The distinctive health concerns of freight shipping workers

20th July 2015 0 Comments

Long-distance shipping workers operate in an environment which presents diverse and unexpected health risks and dangers. In the close quarters of a vessel, infectious disease is much more of a threat than on shore. These atypical work environments have given rise to swathes of research into protocol and best practice, as well as much medical research. 


A history of nautical medical provision

‘Emporiatrics’ is the science behind keeping travellers healthy. It has a long and fascinating history. For example, the word ‘quarantine’ comes from the Venetian word for fourty, ‘quaranta’, referring to the number of days crew members would have to wait in-port before coming ashore during plague outbreaks. 

From these crude-though-effective medical beginnings, emporiatrics has grown incredibly sophisticated. Ships are a closed environment – often days or weeks away from adequate medical facilities. Therefore, many regulating bodies have legislated, obliging vessels to stock a wide range of medical resources so the crew are ready to deal with any and all urgent medical developments. 

A large part of emporiatrics is preparation before embarking on a voyage. Vaccinations, antimalarial treatments and even pre-emptive appendectomies are all ways to bridge the gap between a cramped ships resource-poverty and the needs of potential medical needs the crew.


Legionella in Air Vents

There were at least 55 incidents of Legionella outbreak on ships between 1977 and 2004. On particularly large outbreak is strongly suspected to have been caused by Legionella in the Air-Conditioning system of a cruise ship. 

Drinking water has always been subject to controls, from simple rationing to disinfecting with chlorine.  Legionella thrives in stagnant water. Like most bacteria, it has an optimal temperature range of 32-42°C making a ship’s storage tanks a danger zone in equatorial latitudes. 

The risks of drinking tainted water are well understood, but since Legionnaires disease has an airborne pathogenesis, it was speculated that stagnant water in air conditioning systems could cause an outbreak. Since Legionella requires specialised antibiotics to combat, it is better to take preventative steps than stock curative resources in the space-limited nautical environment. 

The UK Government researched the likelihood of a Legionnaires outbreak via this infection pathway, and finding it a possibility, produced MGN 38 (M+F), a guidance note educating shipmasters and recommending methods to reduce the likelihood of infection through regular maintenance, changes of crew behaviour and special equipment. 

 

The Next Step

A study of Legionella prevalence in ferries and cruise ships found that 42% of all water samples contained the bacterium. Most of the positive results came from showers (24/44). 

There is no vaccine for Legionella. Combined with its relatively high mortality rate, this fact means that any steps that can reasonably be made to prevent its outbreak in a closed ship-environment should be taken.

Just as the understanding of bacteria growing in drinking water was applied to air conditioning, so too can similar measures be taken against Legionella in all on-board water supplies. Modern freight and cargo vessels can easily take on enough water to allow crew to shower and bathe, and this water supply should also be identified as a potential source of infection.

Hose systems, transporting water onto ships, are often complex and extensive. This makes them very difficult to properly maintain, or even to inspect, and so any water taken on board is a potential infection risk. 

 

Our shower heads can be used in conjunction with conventional regular superheating and chlorination sterilisation to minimise the risk of airborne infection from showering other hygiene-based water usage.  

 

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