Background

Fishing is a well-known industry, and there are certain risks of work-related diseases and accidents, occupational hazards and safety issues. Depending on the types of operation, fishermen may be vulnerable to major injuries and occupational hazards, which significantly impact public health. Work-related health risks are attributed to almost 2.78 million deaths worldwide. In developing countries, between 20% and 50% of the workforce is exposed to health risks.¹ According to the International Labor Organization (ILO), due to its vulnerability, the fishing sector has one of the highest mortality rates in the workplace; and in most cases, when a death occurs at sea, there is no emergency care.^2,3 Due to the numerous hazards and health risks recorded from the ancient occupation, the fishing industry is reported to be one of the most dangerous occupations with about 120 million accidents and 200 000 fatalities annually at global level.^4,5 In the developed countries, reports have revealed that countries that accounted for fisheries-related accidents, often show rates higher than 100 fatalities per 100 000 active fishers.⁶

In 2007, substandtial work on Fishing Convention was adopted during the 96th International Labour Conference of ILO. The convention demands that fishers should have acceptable working conditions on boarding fishing vessels related to basic standards, including work health & safety protection, health care, and social security. The Convention entered into force on 16 November 2017. As of 23 March 2020, 18 states have ratified the convention, including Senegal, Gambia’s only neighbor.⁶ Generally, fisheries play an imperative role in the attainment of the post-2015 United Nations Sustainable Development Goals (SDGs) 1, 2, and 3: poverty mitigation, end starvation, and ensuring healthy lives, respectively as the fish is a source of food and helps the body with essential nutrient for growth.⁷ For the past 40 years, the international community including ILO, Food and Agricultural Organization (FAO), and the International Maritime Organization (IMO), have fisheries accidents and fatalities reporting part of their agenda. However, many countries still lack an effective reporting, injury and fatalities analysis system.⁶ FAO estimates that more than 15 million people are aboard vessel employed⁸ and amended its global estimate for the number of fatalities in the fisheries in 2019 to 32 000 casualties yearly. Worldwide, the number of fishing casualties increased from around 30 million to 40 million between 2000 and 2016 and this was the basis for the amendment.⁶

Common hazards and injuries reported in the fisheries industry include swelling of the eye, sunburns, falls, mechanical, and electrical accidents, etc. Furthermore, noise-induced loss, allergic respiratory conditions and work-related stress issues are predicted to substantially increase over some time without any organized and effective interventions.^4,9 Studies in Africa have reported cuts from sharp knives, eye redness, as well as pricks from fish spines as part of injuries and hazards. In Ghana, ocular disorders among the fisherfolk as a result of smoke and sun rays have been reported.¹ Another study in India reveals that the fisherfolk do not utilize medical services and are reluctant to recuperate and recover from injuries sustained.¹⁰ Some of the distressing factors for fisher folks include exposure to cold, wind, rough seas, substantial involvement of physical effort, frequency of injuries during work, noise, inadequate hygiene, unexpected threats, failure with equipment, and psychological stress and economic stress pressure.^3,11 Slips, trips, falls, and exposure to loud noises are major physical dangers in handling facilities, while chemical mishaps, solvents, vapors, fumes, and unburned hydrocarbons are common chemical hazards.³ Occupational dangers are produced by mechanical factors influencing the musculoskeletal system, whereas biological hazards are caused by parasite infection, bacteria or viruses, or injuries from animals such as shark or crocodile bites.³ Fatal accidents constitute an inherent and unsolved problem among fishermen.¹² Fish processing is a series of events that spans the entire process of handling fish and fish products, from harvesting through customer delivery.¹³

The Gambia’s industrial fisheries growth has been slow. Industrial fisheries produce only 10% of the total fish consumed in the country and 20% of the fish processed locally.¹⁴ Most fishing vessels lawfully operating in Gambian waters are foreign-owned and land their catch abroad.¹⁴ In The Gambia, a good percentage of the fish consumed comes from captured fisheries. The traditional fishing subsector employs between 25 000 and 30 000 people, while about 2,000 people enjoy the industrial sector employment. Beyond this, an estimated 200 000 people have their livelihoods dependent on fisheries and fisheries-related activities.¹⁴ Artisanal fishing in the Gambia uses small boats, primarily canoes, that ply the sea and rivers.¹⁵ Between 1997 and 2003, artisanal catches averaged 29 000 tons per year, with pelagic making up about 70% of the landings. Artisanal fishing employs between 25 000 and 30 000 people directly and indirectly, with 80% occurring along the Atlantic coast and 20% along the Gambia River.¹⁵ Industrial fishing is smaller than artisanal fishing and generates 1500 to 2000 employment. Nevertheless, fishing and related activities support close to 200 000 people.¹⁵

Lack of data on occupational risks and fatalities associated with fish processing in Tanji and other coastal fishing areas in The Gambia. Fishers are exposed to health hazards and injuries both on and offshore. While fishing activities are known to attract high occupational fatality rates, the lack of specific information, especially on non-fatal injuries, has contributed to the serious under-reporting of the hazards and injuries registered among the fisherfolk. Hence, a better understanding of the working environment, the injuries and hazards are necessary to create solution-specific safety campaigns and interventions. This aimed at examining the determinants of occupational hazards and injuries among fishermen at Tanji fishing site, a major fish-landing site in the Gambia, West Africa.

Methods

Sample size

A sample size of 240 was estimated using Cochran’s formula with a work-related accident annual incidence of 82.6%,¹⁸ z of 1.96 for 95% confidence level, and sampling error at 5%. However, the researchers adjusted the final sample size to 240 fishermen.

Results

The study recruited 240 fishermen in the coastal communities of Tanji with a 100% response rate.

Characterization of Fishermen in Tanji Coastal Fishing Community, Gambia

The mean age of fishermen was 39 years with a standard deviation of ±9. Majority of the fishermen (42%) were 35 years old and below. More than half of the participants spent 11 to 25 years as Fishermen with a mean years of 20 and SD of ±9. Six in every ten fishermen (60%) were reported as Non-Gambian nationals. About 84% were married, and 33% of the fishermen had never been to school. Sixty percent of the fishermen were smokers, and 71% reported spending more than 5 hours fishing per day with mean hours of 6 and SD ± 2. The mean number of years using the current boat was 5 with an SD of ±3, as shown in Table 1. Planked canoe with outboard engine formed the majority in terms of types of fishing boats used by 94%, and about 41% of the participants played the role of captain/skipper during fishing.

Table 1.

Characteristics of study participants in Tanji, Gambia.

The proportion of occupational hazards were 95%, while reported injuries were 85%, respectively, as shown in Figure 1. In terms of types of occupational hazards reported across fishermen, ergonomics, physical and environmental/climatic hazards formed the majority at 25%, 23%, and 21%, respectively, as shown in Figure 2.

Figure 1.

Showing prevalence of any form of hazards and injuries among fishermen in Tanji.

Figure 2.

Showing Types of hazards reported among fishermen in Tanji.

Muscle trains and falling were reported as the two most common types of injuries at 19% and 17%, respectively, as shown in Figure 3.

Figure 3.

Showing Types of injuries sustained by fishermen in Tanji.

Characterization of occupational hazards and injuries among Fishermen in Tanji, Gambia

The proportion of occupational hazards was higher among planked canoes with outboard engine and low in paddle and drug-out canoe (P = .05), physical hazards (P =< .001), chemical hazards (P = .003), psychological hazards (P < .001), ergonomics (P < .001), environmental/climatic hazards (P < .001) and respiratory conditions (P = .021). In terms of injuries reported, some significant independent variables include smoking status (p = .02), physical hazards (P = .05), chemical hazards (P = .004), use of PPE (P = .009), and having no fishing safety rules for the vessel (P = .006), as shown in Table 2.

Table 2.

Occupational hazards and injuries characteristics of fishermen in Tanji, Gambia.

Determinants of occupational hazards and injuries among Fishermen

Fishermen using PPE were 88% (adjusted Risk Ratio (aRR): 0.12, 95% CI: 0.01-0.99) less likely to have hazards relative to those who do not use PPE, as shown in Table 3. The area under the ROC curve of 97.5% for the preferred model with at least 95.8% accuracy rate indicates the model’s favorable sensitivity and specificity characteristics, as shown in Figure 4. It also indicates a good predictive potential of the fitted model to predict occupational hazards across fishermen in Tanji.

Table 3.

Adjusted risk ratios for reported occupational hazards among Fishermen in Tanji, Gambia.

Figure 4.

Showing area under receiver operating (ROC) curve (AUROC) of binary logistic models for predicting occupational hazards.

As shown in Table 4, smokers’ fishermen were 3.18 times (aRR: 3.18, 95% CI: 1.32-7.66) were more likely to have sustained injuries relative to non-smokers. Participants with chemical hazards were 3.14 times (aRR): 3.14, 95% CI: 1.26-7.86) more likely to sustain injuries relative to those without chemical hazards. Fishermen with no fishing safety rules were 2.81 times (aRR: 2.81, 95% CI: 1.15-6.85) more likely to sustain injuries relative to those who do not have fishing safety rules. The area under the ROC curve of 76% for the preferred model with at least 86.7% accuracy rate indicates the model’s favorable sensitivity and specificity characteristics, as shown in Figure 5. It also indicates a good predictive potential of the fitted model to predict occupational injuries across fishermen in Tanji.

Table 4.

Adjusted risk ratios for reported injuries among Fishermen in Tanji.

Figure 5.

Showing area under receiver operating (ROC) curve (AUROC) of binary logistic models for predicting occupational injuries.

Discussion

This study was meant to explore the characteristics and determinants of occupational hazards and injuries among coastal fishermen in one of the busiest fishing site in the Gambia. The study findings showed that a higher proportion of fishermen were non-Gambians, similar to a study done in Vietnam where the majority were immigrants from South Vietnam.¹⁹ Male fishermen predominate fish harvests because it is perceived as a more risky endeavor held by men.²⁰ The average age and working experience of fishermen in the Gambia were 39 and 20 years, respectively. This is slightly below the reported mean age for fisherfolk in Brazil at 46 years, with a proportion of males at 94.8% and less the reported mean age of 48 years reported by Camara et al.^21,22 This could be attributed to the fact that fishing is on-the-job training in the Gambia and requires physical and manual strength to perform it. The younger the fisherfolk, the greater the likelihood that they may face workplace hazards and injuries. In Ethiopia, a study found that employees with more work experience had a sixfold increased likelihood of being aware of hazards compared to those with less experienced.²³ Due to their lack of experience, younger workers tend to exaggerate their physical abilities or underestimate the hazards and risks associated with their work.²⁴ One likely interpretation is that those who have worked for a more extended period may have developed superior knowledge and abilities regarding the equipment and tools in use and have become accustomed to the work environment. Additionally, they may be exposed to various safety training programs, which may increase their awareness.

The majority never attained formal education training and are found to be active smokers of unknown content. Most currently used boats were planked canoe with outboard engine, with 5.2-year-old on average and spent 6 or more hours on fishing services in the sea. These findings were supported by a study done in Morocco where the prevalence of tobacco smoking was 69.9%, with almost three-quarters had consumed more than 10 pack-years.²⁵ In The Gambia, just like other African countries, physically demanding jobs like fishing are considered for mostly school dropouts as their means for survival. The possible reason fishermen smoke could be due to harsh environmental conditions such as cold weather at sea.

The findings from this study revealed an extremely high proportion of occupational hazards and reported injuries to be 95% and 85%, respectively. Major occupational hazards observed during the study include ergonomics, physical and environment/climate hazards, and muscle strain and falling were the common injuries reported. However, bruises, cut and lacerations, slip and falls, and stings from the fish spine were also reported. Furthermore, the roles that fishermen played exposed them to a variety of occupational hazards and risks.^26,27 The findings revealed that high proportions of hazards were observed among planked canoes with outboard engines and extremely low among dug-out canoes with outboard engines and paddle ones. Higher proportions of hazards within the fishing workspace were found relative to all-hazard categories (Physical, chemical, psychological, ergonomics, and environmental/climate) and respiratory conditions. In terms of injuries reported, findings revealed the outcome of injuries to be common among active smokers, workspace with prevailing physical and chemical hazards, non-active users of PPEs and vessel crew with fragile fishing safety rules and procedures. Pocock et al.²⁸ reported slightly different findings, stating that common accidents and injuries included severed limbs, injuries from ropes, winches, and jagged fish bones, as well as exposure to noxious fumes from the fish storage area and men inadvertently falling off the boat. The reason for the association between the above variables could be attributed to the irregular use of PPEs to protect themselves and has the potential to accelerate the incidence of workplace hazards, injuries, and accidents. Most of the fishermen believed that the use of PPEs could be strengthened by enforcing existing rules and creating awareness through health education and promotion. The boat’s poor design and maintenance conditions put them at risk of accident during operations, and the benefit of having safety rules for their vessels would reduce the rate of workplace incidences.

In this study, only 3.3% of fishers at the Tanji fishing site have completed secondary levels of education. These findings contrast with research conducted in Ghana, which revealed low educational attainment among fishing communities, despite the majority having completed basic and secondary school.²⁶ Almost a third of the participants in this study had never attended school. These findings corroborate research conducted in Botswana, where more than half of fishermen lacked any level of schooling.²⁹ This is due to the low technological level and skill required in local fishing, which does not necessitate an advanced education. Individuals gain awareness through education; thus, the lower the level of education among fishermen, the greater the likelihood of encountering workplace risks and hazards.^30,31

The study further reveals that the likelihood of fishermen to experience occupational workspace hazards decreased significantly by 88% among proper PPE users relative to non-PPE users. Workspace injury outcome among active smokers was observed 3.18 times more likely to occur compared to non-smokers. Chemical hazard was a significant outcome among all the other hazards categories observed. Therefore, fishermen’s exposure to this hazard increased their risk of injury 3.14 times compared to their exposure to other hazards. It was also observed that the injury outcome was determined by the presence or absence of safety rules. Fishing workspace with safety rules predisposed fishermen 2.81 times more likely to sustain injury relative to those without safety rules and procedures within their workspace.

Workers’ hazard understanding and exposures were linked with the existence of occupational safety laws in this and other research.³² It is clear that adequate implementation of occupational safety laws can monitor workers’ behavior and ensure that they follow safety protocols. This effectively mitigates safety culture bottlenecks and increases worker awareness of workplace hazards when properly integrated with other safety programs.

Strength and Limitation

This is among the few studies done in Gambia to assess the prevalence and determinants of OSH hazards and injuries among fishermen in local context. This study established merely a relationship, not causality. Social desirability bias is a major downside of self-reported surveys such as this one, as individuals may report more socially approved answers than their true day-to-day conduct. Since this is a cross-sectional study, the limitations inherent in this methodology must be taken into account when interpreting the results.

Conclusion

This study revealed that the prevalence of OSH hazards and injuries among fishermen was high. This would mean that there is a dire need to formulate and strengthen safety measures and trainings that are adaptable to local context as significant proportion of the fishermen have never been to school and others with only primary education. Programs aimed at increasing worker knowledge of occupational hazards and injuries should concentrate on issues such as safety training, safety promotion, and implementation of relevant workplace safety regulations.