Changes in Physical Fitness and Some Bodily Functions Before and After a Trip

of the crew's body and with it the change in the incidence of various diseases which we will discuss below:

4.3.1. Changes in physical fitness and some body functions before and after a trip

+ Physical changes of ocean-going ship crew after a voyage

We also conducted a study on the physical changes of the crew members before and after the sea voyage. The results showed that the body weight, average chest circumference, and BMI of the crew members from the obese level and above all increased after the voyage compared to before the voyage (statistically significant). On the contrary, the crew members with normal BMI decreased statistically significantly after the voyage compared to before the voyage. This difference, in our opinion, is probably mainly due to the serious imbalance in the diet of the crew members, with a high content of protein, sugar, and fat, while green vegetables are very lacking. On the other hand, because there are few conditions for physical exercise on the ship and there is little movement, the body weight, average chest circumference, and BMI increased significantly after the voyage compared to before the voyage. For the group of crew members with normal BMI, perhaps due to limited metabolic activity, combined with limited wave-bearing capacity, which also limited eating and drinking, after the trip, the BMI decreased significantly compared to before the trip. Our study also showed that the crew members with thin and normal body types suffered from seasickness significantly more than the TV group with fat body types. Research by Skuladottir, Svanlaug, Akkilles [121], Stamler J,

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sea base

reduced

Caggiula AW, Grandits GA [126] on the effect of long-term travel on body weight also gave similar comments.

A diet lacking in green vegetables leads to a lack of fiber, which makes intestinal motility difficult, in addition to causing constipation, it is also the cause of increased blood pressure.

absorption of sterols (which are precursors of cholesterol) from food and increased reabsorption of cholesterol, resulting in increasingly severe lipid metabolism disorders.

Prolonged psychological stress will also affect digestion, food absorption and physical strength in the group of lean crew members. Our research results are also consistent with the research of Nguyen Truong Son [50] and Grifill [93], Bogdan Jaremin [77] and Lawther A. [107],

+ Changes in physiological functions of ocean-going sailors

Many physiological functions of the crew after the journey also changed significantly compared to before the journey:

- The most obvious changes in the circulatory system function are pulse rate, systolic and diastolic blood pressure. The results of a study on some circulatory system function indicators of oceangoing sailors after a long voyage at sea showed that the average pulse rate and blood pressure (including systolic and diastolic blood pressure) were higher than before the voyage, with statistical significance at p < 0.01, while the proportion of sailors with normal blood pressure (82.67/76.33)

%) and the electrocardiogram with normal sinus rhythm rate (57.00/49.66%) decreased significantly after the trip (p < 0.05). The overall rate of electrocardiogram change increased from 31.67% to 43.66% after the trip.

family,

constrained,

copper

This change in cardiovascular function, in our opinion, is due to the fact that during the journey, crew members have to work in the microclimate conditions of ships with many disadvantages such as vibration, shaking, high fuel fumes and a diet high in sugar, fat, and low in green vegetables and fiber. In addition, crew members also have to bear psychological and neurological burdens such as isolation from the mainland, being away from home, lacking cultural life, working in a cramped space, and poor posture.

especially having to live and work for a long time in a society. All of these things are the cause of creating a state of continuous stress.

prolonged and strengthens the sympathetic nervous system, thereby causing tachycardia and increased blood pressure. The results of our study are also consistent with the studies of other authors [17], [20], [45]. The mechanism of increased blood pressure in this case is explained as follows:

Increased myocardial contractility

TM and arterioles

Increased heart rate

HA(P) = Cardiac output(Q)  Peripheral resistance(R)

Sympathetic nervous system

Increased peripheral resistance

Increased cardiac output

Increased BP

Thus, working conditions at sea are factors that contribute to increased changes in cardiovascular function. If these effects persist, the circulatory dysfunction will increase and eventually lead to a real pathological condition.

vibration

frequency system m

+ The results of the study on the changes in some functions of the circulatory system before and after the journey according to occupational groups on ships show that the group of ship engine crew members tends to change more than other groups of crew members. This difference, in our opinion, is due to the fact that the ship engine crew members often have to work in conditions with many toxic factors such as noise, vibration, and temperature that exceed the permitted hygiene standards, which has an impact on

central nervous system and thereby strengthens the sympathetic nervous system leading to more fluctuations in blood pressure of the TV group, following the trend

increased compared to before the trip.

+ Research on changes in urine composition of sailors before and after the journey showed that the rate of sailors with red blood cells, white blood cells and proteinuria increased after the journey (p<0.05). Is this also related to the burden caused by the long journey at sea?

+ Regarding changes in blood biochemical composition before and after a one-year sea voyage, our research results show that blood sugar levels increased after the voyage, especially the rate of crew members with impaired glucose tolerance increased significantly after the voyage (p<0.05), the rate of crew members with type 2 diabetes also increased. If impaired glucose tolerance continues to persist, the risk of crew members developing diabetes will increase.

+ Regarding changes in blood lipid composition, we found that the levels of all components from cholesterol to triglyceride, HDL-C, LDL-C in the blood of the crew members after the trip increased compared to before the trip. Meanwhile, the rate of dyslipidemia in the crew members before the trip increased significantly after the trip (65.66% to 80.67%) with p<0.05. In our opinion, this change is caused by an unbalanced diet and a sedentary lifestyle on board during long sea voyages.

Some neuropsychological changes of crew members

reason for

pathogenesis

+ Regarding the psychological burden during long journeys at sea, we see that: stress factors due to noise pollution, vibration, fear of accidents and disasters, loneliness, torment, sexual emotional stress, worries about economics and family are factors that contribute to increasing the mental burden of the crew. If this stress persists, it will cause the development of

Pathological disorders of seafarers, primarily disorders and disorders related to the nervous system and related organs. Research

Shuji Hisamune, Miho Ehara, Sonone Muramatsu on Japanese crew (2004) [122]; Bogdan Jaremin's study on Polish crew (2005) [77], also gave similar comments.

Researching the change in the incidence of neurological diseases of ocean-going crew members, we found that: after the trip, the incidence of some neurological diseases of crew members (functional neurological disorders, sleep disorders...) increased compared to before the trip (from 2.41% to 10.34%) with statistical significance with p

< 0.05. The ability to concentrate, pay attention and think of the crew members is significantly reduced compared to before the trip. The cause of this situation may be due to the crew members working at sea for long periods of time, isolated from the vibrant life on land and from relatives. On the contrary, life on the ship with the boring rhythm of working in shifts makes the crew members always lonely and leads to an increase in mental behavioral disorders. Working at sea is always affected by unstable weather conditions, hydrological climate, unusual waves and storms, in addition to the fear of being pirated... so the fear of insecurity on board always haunts most crew members on each trip. Therefore, mental health issues need to be mentioned in health care for crew members [33], [53], [76], [84].

4.3.2. Changes in the rate of some diseases of ocean-going crew members

Vietnam after a journey

+ Changes in the rate of metabolic syndrome in sailors after a voyage

high, i present

ready for

The group of nutritional and endocrine metabolic diseases accounts for a fairly high percentage of 69.33% before going to sea and this percentage increases to 85.67% after a long sea voyage. The disease is mainly detected through paraclinical tests, clinical symptoms are not prominent so sailors pay little attention and do not

pay attention to treatment and timely adjustment of diet and lifestyle. In this study, we found that 56/300 crew members had both blood sugar and blood lipid disorders and obesity. This is explained by the fact that the diet on board is rich in nutrients but has an unbalanced composition, with excess protein, fat, and sugar but little fiber and green vegetables. In addition, lack of physical activity also increases the incidence of metabolic syndrome [22], [38], [129].

Analyzing the types of diseases caused by metabolic disorders, the research results showed that lipid metabolism disorders increased after the sea voyage with p < 0.05; The rate of overweight and obesity grade I was quite high at 20%. Living in a confined space with little movement and less exercise compared to on land is a risk factor. The results of our research are also consistent with the studies of MA. Bouza Prego, JL. Saleta Canoá, MP. Castro Rodriguez, D. Bellido Guerrero, S. Pita Fermández (2010) also stated that an unreasonable diet, a loose lifestyle, and little exercise increase the incidence of metabolic syndrome and increase the risk factors for cardiovascular disease.. [108]. The study of S. Fribo Moller Pedersen, J. Riis Jepsen on Danish crew members also gave similar comments [129].

life

play

activity

In addition, the crew's shift schedule is 4 hours/time, the rest of the time they spend sleeping, the rest is free time, they feel redundant and always find it difficult to use this free time. While on shore, they can have many other activities such as serving, taking care of family, entertainment, sports, social relations..., when working on the ship, the crew cannot do this. According to Nguyen Truong Son, all of this leads to an unstable psychological state, boredom, and sadness [53]. The inability to organize fun activities

Leisure time entertainment can easily lead crew members to negative, unhealthy activities such as gambling, alcoholism, and smoking.

This unhealthy lifestyle is found in most seafarers and they are also ready to relax when the ship is in port, regardless of any health risks. Therefore, after a long sea voyage, seafarers not only have an increased risk of metabolic syndrome but also have a risk of sexually transmitted diseases [75], [128].

+ Changes in the rate of circulatory system disorders and diseases of crew members after a voyage

Cardiovascular function is greatly affected by the working conditions, living conditions and diet of the crew during the sea voyage. Our study shows that before the sea voyage, the rate of circulatory diseases increased from 22.33% to 40% after the voyage. The actual rate of hypertension among crew members increased significantly, from 17.33% before the voyage, to 23.67% after the voyage. This is a fairly high rate for relatively young crew members (average age is 36.45 years old). Other cardiovascular disorders such as arrhythmia, coronary artery disease, etc. also increased significantly after the voyage (see table 3.37).

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far from shore

The rate of post-trip hypertension in our study was lower than that of Bui Thi Ha [16] on petroleum transport crew members (the rate of hypertension was 31.62%), and Nguyen Thi Ngan's study on crew members of VOSCO company 10 years ago was 34.14% [39]. To explain this, we assume that the average age and career of crew members in our study was lower (younger) than that of Bui Thi Ha and Nguyen Thi Ngan. However, the rate of hypertension in my study was higher than that of workers on land and fishermen.

Hai Phong area [73].

The prevalence of stage I and stage II hypertension also increased significantly.

after a sea voyage. In addition, the occupational group and title of the crew on the ship also affect the rate of hypertension: The ship's engine group has the highest rate (26.85%), the deck group (24.41%), and the remaining crew group (16.92%). The study also showed that the officer group had a much higher rate of hypertension than the crew group (32.03/19.28%) with OR = 1.97 (p<0.01).

Therefore, hypertension should be recognized as an occupational disease of seafarers. On the other hand, seafarers with hypertension are quite young, around 30 - 45 years old. The number of seafarers with isolated diastolic hypertension is greater than isolated systolic hypertension. This is quite different from the incidence of hypertension in workers on land, which is mainly isolated systolic hypertension [20], [45]. In our opinion, this difference is probably due to the increased tone of the sympathetic nervous system during and after long journeys at sea.

Regarding the level of hypertension among crew members, we found that most crew members had stage I hypertension (13.67% before the trip; 17.34% after the trip). These crew members need to be monitored regularly and need to be advised to change their lifestyle, diet and exercise. If blood pressure does not decrease after 3 months, medication must be used. The number of crew members with stage II hypertension before the trip was 3.67%; after the trip was 6.34%. These crew members need to take medication to control blood pressure during the trip at sea. At the end of a trip, blood pressure needs to be treated to stabilize before a health certificate is issued to go on the next trip.

trip

Changes in mental behavioral disorders in seafarers after a voyage

Mental activity is essentially a reflection of objective and subjective reality.

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