Basic differences in the health profile between seafarers from the Philippines and Denmark
Abstract
Background: Seafarers in international trade are today recruited world-wide based on qualifications and costs. Health is another aspect. In this study, two cohorts of seafarers from the Philippines and Denmark undergoing pre-employment health examinations were compared. The purpose is to investigate differences in the outcome of the examinations and compare basic parameters.
Materials and methods: Two cohorts of equal number of seafarers from the Philippines and Denmark were established. A total of 9,654 consecutive health examinations at a large clinic in the Philippines were compared with a group with the same size examined in a number of clinics in Denmark. The Filipino seafarers were screened according to different company standards whereas the Danish seafarers were examined according to statutory standards.
Results: The age structure was different. Only 18% of seafarers from the Philippines were 45 years of age or above whereas almost 43% of the Danish seafarers were in this age category. Obesity was frequent in both cohorts although depending on the standard used as reference. Extreme obesity (body mass index, above 35) was 10 times more frequent among the Danish seafarers. A total of 4.4% of the Filipino seafarers were declared unfit whereas only 0.5% were found unfit among the Danish seafarers. Among the latter, 5.2% were found fit with limitations, which is a category not used in the Philippines.
Conclusions: The two groups are inhomogeneous and the health examinations the seafarers underwent differ. Comparisons should be done with caution. The difference in the age distribution of the two groups of seafarers is important factor due to the strong impact of age on health. Obesity was of major concern in both groups, although there were more with severe overweight and especially with extreme overweight among the Danish seafarers. Smoking frequency seems to be on the same level.
Keywords: maritime medicinepre-employment health examinations
References
- Guillot-Wright S. The changing economic structure of the maritime industry and its adverse effects on seafarers' health care rights. Int Marit Health. 2017; 68(2): 77–82.
- P&I Clubs. In: Textbook of Maritime Medicine, Chapter 6.5. http://textbook.ncmm.no/.
- Seidenstücker K, Neidhardt S, Schepers B. Pre-employment medical examinations - what is the issue? Int Marit Health. 2017; 68(3): 174–175.
- Abaya AR, Roldan S, Ongchangco JC, et al. Repatriation rates in Filipino seafarers: a five-year study of 6,759 cases. Int Marit Health. 2015; 66(4): 189–195.
- Faurby MD, Jensen OC, Hjarnoe L, et al. The costs of repatriating an ill seafarer: a micro-costing approach. Health Econ Rev. 2017; 7(1): 46.
- Danish Maritime Authorities. Medical examinations in Denmark. https://www.dma.dk/SoefarendeBemanding/LaegeHelbred/Laegeundersoegelse/Sider/LaegeundersoegelseDanmark.aspx.
- Guidelines on the medical examinations of seafarers. https://www.ilo.org/sector/Resources/codes-of-practice-and-guidelines/WCMS_174794/lang--en/index.htm.
- Weisell R. Body mass index as an indicator of obesity. Asia Pacific J Clini Nutrition. 2002; 11(s8): S681–S684.
- WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004; 363(9403): 157–163.
- Chowdhury R, Shah D, Payal AR. Healthy Worker Effect Phenomenon: Revisited with Emphasis on Statistical Methods - A Review. Indian J Occup Environ Med. 2017; 21(1): 2–8.
- Pedersen J, Bjorner JB. Worklife expectancy in a cohort of Danish employees aged 55-65 years - comparing a multi-state Cox proportional hazard approach with conventional multi-state life tables. BMC Public Health. 2017; 17(1): 879.
- de Meijer C, Wouterse B, Polder J, et al. The effect of population aging on health expenditure growth: a critical review. Eur J Ageing. 2013; 10(4): 353–361.
- Hansen HL, Hjarnoe L, Jepsen JR. Obesity continues to be a major health risk for Danish seafarers and fishermen. Int Marit Health. 2011; 62(2): 98–103.
- Jepsen JR, Rasmussen HB. The metabolic syndrome among Danish seafarers: a follow-up study. Int Marit Health. 2016; 67(3): 129–136.
- Møller Pedersen SF, Jepsen JR. The metabolic syndrome among Danish seafarers. Int Marit Health. 2013; 64(4): 183–190.
