1 Introduction to Nautical Medicine.- 1.1 The History of Nautical Medicine.- 1.1.1 A Medical View of the Development of Shipbuilding and.- Navigation.- 1.1.2 Hygiene.- 1.1.2.1 Diet.- 1.1.2.2 Water Supply.- 1.1.2.3 Ventilation.- 1.1.2.4 Cleanliness, Heating and Lighting.- 1.1.2.5 Clothing.- 1.1.3 Quarantine.- 1.1.4 Diseases at Sea.- 1.1.4.1 Scurvy.- 1.1.4.2 Tropical Diseases.- 1.1.4.3 Other Diseases.- 1.1.4.4 Seasickness (Kinetosis).- 1.1.4.5 Venereal Diseases.- References.- 1.2 The Ship's Doctor, Yesterday and Today.- 1.2.1 Greek and Roman Age.- 1.2.2 The Middle Ages and Venice.- 1.2.3 The Age of the Explorers.- 1.2.4 French Naval Medicine.- 1.2.5 British Naval Medicine.- 1.2.6 The Ship's Doctor, the Pharmacist and the Medicine Chest.- 1.2.7 Medical Guides and Famous Ship's Doctors.- 1.2.8 The Ship's Doctor in Recent Decades and Nowadays.- References.- 1.3 The Ship's Medical Centre and Medicine Chest.- 1.3.1 Shipbuilding.- 1.3.2 Number of Crew.- 1.3.3 Vessels Engaged in Deep Sea Voyages.- 1.3.3.1 Passenger Vessels.- 1.3.4 Doctor on Board.- 1.3.4.1 Cruise Ships.- 1.3.4.2 Cargo Ships.- 1.3.5 The Ship's Medicine Chest.- 1.3.5.1 Ships Carrying Dangerous Cargo.- 1.3.5.2 High-Risk Vessels.- 1.3.5.3 Fishing Vessels.- 1.3.5.4 Vessels Solely Engaged in Coastal Regions.- 1.3.5.5 Vessels in Deep Sea Voyages.- 1.3.5.6 Accidents (see also Chapt. 3.2).- 1.3.5.7 Common Cold.- 1.3.5.8 Gonorrhoea and Other Venereal Diseases.- 1.3.5.9 Skin Diseases.- 1.3.5.10 Dental Complaints.- 1.3.5.11 Stomach and Intestinal Complaints.- 1.3.5.12 Diseases of Muscles and Joints.- 1.3.5.13 Eye Trouble.- 1.3.5.14 Kidney and Bladder Complaints.- 1.3.5.15 Mycosis.- 1.3.5.16 Ear Trouble.- 1.3.5.17 Burns.- 1.3.5.18 Lice, Pediculosis.- 1.3.5.19 Constipation.- 1.3.5.20 Haemorrhoids.- 1.3.5.21 Nervous Complaints.- 1.3.5.22 Scabies.- 1.3.5.23 Kinetosis (Seasickness).- 1.3.5.24 Psychosis/Alcoholism (see also 1.3.5.21).- 1.3.5.25 Abscesses.- 1.3.5.26 Hepatitis.- 1.3.5.27 Diabetes.- 1.3.5.28 Miscarriage.- 1.3.5.29 Epilepsy.- 1.3.5.30 Asthma.- 1.3.6 Other Medical Supplies.- 1.3.6.1 Medicines for Diseases of the Heart and Cardiovascular System.- 1.3.6.2 Analgesics.- 1.3.6.3 Antibiotics.- 1.3.6.4 Cortisone.- 1.3.6.5 Infusions.- 1.3.6.6 Disinfectant.- 1.3.6.7 Injection Syringes and Needles.- 1.3.7 Control of Medical Chest.- 1.3.8 Definition of Medicaments.- 1.3.9 Training.- 1.3.9.1 Doctor on Board (see also Chapt. 1.2).- 1.3.9.2 No Doctor on Board (see also Chapt 1 4).- 1.3.10 Medical Locker.- 1.3.11 Radio Advice (see also Chapt. 1.4).- 1.3.12 Conclusion.- References.- 1.4 Medical Care on Ships Without a Doctor - Radio Medical Advice.- 1.4.1 Health Situation on Board.- 1.4.2 Who Performs Medical Treatment on Board?.- 1.4.3 Medical Education of Shipboard Personnel.- 1.4.4 Radio Medical Advice.- 1.4.4.1 The Ship's Side - Medical Emergencies on Board.- 1.4.4.2 The Shoreside - Who Gives Radio Medical Advice?.- 1.4.4.3 Results of Radio Medical Advice.- 1.4.4.4 Conclusion.- References.- 2 The Seafarer's Environment.- 2.1 Work and Recreation at Sea.- 2.1.1 Work Structure and Hazards of the Individual Shipping Branches.- 2.1.2 Occupational Health Conditions of Individual Working Areas.- 2.1.3 Results of the Examinations of the Psycho-physical Load in Crew Members on Board Seagoing Vessels.- 2.1.4 Leisure Time - Hobbies and Games.- 2.1.5 Future Problems of Occupational Health and Physiology.- References.- 2.2 Ship Design - its Effects on the Seafarer's Physical and Mental Health.- 2.2.1 Introduction.- 2.2.2 Work Environment Problems on Ships.- 2.2.2.1 Lighting (see also Chapt. 2.5).- 2.2.2.2 Noise (see also Chapt. 2.6).- 2.2.2.3 Vibration (see also Chapt. 2.6).- 2.2.2.4 Thermal Environment (see also Chapt. 2.4).- 2.2.2.5 Air Pollution.- 2.2.2.6 Accidents and General Work Problems.- 2.2.3 Design for Better Working Conditions.- 2.2.3.1 Examples of Measures.- 2.2.3.2 Project Methodology.- 2.2.3.3 Evaluation.- References.- 2.3 The Effect of the Macroclimate.- 2.3.1 External Climatic Conditions.- 2.3.2 Effects of the Climate on Seafarers.- 2.3.3 Prevention of Harmful Climatic Effects.- References (see Chapt. 2.4).- 2.4 The Microclimate of the Ship.- 2.4.1 The Components of Microclimate.- 2.4.2 Evaluation of Microclimatic Loads on Seafarers.- 2.4.3 Measuring the Microclimate.- 2.4.4 Air Conditioning on Board Ships.- References.- 2.5 The Ship's Lighting.- 2.5.1 Introduction.- 2.5.2 Dimensions of Illumination Units.- 2.5.3 Different Types of Light (Luminous) Source.- 2.5.4 Light Receptors in the Eye.- 2.5.5 Special Points Regarding Illumination on Board Ship.- References.- 2.6 Noise and Vibration Aboard Ship.- 2.6.1 Shipboard Habitability.- 2.6.2 Appraisal of Effects of Exposure to Noise.- 2.6.2.1 Nomenclature.- 2.6.2.2 Risk of Damage to Hearing.- 2.6.2.3 Other Effects.- 2.6.3 Codes on Noise Levels in Ships.- 2.6.3.1 National Norms.- 2.6.3.2 International Code (IMO).- 2.6.4 Noise Control in Ships.- 2.6.4.1 Acoustic Planning.- 2.6.4.2 Ship Noise Sources and Transmission Path.- 2.6.4.3 Elements of Noise Control in Ships.- 2.6.5 Appraisal of Effects of Exposure to Vibration.- 2.6.5.1 Nomenclature.- 2.6.5.2 Whole-Body Vibration Effects.- 2.6.5.3 Evaluation of Human Whole-Body Vibration.- 2.6.6 Codes for Evaluating Shipboard Vibration.- 2.6.7 Vibration Control in Ships.- 2.6.7.1 Design Planning.- 2.6.7.2 Sources of Vibration and Transmission Path.- 2.6.7.3 Elements of Vibration Control.- References.- 2.7 The Ship's Water Supply.- 2.7.1 Introduction.- 2.7.2 Sources of the Ship's Fresh Water.- 2.7.3 Quantitative Problems with the Ship's Water.- 2.7.4 Quality of Fresh Water on Board Ship.- 2.7.5 Water Systems on Ships.- 2.7.6 Disinfection of Water.- 2.7.6.1 Chlorination.- 2.7.6.2 Filtration.- 2.7.6.3 Disinfection with Ultraviolet Light.- 2.7.7 Utilisation and Sanitary Supervision of Water Systems.- 2.7.8 Drinking Water on Lifeboats and Rafts.- References.- 2.8 Waste and Waste-Water Disposal Aboard Ship.- 2.8.1 Introduction.- 2.8.2 Types of Waste and Sewage Systems on Board Ship.- 2.8.3 Requirements of the International Conventions.- 2.8.4 Sanitary Problems of Ballast Water.- 2.8.5 Sewage-Treatment Plants on Ships.- 2.8.6 Sewage-Treatment Facilities in Ports.- 2.8.7 Holding Tanks.- 2.8.8 Solid Waste on Ships.- References.- 2.9 The Seafarer's Food.- 2.9.1 Nutritional Requirements on Board Vessels.- 2.9.2 The Energy Requirement.- 2.9.3 Nutritive Substances.- 2.9.4 Scale of Ship's Provisions.- 2.9.5 Procurement of Provisions.- 2.9.6 Storage of Provisions on Board.- 2.9.7 The Qualification of the Ship's Cook.- 2.9.8 Further Problems of Nutrition on Board.- References.- 2.10 Psychological Problems in Seafaring.- 2.10.1 Introduction.- 2.10.2 Main Psychological Problems and Factors.- 2.10.2.1 Mental Capacities and Selection.- 2.10.2.2 Function and Role.- 2.10.2.3 Watch System.- 2.10.2.4 Social Climate.- 2.10.2.5 "Natural" and "Artificial" Environment.- 2.10.2.6 Safety and Proneness to Accidents.- 2.10.2.7 Communication on Board.- 2.10.2.8 Separation from Society and Family.- 2.10.2.9 Information.- 2.10.2.10 Image.- 2.10.2.11 Teaching and Training.- 2.10.3 Future Aspects.- References.- 2.11 Psychological Aspects of Work-load on Board.- 2.11.1 Recent Studies on Board.- 2.11.2 Psychological Factors of Work-load and their Interaction.- References.- 3 The Pathology of the Seafarer.- 3.1 The Occurrence, Frequency and Aetiology of Diseases and Trauma Among Seamen.- 3.1.1 Factors Which May Affect the Health of Seamen.- 3.1.1.1 Macroclimate, Microclimate and Other Load Factors.- 3.1.1.2 Working Time.- 3.1.1.3 Socio-psychological Factors.- 3.1.1.4 Nutrition.- 3.1.1.5 Other Factors.- 3.1.2 General Characteristics of Diseases in Seamen.- 3.1.3 Calculation of Morbidity Rates Among Seamen.- 3.1.4 Genesis, Frequency and Aetiology of Some Diseases in Seamen (International Classification of Diseases I-XVII).- 3.1.4.1 Infectious and Parasitic Diseases (I).- 3.1.4.2 Neoplasms (II).- 3.1.4.3 Endocrine, Nutritional and Metabolic Diseases (III).- 3.1.4.4 Diseases of the Blood and Blood-Forming Organs (IV).- 3.1.4.5 Mental Disorders (V).- 3.1.4.6 Diseases of the Nervous System and the Sense Organs (VI).- 3.1.4.7 Diseases of the Circulatory System (VII).- 3.1.4.8 Diseases of the Respiratory System (VIII).- 3.1.4.9 Diseases of the Digestive System (IX).- 3.1.4.10 Diseases of the Genito-urinary System (X).- 3.1.4.11 Diseases of the Skin and Subcutaneous Tissue (XII).- 3.1.4.12 Diseases of the Musculoskeletal System (XIII).- 3.1.4.13 Other Groups of Diseases (XIV, XV, XVI, XVII).- References.- 3.2 Accidents in Seafaring.- 3.2.1 Frequency and Aetiology of Accidents.- 3.2.2 Occupational Accidents in Seafaring According to Different Parameters.- 3.2.2.1 Age.- 3.2.2.2 Period of Duty on Board.- 3.2.2.3 Work-places.- 3.2.2.4 Injured Body Parts.- 3.2.2.5 Kinds of Injury.- 3.2.2.6 Number of Sick Days.- 3.2.2.7 Aetiology.- 3.2.2.8 Further Parameters.- 3.2.2.9 Death Due to Occupational Accidents on Board.- 3.2.3 Treatment of Accidents on Board.- 3.2.4 Prevention of Accidents.- References.- 3.3 Gastro-Intestinal Diseases.- 3.3.1 Introduction.- 3.3.2 Oesophageal Disorders.- 3.3.3 Gastritis, Gastric Ulcer and Gastric Carcinoma.- 3.3.4 Duodenal Ulcer.- 3.3.5 Gastro-intestinal Bleeding.- 3.3.6 Diarrhoea.- 3.3.7 Constipation.- 3.3.8 Jaundice.- 3.3.9 Other Infections Causing Liver Disease.- 3.3.10 Biliary Disease.- 3.3.11 Pancreatitis.- 3.3.12 Nutrition.- References.- 3.4 Respiratory Diseases.- 3.4.1 Morbidity.- 3.4.2 Common Cold, Influenza.- 3.4.3 Other Communicable Diseases.- 3.4.4 Asthma and Others.- 3.4.5 Tuberculosis.- References.- 3.5 Musculoskeletal Diseases.- 3.5.1 General Pattern.- 3.5.2 The Knee Joint.- 3.5.3 The Hip Joint.- 3.5.4 The Upper Limbs.- 3.5.5 The Trunk.- 3.5.6 Discussion.- References.- 3.6 Venereal Diseases ("Sexually Transmitted Diseases": STD).- 3.6.1 Introduction.- 3.6.2 Gonorrhoea.- 3.6.3 Non-gonococcal Urethritis (NGU).- 3.6.4 Syphilis.- 3.6.5 Ulcus Molle.- 3.6.6 Lymphogranuloma Inguinale (Venereum).- 3.6.7 Granuloma Inguinale (Donovanosis).- References.- 3.7 Skin Diseases.- 3.7.1 Solar Changes.- 3.7.2 Urticaria.- 3.7.3 Miliaria.- 3.7.4 Hand Eczema.- 3.7.5 Skin Problems on the Feet.- 3.7.6 Some Problems Due to Parasites.- 3.7.7 Tattoos.- 3.7.8 Oil Folliculitis and Acne.- References.- 3.8 Cardiovascular System Diseases.- 3.8.1 Morbidity, Mortality.- 3.8.2 Risk Factors.- 3.8.3 Hypertension.- 3.8.4 Angina pectoris, Myocardial Infarction.- 3.8.5 Preventive Aspects.- References.- 3.9 Urologic Diseases.- 3.9.1 Urinary Tract Stone.- 3.9.2 Urinary Retention.- 3.9.3 Urinary Tract Infection.- 3.9.4 Haematuria.- 3.9.5 Proteinuria.- 3.9.6 Prostatic Disease.- 3.9.7 Urethral Stricture.- 3.9.8 Kidney and Bladder Tumours.- 3.9.9 Renal Tuberculosis.- 3.9.10 Disorders of the Testes.- 3.9.10.1 Undescended Testes.- 3.9.10.2 Torsion of the Testis.- 3.9.11 Medical Standards for Seafarers.- References.- 3.10 Mental Disease.- 3.10.1 Neuroses.- 3.10.1.1 Sexual Neuroses.- 3.10.1.2 Anxiety Neuroses.- 3.10.1.3 Depressive Neurosis.- 3.10.1.4 Hypochondriac Neurosis.- 3.10.1.5 Treatment of Neuroses.- 3.10.2 Functional Psychotic Syndromes.- 3.10.2.1 Delirium.- 3.10.2.2 Obnubilation.- 3.10.2.3 Reactive Psychoses.- 3.10.3 Mental Disorders with an Organic Background.- 3.10.3.1 Cerebral Trauma.- 3.10.3.2 Cerebral Concussion.- 3.10.4 Intoxication and Addiction.- 3.10.4.1 Alcoholism and Alcoholic Psychoses.- 3.10.4.2 Chronic Alcoholism.- 3.10.4.3 Acute Alcohol Intoxication.- 3.10.4.4 Pathological Inebriation.- 3.10.4.5 Acute Alcoholic Hallucinations.- 3.10.4.6 Alcoholic Paranoia.- 3.10.4.7 Narcomania and Drug Dependence.- 3.10.5 Psychoses.- 3.10.5.1 Schizophrenia.- 3.10.5.2 Cyclophrenia.- 3.10.6 Personality Disorders.- 3.10.7 Treatment of a Mentally Ill Crew Members on Board Ship.- References.- 3.11 Other Diseases (Neurological, Ophthalmic, ENT and Other Conditions).- 3.11.1 Neurological Diseases.- 3.11.2 Ophthalmic Diseases.- 3.11.3 Ear, Nose and Throat Diseases.- 3.11.4 Other Pathological Conditions or Disorders.- References.- 3.12 Dental Problems in Seafaring.- 3.12.1 Morbidity.- 3.12.2 Oral and Dental Care.- 3.12.3 Dental Care on Board.- 3.12.4 Dental Problems in Fishery.- 3.12.5 Final Remarks.- References.- 3.13 The Sick Seafarer Ashore.- 3.13.1 The Seamen's Doctor.- 3.13.2 Personal Experiences of Practice at a Port Clinic in the USA.- 3.13.3 Hospital Treatment.- 3.13.4 Repatriation by Air.- 3.13.5 General Recommendations.- References.- 4 Preventive Medicine Aboard.- 4.1 Health Education of the Seafarer.- 4.1.1 Safety and Health Training.- 4.1.2 Organisation and Means.- 4.1.3 Smoking and Alcohol.- 4.1.4 Monotony and Other Psychological Factors.- References.- 4.2 The Seafarer's Personal Hygiene.- 4.2.1 Life Situation on Board.- 4.2.2 The Impact of Climate.- 4.2.3 Clothing.- 4.2.4 Sleep and Rest.- 4.2.5 Smoking.- 4.2.6 Physical Exercise.- 4.2.7 The Interior of the Cabin.- References.- 4.3 Food Hygiene Aboard Ship.- 4.3.1 Introduction.- 4.3.2 Epidemiology.- 4.3.3 Food Handling and Food Handlers.- 4.3.4 Delivery of Food to the Ship.- 4.3.5 Galley Design.- 4.3.6 Ice-Making and Milk-Making Machines.- 4.3.7 Refrigerated Stores.- 4.3.8 Unrefrigerated Stores.- References.- 4.4 Alcohol, Drugs and Smoking in Seafaring.- 4.4.1 Alcohol.- 4.4.2 Drugs.- 4.4.3 Smoking.- References.- 4.5 Infectious Diseases - Vaccination and Passive Immunization.- 4.5.1 Infectious Diseases.- 4.5.2 Vaccination and Passive Immunization.- 4.5.2.1 Vaccination Against Smallpox.- 4.5.2.2 Vaccination Against Yellow Fever.- 4.5.2.3 Vaccination Against Cholera.- 4.5.2.4 Typhoid Vaccination.- 4.5.2.5 Vaccination Against Poliomyelitis.- 4.5.2.6 Other Vaccinations.- 4.5.2.7 Passive Immunization with Normal Immunoglobulin.- 4.5.2.8 Passive Immunization with Specific Immunoglobulins.- References.- 4.6 DDD - Disinfection, Disinfestation and Deratting.- 4.6.1 Disinfection.- 4.6.1.1 Specific Targets of Disinfection.- 4.6.1.2 The Ship.- 4.6.1.3 Conclusion.- 4.6.2 Disinfestation.- 4.6.2.1 Transmission of Disease.- 4.6.2.2 The Hold.- 4.6.2.3 In-transit Fumigation.- 4.6.2.4 Fumigation of Holds in Port.- 4.6.2.5 Containers.- 4.6.2.6 Conclusion.- 4.6.3 Deratting.- 4.6.3.1 Prevention of Rats.- 4.6.3.2 Searching for Rats.- 4.6.3.3 Control of Rats.- 4.6.3.4 Conclusion.- References.- 4.7 International Health Regulations.- 4.7.1 Part I - Definitions.- 4.7.2 Part II - Notification and Epidemiological Information.- 4.7.3 Part III - Health Organisation.- 4.7.4 Part IV - Health Measures and Procedure.- 4.7.5 Part V - Special Provisions Relating to Each of the Diseases.- Subject to the Regulations.- 4.7.5.1 Plague.- 4.7.5.2 Cholera.- 4.7.5.3 Yellow Fever.- 4.7.6 Part VI - Health Documents.- 4.7.7 Part VII - Charges.- 4.7.8 Part VIII - Various Provisions.- 4.7.9 Part IX - Final Provisions.- References.- 5 Special Fields in Nautical Medicine.- 5.1 Health Standards - Fitness for Duty at Sea.- 5.1.1 Differences in Regulations Concerning Specific Disorders.- 5.1.1.1 Diabetes.- 5.1.1.2 Cardiovascular Disease.- 5.1.1.3 Peptic Ulcers.- 5.1.1.4 Epilepsy.- 5.1.2 Conclusion.- References.- 5.2 Toxicology in Seafaring - Dangerous Goods.- 5.2.1 Definitions and Criteria of Hazard.- 5.2.2 Shipping Conditions and Toxic Effects of Dangerous Goods.- 5.2.3 Kinds of Toxic Effects of Dangerous Goods; Principal Clinical Syndromes.- 5.2.4 Medical First Aid and Treatment of Poisoning.- 5.2.5 Means for Prevention of Poisoning.- References.- 5.3 Health Problems on Tankships Carrying Oil, Gas or Bulk Chemicals.- 5.3.1 Introduction.- 5.3.2 Hazards in Petroleum and Gas Carriers.- 5.3.2.1 Oxygen Deficiency.- 5.3.2.2 Toxic Effects of Hydrocarbons.- 5.3.2.3 Toxic Effects of Hydrogen Sulphide (H2S) (Sulphuretted Hydrogen).- 5.3.2.4 Toxic Effects of Carbon Dioxide (CO2).- 5.3.2.5 Toxic Effects of Organic Lead Compounds.- 5.3.2.6 Toxic Effects of Sodium Hydroxide (Caustic, Caustic Soda).- 5.3.2.7 Working on Petroleum Tankships.- 5.3.3 Chemical Carriers.- 5.3.4 Occupational Hygiene Considerations.- References.- 5.4 The Fishing Fleet.- 5.4.1 Medical Standards.- 5.4.2 Accidents.- 5.4.3 General Medical Problems.- 5.4.4 Diseases Specific to Fishermen.- 5.4.4.1 Salt Water Boils.- 5.4.4.2 Dogger Bank Itch or Curly Weed Rash.- 5.4.4.3 Fish Erysipeloid.- 5.4.4.4 Haddock Rash.- 5.4.4.5 Acute Tenosynovitis of the Wrist (Jumbo Wrist).- 5.4.4.6 Fishermen's Conjunctivitis.- 5.4.4.7 Poisonous Stings.- 5.4.5 Medical Training.- 5.4.6 International Standards of Medical Care.- References.- 5.5 The Female Seafarer.- 5.5.1 Introduction.- 5.5.2 Females and the Ship's Community.- 5.5.3 Health Problems.- 5.5.3.1 Merchant Marine.- 5.5.3.2 Fishing Vessels.- 5.5.4 Medical Provisions.- 5.5.5 Standards of Fitness.- 5.5.6 The Future.- References.- 5.6 The Child at Sea.- 5.6.1 Introduction.- 5.6.2 Children on Board: The Present Situation.- 5.6.3 Children on Board: Health Problems.- 5.6.4 The Future.- 5.6.4.1 Minimum Age.- 5.6.4.2 Health Certificate.- 5.6.4.3 Family Apartments.- 5.6.4.4 Contents of the Medicine Chest.- 5.6.4.5 Insurance.- References.- 5.7 Health Care of Passengers.- 5.7.1 Introduction.- 5 7 2 Immunization.- 5.7.3 Passenger Facilities.- 5.7.4 Gastro-intestinal Problems.- 5.7.5 Cardiovascular Disorders.- 5.7.6 Respiratory Disorders.- 5.7.7 Mental Illness.- 5.7.8 Alcoholism.- 5.7.9 Genito-urinary Problems.- 5.7.10 Seasickness (Kinetosis).- 5.7.11 Sunburn.- 5.7.12 Physical Handicap.- 5.7.13 Miscellaneous.- 5.7.14 Medical Services.- References.- 5.8 The Sea Pilot.- 5.8.1 Introduction.- 5.8.2 The Pilotage Operation.- 5.8.3 The Health of the Sea Pilots.- 5.8.4 Prevention and Control of Occupational Ill Health.- 5.8.4.1 Work Practices.- 5.8.4.2 Pilot Health Monitoring.- 5.8.5 Conclusions.- References.- 5.9 Extreme Conditions Aboard Ship.- 5.9.1 Shipwreck.- 5.9.2 Extreme Length of Working Hours Without Rest.- 5.9.3 Extreme Stress or Responsibility.- 5.9.4 Extremes of Temperature Aboard Ship.- 5.9.4.1 Extremes of Cold (see also Chapt. 5.10).- 5.9.4.2 Extremes of Heat (see also Chapt. 2.4).- References.- 5.10 Search and Rescue Medicine - Survival at Sea.- 5.10.1 The Human Body.- 5.10.2 Hypothermia.- 510.3 Man Overboard.- 5.10.4 Distress Signals.- 5.10.5 Rescue.- 5.10.6 Treatment of Hypothermia.- 5.10.7 Motion Sickness.- 5.10.8 Water.- References.- 5.11 Life-Saving Appliances.- 5.11.1 Individual Life-Saving Appliances (Life-jackets).- 5.11.2 Cold Protection.- 5.11.3 Collective Life-Saving Appliances.- References.- 5.12 Offshore Medicine.- 5.12.1 The Medics.- 5.12.2 Back-Up Services.- 5.12.3 Medical Facilities.- 5.12.4 Special Problems.- 5.12.4.1 Hydrogen Sulphide.- 5.12.4.2 Methane.- 5.12.4.3 Methanol.- 5.12.4.4 Ethylene Glycol.- 5.12.4.5 Drilling Mud.- 5.12.4.6 Noise.- 5.12.4.7 Psychological Disturbances.- 5.12.4.8 Diving.- 5.12.4.9 Summary.- References.- 5.13 Underwater Medicine and Diving.- 5.13.1 Introduction.- 5.13.2 Diving.- 5.13.2.1 Means and Methods of Diving.- 5.13.2.2 Types of Underwater Work.- 5.13.2.3 Diving Equipment.- 5.13.2.4 Diving Suits.- 5.13.2.5 Logistics/Surface Support.- 5.13.2.6 Pathways to the Deep.- 5.13.2.7 Working in the Deep.- 5.13.3 The Diver.- 5.13.3.1 Skin and Sports Divers.- 5.13.3.2 Professional Divers.- 5.13.3.3 Diver Health Certificate.- 5.13.4 Diving Medicine.- 5.13.4.1 Definition.- 5.13.4.2 Scope of Diving Medicine.- 5.13.4.3 Necessity of Diving Medicine.- 5.13.4.4 General Tasks of Physicians in Diving Medicine.- 5.13.5 Living and Working Underwater.- 5.13.5.1 The Effects on Humans.- 5.13.5.2 Working from Diving Bells, from Underwater Habitats and in Caissons.- 5.13.5.3 Supervision of Divers Underwater.- 5.13.6 Accidents, Sickness Underwater and Rescue.- 5.13.6.1 Accidents.- 5.13.6.2 Rescue.- 5.13.6.3 Decompression Sickness and Its Symptoms.- 5.13.6.4 Therapeutic Recompression.- 5.13.6.5 Internal Medical and Surgical Treatment Under High Pressure.- 5.13.6.6 Possible Problems in Medical Treatment in Diving.- 5.13.7 Frequent Diseases in Diving.- 5.13.8 Prevention of Diving Accidents.- 5.13.9 Future Trends in Modern Diving and Diving Medicine.- 5.13.9.1 Diving Medicine.- 5.13.9.2 Diving Technology.- References.- 5.14 Forensic Nautical Medicine.- 5.14.1 Forensic Medicine.- 5.14.2 Forensic Nautical Medicine.- 5.14.3 Forensic Medical Examination and Evaluation of Fatalities in Seafaring.- 5.14.4 Identification in the Realm of Forensic Nautical Medicine.- 5.14.5 Evaluation of Crimes in Connection with Alcoholic Influence.- References.- Sources of Information.
