Maritime Health Research and Education-NET

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Tanker in the Atlantic 2005
Filipino seaman throwing heaving line with monkey fist.
Seemannsclub Oase, Stade, Germany 2020
Health and safety training of Fishermen in Panamá
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

1. Introduction[edit | edit source]

The Maritime Health Research and Education-NET (MAHRE-Net) is a non-profit network of maritime universities, seafarers, maritime students and researchers. The target populations include maritime students, seafarers, fishermen, port workers, offshore workers, divers and their social relations. 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 maritime preventive strategies and policies. The program include the permanent monitoring of the four main topics of the EU-Occupational Health strategy: Mental health, Ergonomics, Safety climate and chemical related Skin diseases. In the cohort design strategy, we will follow and support the young people from the maritime schools in their careers. 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 unions, other organizations and shipping companies. The main results of the surveys is published in the Maritime OH portal with links to the actors that make prevention based on the results.

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. All other industries are very welcome to promote the similar research and education goals
  3. Using the standard protocols with different themes
  4. Harmonise exposure and outcome information by using standard questionnaires
  5. Objective and subjective assessments of workplace hazards exposures
  6. Develop and validate Job-exposure Matrices
  7. Systematic reviews and pooled studies from the cohort rounds
  8. Cohort-Linkage to pre-entry and follow-up health exams and other health registers
  9. Propose and help with prevention measures based on the results:
  10. Make training materials based on the cohort study outcomes and other scientific sources
  11. OHS training to maritime doctors, seafarers, fishermen, students and others
  12. Integrate research methodology in the supervision of student’s thesis work
  13. Adapt to the OMEGA-NET on data sharing and reporting cohort meta-data
  14. 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. Nordic Occupational Skin Questionnaire (NOSQ-2002)
  6. Food Frequency Questionnaire (FFQ)
  7. Self-Reported Injury at work
  8. Objective and subjective assessments of workplace and hazards exposures
  9. European Working Conditions Surveys (EWCS) part of can be used
  10. Permanent variables: age, nationality gender, height, weight, smoking, general health, officer/not officer, job/workplace, ship type&size
  11. MAHRE-Net maritime health research and education-Net [1]

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

5.1 Minutes from Board meetings [edit | edit source]

5.2 Members Updated 11-01-21[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]

5.9.1 Practical guide for sending out the Forms to the students [edit | edit source]

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

5.11 Presentations pptx [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. Nyhetsbrev+uke+51&utm_medium=email&utm_term=0_269755219a-0df7cc29a7-132116122 Systematic dissemination of knowledge in work environment-e.g. STAMI Specific project
  3. Job-Exposure Matrices will support with the needed evidence to the health examinations according to the requirements in the ILO/WHO Guidelines
  4. The companies receive updated knowledge that enables for a strategic and thus more cost-effective prevention efforts also in the Job-Exposure Matrices
  5. The MAHRE-Net supports the international organisations with the updated scientific evidence for updating of the international conventions and regulations
  6. 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 RESEARCH EDUCATION [edit | edit source]

7 MARITIME HEALTH PORTAL[edit | edit source]

8 MANAGEMENT [edit | edit source]

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

UN Sustainable Development Goals (Lima, Peru)

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

10 Integrated Mental Health and Work Policy OECDs recommendation[edit | edit source]

... To monitor and improve the overall school and preschool climate to promote social-emotional learning, mental health and wellbeing of all children and students through whole-of-school-based interventions and the prevention of mental stress, bullying and aggression at school, using effective indicators of comprehensive school health and student achievement; Promote and enforce psychosocial risk assessment and risk prevention in the workplace to ensure that all companies have complied with their legal responsibilities. Develop a strategy for addressing the stigma, discrimination and misconceptions faced by many workers living with mental health conditions at their workplace [2]

11 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.
https://en.wikiversity.org/wiki/Maritime_Health_Research_and_Education-NET/MARITIME_HEALTH_PORTAL 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.

12 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 actual risk elements in the work environment that will never be learned from the register based studies. Análisis de frecuencia simple esta muy util para iniciar el trabajo preventivo. Ademas los resultados en gráficos son muy útiles para la educación básica y avanzado. Mediante el uso de cuestionarios cortos estandarizados, se obtiene una buena tasa de respuesta. The General Data Protection Regulation (GDPR) enforced in EU since 2018 can be very complicated to manage in the research. The general survey data we use focuses on the general exposure data in work environment and not personal identifiable information. Still an assessment on GDPR data is always needed and in most cases our survey research do not apply to the same ethical rules as for clinical database research. 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.

13. The preventive maritime occupational health strategy[edit | edit source]

The maritime occupational and environmental health strategy in development will be based on the needs for new knowledge of the main OH indicators. A continued accumulation of new knowledge from MAHRE-Net constitutes the base for a continued development of a preventive maritime OH strategy for "constant care" of the workers at the sea.[3] Based on the national and international OH strategies, e.g. the EU-OSHA EU Strategy [4], The US-CDC and the WHO, ILO OH strategies we selected the four most important OH areas for constant systematic monitoring in the MAHRE-Net: 1. safety-climate, 2. mental health, 3. musculoskeletal risk and 4. Chemical risks. Besides these four main occupational health indicators the following public health indicators can be/are included in each of the surveys: height/weight for Body Mass Index, Smoking, General Health, Alcohol and questions on prevention The validated and international standard questionnaires are available with no extra costs for the students thesis writing that seems to be an ideal way to make good progress despite the scarce financials. We profit from the results of the outstanding scientists from the Nordic countries and and other countries who developed and validated the standardized questionnaires over the latest thirty years. We offer supervision and methodological support for the Bachelor and MScPubHealth graduation thesis and the thesis students in the maritime universities and other health educations like nurses, medical doctors, pharmaceuticals etc. Data from the Radio Medical services and the seafarers health examinations are also included. he intention is to obtain win-win situation with the students getting inspired to continue to do more advanced studies. However, other types of research design apart from the monitor program are encouraged to be made by enthusiastic researchers based on paid clinic time, private time or funds. Projects with pooling of data from many countries and trends analysis and combining of different questionnaires will require experienced researchers and fundings. Altogether the research activities in MAHRE-Net is intended to be very wide from the most basic levels to the highest levels of competencies with a constant education and learning.

14. Links to organizations, documents and funds[edit | edit source]

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 == https://www.fi-compass.eu/esif/emff
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

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References[edit | edit source]

  1. MAHRE-Net maritime health research and education-Net
  2. https://legalinstruments.oecd.org/public/doc/334/334.en.pdf
  3. https://www.maersk.com/about/core-values    
  4. https://www.dropbox.com/s/kralxs9yvl569x0/The%20implementation%20of%20Occupational%20Safety%20and%20Health%20in%20the%20EUST_14630_2019_INIT_en.pdf?dl=0