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At least 145 records · Page 8Linked to original sources
PubMed2003

Can we always ignore ship-generated food waste?

Considerable quantities of food waste can be generated at a rapid rate in ships, particularly those with large numbers of people onboard. By virtue of the amounts involved and its nature, food waste is potentially the most difficult to manage component of a ship's garbage stream, however, in most sea areas it may be dealt with by the simple expedient of direct discharge to sea. As a consequence, only minimal attention is paid to food waste management by many ship and port operators and advisory bodies, and there is a paucity of information in the available literature. The determination that management of ships' food waste is inconsequential is, however, incorrect in many circumstances. Disposal to sea is not always possible due to restrictions imposed by MARPOL 73/78 and other marine pollution control instruments. Effective management of food waste can be critical for ships that operate in areas where disposal is restricted or totally prohibited.

Environment↗
PubMed1996

Outbreak of Legionnaires' disease among cruise ship passengers exposed to a contaminated whirlpool spa.

BACKGROUND: Outbreaks of travel-related Legionnaires' disease present a public-health challenge since rapid, sensitive, and specific diagnostic tests are not widely used and because detection of clusters of disease among travellers is difficult. We report an outbreak of Legionnaires' disease among cruise ship passengers that occurred in April, 1994, but that went unrecognised until July, 1994. METHODS: After rapid diagnosis of Legionnaires' disease in three passengers by urine antigen testing, we searched for additional cases of either confirmed (laboratory evidence of infection) or probable Legionnaires' disease (pneumonia of undetermined cause). A case-control study was conducted to compare exposures and activities on the ship and in ports of call between each case-passenger and two or three matched control-passengers. Water samples from the ship, from sites on Bermuda, and from the ship's water source in New York City were cultured for legionellae and examined with PCR. FINDINGS: 50 passengers with Legionnaires' disease (16 confirmed, 34 probable) were identified from nine cruises embarking between April 30 and July 9, 1994. Exposure to whirlpool spas was strongly associated with disease (odds ratio 16.2, 95% Cl 2.8-351:7); risk of acquiring Legionnaires' disease increased by 64% (95% Cl 12-140) for every hour spent in the spa water. Passengers spending time around the whirlpool spas, but not in the water, were also significantly more likely to have acquired infection. Legionella pneumophila serogroup 1 was isolated only from the sand filter in the ship's whirlpool spa. This isolate matched a clinical isolate from the respiratory secretions of a case-passenger as judged by monoclonal antibody subtyping and by arbitrarily primed PCR. INTERPRETATION: This investigation shows the benefit of obtaining a recent travel history, the usefulness or urine antigen testing for rapid diagnosis of legionella infection, and the need for improved surveillance for travel-related Legionnaires' disease. New strategies for whirlpool spa maintenance and decontamination may help to minimise transmission of legionellae from these aerosol-producing devices.

Adolescent↗
PubMed2000

Traveler's diarrhea at sea: three outbreaks of waterborne enterotoxigenic Escherichia coli on cruise ships.

Enterotoxigenic Escherichia coli (ETEC) has become the leading bacterial cause of gastroenteritis outbreaks on cruise ships. Investigation of recent outbreaks of ETEC gastroenteritis on 3 cruise ships indicated that all were associated with consuming beverages with ice cubes on board the ship (relative risk [RR], 1.4, 95% confidence interval [CI], 1.0-1.9, P=.02; RR, 1.9, 95% CI, 1.3-2. 9, P<.001; and RR, 1.3, 95% CI, 1.0-1.6, P<.01), and 2 were associated with drinking unbottled water (RR, 2.7, 95% CI, 1.8-4.1, P<.001; RR, 1.7, 95% CI, 1.3-2.3, P<.001). Multiple ETEC serotypes were detected in patients' stool specimens in each of the 3 outbreaks, and 12 (38%) of 32 isolates were resistant to > or =3 antimicrobial agents. ETEC appears to be emerging as a waterborne pathogen on cruise ships. Water bunkered in overseas ports was the likely source of ETEC infection in these outbreaks. To ensure passenger safety, cruise ships that take on water in foreign ports must ensure that water treatment and monitoring systems function properly.

Adult↗
PubMed1994

International dissemination of epidemic Vibrio cholerae by cargo ship ballast and other nonpotable waters.

In 1991 and 1992, toxigenic Vibrio cholerae O1, serotype Inaba, biotype El Tor, was recovered from nonpotable (ballast, bilge, and sewage) water from five cargo ships docked in ports of the U.S. Gulf of Mexico. Four of these ships had taken on ballast water in cholera-infected countries; the fifth took on ballast in a noninfected country. Isolates examined by pulsed-field gel electrophoresis were indistinguishable from the Latin American epidemic strain, C6707; however, they differed significantly from the endemic Gulf Coast strain (VRL 1984), the sixth-pandemic strain (569-B), and a V. cholerae non-O1 strain isolated from a ship arriving from a foreign port. On the basis of our findings, the Food and Drug Administration recommended that the U.S. Coast Guard issue an advisory to shipping agents and captains requesting that ballast waters be exchanged on the high seas before entry of ships into U.S. ports.

Cholera↗
PubMedDate not supplied

Cabin location and the likelihood of motion sickness in cruise ship passengers.

BACKGROUND: The prevalence of motion sickness approaches 100% on rough seas. Some previous studies have reported a strong association between location on a ship and the risk of motion sickness, whereas other studies found no association. This study was undertaken to determine if there is a statistical association between the location of the passenger cabin on a ship and the risk of motion sickness in unadapted passengers. METHODS: Data were collected on 260 passengers on an expedition ship traversing the Drake Passage between South America and Antarctica, during rough sea conditions. A standard scale was employed to record motion sickness severity. RESULTS: The risk of motion sickness was found to be statistically associated with age and sex. However, no association was found with the location of the passenger cabin. CONCLUSIONS: Previous research reporting a strong association of motion sickness and passenger location on a ship, studied passengers in the seated position. Passengers who are able to lie in a supine position are at considerably reduced risk of motion sickness. Expedition or cruise ships that provide ready access to berths, allow passengers to avoid the most nauseogenic positions. The location of the passenger cabin does not appear to be related to the likelihood of seasickness.

Adolescent↗
PubMedDate not supplied

Radio aid to ships at sea.

OBJECTIVE: To review the first 30 months' experience in providing medical advice by radio to the masters of vessels in the Indian and Southern Oceans. The Department of Emergency Medicine at Fremantle Hospital has provided this service since October 1987. DESIGN: Details of all cases were collected prospectively. SETTING: The master of the ship communicates with the senior medical staff in the Department of Emergency Medicine by telex or radio-telephone. RESULTS: Seventy-five patients were discussed in 30 months. They were aboard 68 ships from 17 nations. Forty-eight patients has spontaneous illnesses, of which 41 were classified as medical and 7 surgical. Twenty-seven patients sustained injury. The most frequent medications advised by the doctor were analgesics and antibiotics. In 12% of cases, the doctor recommended that the ship change course significantly in order to discharge the patient to medical care. In another 11% of cases the patient was discharged at an unscheduled but nearby port, although not all of these diversions were urgent. CONCLUSIONS: Despite the difficulties in assessing a patient one cannot see, most illnesses can be diagnosed with a reasonable degree of certainty and useful treatment can be instituted aboard ship. Improving communication systems make the task easier, but variation in the contents of the pharmaceutical cabinets aboard ships is a problem.

Adolescent↗
PubMed2000

A model of the expected occurrence of adverse pregnancy outcomes aboard U.S. Navy ships.

The goal of this study was to model the incidence of ectopic pregnancy and spontaneous abortion if pregnant women in the first 20 weeks of gestation were to remain aboard ship while at sea during deployments. Ectopic pregnancies and other pregnancy complications at sea can be life-threatening events. Data sources included shipboard medical departments, an Enlisted Personnel Survey, and the Naval Health Research Center Hospitalized Pregnancy and Women Aboard Ship studies. The overall pregnancy rate was 19 per 100 woman-years (95% confidence interval, 18-20), based on the complement of women assigned to participating ships. If pregnant women routinely were to remain aboard ships at sea during deployments through their first 20 weeks of pregnancy, it is expected that approximately 9 ectopic pregnancies and 40 spontaneous abortions would occur aboard ships at sea.

Abortion, Spontaneous↗
PubMed2000

Epidemiology of musculoskeletal and soft tissue injuries aboard a U.S. Navy ship.

OBJECTIVE: The objective of this study was to characterize injuries occurring to crew members aboard a U.S. Navy ship. METHODS: A retrospective review of crew member medical records was conducted covering a 90-day period during which the ship was intermittently at sea. Data on new injuries were collected and sorted. Injuries were classified as soft tissue or musculoskeletal, acute or overuse, and occurring with the ship at sea or in port. RESULTS: There was a total incidence of 16.5 injuries per 100 man-months. Acute musculoskeletal injuries contributed 2.6 injuries per 100 man-months and resulted in 79 lost and 192.5 modified work days. Overuse musculoskeletal injuries were responsible for 9.3 injuries per 100 man-months and caused 1 lost and 255.5 modified work days. Soft tissue injuries had an incidence of 4.6 injuries per 100 man-months and resulted in no lost and only 106 modified work days. The relative risk of sustaining a soft tissue injury in port compared with at sea was 1.1, but this was not statistically significant. The relative risk of sustaining an acute musculoskeletal injury in port compared with at sea was 3.5 (p = 0.01). CONCLUSIONS: Overuse musculoskeletal injuries occurred with the greatest incidence, but acute musculoskeletal injuries were responsible for the greatest morbidity. Soft tissue injuries occurred with an intermediate incidence but had the lowest overall morbidity. The safest place for crew members assigned to this Navy ship was aboard that ship at sea. Further studies of this nature could help guide medical efforts at injury treatment and prevention for shipboard personnel.

Accidents, Occupational↗
PubMed2003

Ergonomical valorization of working spaces in multipurpose ships.

In this work it is shown how anthropological data are among the most needed factors in ergonomical valorization of crew working spaces. Ship's working or living environment involves many unique human factors, which should be specially considered in our case as limitation of crew space. In this work we have chosen ships of different years of construction to prove this tendency. As a micro study, the work posture analysis using the pulling force experiment is performed in order to determine lumbar moment, intra-abdominal pressure as a measure of evaluating and comparing different crew work positions. As a macro-study, the "crew work posture analysis" was carried out by the use of the data collected from real cases. The most probable work postures in different spaces of a ship are classified and after some corrections of the work place the profile and its grade were determined. The "statistical analysis for real ship's spaces" is also performed, as well as another macro study, in order to show some real designed ship spaces from the point of view of the allocated volume.

Anthropology, Physical↗
PubMed2003

Molecular diversity of noroviruses associated with outbreaks on cruise ships: comparison with strains circulating within the UK.

The molecular diversity of norovirus (NV) strains associated with 26 outbreaks of NV gastroenteritis has been determined. The outbreaks occurred on 14 cruise ships from seven cruise lines, during the period from 1998 to 2002. The ships cruised in seas worldwide, including the Mediterranean, the Baltic and the Caribbean. Genogroup I NVs were more common in the cruise ship setting than in hospitals, with 38% of the cruise ship outbreaks associated with genotype I NVs, as compared to < 10% in hospital and other semi-closed institutions in the UK. Outbreaks on cruise ships were more common in the period April to September, than in the winter. Two mixed genogroup I and II outbreaks were detected, which suggested contaminated food or water as the source of the infection.

Caliciviridae Infections↗
PubMed1990

Ship size as a factor in illness incidence among U.S. Navy vessels.

Illness incidence was examined aboard U.S. Navy vessels to ascertain whether sick call rates vary with ship size. Outpatient data from ships of three different sizes (destroyers/frigates, cruisers, aircraft carriers) were surveyed, controlling for geographical region of deployment. Overall rates of illness were lower for the largest ships when contrasted with the smallest vessels for all three operational theaters; these rate differences were significant for the East Asia and Indian Ocean regions. Among major categories of disease, significantly higher rates aboard the small vessels were seen in at least two of the geographic regions for respiratory disorders, digestive diseases, and musculoskeletal problems. Infective and parasitic diseases, skin and subcutaneous disorders, as well as symptoms and ill-defined disorders were significantly higher for small ships in one theater. It was concluded that ship size is a factor in illness incidence and should be considered in medical resource planning.

Epidemiology↗
PubMed1998

Rubella among crew members of commercial cruise ships--Florida, 1997.

During April-July 1997, two different commercial cruise lines notified CDC of rubella outbreaks among crew members. In July 1997, CDC initiated an investigation on one cruise ship to determine the extent of and risk factors for rubella infection among crew members and to assess the potential risk for rubella transmission to passengers-particularly rubella-susceptible pregnant women at risk for giving birth to an infant with congenital rubella syndrome (CRS). This report summarizes rubella outbreaks involving two cruise ships and the results of the CDC investigation on one cruise ship, which demonstrate that crew members can serve as a susceptible population for rubella infection and should be vaccinated with measles-mumps-rubella vaccine (MMR) if they are not immune. Although the outbreaks were limited to crew members, cruise ship travel provides an environment conducive to the potential spread of rubella and other infectious diseases among crew and passengers; therefore, women of childbearing age, particularly pregnant women, should be immune to rubella before traveling on cruise ships to reduce the risks for rubella infection and CRS.

Disease Outbreaks↗
PubMed1993

Transplantation of shipped donor livers.

Between September 1988 and November 1991, 201 donor hepatectomies and transplantations were performed. Fifty-four livers (26.9%) were harvested by other teams and shipped for transplantation; 147 livers (73.1%) were procured by teams from our transplant center. Comparing the maximal postoperative serum-aminotransferases (s-AT), we evaluated the postischemic damage of shipped organs (AST 951 +/- 931 IU/l; ALT 820 +/- 666 IU/l) and nonshipped organs (AST 753 +/- 1256 IU/l; ALT 636 +/- 896 IU/l); this did not differ significantly. Donor-related factors, such as critical parameters (i.e., cardiac arrest, arterial hypotension, age over 50 years, or elevated preoperative s-AT), length of stay in the intensive care unit before harvesting, and cause of death showed similar patterns in both groups. The mean cold ischemia time in the group of shipped livers (12 h 10 min +/- 4 h 22 min) and in the nonshipped livers (10 h 6 min +/- 3 h 53 min) did not differ significantly. Five cases (2.5%) of a primary non-functioning graft presenting with significantly (P < 0.001) elevated s-AT (AST 4944 +/- 2280 IU/l; ALT 3186 +/- 1918 IU/l) necessitated an early retransplantation. One organ was shipped and four organs were nonshipped, thus corresponding to their portion of all grafts. These data indicate that the transplantation of shipped livers is a safe procedure procedure, provided that procurement is done by experienced centers.

Adolescent↗
PubMed2004

Outbreaks of Gastrointestinal Diseases on Cruise Ships: Lessons from Three Decades of Progress.

Dramatic improvements in sanitary engineering and, especially, operational procedures aboard cruise ships began in the mid-1970s after several large outbreaks of acute gastroenteritis. The US Centers for Disease Control and Prevention's Vessel Sanitation Program, working with the cruise industry, conducts ship inspections, provides public access to ship sanitation scores, and reports outbreak investigations. The significant increase in median ship sanitation scores over the past decade has been concomitant with a reduction in outbreak frequency to 3.7 per 1000 cruises. Most outbreaks of the past decade were linked to noroviruses (Norwalk-like viruses), enterotoxigenic Escherichia coli, or the residual "unknown" causes. Although norovirus outbreaks may begin as foodborne or waterborne disease, easy person-to-person transmission occurs through fecal- or vomitus-splattered surfaces, other items, clothing, and especially, hands. Control of person-to-person spread of illness among crew and passengers becomes the major objective. Rigorous handwashing, environmental disinfection, and other food service job-related restrictions are required to prevent multiple outbreaks on the same ship. Vigilance by public health and industry officials has prevented many thousands of illnesses and some associated deaths. Clinicians providing pretravel health advice and post-travel diagnoses and care can benefit from and contribute to epidemiologic investigations and thereby enhance the health of cruise passengers individually and collectively.

Journal Article↗
PubMed2005

Mice acquire flavor preferences during shipping.

Vigorous motion can cause rodents to develop flavor aversions and show other signs of malaise. We tested whether a flavor aversion could be induced by shipping mice from an animal breeder to a test site. Boxes of 12 male C57BL/6J mice were shipped approximately 950 km from Bar Harbor, ME to Philadelphia, PA by truck. For some boxes, the gel provided for hydration was flavored with almond and for others it was flavored with banana. After the journey, the mice were individually housed and allowed to recover for 5 days. They then received a choice between the two flavors of gel. Contrary to expectations, mice preferred the flavor they had previously ingested during shipping. Controls given flavored gel under similar conditions but while stationary did not show a preference. These results suggest that mice find shipping or its sequelae pleasurable. If mice are travel sick this must be inconsequential relative to other components of the shipping experience.

Animal Feed↗
PubMed2002

SHIP represses mast cell activation and reveals that IgE alone triggers signaling pathways which enhance normal mast cell survival.

The hemopoietic specific, Src homology 2-containing inositol 5' phosphatase (SHIP) hydrolyzes the phosphatidylinositol (PI)-3-kinase generated second messenger, PI-3,4,5-trisphosphate (PIP(3)), to PI-3,4-bisphosphate (PI-3,4-P(2)) in normal bone marrow derived mast cells (BMMCs). As a consequence, SHIP negatively regulates IgE+antigen (Ag)-induced degranulation as well as leukotriene and inflammatory cytokine production. Interestingly, in the absence of SHIP, BMMCs degranulate extensively with IgE alone, i.e. without Ag, suggesting that IgE alone is capable of stimulating signaling in normal BMMCs and that SHIP prevents this signaling from progressing to degranulation. To test this, we compared signaling events triggered by monomeric IgE versus IgE+Ag in normal BMMCs and found that multiple pathways are triggered by monomeric IgE alone and, while they are in general weaker than those stimulated by IgE+Ag, they are more prolonged. Moreover, while SHIP prevents this IgE-induced signalling from progressing to degranulation or leukotriene production it allows sufficient production of autocrine acting cytokines, in part by activation of NFkappaB, to enhance BMMC survival. Interestingly, the activation of NFkappaB and the level of cytokines produced are far higher with IgE than with IgE+Ag. Moreover, IgE alone maintains Bcl-X(L) levels and enhances the adhesion of BMMCs to fibronectin and this likely enhances their survival still further.

Animals↗
PubMed1998

Role of SHIP in FcgammaRIIb-mediated inhibition of Ras activation in B cells.

Previous studies by our lab and others established that co-crosslinking sIg and IgG receptor FcgammaRIIb in B cells in a feedback suppression model (negative signaling) promoted tyrosine phosphorylation of the inositol 5-phosphatase SHIP and its interaction with Shc and that these events were associated with inhibition of the Ras pathway. We therefore hypothesized a competition model in which the SH2 domain of SHIP competes with that of Grb2 for binding to phospho-Shc to inhibit the Ras pathway. Here, we provide evidence consistent with this hypothesis. First, FcgammaRIIb-deficient B cells, which do not undergo SHIP tyrosine phosphorylation nor interaction with Shc, displayed an active Ras pathway under negative signaling conditions; reconstitution of FcgammaRIIb expression restored the block in Ras. Second, under conditions of negative signaling leading to SHIP-Shc interaction in wild-type B cells, we observed a profound reduction in the activation-induced association of Grb2 to Sos. Experiments reported here and elsewhere revealed the Grb2-Sos interaction required the engagement of the Grb2 SH2 domain by phospho-Shc. Third, we demonstrated that phospho-Shc cannot concomitantly bind Grb2 and SHIP, indicating that the two proteins competed for the same phospho-tyrosine residue on Shc. These data are consistent with the proposed competition model, and further indicate that the activation induced Grb2-Sos association is rate limiting for Ras activation.

Adaptor Proteins, Signal Transducing↗
PubMed1996

The SHIP phosphatase becomes associated with Fc gammaRIIB1 and is tyrosine phosphorylated during 'negative' signaling.

Immune-complex mediated co-ligation of antigen and Fc receptors on B-cells leads to abortive antigen receptor (BCR) signaling and provides a mechanism for feedback regulation of the immune response. A phosphotyrosine-containing 13 amino acid sequence (ITIM) found in the FcgammaRIIB1 cytoplasmic tail mediates this inhibition and specifically associates with the phosphotyrosine phosphatase SHP1. In vitro binding studies demonstrate that the phosphorylated ITIM binds unidentified proteins of 70 and 160 kD in addition to SHP1. Here we report the identification of p70 as SHP2 and p160 as the SH2 containing phosphatidylinositol 3,4,5-trisphosphate 5-phosphatase SHIP. SHIP is inducibly tyrosine phosphorylated following BCR-FcgammaRIIB1 co-ligation. Further, we observe SHIP association with tyrosine phosphorylated FcgammaRIIB1 in intact cells following BCR-FcgammaRIIB1 co-ligation. To a much lesser but significant degree, tyrosine phosphorylation of SHIP is also observed upon BCR ligation. These observations suggest that SHIP may play an important role in FcgammaRIIB1 dependent and independent regulation of BCR signaling.

Animals↗