Introduction:
More than 80% of the world's goods are shipped via maritime transportation networks, making seafarers indispensable in the movement of goods and commodities between countries. However, they face unique challenges and hardships compared to their counterparts on land due to their working conditions. This study aimed to assess the frequency of respiratory diseases among sailing seafarers between 2021 and 2023.

Methods:
A retrospective descriptive study was carried out to analyze medical data on respiratory diseases in seafarers between 2021 and 2023 using the Centro Internazionale Radio Medico (C.I.R.M.) database. C.I.R.M. is the Italian Telemedical Maritime Assistance Service (TMAS) Center. In the C.I.R.M. database, diseases are classified according to the WHO International Classification of Diseases 10th revised version (ICD10). The diagnoses were retrieved from the database along with relevant variables.

Results:
During the study period, 1045 contacts were made to the Italian TMAS due to respiratory diseases. Among these contacts, 37% were categorized as upper respiratory infections (URIs), 17.3% as chronic lower respiratory diseases (CLRDs), 16.2% as flu or influenza, and 12.7% as COVID-19. 2.2% of contacts had respiratory failure and 1.2% had chronic obstructive pulmonary disease (COPD). Asthma (53.6%) and the common cold (36.5%) were the most common reasons for consultation among CLRDs and URIs, respectively. The average age of seafarers at the time of contact was 40.5 (standard deviation of 11.9) years. The frequency of respiratory diseases was highest in the age group of 30 – 40-years sailors (42.6%). The occupational groups could be evaluated in 853 out of 1045 contacts. Most seafarers contacting for respiratory disorders were deck crew (30.4%), followed by deck officers (22%). We obtained information on the nationalities of 557 contacts. Most of the seafarers came from Asian and Pacific regions (73.2%), particularly Filipino (54.7%) and Indian (26%). Evaluation of the action taken information was available for 335 contacts. Accordingly, 215 (64.2%) patients were treated onboard, 23 (6.9%) were evacuated by a rescue boat, one (0.3%) individual was evacuated by helicopter, and 11 (3.3%) cases required a vessel diversion. The vessel diversion was due to COVID-19 cases and evacuation by helicopter and a rescue boat were due to respiratory failure.

Conclusions:
This study highlights the importance of addressing respiratory diseases in the maritime industry. By understanding the distribution of respiratory diseases among various occupational groups, targeted interventions can be developed to mitigate occupational risks.