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The Magnitude of Cardiovascular Disease Risk Factors in Seafarers from 1994 to 2021: A Systematic Review and
Getu Gamo Sagaro1,2, Ulrico Angeloni3, Claudia Marotta3
1Telemedicine and Telepharmacy Center, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy.
Insights
Cardiovascular disease risk factors like hypertension, overweight, and smoking are common in seafarers. Early intervention and management are crucial for preventing serious health events at sea.
Area of Science:
- Maritime Health
- Cardiovascular Disease Epidemiology
- Occupational Health
Background:
- Acute cardiac events pose significant risks to seafarers, leading to medical consultations, disembarkation, repatriation, and fatalities at sea.
- Effective management of modifiable cardiovascular disease (CVD) risk factors is essential for preventing CVD in this population.
Purpose of the Study:
- To estimate the pooled prevalence of major cardiovascular disease risk factors among seafarers.
- To provide data that can guide interventions aimed at reducing CVD risk in maritime professionals.
Main Methods:
- A systematic review and meta-analysis of studies published between 1994 and December 2021.
- Searches were conducted in PubMed/Medline, Scopus, Google Scholar, and Web of Science.
- The Joanna Briggs Institute (JBI) critical appraisal tool and DerSimonian-Laird random-effects model were used.
Main Results:
- The meta-analysis included 21 studies with 145,913 participants.
- Prevalence rates: hypertension (45.32%), overweight (41.67%), smoking (40.14%), alcohol consumption (38.58%), and obesity (18.60%).
- Smoking prevalence showed a significant decrease after 2013.
Conclusions:
- Cardiovascular disease risk factors, including hypertension, overweight, smoking, alcohol use, and obesity, are highly prevalent among seafarers.
- Findings underscore the need for targeted prevention strategies and health guidance for shipping companies and seafarers.
- This research highlights critical areas for improving seafarer health and reducing cardiovascular risks.
Objectives:
The incidence of acute cardiac events is one of the main reasons for medical consultation, disembarkation, repatriation, and death among seafarers at sea. Managing cardiovascular risk factors, particularly those that can be modified, is the key to preventing cardiovascular disease. Therefore, this review estimates the pooled prevalence of major CVD risk factors among seafarers.
Methods:
We conducted a comprehensive search of studies published between 1994 and December 2021 in four international databases, namely PubMed/Medline, Scopus, Google Scholar, and Web of Science (WOS). Each study was evaluated for methodological quality using the Joanna Briggs Institute (JBI) critical appraisal tool for prevalence studies. The DerSimonian-Laird random-effects model with logit transformations was used to estimate the pooled prevalence of major CVD risk factors. The results were reported in accordance with the Preferred Items for Systematic Review and Meta-analysis (PRISMA) guidelines.
Results:
Out of all 1484 studies reviewed, 21 studies with 145,913 study participants met the eligibility criteria and were included in the meta-analysis. In the pooled analysis, the prevalence of smoking was found to be 40.14% (95% CI: 34.29 to 46.29%) with heterogeneity between studies (I2 = 98%, p < 0.01). The prevalence of hypertension, overweight, obesity, diabetes mellitus, and alcohol consumption was 45.32%, 41.67%, 18.60%, 12.70%, and 38.58%, respectively. However, the sensitivity analysis after excluding studies showed a pooled prevalence of hypertension, overweight, obesity, and diabetes mellitus of 44.86%, 41.87%, 15.99%, and 16.84%, respectively. The subgroup analysis demonstrated that smoking prevalence among seafarers had decreased significantly after 2013.
Conclusion:
This study demonstrated that CVD risk factors, particularly hypertension, overweight, smoking, alcohol consumption, and obesity, are prevalent among seafarers. These findings may serve as a guide for shipping companies and other responsible bodies in order to prevent CVD risk factors among seafarers. PROSPERO Registration: CRD42022300993.
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