Perspective directions of research on the prevention of morbidity and traumatism of the members of vessel`s crew of the river transport fleet during the development of the Northern Sea Route

The new stage of development of the Northern Sea Route, the only highway connecting the subarctic and arctic regions of the Russian Federation, involves the development of a transport system, the complex of which includes all the rivers flowing into the Arctic Ocean. Despite the large number and vastness of the river basins in the Russian Federation, their importance for the effective operation of the country’s economy, the problem of preventing traumatism of the members of vessel`s crew of the river transport fleet was reflected in research by a small number of practitioners, individual scientists and medical research teams.

Improving the performance of the health care system; ensuring the availability and quality of medical care to the members of vessel`s crew of the river transport fleet, the formation of sustainable industrial motivation and conscious attitude to their health for this contingent of industrial workers, striving for a high health culture and a healthy lifestyle as the basis of a long-term and full-fledged life; The creation of a positive attitude towards the health care system at the river men is the stated goal of the organizational and methodological work of the medical service of the river fleet.

To do this, it is necessary to specify the state guarantees for providing free medical care to the members of vessel`s crew of the river transport fleet, to create an effective model for managing the financial resources of these guarantees, and to improve the provision of outpatient medication to water workers as part of the compulsory health insurance system. This is not possible without improving the qualifications of medical workers and creating a system for motivating them to quality work, developing medical science and innovation, and informatization of water transport healthcare.

The new stage of development of the Northern Sea Route, the only highway connecting the subarctic and arctic regions of the Russian Federation (RF), involves the development of a transport system, the complex of which includes all the numerous rivers flowing into the Arctic Ocean. The Arctic territories are a key strategic reserve for the country’s development. The efficient operation of the river and sea transport infrastructure in the northern regions determines the dynamic growth of the RF economy.

The need to study the traumatism of the members of vessel`s crew of the river fleet is dictated by the socio-hygienic significance of injuries and accidents, their prevalence, long-term temporary disability, complexity of vocational rehabilitation, moral and economic damage inflicted on the state. The lack of system analysis in the prevention of traumas of this contingent of industrial workers leads to a repetition of situations of the same type that is dangerous as a result of injury resulting in serious injuries [1-5].

The maintenance of the economic development of the northern territories of the RF is the modernization of systems for ensuring the safety of river vessels, the development of transport and technological port complexes, which will inevitably lead to an increase in the labor intensity of the members of vessel`s crew of the river transport fleet in adverse professional conditions of subarctic regions. In such a situation, the prognosis of the incidence and injury of a contingent of the members of vessel`s crew can be very negative. At the same time, the forces and means of health care should be directed towards their prevention and readiness to minimize the consequences. Therefore, research on the prevention of injuries in the river transport fleet should be considered as a form of preservation of the workforce of a contingent of industrial working groups of the members of vessel`s crew due to a difficult demographic situation and a limited influx of specialists [6-10].

The unified transport network of the Russian Federation includes the largest river arteries of Siberia, land, air and pipeline modes of transport. Perspective volumes of transportation by river transport fleet may be associated with the development of oil and gas fields on the Yamal Peninsula, in the basins of the Ob, Yenisei, Lena, Amur rivers, as well as in the adjacent areas of the Barents Sea (Timan-Pechora oil and gas province, Shtokman gas condensant and Prirazlomnoye oil and gas bearing regions, and others) and the development of offshore oil and gas exports from these fields to Europe. The development of commercial timber processing enterprises in the Yenisei and Lena river basins and the resumption of timber cargo exports, an increase in transit traffic due to the export of ferrous metals and mineral fertilizers produced by exporting enterprises in the European part of the RF will further increase the growth of the river-sea coastal shipments and increase the demand for river water transport fleet [11-15].

Despite the fact that the shipping system of Siberian rivers is an important part of the infrastructure of the economic complex of the Far North and a link between the Russian Far East and the western regions of the country, it has not been the subject of systematic targeted medical research on the prevention of the incidence and injuries of the members of vessel`s crew of river fleet as a professional contingent groups of industrial workers.

Individual scientific works in the largest Ob, Lena and Amur river`s basins should be the reason for revising long-term scientific planning and motivation, both regional medical research teams and individual scientists to create a systematic program for studying and preventing traumatism of industrial groups of workers of river transport fleet in the area of responsibility of the Northern Sea Route [16].

The purpose of the systemic development of the health service of the members of vessel`s crew of the river transport fleet should be a real improvement in the quality and accessibility of medical care, drug support, provision of sanitary and epidemiological well-being, increased life expectancy, prevention of diseases and other conditions threatening the life and health of river men by improving health care systems [17-21].

To do this, it is necessary to increase the efficiency of the health care system; to ensure the availability and quality of medical care to the members of vessel`s crew of the river transport fleet, to form a sustainable motivation and conscious attitude to their health, striving for a high health culture and healthy lifestyle as the basis of a long-term and full life for this contingent of industrial workers; Creation of a positive attitude to the river people to the health care system.

The current system of organization of medical care should specify the state guarantees for providing free medical care to the members of vessel`s crew of the river transport fleet, create an effective model for managing the financial resources of these guarantees, and improve the medical provision of outpatient medical personnel under the compulsory medical insurance system. This is not possible without improving the qualifications of medical workers and creating a system for motivating them to quality work, developing medical science and innovation, and informatization of water transport healthcare [22-27].

In modern conditions, the creation and operation of information systems and analytical tools for data processing are the “gold standard” of the organization of industry management. The introduction of new medical technologies is impossible without the parallel introduction of information systems that ensure the optimization of the service delivery process. The introduction and use of modern information and telecommunication technologies in health care is a key enabling task, on the solution of which depends the effectiveness of most of the activities of the State Program “Health Development” [28-30].

The “Health of healthy people” of occupational groups of industrial workers should be the basis of public health. Reorientation from the pathology of health to the health of healthy people will lead to: the need to define and standardize the relevant standards of health standards, systems and organs, depending on the sex and age of the person; replacing the case history with the health history, reflecting the history of quantitative deviations from the standards that correspond to the age and sex standards; reorientation of health services and public services to improve the health of various categories of the population in the territory under their jurisdiction [31-32].

The practical implementation of the transition to a healthy lifestyle is impossible without the approach of preventive medicine to a person. In this regard, the priority is to provide the population, especially healthy people and people with chronic diseases without exacerbation, preventive care within walking distance. It is necessary to develop and introduce outpatient stimulation mechanisms for the earliest possible detection of diseases and to prevent the development of diseases to the stage leading to hospitalization [33-34]. The implementation of these measures is aimed at improving the indicators of temporary disability of the working population.

Formation of a responsible attitude to their health at the river men, refusal from the use of toxic substances (tobacco, alcohol and drugs), assistance in organizing a healthy lifestyle, correction and regular monitoring of behavioral and biological risk factors for non-communicable diseases at the population, group and individual levels should be crucial health policy [35-37].

The basis for promoting healthy lifestyles, along with informing workers about the dangers of tobacco use, poor nutrition and unbalanced nutrition, low physical activity, alcohol, drug and other toxic substances abuse, should be training in hygiene, work and rest. In order to increase the motivation of the members of vessel`s crew to maintain a healthy lifestyle, it is necessary to create appropriate production, organizational, social and medical conditions. The task consists not only in the timely identification of risk factors for non-communicable diseases and injuries, but also in their timely correction.

The authors express sincere love to their parents. The authors are grateful to Bychikhin NP, Orlov GA, Kucherenko VZ, Kudrina VG, Zhuravlev SM, Korotkikh RV, Lindenbraten A.L., Zabin Yu.L., Novikov P.E., Siburina T.A., Dobrodeeva L.K., Kuznetsova M.N., Klepikova R.A., Udalova L.S., Smolnikov L.A., Pyankov S.M., Pisarenko E.F., Ternovsky L.N., Batygina N.I., Rzhevskaya V.N., Dubeerman L.B., Luss E.A., Akhmeev V.N., Schumacher R.E. and to all anonymous reviewers for their support, valuable advice, and helpful comments.

1. Borovaja AJ (1938) Proizvodstvennyj travmatizm na Kamskom bassejne. Trudy Permskogo med. in-ta. Vyp. XI. Perm'. 51-63.
2. Desjatov AA (1928) Ob izuchenii travmatizma na vodnyh putjah. Gigiena i jepidemiologija 90-94.
3. Desjatov AA (1929) Social'naja pomoshh' rabotnikam vodnogo transporta Severo-Zapadnoj oblasti v 1926-1927 gg. Voprosy zdravoohranenija 57-59.
4. Popov PS (1964) Opyt mediko-sanitarnoj chasti Irtyshskogo bassejna. Zdravoohranenie Ros. Federacii 26-30.
5. Smirnov D, Garshenin V (1988) Profilaktika travm plavajushhego sostava. Rechnoj transport 25.
6. Shapovalov KA (1986) Characteristics of floating crew injuries based on surgical clinic. Medical and Biological Problems of the European North: Abstracts V zonal conference of young scientists and physicians dedicated to the 275th anniversary of M.V. Lomonosov. Arkhangelsk 159-161.
7. Shapovalov KA (1986) Risk factors for incurring injuries on board ships of the cargo fleet of the northern basin. G Sanit 87-88. Link: https://goo.gl/51x6Gn
8. Shapovalov KA (1986) Medical and social issues of alcoholism and the struggle for sobriety of floating crew: guidelines. Arkhangelsk: Regional organization of the society «Knowledge» of the RSFSR, Arkhangelsk State Medical Institute, Northern Central Basin Clinical Hospital named after N.A. Semashko.
9. Shapovalov KA (1987) Injuries among women employed in water transport. Zdravookhr Ros Fed 19-21.
10. Shapovalov KA (1987) Injuries of floating crew Severodvinsk river basin and its prevention: guidelines. Arkhangelsk: Regional organization of the society «Knowledge» of the RSFSR, Arkhangelsk State Medical Institute, Northern Central Basin Clinical Hospital named after N.A. Semashko.
11. Shapovalov KA (1987) Integrated health and social characteristics of floating crew injuries river fleet. Minsk 1987 (Manuscript deposited in VNIIMI of MZ of the USSR № 14225-87).
12. Shapovalov KA (1988) Prevention of injuries among the navigational personnel in waterborne transport (a review of the literature). Medicina truda i promyshlennaja jekologija. 39-42. Link: https://goo.gl/LGBm5E
13. Shapovalov KA (1988) Topical issues of injury prevention of floating crew of river fleet: information materials. Arkhangelsk: Arkhangelsk regional Health Department, Arkhangelsk State Medical Institute, Northern Central Basin Clinical Hospital named after N.A. Semashko.
14. Shapovalov KA (1989) Traumatism in the Fleet. Rrechnik Severa (Northern River Shipping Company, Arkhangelsk, Arkhangelsk region).
15. Shapovalov KA (1990) SafeWork. Rechnoji transport 24.
16. Bezrodnyh AA, Makarov VM, Vasil'ev EP, i dr O (1980) sostojanii zdorov'ja plavajushhego sostava teplohodov, kursirujushhih v rajone Lena - Severnyj Ledovityj okean. Zdravoohranenie Ros. Federacii 22-23.
17. Shapovalov KA (1990) Features of katatravma on ships of northern basin. Ortoped Travmatol Protez 65-66.
18. Shapovalov KA (1992) Injuries of the floating crew of transport, fishing and river fleets of northern pool and measures for its prevention: Abstract of Dissertation for the degree of Kandidat of Medical Sciences / Shapovalov Konstantin Albertovich, Scientific-research Institute of Medical and Medical-Technical Information of the Research-and-production Association "Soyuzmedinform". Moscow.
19. Shapovalov KA (1993) Organization of trauma care of floating crew of the Northern Basin: monograph. Arkhangelsk, Arkhangelsk State Medical Institute 1993 (Manuscript deposited in GCMB, № D-23691).
20. Shapovalov KA (1997) Medical and social problems of traumatism of floating crew on transport, river, fishing fleets and the organization of emergency trauma care on ships: monograph. Syktyvkar, Komi Book Publishers.
21. Shapovalov KA (1997) Medical and social injury prevention of floating crew of transport and river fleets: guide for physicians. Moscow, Association of Physicians of Maritime and River Transport.
22. Shapovalov KA (1998) Medical and social justification of trauma care floating crew: Dissertation for the degree of Doctor of Medical Sciences / Shapovalov Konstantin Albertovich, Research-and-production Association «Medico-social Studies, Economics and Informatics» of the Ministry of Health of the Russian Federation. Moscow.
23. Shapovalov KA (2005) Systematic approach to injury prevention of floating crew. Zhizn i Bezopasnost 166-178.
24. Shapovalov KA (2017) Traumatism in Operating Crew of Inland Water Transport. Vestnik traumatologii i orthopedii im. Priorova N.N. 76-85.
25. Shapovalov КА (1986) On traumas of the crews on board the North Dvina Basin Company. Man and Vessel of the Year 2000: X Int. Sympos. of Maritime Med. USSR, Riga, Sept. 22-26, 1986: abstr. – Moscow. 101-103.
26. Shapovalov КА (1992) Traumatism with fatal outcome in maritime workers. International Maritime Health 57-60.
27. Shapovalov КА (1991) Treatment of open fractures in seafarers. International Maritime Health 42: 39-41.
28. Shapovalov KA (2007) Contingent of industrial workers: features of a traumatism of floating structure and complex actions for its prevention. Geneva: World Health Organization (Pubrights).
29. Shapovalov КА, Shapovalova LA (2013) Emergency treatment for injuries of floating crew on ships of northern pool. Prehospital and Disaster Medicine: The Official Journal of the World Association for Disaster an Emergency Medicine. 18th World Congress for Disaster and Emergency Medicine, 23-31 May 2013, Manchester, United Kingdom. 28: 7.
30. Shapovalov KA, Shapovalova LA (2017) The Author's Training Program and Methodical Complex “Basics of a Healthy LifeStyle” for the Prevention of Traumatism of Members of Vessel`s Crew. GPC 2017 2nd International Conference on General Practice & Primary Care. Abstracts Ref. No: GPC-ABS-APR-82, Zurich, Switzeland.
31. Shapovalov KA, Shapovalova PK (2017) Medical and Social Consequences of Traumatism of Members of Vessel`s Crew on River Transport Fleet. – Geneva: World Health Organization. Pubrights. 5.
32. Shapovalov КА (2017) Prevention of Occupational Traumatism Among Members of Vessel`s Crew on River Transport Fleet of Northern Water`s Basin as a Form of Preserving Health and Labor Resources. ICME 2017 6th International Conference on Medical & Nursing Education. Abstract Ref. No: ICME_2017_01S24, Vienna, Austria.
33. Shapovalov КА (2013) Traumatism of floating crew of the river fleet. OA Alcohol an OA Publishing London Journal 1: 12. Link: https://goo.gl/wTK9VQ
34. Shapovalov KA (2016) Falls from a height. Risk of suffering a traumatism for crew on vessels of the water basins of the North. Bulletin of the Maritime Institute in Gdańsk 31: 96-100.
35. Shapovalov KA (1987) The role of antialcoholic education of floating crew in reducing injuries: guidelines. Arkhangelsk: Regional organization of the society Knowledge of the RSFSR, Arkhangelsk State Medical Institute, Northern Central Basin Clinical Hospital named after N.A. Semashko.
36. Shapovalov KA (2013) Injuries of floating crew of Northern water pool in a state of alcohol intoxication. International Maritime Health 64: 41-50. Link: https://goo.gl/uX4qGQ
37. Shapovalov КА, Shapovalova LA (2013) Alcohol and injuries: causes and consequences. OA Alcohol (an OA Publishing London Journal 1: 10. Link: https://goo.gl/fgyjLp

© 2018 Shapovalov KA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.