Objectives: To study the incidence of myocardial infarction (MI) on board ship, the impact of conditions of work on the mortality and survival rate, to analyze the recommendations and possible preventive interventions to reduce the loss of life at the work-site among Polish seafarers and deep-sea fishermen.

Methods: To use various sources of information for the retrospective study of the MI incidence among 11,325 Polish seamen and deep-sea fishermen. To analyse the impact of the marine environment and work-related factors on the course, treatment and prognosis of MI. The results were compared with the incidence and mortality rate of MI among general male workers population in Poland.

Results: In this retrospective study, 106 cases of the MI at sea were included. Their diagnosis was based on the medical documentation and legal investigation of cases. The most significant findings seem to indicate that the incidence of MI at the work-site among Polish seafarers was not higher than among general population of Polish males in the same decade, probably due to the "healthy worker" effect. However, the pre-hospital and one-month mortality due to MI were higher in the group of seafarers as compared to the group of general male population. The analysis of conditions of seafarers' work and life and the possibility of treatment at sea in a case of the MI on board strongly suggest that the work-related factors had significant impact on the loss of life among them. The preventive measures, very complex and difficult from the organizational and economic point of view, are still far from being recommended and implemented in the shipping industry.

Conclusions: The study has confirmed that seafarers are at high risk of death in case of a MI on board. The impact of their work environment and work-related factors reduce significantly the chance of survival at sea in such cases. The preventive measures are difficult to implement.

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