الفهرس 
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Abstract
The role of a fisherman is demanding in terms of both time and energy. Their working environment can be uncomfortable at many times. They have to stay for long trips at sea on the board of the vessel staying at open air. Furthermore, they are exposed to high demands in their work, which may conflict with a normal family life, so since 1713 fishing has been noted as an occupation with a high risk of occupational hazards especially traumatic injury.
There are several problems considered when assessing the occupational health problems associated with the fishermen. The predominant issues noticed are traumatic injuries; musculoskeletal disorders, stress, NIHL and sunburns. The provision of occupational health support for fishermen presents a challenge because of the peripatetic nature of this job.
Aim of work:
This work is aimed to promote the different health aspects of the fishermen with the following objectives:
1. To identify some of occupational health problems affecting fishermen due to exposure to hazards in their work.
2. To assess occupational and personal risk factors that may be associated with these health problems.
Subjects and methods:
To achieve these objectives, a comparative cross-sectional study was conducted among 124 fishermen worked in Alexandria City and control group includes 130 sellers worked in Alexandria City.
All fishermen who were participating in the study were subjected to:
I- A pre-designed questionnaire to collect information about:
1- Personal and socio-demographic data and smoking habits:
Age, sex, body mass index, level of education, income and marital status and smoking habit.
2- Occupational history as:
• Specialty on the boat (Skipper, Mate, Deckhand or mechanic) and type of fishing either Off-shore or In-shore fishing and type of boat worked on.
• size of working crew and duration of work\years.
• No. of working days per each fishing trip, No. of working hours per day and No. of boats worked on during career.
• Presence of other jobs besides fishing, using personal protective equipments and its kinds.
3- Past and family history:
Past history of MSDs and family history of hearing loss before age of 50 years, past history of ear infections and past history of previous ear surgery.
4- Musculoskeletal complaints:
By using Nordic Musculoskeletal Questionnaire (NMQ).
5- Stress level:
A) By using National Stress Awareness Day Questionnaire (NSAD). It includes 24 questions answered by yes or no and according to the total score.
6- Accidents and injuries:
By using questionnaire proposed by Jensen et al. (1993).
7- Auditory complaints:
By using audiometric questionnaire proposed by Oregon State University Environmental Health and Safety Department.
8- Sunburn:
By using questionnaire proposed by Dogliotti, (2001).
II- Environmental assessment:
To assess noise level in working environment by using sound level meter (no. 407740).
Results:
The results of the present study showed that that fishermen and control group were comparable regarding socio-demographic and occupational characteristics, where there were no significant differences between the two groups as regard age, level of education, income, marital status and duration of work. Most of the fishermen were smokers (86.3%) in contrast to smaller percent in control group (61.5%). More than half of the fishermen were normal weight (68.5%) in contrast to control group, most of them were over weight and obese (47.7%, 27.4% respectively).
The present study also showed that the occupational characteristics of the fishermen were as the following: the majority of them were working in-shore in crews of ≤ 10 members (81.5%, 85.5% respectively). More than half of them worked on boats of ≤ 150 HP (51.9%), stay in fishing trip for ≤ 10 days (50.8%) and worked on less than 5 boats during their career (53.8%). Also, there were different specialties worked on the boat including skipper, mate, deckhand and mechanic (19.4%, 22.6%, 25.8%, and 17.7% respectively). About 55.4% of fishermen were using personal protective equipments, mainly boots (54.0%), followed by garments (14.5%) then gloves (9.7%).
The results of The present study showed that the fishermen had a higher frequency of different health problems compared with control group and the difference was statistically significant (p<0.001), where more than (91.0 %) of fishermen had MSCs during last 12 month compared to (38.5%) in the control group. Results of the study showed that the most important risk factors were: old age above 40 years (OR=8.56), illiterate fishermen (OR=9.76) with severe stress (OR=21.38), working in small crews (OR=5.77), on small boats (OR= 5.44) in fishing trip for less than 10 days(OR=11.32), working for more than 20 years, (OR=9.88), and the risk was higher among mate (OR=12.6).
Results of the study showed that most of the fishermen suffered from severe stress (62.9%) and 30.6% had moderate stress and only 6.5% had mild stress. The associated risk factors were old age fishermen (OR= 3.18) having not enough income (OR=4.00) and working in-shore (OR=3.35). Also, the risk was higher among mate (OR= 10.0), working for more than 20 years (OR=6.82), on more than 5 boats during career (OR=3.04), in fishing trip for more than 10 days (OR=2.84) and for more than 10 hours per day (OR=3.24).
The result of the present study showed that the most common causes of accidents among the fishermen were falling overboard (71.0%), during hauling of gear (44.0%) and handling fish (26.4%). The most common type of injury were cut wound (73.4%) and laceration (47.6%) occurring in hands and fingers (58.9%, 45.2% respectively), followed by eye injuries (36.3%).
Regarding risk factors associated with injuries the results showed that the most important factors were: old age (OR=4.21), in-shore fishermen (OR=6.71), stayed in fishing trip for more than 10 days (OR=3.21), for more than 10 hours per day (OR= 15.16), severe stress (OR=2.70), on small boats (OR=7.92), not using personal protective equipments (OR=6.83) and the risk was higher among skipper and deckhand.
The result of the present study showed that only small percent of the fishermen had deafness either one side or both ears (10.5%, 1.6% respectively). The most frequent auditory complains were ringing in both ears (24.2%), pain in both ears (23.4%) and dizziness (17.7%). The associated risk factors were found to be in-shore fishermen (OR=5.15) and the highest risk was among mechanics (OR=15.00), not using personal protective equipments (OR=3.67), working on small boats (OR=3.03) and these was confirmed by the logistic regression analysis.
Regarding sunburn the results of the present study showed that the majority of fishermen had mild to moderate degree of sunburn (51.6%, 19.4% respectively), so most of them complained of redness (64.8%), tenderness (16.9%), and only small percent stayed awake all night due to severe pain (9.9%). The most prominent risk factors associated with sunburn found to be old age fishermen (OR=4.65), stayed in fishing trip for more than 10 days, (OR= 2.53), for more than 10 hours\day (OR=4.68) and the highest risk was among skipper and deckhand.
shows that 17.7% of fishermen were exposed to mean sound level of 113 ± 5.72 dB in the engine room, 21% exposed to 90.83 ± 5.7 dB on board of boots < 150 HP and 114.82 ± 7.87 dB on board of non-maintained boots (19.3%) for mean working times exceeding OSHA PEL. On the other hand, there is no risk for fishermen working on board of boats > 150 HP (59.7%) as they were exposed to mean sound level of 77.55 ± 6.42 dB which according to OSHA PEL has no time limits.
Conclusion:
It can be concluded from this study that fishermen in Alexandria city are at great risk for many health problems as auditory problems (deafness, ringing, pain and dizziness) and musculoskeletal complaints at almost all body parts affecting their normal daily activities.
Also, most fishermen suffer from severe stress, sunburns and at great danger for work accidents and injuries. This risk increases with long working duration, long fishing trip, severe stress, working on small boats, instability on single boat and not using personal protective equipments.
Recommendations:
We recommended that fishermen can protect themselves from hazards to prevent health problems by using PPEs and proper first-aid procedures to minimize the risk of complications. Call for other researches and promote other types of epidemiological studies to confirm association between risk factors and occupational health problems among fishermen.Thus, setting the proper recommendations and the needed precautions for proper control measures of these problems.