Surveillance of hospital contacts among Danish seafarers and fishermen with focus on skin and infectious diseases-a population-based cohort study.

Objectives: A systematic overview of time trends in hospital contacts among Danish seafarers and fishermen by job title and analyses on skin and infectious diseases.

Methods: Occupational cohorts with hospital contacts 1994-1998 and 1999-2003. Standardized hospital contact ratios (SHCR) were estimated using national rates and ranked by SHCR size.

Results: For non-officers in 1994-1998, infectious diseases had the highest SHCR, followed by neoplastic and endocrinal diseases; in 1999-2003 skin diseases were followed by endocrinal and gastrointestinal diseases. For fishermen in 1994-1998, nervous system, gastrointestinal, and skin diseases had the highest SHCRs; in 1999-2003 it was nervous system, skin, and lymphohematopoietic diseases. As for skin diseases, male fishermen and non-officer seamen generally had increased SHCRs, but engine room personnel specifically had a low SHCR for eczema (eight cases). Fishermen had high SHCRs for tuberculosis in both time periods (six and nine cases, respectively). Non-officer seamen on cargo ships had increased SHCRs for HIV in both time periods and for hepatitis in 1994-1999. Extending the follow-up until 2000 or 2005 showed similar results.

Conclusions: Surveillance of seamen's health gives useful information. The elevated SHCR for HIV infection among non-officers has not declined despite preventive information campaigns. Tuberculosis among fishermen may be due to infection on shore. Skin diseases had very high SHCRs, not due to cutaneous oil exposure.