Objectives: To investigate work related mortality from gastrointestinal diseases and from alcohol among seafarers who were employed in British merchant shipping from 1939 to 2002.
Methods: A longitudinal study, based on official mortality files from 1976-2002 and official mortality returns from 1939-1975, with a population of 7.29 million seafarer-years at risk.
Results: From 1939 to 2002, there were 864 deaths from gastrointestinal diseases and 72 from alcoholism. Overall mortality from gastrointestinal diseases fell from 18.4 per 100,000 in 1939-49 to 9.3 in 1970-79 and 0.3 in 1990-2002. Mortality from alcoholism, and from alcohol-related diseases such as liver cirrhosis and diseases of the pancreas, increased up to the 1960s or 1970s, but fell thereafter. From 1950 to 1972, mortality from gastrointestinal diseases was 1.8 times higher among Asian seafarers compared to British seafarers, largely because of liver disease, peritonitis and peptic ulcer. At the time of the last censuses of seamen in 1961 and 1971, compared with the general British male working aged population, morality among British seafarers was greatly increased for peritonitis and alcoholism but not for most other gastrointestinal diseases.
Conclusions: Sharp reductions in mortality from gastrointestinal diseases and from alcoholism since the 1970s contrasts with increases among the general British population, and are largely because of the “flagging-out” of most British deep sea ships, and consequent reductions in long voyages, as well as reductions in alcohol consumption among seafarers at work. Largely because of the healthy worker effect, seafarers were usually only at increased risks from particularly acute diseases.