Cardiovascular Causes of Death on Board Ships Assisted by Centro Internazionale Radio Medico (CIRM)

Sailing ships do not carry medical doctors or adequately trained paramedical staff and can need time to reach a port for medical reasons. This situation and the fact that merchant seafaring is a rather hazardous occupation makes seafarers more susceptible to risks with consequences on the health status and on the development of some types of disorders. It is the case of cardiovascular diseases that although have a similar frequency in seafarers compared to the general population, they can have a dramatic sudden occurrence at sea. The present study has investigated the cardiovascular causes of deaths on board ships assisted by Centro Internazionale Radio Medico (CIRM) in the years 1999-2008. CIRM is the Italian Telemedical Maritime Assistance Service (TMAS) and provides free medical assistance to ships of any nationality, sailing in all seas of the world. During the period under observation, CIRM has assisted 12,465 patients on board ships. Deaths occurring were 205 (1.64%) and involved 192 crew members and 13 passengers. On referring our epidemiological analysis to cardiovascular diseases, during the period analyzed CIRM has assisted 1,074 patients suffering from cardiovascular problems. Among these individuals, 72 deaths occurred (6.7%). On referring this figure to the total number of fatalities occurring, they represent the 35.12% of total deaths (205) and therefore they account for the first cause of deaths on board ships as well. Analysis of diagnosis/symptomatology referred according to the ICD-10 epidemiological code releaveld that ischemic heart diseases (I20-I25) were at the first place (n = 37, 51.39%), followed in the order by other forms of heart diseases (I30-I52) (n = 29, 40.28%), hypertensive diseases (I10-I15) (n = 4, 5.56%) and cerebrovascular diseases (I60-I69) (n = 2, 2.78%). This investigation follows a previous study of our group on the causes of death on board ships derived from data of a maritime telemedical centre. This analysis, with limitations of correct/verified diagnosis at sea done from a remote physician through telecommunication systems is the only way of evaluating mortality close to the end of life or immediately after the event. This may contribute to identify situations of high risk of death for seafarers and to undertake possible preventive measures.