{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:44:26Z","timestamp":1760147066942,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,8]],"date-time":"2023-01-08T00:00:00Z","timestamp":1673136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Supervised by three or four medical doctors and one nurse in rotating shifts, the medical clinic in Costa Rica\u2019s Mo\u00edn Container Terminal is open 24\/7 for visits from port workers. In our study, we aimed to identify the sociodemographic and clinical characteristics of a consecutive series of patients who attended the medical clinic for outpatient services during an 8-month period. Our descriptive study involved collecting patient records from the medical clinic during the first 8 months of 2021 (i.e., 1 January\u201331 August 2021), during which 3050 visits from 1301 port workers were registered. Terminal tractor drivers, crane operators, and stevedores were the most frequent job categories among the patients. Doping (i.e., ICD-10 Z03.6) was observed in 64% of the visits. The top ICD-10 codes among all other patients not observed to have engaged in doping (n = 469) were diseases of the musculoskeletal system (7.2%) and abnormal clinical and laboratory symptoms (6.2%). Problems with the musculoskeletal system were primarily back pain (36.0%), muscle contracture (30.1%), and secondary headache (25.2%). Two-thirds of the visits were due to screening for alcohol and drugs or doping; however, inconsistency in the coding system complicates the analysis of data, and a dropdown menu in the registration is therefore needed to prevent errors. Relative risk calculations are impossible due to a lack of data about the at-risk population but should be pursued under different circumstances in future studies. In the support chain of goods, the medical clinic in the port plays a key role in saving time in shipping, which means that the injured or sick employees in most cases can continue working. For the shipping industry, quick un- and offloading is very important to stay competitive in the market for transport.<\/jats:p>","DOI":"10.3390\/ijerph20021124","type":"journal-article","created":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T01:36:17Z","timestamp":1673228177000},"page":"1124","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Port Workers\u2019 Use of Medical Services in a Maritime Container Terminal in Costa Rica"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6441-6625","authenticated-orcid":false,"given":"Alejandro","family":"Mart\u00ednez","sequence":"first","affiliation":[{"name":"Department of Maritime Health, College of Physicians and Surgeons, Sabana Sur, San Jos\u00e9 CP 10109, Costa Rica"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7672-9891","authenticated-orcid":false,"given":"Olaf C.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Centre for Maritime Health and Society, Department of Public Health, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,8]]},"reference":[{"key":"ref_1","unstructured":"(2022, February 01). Who Are Seafarers & Why Do They Matter? Clear Seas. Available online: https:\/\/clearseas.org\/en\/blog\/why-seafarers-matter\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1080\/10803548.2016.1199501","article-title":"Occupational hazards to health of port workers","volume":"23","author":"Wang","year":"2017","journal-title":"Int. J. Occup. Saf. Ergon."},{"key":"ref_3","unstructured":"(2022, September 20). Stevedoring Services and Supervising of Cargo Loading and Unloading. Available online: https:\/\/www.bws.net\/solutions\/expertise\/stevedoring."},{"key":"ref_4","unstructured":"(2022, November 20). Our Terminal\u2014APM Terminals. Available online: https:\/\/www.apmterminals.com\/en\/moin\/about\/our-terminal."},{"key":"ref_5","unstructured":"Dock Worker Job Description (2022, July 29). Recruiting Resources: How to Recruit and Hire Better. Available online: https:\/\/resources.workable.com\/dock-worker-job-description\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.5603\/IMH.2019.0027","article-title":"Dockworkers\u2019 health and safety. A cross-sectional study of self-perceived safety and psychosocial work environment amongst Danish dockworkers","volume":"70","author":"Nielsen","year":"2019","journal-title":"Int. Marit. Health"},{"key":"ref_7","unstructured":"Costa Rica\u2014Data Protection Overview (2022, August 02). DataGuidance. Available online: https:\/\/www.dataguidance.com\/notes\/costa-rica-data-protection-overview."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"805","DOI":"10.3233\/WOR-162249","article-title":"Musculoskeletal disorders and their influence on the quality of life of the dockworker: A cross-sectional study","volume":"53","author":"Schmidt","year":"2016","journal-title":"Work"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Cezar-Vaz, M.R., Bonow, C.A., Xavier, D.M., Vaz, J.C., Cardoso, L.S., de Mello, M.C.V.A., da Costa, V.Z., and Sant\u2019Anna, C.F. (2018). Prevalence of Low Back Pain and Dorsalgia and Associated Factors among Casual Dockworkers. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15102310"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Cezar-Vaz, M.R., Bonow, C.A., da Silva, M.R.S., de Farias, F.L.R., and de Almeida, M.C.V. (2016). The Use of Illegal Drugs and Infectious Contagious Diseases: Knowledge and Intervention among Dockworkers. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13010125"},{"key":"ref_11","first-page":"CD012921","article-title":"Random drug and alcohol testing for preventing injury in workers","volume":"12","author":"Els","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.drugpo.2016.07.010","article-title":"Maritime transportation of illegal drugs from South America","volume":"39","author":"Atkinson","year":"2017","journal-title":"Int. J. Drug Policy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"187","DOI":"10.5603\/IMH.2019.0029","article-title":"How to calculate incidence rates from proportionate data","volume":"70","author":"Jensen","year":"2019","journal-title":"Int. Marit. Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/2\/1124\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:03:35Z","timestamp":1760119415000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/2\/1124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,8]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["ijerph20021124"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20021124","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2023,1,8]]}}}