Medical practice during a world cruise: a descriptive epidemiological study of injury and illness among passengers and crew.

STUDY OBJECTIVE To describe the medical practice of one physician and two nurses during a 106-day westward cruise from Los Angeles to New York in 2004 with an average of 464 passengers (51% women) and 615 crew (22% women) aboard. METHODS Patient data were registered continuously and reviewed after the voyage. RESULTS There were 4244 recorded patient contacts (=40 per day), 2866 of which directly involved the doctor (=27 per day). Passengers accounted for 59% of the doctor consultations, while crew accounted for 59% of the nurse consultations. The most frequent consultation cause was respiratory illness (19%) in passengers and skin disorders (27%) in crew. Among 101 reported injuries (56 passengers, 45 crew) wound was the most common type (passengers 41%, crew 40%). The most frequent accident location for passengers was ashore (27%) and for crew galleys aboard (31%). 133 crew were on sick leave for a total of 271 days, and seven were medically signed off, six of them following injuries. Seven passengers and 13 crew were referred to dentists ashore, five passengers and two crew were referred to medical specialists ashore and returned to the ship, while seven passengers and one crew were hospitalized in port. CONCLUSION The medical staff on long voyages will have a busy general practice. Broad experience in emergency and general medicine, good communication skills and previous cruise experience are useful qualifications. While the ACEP PREP may be sufficient for shorter cruises, additional equipment is recommended for long voyages.