Medical causes of repatriation in commercial seafarers and offshore workers: a scoping review

Workers at sea including commercial seafarers and those working in offshore establishments have increased risk for occupational disease and injury. Due to limited medical resources in vessels and platforms, and the remote nature of the work, repatriation to a shore-based facility may be required for treatment. The objective of this review was to summarize the literature on medical causes of repatriation among commercial seafarers and offshore workers.

As per Joanna Briggs Institute (JBI) methodology for scoping reviews, a search for papers in English of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus and Oceanic Abstracts was conducted. Studies that reported medical causes of repatriations in commercial seafarers and offshore workers were included. For the purposes of this study, commercial seafarers and offshore workers are defined as persons working in the maritime environment for three or more consecutives days. Recreational seafarers, passengers, and military personnel were excluded. Included papers underwent data extraction and medical causes of repatriation were classified into International Classification of Disease (ICD) 11th Revision codes.

The search yielded 33 publications including 27 retrospective studies and 6 case studies. 9 of 27 studies focused on offshore workers and 18 included seafarers. The most common causes of medical repatriation reported in the literature were injuries, poisonings, and other consequences of external causes (ICD-22, ICD-23) at 25.2%. Diseases of the digestive system, including dental, (ICD-13) comprised 15.9%, and the musculoskeletal system (ICD-15) was 13.3%.

Gaps in the available literature included a lack of demographic and occupational information required to properly assess risk factors for occupational illnesses and injuries among seafarers. The data indicate that injuries, diseases of the gastrointestinal system, and musculoskeletal system are the most common literature-reported causes of repatriation in occupational seafarers. This work may support enhancements to onboard medical capability and medical standards for workers in the marine and offshore industries.