State of health and health promotion needs in fishermen

Background
The tremendous physical workload of commercial fishing is widely known. Fishermen work in challenging settings; their work has no routine and is dictated by a lot of factors like wind, rain, or motion of the sea. Fishing has often been considered one of the most dangerous occupations as consequence of the marked mortality and rates of disease-related hospitalization. During the last 20 years, increased numbers of safety measures were developed and positive structural changes for the physical work environment were implemented in the fishery sector. Nevertheless, no clear trend in the decline of musculoskeletal pain among fishermen can be seen today.

Purpose
The main purpose is to describe, clarify and communicate the health situation and health promotion needs in Danish fishermen in the evolving and challenging occupational environment.

Research questions
RQ1: What are the most important political, economical and structural changes in the fishermen’s occupational work environment through the last 30 years
RQ2: What are the predictors through a lifetime occupation for musculoskeletal disease in Danish fishermen nowadays? More attention will be placed on the role of fatigue, mental health, structural changes in the work environment, workload and the use of pain treatments.
RQ3: What kinds of health promotion plans have previously had an effect and which plans can be developed?

Methods
The project contains three parts. First, a qualitative research will be conducted to answer the research question 1 (RQ1), secondly, a register based analysis will be performed to answer RQ2. To analyze the dynamic and challenging occupational environment together with chronic work exposures, concepts from life course epidemiology like accumulation of risk, critical period and chains of risk model will be applied in the research. The idea is to link time-dependent work related information, hospitalisation due to musculoskeletal disorders derived from register data and structural and political changes in the Danish fishery. Finally, the communication of results and recommendations of health promotion will be dealt with in RQ3, which can be answered during the project but also at the end. Possible health promotion interventions will be analysed based on a systematic literature review concerning existing health promotions strategies and interventions targeting musculoskeletal diseases in occupational setting with high and straining workload.

Time schedule
1st September 2017 - 30th August 2020

PhD student
The project is carried out by PhD student Line Nørgaard Remmen.

Supervisors
Associate professor Gabriele Berg-Beckhoff, Unit for Health Promotion Research, IST, SDU (main supervisor)
Senior researcher Kimmo Herttua, Centre of Maritime Health and Society, IST, SDU (co-supervisor) 
Head of research Keld Thorgaard, UC SYD (co-supervisor)