Life Conditions of Members of Vessel’s Crew of the Northern Fishing Basins, Affecting the Musculoskeletal System. Risk Factors for Occupational Traumatism

The fishing fleet is the basis for the economic and social development of the mining regions. The life conditions of members of vessel’s crew of the Northern fishing basins affecting the musculoskeletal system are discussed. The main and additional risk factors of occupational traumatism are identified. The urgency of accident prevention on fishing vessels as a task of modern medical science, including marine medicine, is substantiated. Among the promising organizational and medical areas for reducing injuries to fishermen are the following:

The duration of the adaptation of the organism to high latitudes, the most dangerous is in relation to accidents. The reason for slowing the regeneration of bone tissue during the local action of cold is a persistent circulatory disorder due to vascular spasm. Under the influence of cooling in a humid environment, the floating composition, representatives of other open productions of the northern regions, in 98% of cases, changes of bone tissue of a degenerative-dystrophic nature were radiographically detected. They are marked mainly in the bones of the extremities that undergo cooling during work, namely, the phalanges of the fingers, the heads and metaphases of the first metatarsal bones, metacarpal bones. Changes are expressed in the formation of osteophytes, spilled osteoporosis, islands of enosteous sclerosis, thickening of the bone beams of the spongy substance. Extensions of bone marrow spaces between the beams depend on the period of cooling and the depth of the neurovascular disorders and occur not only in the place of application of cold, but also in the bone tissue of the alveolar processes [7][8][9][10][11][12]. Among the reasons that cause professional pathology on fishing vessels, a significant place belongs to noise and vibration, which has a constant aroundthe-clock effect on the ship's crew during the entire voyage. On fishing vessels in 80.0% of cases increased permissible noise levels, in 25.0%-vibration. In the engine room of ships, noise levels meet the standards in 26.0% of cases, vibration-in 73.0%. In the central control station on fishing vessels, the compliance with noise standards is 18.0%, vibration -37.0% of cases [13]. Existing noise levels on ships predetermine a high degree of mobilization of adaptation mechanisms among ship crew members, which may lead to their accelerated depletion and the development of pathological changes in the body. As a result of the vibration factor, a number of pathological states of both soft tissue elements and the skeleton base may develop, manifested as restructuring of the bone structure and strengthening of the bone tissue along the force lines of maximum pressure and thrust, a trophic bone pathology develops, which is the development of regional resorption distal nail phalanxes, the formation of enostoses, spondylosis of the thoracic spine. In the development of lesions of the osteo-articular system, it is not the parameters of vibration that are of primary importance, but the neurotrophic disorders caused by it. In the conditions of long voyages, an important factor in determining the health of members of vessel's crew is hypodynamic illness. Motor activity of fishermen is reduced by 6-10 times compared with coastal conditions. For members of ship teams, a decrease in the absolute value of the velocity of propagation of a shock mechanical wave was established as it passed through the muscles of ship crew members who were in a long voyage condition. Experimental and clinical data suggest that the restriction of muscle activity causes a complex of polymorphic disorders of members of vessel's crew on the part of blood circulation, respiration, neuromuscular and neuroendocrine systems, which are currently united by the concept of "hypokinesis disease" [14]. Thus, the complex effect of production factors determines significant professional changes in various body systems of fishermen, creates stress conditions for the adaptation mechanisms and, when realizing factors appear, an increased traumatism rate [15][16][17].

Risk factors for occupational traumatism to fishermen on ships
Injuries occupy a leading place in the structure of the overall morbidity of members of crew on fishing vessels [18][19][20][21]. In the conditions of every day increasing mechanization and automation of labor on ships, traumatism prevention should be considered as the main reserve for the preservation of labor resources [22][23][24][25][26][27]. On modern fishing vessels, there is a qualitative change in the nature of the work of the crew members, who began to be engaged primarily in operator activities in the control system of a continuously moving facility. The use of integrated mechanization and automation in the fleet led to the fact that the labor component of members of vessel's crew decreased especially the physical component of labor, reduced the time required to process the information received and make the necessary decision due to a significant increase in the speed of ongoing production events [28][29][30][31]. Types of jobs of fishermen began to be characterized by a high degree of tension. The following occupational hazards that are potentially hazardous to the health of fishermen are highlighted, which increase the likelihood of diseases, their development and adverse outcome, directly or indirectly leading to the risk of injury [32][33][34][35][36]. On long voyages, the effects of meteorological factors (temperature, humidity, atmospheric pressure) and occupational hazards lead to different shifts in the health status of members of vessel's cre [43][44][45][46][47]. Typical of these are: Changes in the content of Na + and Ca ++ in the urine [48][49][50][51][52][53][54].

The reasons for the intensity of labor professionals on
A long stay of the fishermen on the voyage leads to the development of general fatigue, and therefore the likelihood of traumatism increases. Thus, the problem of preventing accidents on fishing vessels remains one of the most pressing issues of modern science, including maritime medicine. Among the promising organizational and medical areas for reducing injuries to fishermen are the following: A.
Elimination of the impact of specific conditions of production activity of fishermen working on long voyages in northern latitudes -cold and moisture, due to the creation of more comfortable working conditions and rest between watches.

B.
Reducing the effects of vibration and noise on the body of members of vessel's crew in the development of modern design solutions for the construction of new fishing vessels.

C.
A qualitative change in the organizational and medical approach to reducing the labor intensity of specialists on fishing vessels. D. Development of relevant medical and psychological programs to influence additional risk factors for traumatism of members of vessel's crew aimed at reducing and (or) eliminating family and household problems, low physical activity, bad habits, low medical literacy and low medical (preventive) activity of fishermen.