# Maritime Health Research and Education-NET/Publications on the way/Health services among port workers in Costa Rica: analysis of data from a container terminal clinic/Draft Article

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TITLE: Health services among port workers in Costa Rica: analysis of data from a container terminal clinic
AUTHORS: AM, OJ
INTRODUCTION
The working environment of port workers has been investigated quite sporadically internationally and repeated surveys are needed.Work on the ports is most often carried out outdoors in all kinds of weather, with exposure to several different work-related factors Diesel exhaust emission that also threatens workers' health is measured Noise is one of the major occupationally harmful factors and in other areas, there is not only noise but also exposures to various harmful chemicals, including when working with containers. A cross-sectional study among port workers in three cities in Denmark, using both quantitative and qualitative methods, found that the port workers feel secure about the safety of their workplace and that good cooperation between colleagues was the reason for the feeling of security. Most of them were very satisfied with their work and they enjoy working hours. Most of them did not find it stressful to be unemployed where there is no guarantee of work (and half had never felt stressed). The working environment of port workers has been investigated quite sporadically internationally and repeated surveys are needed. According to a cross-sectional study conducted by Zolkafi and Zain, the port workers’ age, different types of work categories, working experience, and body mass index (BMI) were associated with the prevalence of musculoskeletal disorders. For example, the young age group (21- 39 years) of port workers were 9 times more likely (95% CI 1.83- 40.55) to suffer from back injuries, however, the older age group (40- 55 years old) had a 5 times higher chance of getting hand injury and a 2 times higher chance of getting elbow injury. 75% (n=68) of total studied port workers who referred to physiotherapy department for rehabilitation purposes constituted crane operator category, while the small percentage comprised office and maintenance category. In a retrospective study conducted in a seaport in the South of Brazil, Almeida et al. found that lower back pain was the most frequent MSD, affecting more wharf workers and longshoremen. They claim that the occurrence of work-related MSDs is due to labor activities requiring the manual handling of heavy loads, using frequently equipment such as, vehicles, tractors, and mechanical shovels, which expose workers to whole-body vibration. Moreover, working tasks are performed in a sitting position, with arms maintained above shoulder-level, and the lack of regular exercise all contribute to the development of WRMSDs.
METHODS
Study population
There is about 1500 port workers in the terminal and they work 24/7 in 3 shifts. The observations period was from 1st Jan-15 Sep 2021. Some of them visit the clinic only once and some come 2 or more times and some of them, (1500 - 1301) 199 did not come to the clinic in the observation period. The total number of patients coming to the clinic one or more times is 1301 and the total number of patient visits is 3072. To see any possible bias by using either the total number of patients coming at least once or
the total number of visits (3071) gave nearly the same frequencies in the demographic and diseases variables (Table 1-2)
Data collection
The collected information included patient age, gender, times of admission........ The enrolled patients were divided into six age groups, aged youngest–19, 20–29, 30–39, 40–49, 50-59, and >60 years.
Statistical analysis
DISCUSSION
This is to our knowledge, the first study to analyse the characteristics of demographic, injury and disease frequencies of workers visiting a medical clinic in a large container terminal. The study included 1301 patients coming one or times to the terminal medical clinic, 1139 (88%) males and 162 (12%) females. Total number of clinic visits was 3055.
References:
* ↑ https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/normativeinstrument/wcms_107615.pdf ILO Guidelines
* ↑ Wang Y, Zhan S, Liu Y, Li Y. Occupational hazards to the health of port workers. Int J Occup Saf Ergon JOSE. 2016 Jul 18;1–5.
* ↑ Debia M, Neesham-Grenon E, Mudaheranwa OC, Ragettli MS. Diesel exhaust exposures in port workers. J Occup Environ Hyg. 2016 Jul;13(7):549–57.
* ↑ Baur X, Budnik LT, Zhao Z, Bratveit M, Djurhuus R, Verschoor L, et al. Health risks in an international container and bulk cargo transport due to volatile toxic compounds. J Occup Med Toxicol Lond Engl. 2015;10:19
* ↑ Nielsen NO, Nielsen SRG. Dockworkers’ health and safety. A cross-sectional study of self-perceived safety and psychosocial work environment amongst Danish dockworkers. Int Marit Health. 2019;70(3):171–179.
* ↑ Zolkafi, Mohd Azrul Anuar & Zain, Izham. Prevalence of work-related musculoskeletal disorder among port workers: Quantitative analysis at the physiotherapy center of the Malaysian shipping industry, Selangor. Journal of Occupational Safety and Health. 2013; 10. 51-66.
* ↑ Almeida MCV, Cezar-Vaz MR, Soares KFS, Silva MRS. The prevalence of musculoskeletal diseases among casual dock workers. Rev. Latino-Am. Nursing 20 (2); Apr 2012; https://doi.org/10.1590/S0104-11692012000200005