Dissertation/Thesis Abstract

Measurement of Pain and Injury in Commercial Lobstering, What Can Be Done about It, with Evidence of Commercial Fishing as a Determinant in Mortality
by Fulmer, Scott Price, Sc.D., University of Massachusetts Lowell, 2020, 171; 28089452
Abstract (Summary)

A survey of inshore lobstermen in Maine and Massachusetts was conducted to estimate a denominator of exposure to inshore lobstering, count incident injury data from a sample cohort of this population, use this count to calculate rates for incident injuries, and to use official counts of fatalities to estimate a fatality rate. Captains were randomly selected from those licensed to fish in Maine and Massachusetts. Data about work exposure and injuries that occurred on the boat were collected using a survey that was administered once per season via phone or face-to-face interview with the captain. Data included self-reports of the number of weeks worked during the season, average crew size, number of trips per week, and average trip length in hours. In addition, this survey captured relevant information (body segment affected, type of injury, and whether treatment was received) on all acute injuries occurring during the season. Only data on acute injuries were collected and defined as having newly occurred within the last 3 months. Counts of fatalities were obtained from an official surveillance database at the National Institute for Occupational Health and Safety.

The total occupational exposure reported for the cohort was over 2 million man-hours over 4 years, resulting in an average annual FTE of 5,847. The fatality rate averaged over 4 years was 21/100,000 FTE. The incidence rates for all injuries (51.0/100 FTE) and injuries receiving treatment (17.5/100 FTE) were much higher than those reported in other studies of fishing that used US Coast Guard data. Lobstermen presented with all categories of injuries, sprains being the most frequent (7.8/100 FTE) and amputations the least (0.2/100 FTE). Wrist/hand injuries on the right side occurred most frequently of all body locations (3.6/100 FTE).

At least once in the four-year study, captains and their sternmen were invited to participate in an in-person interview about non-acute pain and discomfort. The objective of this data collection was to report on the prevalence of musculoskeletal pain. A total of 395 individuals participated. One half of the respondents reported low back pain. Low back pain was prevalent among both captains and sternmen, while sternmen reported more hand/wrist pain than captains. Multiple locations for pain were common in individual participants. Less than 20% of the subjects reported working the 3 months prior to the interview without pain.

The opioid epidemic has had disproportionate effects across various sectors of the population, differentially impacting various occupations. Commercial fishing has among the highest rates of occupational fatalities in the United States. The death certificate data from approximately 26,000 decedents in two Massachusetts fishing ports from 2000 to 2014 were used to calculate proportionate mortality ratios (PMR) of fatal opioid overdose as a cause of death in commercial fishing. Statistically significant PMRs revealed commercial fishermen were greater than 4 times more likely to die from opioid poisoning than all other employed males living in the same fishing ports. Accidental causes of death were more than 3 times more likely to occur to fishermen than all other employed males, but only 50% more likely if those accidental deaths were not associated with opioid poisoning.

The high rates of injury and high prevalence of pain in the lobster-harvesting industry presented the challenge of how to reduce exposure to risk. Participatory ergonomics methods were used to partner with lobstermen to develop and implement ergonomic improvements. The model included training in ergonomics principles, a forum for ergonomics discussions, and a sequence of meetings planned to focus on problem identification, intervention, evaluation, and dissemination of findings. One crew initiated three specific actions: the introduction of a conveyor belt to assist material handling at a local lobstering pier, the installation of a star block to replace a standard block used to haul traps onto the boat, and the initiation of a design process for improved mechanical assistance for hauling traps onto the boat. Two concepts for redesigning the mechanical assistance were developed through the process. The other crew advised the research to develop short videos intended to disseminate ergonomic ideas to other lobstermen. They collected video footage and narrated a description of a work method to reduce force and postural exposures by cutting and cleating their own line when it becomes tangled with other lobstermen’s lines. The researcher produced a short video from this as an initial example of a series of short videos on lobstering ergonomics. The influence of important cultural norms was observed for future research and development in the community.

Indexing (document details)
Advisor: Buchholz, Bryan
Commitee: Punnett, Laura, Kriebel, David
School: University of Massachusetts Lowell
Department: Occupational Ergonomics & Safety
School Location: United States -- Massachusetts
Source: DAI-B 82/3(E), Dissertation Abstracts International
Subjects: Public health, Occupational safety
Keywords: Commercial fishing, Disease of despair, Musculoskeletal disorder, Occupational mortality, Opioid, Participatory ergonomics
Publication Number: 28089452
ISBN: 9798664795516
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