No abstract

Background: A single-handed transatlantic rowing race was organised between Senegal and French Guyana (2600 nautical miles). During the race, rowers adjust their lifestyle to maintain an optimal level of performance. Nutrition, circadian rhythm disturbance, psychological state, pain and other medical problems impact on physical abilities and increase the occurrence of accidents. We surveyed the prevalence of medical complications during this race and the preparation that we could suggest for this kind of activity. Materials and methods: This is a descriptive, retrospective case series study. Follow-up consisted of sending out a questionnaire and performing individual interviews. Results: A total of 23 participants including 1 woman and 22 men; mean age of 46.5 years (range: 35-59) entered the race. The race lasted for 39 to 52 days with participants rowing between 10 and 12 h/day. Nine participants dropped out. Energy intake was 4500 to 6000 kcal/day and fluid intake was 4 to 5.5 L/ /day. Mean weight loss was 13.3 kg. The resting period was 6 ± 1 h/24 h divided into 1.5 to 2 h periods essentially during darkness. A total of 92% of the racers required medical care for dermatological problems; other conditions requiring medical care were: tendinitis in 10 cases, diarrhoea in 4, moderate to severe seasickness in 4, hallucinations in 3, panic attacks in 2, burns in 2, and disembarkation syndrome ("land sickness") lasting from 45 min to 6 h in 13. Conclusions: Physiological and psychological impact of this type of event is still unclear. The most common medical problems are dermatological, rheumatological complications and minor trauma. Medical and psychological preparation should be offered to candidates for these competitions.

Background: The medical kit is the basis of medical support in maritime environment; it is defined by international or national regulations and guidelines. For offshore races, rules and recommendations are proposed by national or international sailing federations. Sailing and racing offshore alone presents specificities that sometimes make it difficult to apply the usual recommendations. The epidemiology of single-handed offshore race is dominated by traumatic risks. Medical events are relatively rare because competitors are high-level athletes, generally young and subject to complete medical assessments. The scarcity of available scientific data makes it necessary to choose appropriate methods for developing recommendations. The purpose of this work is to propose a medical kit adapted and applicable to these situations. Materials and methods: The method used was that of "Professional recommendations by formal consensus of experts" derived from the Rand/UCLA method. After a critical analysis of the literature, a panel of 19 experts having expertise in medicine in maritime environment was gathered from various medical specialties (cardiologist, internist, intensivist and emergency physician, ear-nose-throat physician and general practitioner) and from varied medical activities. They had not declared any direct conflict of interest. Results: A medical kit proposal has been developed. The choice of drugs was based on the analysis of the epidemiology of medical events observed during the last offshore races. The experts' choice was to reduce the quantity of medication and medical devices in order to limit the risk of confusion of medicines and dosages. Drugs with significant side effects or requiring third party monitoring have been removed. Medical devices designed to do an intervention impossible to perform on oneself have also been eliminated. Conclusions: Solo sailing remains a marginal maritime activity with specific risks. The development of single-handed races requires an adaptation of medical support through the development of a specific medical kit and adapted training. The formalised consensus of experts seems to be an appropriate method for developing recommendations in the field of maritime medicine.