Disabled industrial traumatic brain injury of members of vessel`s crew in water transport of the Northern Water`s Basin
Authors: Shapovalov KA , Shapovalova PK 
Published: January 2023

Introduction: Epidemiological study of Traumatic Brain Injury (TBI) and the improvement of the organizational capabilities of medical care at all stages of its provision plays an important role in forecasting and social and labor rehabilitation of the sailing crew. Planning the development of the neurosurgical service of port hospitals is impossible without knowing the structure of TBI, both in severity and sectoral, occupational and territorial prevalence. Materials and methods: The analysis of the treatment of 92 patients from members of the vessel`s crew who received industrial TBI with a disability while performing voyage tasks in the northern water basin was carried out. When working on the material, analytical and statistical methods were used. The significance of differences was calculated using a t-test for independent samples. Results: In the general structure of traumatism of the studied contingent of the members of the vessel`s crew, TBI accounted for 4.1% of cases, while in the territorial population, they reach 30.0% - 40.0%. Most of the victims worked in the transport fleet of the northern water basin - 68.7% (9.4), while in the fishing fleet - 17.2% (3.3) and the river fleet - 14.1% (4.6). Command staff: navigators (10.5), captains (10.1), chiefs of radio stations (7.4), skippers (6.8), as well as boatswains (27.8), who are responsible for organizing and conducting deck operations, receive TBI 4.0 - 2.5 times more often than rank-and-file personnel. This distribution becomes easy to understand if we take into account that 43.4% of the damage was sustained during the performance of ship operations related to movement on ladders and decks, in the engine room, and their hasty execution by the supervisors in the absence of safety precautions leads to severe TBI. The members of the vessel`s crew receive them several times less often when performing loading and unloading operations (0.9), closing holds (0.4), mooring, and servicing deck mechanisms (0.2 each). The probability of getting TBI is especially high during the first three years of work in the specialty (34.8% of all injuries). With an increase in work experience, injuries decrease by more than 1.4 times among workers with 15 years of work experience. Every third TBI (36.5%) on ships is associated with a fall of the victim from a height, that is, it is a catatrauma. All injuries arise from collisions with blunt objects. Discussion: Every twenty-fifth work-related injury with loss of ability to work, sustained by the members of the vessel`s crew of the northern water basin, while performing ship operations, is a TBI. The minimum knowledge required for shipboard crew members, and ship managers to suspect this life-threatening condition, is given during an injury first aid session that is required by the ship’s medical officer. Conclusion: 1. In the general structure of industrial injuries of the studied contingent of the members of the vessel`s crew, TBI accounted for 4.1% of cases, while in the territorial population, they reach 30.0% - 40.0%. The incidence of TBI in men from among the members of ve+-ssel`s crew is only 1.5 times higher than in women and is the highest in people under 20 years of age (4.8%; 11.0). 2. Most of the victims worked in the transport fleet of the northern water basin - 68.7% (9.4), while in the fishing fleet - 17.2% (3.3) and river - 14.1% (4.6). The members of the vessel`s crew receive them several times less often when performing loading and unloading operations (0.9), closing holds (0.4), mooring, and servicing deck mechanisms (0.2 each). Every third TBI (36.5%) on ships is associated with a fall of the victim from a height, that is, it is a catatrauma. 3. TBI, accompanied by a concussion, in the northern basin accounts for up to two-thirds of all head injuries, of which 69.5% fall on the most able-bodied and productive age of workers (20-39 years). Concussions occur 4 times more often in the transport fleet than in the fishing and river fleet. Sailors and minders make up 44.3% of the victims. Falls from a height onto decks, mooring lines, into the hold, or overboard were the cause of 78.5% of concussions. 4. Mild brain contusions are a rarer pathology and occur mainly in transport and fishing fleets with rank-and-file personnel during falls from a height. 5. Brain contusions of moderate and severe degrees occur only in the transport fleet in the youngest men: in every second case, the patients were 20-29 years old. Every third victim is a sailor, every sixth is a minder. A severe degree of brain injury was more often observed in persons who received TBI while servicing deck mechanisms, moving along ladders, and mooring operations. More than half of them are associated with falls from a height.