Eilif Dahl: Medical practice during a world cruise: a descriptive epidemiological study of injury and illness among passengers and crew
Study objective
To describe the medical practice of one physician and two nurses during a 106-day westward cruise from Los Angeles to New York in 2004 with an average of 464 passengers (51% women) and 615 crew (22% women) aboard.
Methods
Patient data were registered continuously and reviewed after the voyage.
Results
There were 4,244 recorded patient contacts (= 40 per day), 2,866 of which directly involved the doctor (= 27 per day). Passengers accounted for 59 % of the doctor consultations, while crew accounted for 59% of the nurse consultations. The most frequent consultation cause was respiratory illness (19%) in passengers and skin disorders (27%) in crew. Among 101 reported injuries (56 passengers, 45 crew) wound was the most common type (passengers 41%, crew 40%). The most frequent accident location for passengers was ashore (27%) and for crew galleys aboard (31%). 133 crew were on sick leave for a total of 271 days, and seven were medically signed off, six of them following injuries. Seven passengers and 13 crew were referred to dentists ashore, five passengers and two crew were referred to medical specialists ashore and returned to the ship, while seven passengers and one crew were hospitalized in port.
Conclusion
The medical staff on long voyages will have a busy general practice. Broad experience in emergency and general medicine, good communication skills and previous cruise experience are useful qualifications. While the ACEP PREP may be sufficient for shorter cruises, additional equipment is recommended for long voyages.
Prof. Eilif Dahl, MD, PhD, Surgical Department, Rikshospitalet-Radiumhospitalet Health Enterprise, 0027 Oslo, Norway
Presentation information:
Some of the data were presented during the 8th International Symposium on Maritime Health, Rijeka, Croatia, in May 2005.
Potential conflict of interest:
The author has not received any financial support or funding of any kind for this study. He has worked part time for a number of cruise companies as an independent maritime medical consultant and as a ship’s doctor.
Corresponding address:
Eilif Dahl, MD., PhD, Surgical Department,
Rikshospitalet-Radiumhospitalet HF,
0027 Oslo, Norway.
Phone: (47) 22 56 23 24;
fax: (47) 22 56 31 12;
cell phone: (47) 959 21 759;
mail: eilifdahl@hotmail.com