Health Inequality among Fishery Workers during Climate Change: A National Population-Based and Retrospective Longitudinal Cohort Study

Abstract

Background: Owing to specific working environments, it is important to attain sustainable development goals for the health of fishery workers during climate change. Fishery workers have a hazardous working environment, leading to specific injuries and fatal events. However, limited studies have investigated the health status of fishery workers through long-term longitudinal follow-up and compared it with that of farmers and employed workers with similar socioeconomic status. Methods: The Longitudinal Health Insurance Database 2000, a subset of the Taiwan National Health Insurance Research Database was used for this retrospective cohort study. Only fishery workers, farmers, and employed workers were included. Based on the majority of causes of death and related diseases, participants newly diagnosed with 18 diseases, classified into cardiometabolic diseases, mental illness, chronic kidney disease, infection, and malignancy, were included. Participants with an old diagnosis of these diseases were excluded. All included participants were followed up from 1 July 2000 to the diagnosis and withdrawal date, or 31 December 2012, whichever occurred first. Due to the substantial difference in the baseline demographics, we executed a cohort study with propensity score-matched and applied the Cox model to explore the participants’ health status. Results: After matching, there were negligible differences in the baseline demographics of fishery workers, farmers, and employed workers. Compared to farmers and employed workers, fishery workers were more frequently diagnosed with 11 and 14 diseases, respectively, such as hypertension (hazard ratio [HR]: 1.11, p < 0.01), diabetes (HR: 1.21, p < 0.001), dyslipidemia (HR: 1.18, p < 0.001), depression (HR: 1.38, p < 0.001), peptic ulcer (HR: 1.17, p < 0.001), chronic viral hepatitis (HR: 2.06, p < 0.001), hepatocellular carcinoma (HR: 1.67, p < 0.001), and total malignancy (HR: 1.26, p < 0.001). Conclusions: Compared to farmers and employed workers, fishery workers were more impacted by cardiometabolic diseases, mental illness, infection, and malignancy. Therefore, it is imperative to specifically focus on health policies for fishery workers, such as providing curable antiviral treatment and initiating culture-tailored health promotion programs, to mitigate health inequality.

The prevalence of chronic dehydration and associated with cardiometabolic risks among agriculture and aquaculture workers

“…The present study indicated a high prevalence of cardiometabolic risk factors and metabolic syndrome. These findings echo those of a representative previous survey from nationwide samples that both farmers and fishery workers were more affected by cardiometabolic diseases (32). Due to an increasingly aging society, older adult people tend to have a higher risk of stroke morbidity and mortality.…”

“…The risk factors for chronic dehydration include older age, long-term care residents, cognitive impairment, female, and use of diuretics (21,23,30). In the county of Yunlin, the proportion of older people (>65 years) ranks 3 rd among 22 counties in Taiwan with most people working in farms and fisheries; both occupations were more impacted by cardiometabolic diseases (31,32). Older adults are prone to developing dehydration with immobility, impaired thirst, and cardiometabolic diseases.…”

Health Complaints, Mental Status and Quality of Life among the Aquaculture Workers: A Cross-Sectional Study in Northern Region of Peninsular Malaysia

“…The current research showed that only self-esteem was likely to have an inverse relationship with QoL. Previous findings highlighted the detrimental effects of physical and mental problems towards overall well-being in aquaculture workers [ 22 , 31 , 33 , 34 ], particularly psychological distress and mental illness. Research suggested that implementing psychiatric interventions could improve self-esteem [ 56 ].…”

Syndemics of the sea: Adverse disease interactions and the stressors of fisher livelihoods

“…Similarly, the fatal accident rate among British fishers is 115 times greater than that of the general working population of the UK (Pougnet et al, 2013). In Taiwan, where 130,000 households, with approximately 340,000 people, are engaged in the fishery industry, Lin et al (2022) found that compared to farmers and employed workers, fishery workers were more frequently diagnosed with numerous diseases, including hypertension, diabetes, dyslipidemia, depression, peptic ulcer, chronic viral hepatitis, hepatocellular carcinoma, and total malignancy. The health of fishers in Taiwan is further threatened by the replacement of the domestic fishery industrial labor force by migrant fishing workers (Tseng et al, 2023).…”