Vol 61, No 1 (2010)
Editorial
Published online: 2010-05-21
Passenger accidents and injuries reported during 3 years on a cruise ship
IMH 2010;61(1):1-8.
Abstract
Background. The objective was to register and analyze data from all passenger injuries reported to the
medical centre of a cruise ship with a median passenger load of 719 per day during a three-year period,
and to determine high risk areas, equipment, and behaviour.
Methods. All reported passenger injuries were registered at first visit. An injury was 'serious' if it led to hospitalization ashore or if full recovery was not expected within two weeks.
Results. During 3 years, 663 injuries (62.7% women) were reported aboard; 12.5% were classified as serious. The victims' median age was 72 (range: 1-97) years. The incidence rate was 0.8 injuries per 1000 passenger-days. Most victims (65.3%) suffered injuries aboard, 3.6% on tenders, and 31.1% ashore. The most common accident locations aboard were cabins (20.1%) and bathrooms (13.4), and ashore, streets (29.6%) and buses (16.1%). Slips/trips/falls caused 44.8% of injuries aboard and 69.4% ashore (p < 0.001). The most frequently injured body part was the lower extremity (43.0%), and open wounds the most common injury type (41.6%). More wounds and fractures/dislocations occurred ashore than aboard (p < 0.05). Only 2% were hospitalized in port, while 5% were referred to specialists in local ports and returned to the ship. There were no helicopter evacuations or ship diversions.
Conclusions. Passenger injuries contribute considerably to the workload of the medical team aboard. A well-equipped, competent medical staff will effectively treat most injuries aboard and thus reduce the number of costly and inconvenient helicopter evacuations, ship diversions, port referrals, and medical disembarkations.
Int Marit Health 2010; 61, 1: 1-8
Methods. All reported passenger injuries were registered at first visit. An injury was 'serious' if it led to hospitalization ashore or if full recovery was not expected within two weeks.
Results. During 3 years, 663 injuries (62.7% women) were reported aboard; 12.5% were classified as serious. The victims' median age was 72 (range: 1-97) years. The incidence rate was 0.8 injuries per 1000 passenger-days. Most victims (65.3%) suffered injuries aboard, 3.6% on tenders, and 31.1% ashore. The most common accident locations aboard were cabins (20.1%) and bathrooms (13.4), and ashore, streets (29.6%) and buses (16.1%). Slips/trips/falls caused 44.8% of injuries aboard and 69.4% ashore (p < 0.001). The most frequently injured body part was the lower extremity (43.0%), and open wounds the most common injury type (41.6%). More wounds and fractures/dislocations occurred ashore than aboard (p < 0.05). Only 2% were hospitalized in port, while 5% were referred to specialists in local ports and returned to the ship. There were no helicopter evacuations or ship diversions.
Conclusions. Passenger injuries contribute considerably to the workload of the medical team aboard. A well-equipped, competent medical staff will effectively treat most injuries aboard and thus reduce the number of costly and inconvenient helicopter evacuations, ship diversions, port referrals, and medical disembarkations.
Int Marit Health 2010; 61, 1: 1-8
References
- Cruise Lines International Association. 2008 CLIA Cruise Market Overview. Statistical cruise industr y data through 2007. www.cruising.org/press/overview2008 (11.05.2008).
- Dahl E. Almenpraksis til sj ø s (General practice at sea). Tidsskr Nor Laegefor. 1979; 99: 327–330.
- DiGiovanna T, Rosen T, Forsett R, et al. Shipboard medicine: a new niche for emergency medicine. Ann Emerg Med. 1992; 21(12): 1476–1479.
- Dahl E. Anatomy of a world cruise. J Travel Med. 1999; 6(3): 168–171.
- Dahl E. Medical practice during a world cruise: a descriptive epidemiological study of injury and illness among passengers and crew. Int Marit Health. 2005; 56(1-4): 115–128.
- Bledsoe GH, Brill JD, Zak D, et al. Injury and illness aboard an Antarctic cruise ship. Wilderness Environ Med. 2007; 18(1): 36–40.
- Peake DE, Gray CL, Ludwig MR, et al. Descriptive epidemiology of injury and illness among cruise ship passengers. Ann Emerg Med. 1999; 33(1): 67–72.
- Dahl E, Ulven A, Horneland AM. Crew accidents reported during 3 years on a cruise ship. Int Marit Health. 2008; 59(1-4): 19–33.
- Tomaszewski R, Nahorski WL. Interpopulation study of medical attendance aboard a cruise ship. Int Marit Health. 2008; 59(1-4): 61–68.
- Jaremin BM. Traumas and accidents on a passenger vessel. The 4 th International Symposium on Maritime Health, Oslo, Norway, 1994. Abstract 32.
- Hudson D, Nilsen P, Dahl E, et al. Factors associated with injuries occurring aboard vessels in Alaska: differences between residents and nonresidents. J Travel Med. 2006; 13(2): 67–72.
- Prina LD, Orzai UN, Weber RE. Evaluation of emergency air evacuation of critically ill patients from cruise ships. J Travel Med. 2001; 8(6): 285–292.
- Caumanns C. Occupational accidents and injury patterns in merchant seamen. Int Marit Health. 2001; 52(1-4): 39–43.
- Jensen OC, Sørensen JFL, Canals ML, et al. Non-fatal occupational injuries related to slips, trips and falls in seafaring. Am J Ind Med. 2005; 47(2): 161–171.
- Dahl E. Cruise medicine on land (The cruise connection). International Maritime Health Association Newsletter April . 2009; 9: 16–17.
