1. Olaf Jensen, Centre for Maritime Health & Society, Institute of Public Health, Southern Danish University, Esbjerg Denmark IMHA RESEARCH GROUP MEETING & WORKSHOP: “Better and more maritime epidemiological research! - how to improve the culture of research and publication” October 18th, 2014 BARCELONA, SPAIN IMHA Research Training Program Proposal

2. Research organisation DatabaseStrategyTraining

3. XXXXXXXXXXXXXXXXXXXXXXXXX XXX Maritime health Research domain

4. Natural history of disease and health exams Health examinations Fit for duty.......…Restricted........ Unfit Health examination

5. Natural history of disease & research methods Questionnaire based studies Health register based studies Health examination

6. 1)Seafarers on all types and sizes of merchant ships 2)Fishermen on all types and sizes of fishing vessels 3)Offshore workers on platforms 4)Dockers (Port workers) 5)Comparison groups: internal and external (on shore) 6)Agegroups, gender, position on board, nationality 7)Time windows: Study populations and time windows 2000 -----------------------2014 ---------------------2020 Cohort prospectiveCohort retrospective Cross- sectional

7. Study populations geographical

8. RESSOURCES

9. Basic research courses -small questionnaire /interview studies – -As modul in other courses

12. More advanced research courses

13. METHODS PUBLIC HEALTH MODEL OCUPATIONAL MEDICINE EPIDEMIOLOGY - monitoring, surveillance routine data - cross-sectional, case-control, cohort - health register data - subjective data linked to register data - multiple regression, dose-response - descriptive, causal and effect studies QUALITATIVE METHODS – OBSERVATIONS ON THE SHIPS EVIDENCE BASED MEDICINE SYSTEMATIC REVIEWS HEALTH PROMOTION COMMUNICATIONS WITH THE PARTNERS

14. Hazardous incidents Occupational exposures: chemical, noise, heat, ergonomics, Biological risks Radiation risks Stress factors Fatigue/burn-out Safety and management culture Social security Tobacco-alcohol (at sea/ home) Food and drink on (at sea/home) Physical activity (at sea/home) Psycho-social environment Workplace violence Risk factor variables:

15. Work hours per day/week Lengh of days at sea Work years at sea (For calculation of incidence rates, relative risk and dose-response exposure effects) Type of ship, size, crew size, etc Being away from home extended periods Job uncertainty The forces of nature wind, sea, Climatic changes during the voyage Ship movements Stressors from being in confined spaces Lack of entertainment/ education Risk of piracy Risk factor variables:

16. Occupational Injuries Cancer Cardiovascular diseases Diabetes Obesity Hearing damage Neurological disorders (dementia) Psycho-social effects Homesickness and loneliness Seasickness Psychiatric health effects- depression Musculoskeletal diseases Infectious diseases – tropical Allergic diseases. Sunburn and skin cancer Health effect variables

17. 1Accident prevention and safety promotion 1Occupational health risk prevention 2Physical health promotion: cardio- vaskular diseases, diabetes, obesity and cancer 3Mental health promotion: ”the process of enhancing protective factors that contribute to good mental health” 4Raising awareness and prevention of psychosocial risks Intervention programs

18. Long term studies with repeated data collection descriptive and causal studies

19. Long term studies with repeated data collection and also effect studies INTERVENTION can be administrative BeforeAfter

20. Establish IMHA Research training courses -Basic level -Advanced level -Standing alone or – -Integrated in Maritime Medicine Diploma, Master courses -Possibly as part of the established courses in Spain and France Recommendations

21. Thank you very much