Comprehensive Assessment of Occupational Traumatism of Members of Vessel`s Crew on Transport and Fishing Fleets of the Northern Water`s Basin

Members of vessel`s crew of transport and fi shing fl eets is a professional group of industrial workers contingent operating the important links of the economic mechanism of many types of industries. Loss of ability to work, disability, and in some cases may be fatal occupational traumas of members of vessel`s crew, determine the socio-hygienic and medical nature of the problem and its economic importance. The analysis of the provision of medical care in 2216 occupational damages of members of vessel`s crew of the Northern Water`s Basin obtained on board of ships of sea transport, river transport and fi shing fl eets. Occupational accidents on vessels were 156.4 per 1000 employees, including 198.2 in the sea transport ones; 132.9 river transport and 67.7 fi shing. Women from among this cohort of industrial workers are injured on vessels in 1.8 times less often than men. With increasing production time traumatism of members of vessel`s crew sequentially reduced by more than 3.4-fold in patients with experience of over 15 years compared persons the fi rst year of operation. The volume of urgent measures in vessel`s medical point due to the high frequency of fractures among the victims (60.7), including open (10.7); extensive infected wounds with massive damages of deeply lying tissues (23.7) wearing complicated or a combined character. Occupational falls from a height with ladders into the open hold or overboard occur with the sailors and minders when performing general vessel`s, cargo-handling and mooring work (9%). Proportion damages of members of vessel`s crew in alcoholic intoxication on vessel when performing work up to 8% in the total traumatism, including in sea transport fl eet 9% (18.0); river transport 9% (9.9) and fi sheries ones 4% (2.8). Deadly accidents of members of vessel`s crew reached 10% in the overall structure of traumas. Risk factors in the composition of members of vessel`s crew of sea and river transport and fi shing fl eets in the Northern Water`s Basin depended of type of work performed, special vessel`s affected, drinking of alcohol, sex, age, length of service. Research Article Comprehensive Assessment of Occupational Traumatism of Members of Vessel`s Crew on Transport and Fishing Fleets of the Northern Water`s Basin Shapovalov KA* and Shapovalova PK Syktyvkar, Komi Republic, Russian Federation Received: 13 February, 2018 Accepted: 12 March, 2018 Published: 13 March, 2018 *Corresponding author: Shapovalov KA, Doctor of Medical Sciences, Professor, Syktyvkar, Komi Republic, Russian Federation, Email:


Introduction
In the context of ensuring the life of modern sea power countries of the world, have a lot of transport and fi shing ships accident prevention of members of vessel`s crew is one of the most important reserves of saving labor and health of this contingent of professional group of industrial workers. The urgency of the problem of medical care to persons affected by the trauma of the number of the members of vessel`s crew is determined by the high mortality rate in severe damages, duration and severity of the injury with a temporary and sometimes permanent loss of ability to work. The consequences of occupational traumatism are the socio-hygienic and medical-psychological conditioning. Often, it can become a cause of production, personal and family tragedies. Due to the limited labor force infl ow to fl eets reduction of traumas in the conditions of all the members of vessel`s crew increasing automation of labor, the development of preventive measures should be considered as one of the effective measures to save manpower [1][2][3][4].
To unify the diagnosis, prognosis, organizational tactics and methods of treatment of various work-related injuries of members of vessel`s crew medical workers of vessel`s medical point, ambulances port cities, outpatient and hospital units of hospitals, specialized departments and specialized medical center have to apply uniform criteria. Failure to follow the sequence of steps in the evacuation and treatment of victims leads to misallocation on injury severity and negative impact on the immediate and long-term results of treatment [5][6][7][8].
Fishing Fleets of the Northern Water`s Basin. Ann Mar Sci 2(1): 001-008. DOI: http://dx.doi.org/10.17352/ams.000008 In addition, one of the outstanding issues hindering the further development of practical vessel`s trauma is insuffi cient consideration of "sustained minor injuries" and lack of generalized data enabling an objective understanding of the socio-sanitary characteristics of occupational traumatism of members of vessel`s crew with the infl uence of medical, biological and socio-economic factors. The lack of systemic analysis in the prevention of traumatism, leads to a repetition of similar hazardous situations injury, ending with serious damages [9][10][11][12].

Materials and Methods
Northern Water`s Basin includes Barents, Norwegian, North

Results
The The frequency of occupational traumas on various fl eets of Northern Water`s Basin was uneven: the highest -on sea transport vessels (208.1); more lower -on river transport (132.9) and fi shing (67.7) ones. Members of vessel`s crew of the maintenance service of vessels amounted to 47.6% of the victims, which was more than the members of vessel`s crews of operation of services -40%; life -6%, radio -1%, the production processing -2%, mining -1%, health -by 1%.   Occupational injuries to the wrist injury are the most frequent between members of vessel`s crew of Northern Water`s Basin. Bruises (3.5) and wounds (10.5), taken together, account for fewer than fractures of various bones of the hand (17.7). Another formidable pathology of hands is amputation of fi ngers at different levels (9.6). On board of vessel`s traumatic amputation of fi ngers brush occur when working with the hatch covers, when the doors are closed, maintenance deck machinery. Industrial injuries with damage to the brush in transport and fi shing fl eets it has different weight. Every second traumatic amputation on vessels leads to a loss of two or more fi ngers. Members of vessel`s crew in the treatment process are formed functionally defective in the stump, and the treatment often ends adverse professional and labor outcomes.
Occupational damages of foot are characterized by high frequency of fractures (11.0). The number of traumatic amputations of the lower limb phalanges at different levels (0.9) 10.7 times was lower than the brush. Shin injury in the fl oating structure is characterized mainly by bone lesions (10.3), as compared to the soft tissues. Bruising tibia (3.9) and wounds (2.4) occur rarely objectively. Head injuries of members of vessel`s crew lead to a concussion (36%), brain injuries (10%), bone fractures vault (8%) and the base of the skull (4%). In case of damage of the forearm on board of vessel notes the prevalence of bone fractures (58%; P<0.001) over other types. Shoulder traumas are accompanied by the usual shoulder dislocations (38%), bruises and fractures of the humerus (23%), often the detachment of the tendon of the biceps (8%). Damage to the eye make up 4% of all injuries, among them most sailors are injured eye. High is the level of foreign bodies, contusions organ of vision.
When performing vessel`s work associated with the transitions on the stairs and decks, falling from height injuries are accompanied by injuries of the chest with broken ribs. Two broken ribs were observed in 20% of the victims; Ribs 3 -8%; 4 or more -2%.
Spine damages were reported in 3.4% of members of vessel`s crew, who was injured on ships. Every second trauma is accompanied by fractures of the vertebrae. If the damage occurs in fl ight, the transfer of the victim to shore hospital is diffi cult, qualifi ed medical care is delayed. When the spine fracture with spinal cord injury persons of the fl oating structure are patient recovery and rehabilitation of spinal centers. If the injuries of shoulder happened the most common damage is habitual dislocation (1.5) compared with fractures of the humerus (0.9) and bruises (0.9), the gap between the tendon of the biceps (0.2). Among the hip injury dominated soft tissue injuries (2.0) over the fractures of the femur (1.5). Collarbone traumas accounted for only 1.0% of total damage of members of vessel`s crew, including fractures prevailed over gaps acromio-clavicular joint (P<0.001). Fractures of the pelvis are the thirteenth rank place. Production damages to the abdominal cavity and to the neck of on board of vessel are rare types of pathology. Large group of injuries on ships constitute burns (6%), obtained in the performance of vessel`s work. Dominated by thermal damage II degree (72%; P<0.001), an area of 3% of the hands, shins, face, feet.
Occupational traumas of members of vessel`s crew demanded of surgical treatment in 31% of cases. If there is no medical worker on board, fi rst aid for injuries is provided by not experts, most chief mates, responsible for medical support on vessel. Further treatment for industrial vessel`s injuries in a surgical hospital demanded 32% of the victims of the members of crew. Among operated ones, repeated interventions were performed in 14% of patients, which further emphasizes the complexity of the disease and the severity of injuries. The average time of treatment of patients with occupational injuries in the hospital up to 29.2 days, and the duration of their disability reaches 43.4 working days.
After treatment, recovery occurred in 83% of injured in production conditions on ships; translated into light work and then return to members of vessel`s crew -5%; set Group II disability -1%; Group III -1%; fatally ended 10% of accidents.

Discussion
Thus, the members of vessel`s crew of the transport and the fi shing fl eets is a professional group of industrial workers contingent operating the important links of the economic mechanism of many types of industries. Loss of ability to work, disability, and in some cases be fatal occupational injuries of members of vessel`s crew determine the socio-hygienic and medical nature of the problem and its economic importance.
Occupational traumatism of members of vessel`s crew on ships of Northern Water`s Basin is high per 1000 employees, including 198.2 on sea transport; 132.9 -river transport  Therefore, the problem of prevention of accidents on vessels is one of the most pressing issues of maritime medicine [32,33].
The reason for slowing bone regeneration at the local action of cold is persistent poor circulation due to vascular spasm [34].
Under the effect of cooling in a moist environment on members of vessel`s crew, representatives of other public facilities in the North 98% of X-ray examination detected changes in bone degenerative nature. They observed mainly in the bones of the extremities that are exposed during cooling, namely, phalanges, heads and metaphases of the fi rst metatarsal bone, the metacarpal bones. The changes are expressed in the formation of osteophytes, diffuse osteoporosis, thickening of the bone trabeculae of the spongy substance. Expansions of marrow spaces between the beams depend on the depth of the cooling period and neurovascular disorders and appear not only in the application of cold spot, but also in the bone tissue of alveolar processes [35,36].
Among the reasons that cause the vessels to professional pathology, an important place belongs to the noise and vibration, providing a permanent effect on members of vessel`s crew throughout the voyage. On fi shing ships in 80% of cases increased the permissible noise levels in the 25% -vibration.
In the engine room of marine transport vessel noise levels meet the standards in 26% of cases, the vibration -73%; and river transport ones -of 30% and 75% respectively. The central point of management compliance is noise on marine transport vessels 15%, vibration -82%, fi sheries ones -18% and 37% of cases. In the offi ce, residential and public areas of noise and vibration levels do not fully satisfy the requirements of the standards [37,38].
The current levels of noise on marine transport vessels predetermine a high degree of mobilization of adaptive mechanisms of members of vessel`s crew, which can lead to their accelerated depletion and the development of pathological changes in the body [39].