claims.

Data content[edit | edit source]

The target study populations are maritime schools and maritime workers organisations. For each round, one standard questionnaire or part of it and some specific items are used e.g.

  1. General Health Questionnaire (GHQ-12)
  2. Nordic Musculoskeletal Questionnaire(NMQ)
  3. Nordic Safety Climate Scheme (NOSACQ-50)
  4. Copenhagen Psycho-Social Social Questionnaire (CoPSQ)
  5. Food Frequency Questionnaire (FFQ)
  6. Self-Reported Injury at work
  7. Nordic Occupational Skin Questionnaire (NOSQ)
  8. Objective and subjective assessments of workplace hazards exposures
  9. European Working Conditions Surveys (EWCS)
  10. Permanent variables: age, gender, height, weight, smoking, general health, officer/not officer, job position/workplace on board, type of ship, weight of ship,

5 Working papers in development in English[edit | edit source]

5.1 Minutes from Board meetings [edit | edit source]

5.2 Members - open [edit | edit source]

5.3 Workplan [edit | edit source]

5.3 Different Data Sources for Cohorts [edit | edit source]

5.4 Cost-Action[edit | edit source]

5.5 Basic procedure for project collaboration with the universities [edit | edit source]

5.6 Draft Letter to the Maritime University [edit | edit source]

5.7 Possible scenarios for start and follow-up of cohorts[edit | edit source]

5.8 Cohort protocols [edit | edit source]

5.9 Google Forms Questionnaires [edit | edit source]

5.10 Inventory of Cohort Meta-data OMEGA-NET [edit | edit source]


6 Contributions to the Industry[edit | edit source]

  1. The maritime doctors and other maritime health professionals receive updated knowledge on the health risks at sea for the specific jobs and work areas
  2. Job-Exposure Matrices will support with the needed evidence to the health examinations according to the requirements in the ILO/WHO Guidelines
  3. The companies receive updated knowledge that enables for a strategic and thus more cost-effective prevention efforts also in the Job-Exposure Matrices
  4. The MAHRE-Net supports the international organisations with the updated scientific evidence for updating of the international conventions and regulations
  5. The MAHRE-Net supports the Flag states to comply with their obligations to monitor the working and living environments regularly according ILO Conventions: MLC2006 for seafarers and C188 for fishermen.

6.1 Contributions to the Health Risk Prevention[edit | edit source]

The cohort studies can be seen as the diagnostic part of the prevention related to each of the specific items. Guidelines for the prevention for each of the standard questionnaires will be included in the Cohort Protocols.

7 Ethical requirements[edit | edit source]

The ethical rules for database research in the respective Universities and the ICOH Code of ethics are complied with. Confidentiality in handling personal information is done according to the rules set out by the national Data Protection Agencies. Normally there is no personal sensitive information included so approval from the Ethics Committee is not necessary. All questionnaires ask for informed consent as the first question. The supervisors take care to secure that the data is processed under the Act on medical confidentiality as guidelines for good epidemiological practice. The participants' anonymity will be protected in every way and this will be indicated in the project description. It will be ensured that the electronic table is locked so that the information cannot be seen by anyone other than the researchers. The researchers respect individual ownership of the data and share publications and the data where this is convenient and keep always good partnerships as described in The European Code of Conduct for Research Integrity for self-regulation in all research in 18 translations The English version

5 RESEARCH PROJECTS [edit | edit source]

6 EDUCATION [edit | edit source]

7 MANAGEMENT [edit | edit source]

19 Contribution to UNs 17 Sustainable Development Goals[edit | edit source]

Goal 3: Good health and well-being for all workers
Goal 4: Quality Education
Goal 5: Gender Equality
Goal 8: Decent Work and Economic Growth
Goal 10: Reduced Inequality (Compliance with MLC2006 and the C188)
Goal 12: Responsible Consumption and Production (Ships’ SOx and NOx emissions)
Goal 14: Life underwater observations on compliance with good waste management
Goal 17: Partnerships to achieve the Goals

20 Contribution to quality education[edit | edit source]

For the maritime workers and the industry[edit | edit source]

The updated scientific evidence on the prevalent health risk exposures and health conditions on board will qualify the prioritisation of the preventive actions in the Safety Committees on board, in the companies and in the workers organisations. The workers will benefit from the updated maritime doctors to better understand their possible claims and symptoms that calls for adequate clinical and laboratory diagnostics and possible notification as occupational diseases.

For the maritime doctors[edit | edit source]

The outcomes of the cohort studies will be an important part of the continuing training of the Maritime Medical doctors and the training for fishermen and seafarers.
Without this knowledge the medical doctors cannot perform their obligations adequately and give preventive advice for the seafarers and fishermen according to the ILO/IMO Guidelines on the Medical Examinations of Seafarers and act adequately with possible notification of occupational diseases.

For the students[edit | edit source]

Preferably we use our maritime health and safety research outcomes as the basis for our teaching for the MSc.Pub Health and the Maritime students. They learn the research methods in occupational maritime health with assessment of reliability, generalisability and different types of bias in the scientific context including clearance of the ownership of the data. They learn how to apply the research methods in their coming professional tasks and how to search the scientific based knowledge for solving of practical problems in their professional life. The maritime students get interest and knowledge on how to search and use the scientific based maritime knowledge for use in their professional positions as leaders on board.

21 Strengths and Weaknesses[edit | edit source]

In many countries the interest for a seafaring carrier among the young people is rather low. It is a strength to start with the young seafarers at the maritime schools because they can bring fresh perspective and a different way of thinking to the maritime business and help to attract the young seafarers. According to the Unicef, most of them are eager to learn, build their experience and apply their skills in the workforce.Unicef: 6 top benefits hiring young talents The method used is easy to implement in a low budget. It is a strength to use the method that immediately identify risk elements in the work environment that is not seen by the shipping inspectors in the harbours to be amended for the benefit of the seafarers and the companies. In contrast to the register based studies, these studies identify risk elements in the work environment that will never be learned from the register based studies. The students learn how to apply the research methods in their later professional tasks and how to search the scientific based knowledge for solving of practical problems in their professional life. The maritime students get interest and knowledge on how to search and use the scientific based maritime knowledge for their professional positions as leaders on board. Among the weaknesses is that the response rate might be too low from the start, that they change their mail-address so we have no contact and they are not willing to participate or have no time in the later rounds. Another weakness is that the cross-sectional design cannot identify the causal relations in the single studies. However by comparison of different questionnaire rounds the health risk hazards might be present in some cohort parts and not in others and thereby contribute to identify the causal relations.

22 Links to relevant organizations, documents and funds[edit | edit source]

OMEGA-NET cohorts statement on research integrity and responsible research practice
ICOH International Commission on Occupational Health
EPICOH Scientific Committee on Epidemiology in Occupational Health
COST explained in Wikipedia
The OMEGA-NET Cohorts and COST
DiMoPEx (CA 15129)
Links to OMEGA-NET Scientific Publications
The HERA network for an environmental, climate and health research agenda
The COST mission vision and values
The European Survey Research Association
European Working Conditions Surveys (EWCS)
The European Social Fund
Nordic Council Ministers Funding NGO Co-Operation Baltic Sea Region
Funding Nordic Council Ministers
Nordic Council Ministers Funding-opportunity Nordic-Russian Co-Operation
ITF Seafarers Trust
Nippon Foundation

References[edit | edit source]