1. Olaf Jensen, Centre for Maritime Health & Society, Institute of Public Health, Southern Danish University, Esbjerg Denmark IMHA RESEARCH GROUP MEETING & WORKSHOP: “Better and more maritime epidemiological research! - how to improve the culture of research and publication” October 18th, 2014 BARCELONA, SPAIN Research Strategy

2. Research strategy Part 1: International links

3. An ounce of prevention is worth a pound of cure It is easier to forestall a disaster than to deal with it. For This ancient proverb is first recorded in Latin in Henry de Bracton's De Legibus (c. 1240) and has been repeated ever since, often in shortened form. The American Heritage® Idioms Dictionary Copyright © 2002, 2001, 1995 by Houghton Mifflin Company. Published by Houghton Mifflin Company.

4. WHO Prevention strategies 1949 Defintion of health and prevention levels 1978 Alma-Ata - empowerment 2000 Health for all 2011 Healthy workplaces health promotion at work Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

5. ILO: Integrating health promotion into workplace OSH policies: training package Integrating health promotion into workplace OSH policies Stress Violence, Smoke-free workplaces Alcohol and drugs, Nutrition, Physical activity, Healthy sleep HIV/AIDS.

6. Health for seafarers has historically been related to tertiary prevention

7. Directive 92/29/EEC - medical treatment on board vessels ”The objective of this directive is to improve medical assistance at sea - since a vessel represents a workplace involving a wide range of risks”

8. 2014-health for seafarers strategy include all levels of prevention

9. 1)Seafarers on all types and sizes of merchant ships 2)Fishermen on all types and sizes of fishing vessels 3)Offshore workers on platforms 4)Dockers (Port workers) 5)Comparison groups: internal and external (on shore) 6)Agegroups, gender, position on board, nationality 7)Time windows: Study populations and time 2000 -----------------------2014 ---------------------2020 Cohort prospectiveCohort retrospective Cross- sectional

10. Study populations - global

11. METHODS PUBLIC HEALTH STRATEGY OCUPATIONAL MEDICINE EPIDEMIOLOGY QUALITATIVE METHODS EVIDENCE BASED MEDICINE SYSTEMATIC REVIEWS HEALTH PROMOTION HEALTH IMPACT ASSESSMENT TRANSSECTORIAL- & INTERNATIONAL COLLABORATION

12. Hazardous work conditions Safety and management culture Social climate Occupational exposures: chemical, noise, ergonomics, Psycho-social factors, violence Social security Violence, sexual harassment Tobacco-alcohol (at sea/ home) Food and drink on (at sea/home) Physical activity (at sea/home) Stress factors and symptoms Fatigue/ burn-out Biological risks Radiation risks Risk factor variables:

13. Denominator data: Length of time exposed at work: Hours Days Years… In the specific segments of occupations, specific jobs, age, gender, etc - for calculation of adjusted incidence rates, relative risks and dose-response effects Risk factor variables:

14. Death, suicide and disability Cancer Cardiovascular diseases Diabetes Obesity Occupational diseases Injuries Hearing damage, Neurological disorders Psycho-social Psychiatry Musculoskeletal diseases Infectious diseases Allergic diseases. Sunburn and skin cancer Turn-over in the job Health effect variables

15. 1Accident prevention and safety promotion 2Health promotion: cardio-vaskular diseases, diabetes, obesity and cancer 3Mental health promotion: defined as ”the process of enhancing protective factors that contribute to good mental health” 4Raising awareness and prevention of psychosocial risks and promoting organisational solutions and management tools Intervention studies:

16. Research strategy part 2: Practical research plan 2015-2020 Projects -Horizon EU project (Fenoll-Brunet) -Prevention of falsification of medical certificates, - how many sick seafarers are sailing nowadays? (Denisenko) -Reduction of evacuations of passengers and seafarers Telemedical Advice system (Westlund) -…

17. IMHA Research organisation IMHA Research database IMHA Research strategy 1 and 2 IMHA Research training courses Recommendations - to establish

18. Research organisation DatabaseStrategyTraining

19. Thank you very much