Managing marine infections in the fishing and aquaculture industry

The purpose of this Safety Alert is to provide guidance in managing infections caused by marine organisms (bacteria) whilst working in the marine fishing and aquaculture industries.

Background

In December 2015, a trap fisherman died from complications arising from staphylococcal sepsis (blood poisoning) two days after returning from a three week fishing trip.  The worker experienced pain and swelling for a week, and kept to his bed for a couple of days before the vessel returned to port.  He had small infections (pustules) on a left hand finger and left foot toe.  On return to port, he presented to Royal Darwin Hospital in a confused state, with fevers, chills, back pain as well as generalised aches and pains.

Common signs and symptoms include fever, increased heart rate, increased breathing rate, and confusion.

Contributing factors

• Likely received small nicks/cuts to his hand and feet whilst working with the traps.
• Breaks in the skin provided an entry point for bacteria to enter the body.
• Lack of knowledge/awareness of potential for serious infection from open wounds.
• Poor management/first aid of skin breaks to reduce risk of infections.
• Professional medical advice was not requested or sought.

Action required

• Ensure workers wear personal protective equipment – (aprons, gloves, gumboots) to guard against nicks, cuts and scratches.
• Provide sufficient information, instruction and training for new workers, including the dangers arising from not managing marine infections effectively.
• Provide information, instruction and training for Skippers to ensure appropriate first aid treatment is provided, and professional medical advice is sought when appropriate.
• Ensure the vessel’s safety management system includes contact details for a medical practitioner.  Some options are :
  • 1800 641 792 – Marine Search and Rescue - if life threatening
  • 1800 022 222 – Health Direct Australia – (National free service).

First aid for marine cuts, nicks and scratches

• Control bleeding, usually accomplished by direct pressure on the wound site.
• Once bleeding is controlled, meticulously clean the wound, through irrigation. Normal saline or clean tap water should be used, do not use sea water.
• Make sure you are generating enough pressure to remove any possible foreign bodies from the wound.
• After thorough irrigation, add an antiseptic to the irrigation solution, such as povidone iodine for a 1% solution concentration.
• If possible, try to leave this antiseptic solution on the affected area for 5 minutes.
• Do not close the wound tightly, as this may allow for bacteria to be closed in the wound.
• You may need to trim some dead skin from around the wound site, using clean scissors or a knife.
• Close with steristrips, and allow some room for potential discharge to drain freely.
• Most people, with competent immune systems, do not need prophylactic antibiotics.
• At any sign of infection, remove the steristrips and allow any discharge to easily drain from the site.
• At signs of infection (redness, swelling, green/yellow discharge) consult with a medical practitioner to enquire whether antibiotics should be started promptly.
• If antibiotics are available, and ensure they are dispensed as directed by the medical practitioner.

Further information

Codes of Practice

• First aid in the workplace

Other guidance material

• Work health and safety handbook – A safety guide for the NT professional seafood industry
• Australian Maritime Safety Authority - Medical Carriage Requirements
• Australian Maritime Safety Authority Factsheet - Are you considering your first aid kit and medical equipment requirements?
• Australian Maritime Safety Authority Factsheet - Carriage of First Aid Supplies on Domestic Commercial Vessels
• Therapeutic Guidelines: Antibiotics Medical Practitioners can seek guidance from pages 400-402