This small story from a recent Morbidity and Mortality Weekly Report (MMWR), the federal government's weekly compilation of case studies and public health advisories, caught my eye: "Fatal and Nonfatal Injuries Involving Fishing Vessel Winches — Southern Shrimp Fleet, United States, 2000–2011."
We in public health—and probably much of the public—tend to think that our field is about large-scale prevention and intervention efforts on behalf of the population's well-being. Think anti-smoking laws and regulations, battles over soda size, and fights over the Affordable Care Act.
But most of what public health does is, in fact, fairly mundane. It thinks about the ways our daily routines can either harm us or make us healthier— in our eating habits or in our jobs, for example—and then finding ways capitalize on that information.
Take the fishing vessel winches.
It is known that the commercial fishing industry has the highest occupational fatality rate in the U.S.—almost 35 times higher than the rate for all workers. From 2000-2009, most deaths in the industry were drownings, but a significant number were caused by injuries that occurred on board. Deck winches, it turns out, are very dangerous. Deckhands get entangled in the winch cable, causing injuries and fatalities.
It also turns out that most of these winch-related fatalities occur in the Gulf of Mexico shrimp fleet. Using data from the Commercial Fishing Incident Database and the U.S Coast Guard database, scientists from the Centers for Disease Control and Prevention analyzed fatal and non-fatal deck winch injuries in the Gulf shrimp fleet. Data showed that different winch parts—the winch drum versus the winch cathead—had different types of risks. The analysis also showed that deaths were associated with being alone on deck or alone on the ship. Loose clothing was also a risk factor for a fatal injury.
So what are health officials and fishing fleets supposed to do with this information?
First, the published study itself is an important component of public health, as it calls attention to an issue that has not been studied. There's only one other published paper on these injuries in the Gulf fleet.
Second, by quantifying the nature of the injuries, the study has given public health officials data they can use to work with the Gulf fleet to improve safety conditions. The article calls attention to the need for further research to "develop and test" new winch safety technologies. It also calls for discouraging crew members "from working alone on deck, and training should include procedures for stopping the winch in an emergency and administering first aid (e.g., tourniquet use and cardiopulmonary resuscitation) for serious injuries such as those requiring amputations."
Third, as these injuries and preventive measures become better understood, it may well turn out that new safety regulations are needed to protect workers in these sometimes dangerous situations.
This is everyday public health at its best.
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