JtJLY, 1954] LUNG DISEASES AMONG SEAMEN : MALLIK 397

Original Articles

INCIDENCE OF LUNG DISEASES AMONG

SEAMEN EXAMINED AT THE FORT

OF CALCUTTA IN 1952

By A. Iv. MALLIK, m.b.b.s., d.p.h..

Medical Officer, Seamen's Medical Examination

Organisation, Port oj Calcutta

(Under the guidance oj S. C. SEAL, m.b.b.s., d.p.h.,

Ph.D., f.a.p.h.a., Professor oj Epidemiology, All India

Institute oj Hygiene and Puclic Health, Calcutta)

In a previous communication (Mallick, 1953) the results of health examination of 10034

Indian seamen who presented themselves for re-

employment at the port of Calcutta during 1953 "Were reported. In this communication the inci-

dence of lung diseases among the existing and

prospective seamen examined medically during 1952 is described.

During 1952, 11042 existing seamen, aged between 18 and 74 years, who performed voyages prior to 1.4.50, and 1648 candidates aged 18-30 years seeking employment as seamen (prospec- tive seamen) were medically examined for

fitness to undertake jobs in ocean-going ships on international traffic. The existing seamen were ratings who had served previously in the three departments of the ships viz., Deck, Engine or Saloon after being declared fit by the Medical Officers of the shipping lines.. Any candidate in whom catarrhal signs or any abnormal sounds

were detected in the lungs on clinical examina- tion was declared to have clinically unhealthy lungs and was advised further investigation by X-ray, differential blood count, erythrocytic sedimentation rate, examination of sputum for

acid-fast bacilli etc. at the Chest Department of the Medical College Hospital under the Professor of Medicine (Tuberculosis) or at the Tubercu-

losis Relief Association, Calcutta. Only clinical

diagnosis confirmed by these institutions was

accepted for the purpose of reporting. The inci- dences of lung diseases among the existing seamen are given in Table I.

Out of 11042 existing seamen 616 or 5.8 per- cent were clinically suspected to have unhealthy lungs. After X-ray and other investigations 201

of them were returned as free from pathologi- cal lesions and 178 did not turn up till the end

of May, 1953. In the remaining 237 seamen the distribution of lung diseases per 1000 were as follows : Tuberculosis of lungs?5.8, chronic

bronchitis?8.2, eosinophilic lung?4.3, chronic

pleurisy (dry)?1.7 and other lung affections--

1.5. It is presumed that serious lung diseases were detected in 178 seamen which prevented them from appearing again to obtain

" certifi-

cate of fitness " for sea service lest they might be rejected permanently.* Thus the total un-

healthy lungs among these existing seamen were 37.6 per 1000. On the same assumption the

minimum incidence of tuberculosis diseases was

10.1 (5.8-j-4.3, calculated figure for the obsen-

tees with unhealthy lungs) per 1000 seamen or

roughly 1 percent. In all these diseases, as will be seen from Table I, the incidence increased

with age.

Lung conditions by occupation of the Ratings

The distribution of lung diseases among the three types of ratings namely, Deck, Engine, and Saloon, according to age groups, is given in Table II.

The three ratings arranged in order of fre-

quency of total unhealthy lungs are Saloou, Engine and Deck respectively. The same ol'der

of distribution was noted in regard to tuber-

culosis, chronic bronchitis and clinical unhealthy lungs. Only in case of eosinophilic lungs and other lung complaints the incidences were higher among the Engine ratings than among the Saloon or Deck ratings. The incidences of total lung diseases increased with age in case of Engine and Saloon ratings but in case of Deck ratings the incidence dropped slightly in the age groups 40-50. This drop was apparently due to the less incidence of tuberculosis and eosinophilic lungs and clinical unhealthy lungs in the particular age group and was not due to the difference in the

distribution of population in different age groups as seen in Table III.

Lung conditions among the prospective seaman

Of the 1648 new applicants between 18-30

* This presumption is based on the fact that the

specialists' report was obtainable at a concession, rate

and even the money was advanced or given as a gift from the " poor box fund" to tiibstt wli6 werfcf inmbtte to dofp&y thid small expfcase.

398

THE

INDIAN

MEDICAL

GAZETTE

[JULY,

1954

Seamen

Table I

Incidence of lung diseases among 11043 existing and 1648 prospective seamen by age groups examined at the Port of Calcutta during 1952.

Chronic Eosinophilic Chronic Pleurisy Chronic Bronchial Bronchie- Clinically Total unheal-

T.B. Bronchitis lung plurisy (dry) with effusion emphysema asthma ctasis unhealthy lung thy lungs Unclassified

Age- Popu- Nu- Rate Nu- Rate Nu- Rate Nu- Rate Nu- Rate Nu- Rate Nu- Rate Nu- Rate Nu- Rate Nu- Rate

groups lation mber per mbar per mber per mbar per mbar per- mbar per mber per mber par mber per mber per

years mille mille mille mille mille mille mille mille mille mille

18?30 423 1 2.4 .. .. 1 2.4 .. .. 1 2.11 3 7.1

?40 2744 7 2.6 15 5.6 4 1.5 4 1.5 29 10.6 59 21.50

Existing ?50 4639 25 5.4 27 5.8 22 4.7 8 1.7 .. .. 1 0.2 3 0.6 1 0.2 62 13.4 149 32.1

?60 2885 26 9.0 41 14.2 17 5.9 6 2.1 1 0.3 4 1.4 4 1.4 1 0.3 76 26.3 176 61.0

60-f- 351 5 14.2 7 19.9 3 8.6 1 2.8 .. .. 1 2.8 1 2.8 .. .. 10 28.5 28 79.8

18+ 11042 64 5.80 90 8.2 47 4.3 19 1.7 1 0.09 6 0.5 8 0.7 2 0.2 178, 16.1 415 37.6

Prospective 18?30 1648 4 2.4 1 .60 2 1.2 1 .6 .. 11 6.7 19 11.5

No subject for examination

-July, 1954] LUNG DISEASES AMONG SEAMEN : MALLIK 399

Table II

Incidence of lung diseases among seamen at the

Port of Calcutta (1952) by nature of their employment

Other lung Clinical unhe- Total, T.B. Chron. Rrono. Eosin. lung complaints althy lung* healthylung

No. Rate No. Rate No. Rate No. Rate No. Rate No. Rate

o/OO o/OO o/OO o/OO o/OOO o/OO

DECK

Age groups Populatior

18?30 163 1 6.1 .. . 1 6.1 .... .. .. 2 12.3 ?40 <W> 5 5.1 7 7.1 1 1.0 .... 12 12.1 25 25.3 ?50 1724 4 2.3 7 7.1 7 4.1 1 0.6 15 8.7 24 19.7 ?60 964 3 3.1 10 10.4 5 5.2 5 5.2 24 24.9 47 48.7

60+ 110 2 18.2 1 9.1 2 18.2 2 18.2 2 18.2 9 81.8

18+ 3950 15 3.8 25 6.3 16 4.0 8 2.0 53 13.4 117 29.6

ENGINE

Age groups Population

18?30 107 ?10 966 1 1.0 4 4.1 3 3.1 2 2.1 5 5.2 15 15.5 ?50 2236 14 6.3 13 5.8 13 5.8 10 4.5 35 15.6 85 38.0 ?60 1392 14 10.1 21 15.1 9 6.5 9 6.5 38 27.3 91 65.4 60-f 141 2 14.2 4 28.4 .. .. .. .. 5 35.5 11 78.0

18 + 4842 31 6.4 42 8.7 25 5.2 21 4.3 83 17.1 202 41.7

SALOON

Age groups Population

18?30 153 .. .. .. .. .. .... 1 6.5 1 6.5 ?40 789 1 1.3 4 5.1 .. .. 2 2.5 12 ? 15.2 19 24.1 ?50 679 7 10.3 7 10.3 2 2.9 2 2.9 12 17.7 30 44.2 ?60 529 9 17.0 10 18.9 3 . 5.7 2 3.8 14 26.5 38 71.8

60+ 100 1 10.0 2 20.0 1 10.0 1 10.0 3 30.0 8 80.0

18+ 2250 18 8.0 23 10.2 6 2.7 7 3.1 42 18.7 96 42.7

?This refers to cases who were clinically diagnosed to have some defects in the lung but did not finally turn with the specialist's report.

Table III

Distribution of existing seamen by age groups and types of service

Age groups DECK ENGINE SALOON ALL SERVICES

<k

Number Percentage Number Percentage Number Percentage Number Percentage

18?30 163 4.1 107 22. 153 6.80 423 3.8

?10 989 25.0 966 20.0 789 35.1 2744 24.9

?50 1724 43.6 2236 46.2 679 30.2 4639 42.0

?60 964 34.40 1392 28.7 529 23.5 2885 26.1

60+ 110 2.8 141 2.9 100 4.4 351 3.2

18+ 3950 99.99 4842 100.00 2250 100.00 11024 100.00

400 THE INDIAN. MEDICAL GAZETTE [July, 1^54

years of age 27 were clinically suspected of

having some pathological condition in the lungs and were sent for further investigation. Of them

8 were returned healthy, 11 did not turn up and 8 (4.9 per 1000) were found to have some sort

of lung disease including tuberculosis which was detected in 4 of them. The total unhealthy lungs- including the eleven applicants who did

not turn up for the certificate of fitness comes

to 11.5 per 1000.

Summary and comments

Lung diseases including clinically unhealthy lungs among the existing seamen applying for

re-qmployment at the Calcutta Port in 1952

caused a morbidity rate of approximately 3.76

percent. This seems to be fairly high, al.hough in the absence of any corresponding records of

morbidity rate among the general population it

is difficult to say whether this rate is higher than that in the general population. Since these

ratings were declared medically fit by the

medical officers of the different shipping lines

before they undertook any voyage it may be

assumed that they contracted these lung, infec- tions during their sea service which included

some sea voyage as well as stay at home for

some months each year between the voyages.

Taking the diseases separately the incidence of eosinophilic lungs also appears to be high, because it is as yet not so commonly reported among the general population. On the other

hand, the incidence of tuberculosis disease, being approximately 1.0 per cent is not so high compared with the estimated rates in the general population of Bengal namely, \ to 1 per cen^

in the rural areas, 1 to 2 percent in semi-rural

areas, 2 to 4 percent in the urban areas and 5 to

8 percent in special industrialised areas. Among the three ratings the incidence of tuberculosis

disease among the Saloon ratings was higher than those obtained for the Engine and Deck

ratings. It may be mentioned in this connec-

tion that most of the Saloon ratings came from the two towns?Calcutta and Dacca, whereas the Engine and. the Deck ratings generally came from the rural areas. It is now proposed to

follow their health conditions as they turn up for re-examination every three years from the

date of recruitment.

REFERENCE

Mallick, A. K% (1953) , . ...Indian Med. .Gcls.,. 88,- 373.