A review of fatal accident incidence rate trends

Background: Injury prevention in fishing is one of the most important occupational health challenges. Aim: The aim was to describe and compare internationally the trends of the fatal injury incidence rates and to discuss the impact of the implemented safety programs. Materials and methods: The review is based on journal articles and reports from the maritime authorities in Poland, United Kingdom, Norway, Iceland, Denmark, United States and Alaska and Canada. The original incidence rates were recalculated as per 1,000 person-years for international comparison of the trends. Results: The risk of fatal accidents in fishing in the northern countries has been reduced by around 50% to an average of about 1 per 1,000 person-years. Norway and Canada keep the lowest rates with around 0.5 and 0.25 per 1,000 person-years. About half of the fatal injuries are related to vessel disasters and drowning. The safety programs seem to have good effects, but the risk is still about 25 to 50 times higher than for onshore workers. Conclusions: The overall fatal injury rates in the European and North American studies decreased by around 50% most probably as result of the implemented safety programs. However the high risk in fishing compared to onshore workers calls for continued and intensified safety programs. (Int Marit Health 2014; 64, 2: 47–52) ! INTRODUCTION It is generally agreed that an adequate method to prevent fishing injuries and vessel disasters is to adapt the risk management and risk prevention systems used successfully by other industries. Of course, the specific conditions in fishing must be taken in consideration. The cornerstone of risk prevention is the risk assessment process which is carried out as a stepwise process, starting with identification of the hazards and the persons at risk [1]. Here we focus on the overall, epidemiological part of the documentation for the risk assessment process, especially for fatal injuries that will also be relevant for prevention of non-fatal injuries. One important characteristic of the historical development of the fishing fleet structure is the diversity of type and size of fishing vessels to be taken in consideration in the prevention plans. At one end of the spectrum are the multinational companies utilising large factory trawlers, and at the other end, in developing countries, are the small, wooden canoes and other boats used to catch sufficient food for the local communities. For many years, the industry has been economically and socially depressed due to significant declines in stocks of fish. The fishing quotas regulations have grown more intense over the years with strong financial impact and most possibly negative impact Int Marit Health 2014; 65, 2: 47–52 www.intmarhealth.pl 48 on the safety standards. Three hundred years ago, fishing was described as one of the most extreme work conditions [2]. About 60 years ago fishing in the United Kingdom was described as one of the most extreme occupations [3]. Recently Conway [4] described fishermen as “Casting their lot upon the water”. In 1976–1995, the United Kingdom fishing fatality rate ranged on top of all industries, and was the double of merchant seafaring [5]. Today, injury prevention in fishing is still a most important challenge globally. The objectives are: (1) to describe the fatal injury rate trends of the latest decades; (2) to point out the main causal factors and (3) to discuss the impact of the implemented prevention programs. We applied the epidemiological method to describe the fatal incidence rates based on the information from peer-reviewed journal articles and the national Maritime Authority reports. The observation period included the latest decades but also some earlier data were included. The Medline database and the Google were searched with the keywords “injuries”, “epidemiology”, “incidence”, “accident”, “fishing”, and “fisherman.” Only articles and administrative reports with precise denominator and nominator data were included. Further the references served as supplemental source of information. Commercial fishermen in Norway, Iceland, Denmark, United Kingdom, Poland, Canada, United States and Alaska were selected for the review study as they are supposed to be more or less economical and technical comparable in the cold climate of the northern part of the globe. The terms “accident” and “injury” are used synonymously for the same type of harmful event. An occupational injury has been defined as a sudden and unexpected harmful event at work. The precise numbers of fatalities and the numbers of fishermen’s populations per year were extracted from the articles and the reports and the incidence rates were adjusted in Excel for comparison of the incidence rate to fatalities per 1,000 fishermen per year or full time equivalent fishermen per year. For example, from 1980 to 1984 there was on average 25 fatal accidents per year per 10,000 Icelandic fishermen [6]. By dividing the numerator and the denominator with 10 the incidence rate is 2.5 per 1,000 fishermen per year. The rates cannot be compared directly but we can follow the increase and decrease of the development of the rates in parallel over the years. The information on the direct and indirect causes of the accidents was extracted from the articles and the reports. The trends and the main causal risk factors are presented for each country based on the information given in the articles and the reports. The impact of the implemented safety programs over the years on the fatal injury rate trends is evaluated in the discussion. The fatal injury rates in Norwegian fishing decreased from 1955 to 2006, except for the two periods of 1980– –1984 and 1990–1994 due total losses of larger vessels [7, 8]. The incidence rates are calculated per “man-labour years”, based on the precise number of days at sea for every fisherman. The incidence rates (calculated) declined from 1.0 to 0.7 per 1,000 man-labour years during these years. For the period 1998–2006, the calculated risks were respectively 2.5, 0.6, and 0.2 fatal injuries per 1,000 man-labour years for small coastal vessels (Loa) < 13 m, medium coastal vessels 13–28 m, and deep sea fishing vessels > 28 m. The fatal rate in Icelandic fishing was 0.89/1,000 in 1966–1986 and continued to decline from 1980 to 2005 to a level below 0.5 per 1,000 man-years [6]. The study population was “Icelandic seafarers” that also included seafarers from the merchant fleet who add to the lower injury rate. Another explanation of the low rate is that they mainly use large fishing vessels with a higher safety standard than for the smaller vessels [9]. The fatality rates in Danish fishing decreased from 2.4 in 1970–1972 to 1.36 for 1988–1992 per 1,000 person-years [10, 11]. For 1995–2005, the overall rate was 1 per 1,000 fishermen per year and nearly stable during that period [12]. Among the fatalities in Danish fishermen in 1989–2005, 53% occurred in 36 vessel disasters. The rate of disasters among the Danish fishing ships continued with a slight decreasing slope during 2000–2009 and the rate of fatal accidents remained decreased to around 1 or less per 1,000 registered fishermen [13]. For the United Kingdom in the period 1992–2006 the average fatality rate was 1.26 deaths per 1,000 fishermen per year, but with a fair degree of fluctuation. There is only a very small reduction over the 15 years in the rate of fatalities [14]. The fatal rate for United Kingdom fishermen for 1996–2005 was 115 times higher than that of the general workforce in Great Britain. While the fatal accident rate for almost all other United Kingdom occupations fell sharply over the last 30 years, there was no discernible reduction in the fishing industry [5]. In the Polish small-scale fishing industry a total of 177 deaths at sea was identified between the years 1960–1999 and 96% of these were due to external (non-medical) causes [15]. The calculated overall injury rate was 0.9 deaths per 1,000 fishermen per year. The highest incidence rates were in the smaller boats < 13 m in length. Among commercial fishermen in the Canadian Atlantic coast during 1975–1983 there were 84 fatal fishing accidents in 183,378 person-years resulting in a fatal injury