The Health Assessment Of Submariner In Airtight Working Environment

Background and PurposeSubmarine is a kind of ships which can secretly dive underwater and perform combatmissions. It is an important part of the Chinese Navy. Because of good concealment, it canstrike targets of the enemy on land suddenly and precisely and attack medium and largescalewarships to destroy enemy Forces, so it will play a important role in the futurehigh-tech local wars and safeguarding national marine interests.The working environment in submarine is very complex, presenting with airtight cabin,relatively narrow space, highly centralized place, various kinds of equipment and types ofphysical and chemical harmful factors concurrently existing in the cabin. The majorphysical harmful factors include electromagnetic radiation, noise, vibration, low light, poortemperature and humidity, and low air negative ions; the major chemical factors is harmfulgase coming from non-metallic materials, cooking, metabolites and running machine, suchas carbon monoxide, acrolein, formaldehyde, ammonia, hydrogen sulfide, etc. The reasonof various physical and chemical harmful factors forming is complex, and they are greatharm to physical and mental health of submariner. In addition,when submerging, high-fatand high-protein diet, irregular circadian rhythm larger physical and mental burden andpsychological stress state for a long time are implicated to such condition.It was showed that the airtight working environment, harmful factors, especial dietandinordinate biological rhythmswould bring different degrees of effect on the submariner,causing a variety of diseases, physiological state and indicators change and psychologicaldisoders. The physical and mental health of submariner can directly affect the combateffectiveness of submarine, so it should attach great concerning. However，there are fewerstudies the assessing health state of submariner in airtight working environment. So weenrolled a submarine force as the research object, then collected and evaluated health caringinformation of submariners, such as clinic visit, physical and psychological examination. to provide scientific suggestions and methods for the physical and mental health in submarineforce and finally promote combat power.Materials and Methods1. Research objectsAccording to epidemiological survey method，100submariners in a submarine forcewere randomly included. They were all male, and the average age was28.32±2.18years(19-45years),100people in a onshore force were randomly enrolled. They were all maletoo, and average age was28.12±1.97years (19-46years). The There was no statisticaldifference in average age between two groups.2. Methods2.1Investigation of the health care informationWe carried out a retrospective study, according to the situation about disease treatmentand international classification of diseases to classify. Then selected disease treatment casesin one month before submerging (from the first day forward) and during submerging(calculated from the first day) and one month of onshore personnel (the same time withbefore submerged) for statistical analysis.2.2Evaluation of physiological examinationspecific physical examination of onshore personnel and submariner before and aftersubmergingincluded general check (height, weight, blood pressure), ophthalmology(eye,lens and fundus examination), ECG(normal ECG, abnormal ECG), B-ultrasonic wave(fattyliver, kidney stones), blood analysis(blood routine and blood biochemistry) and urinalysis(U-LEU, URO, U-BIL, etc), then compared with the normal reference value, and comparedsubmariner before submerged with onshore personnel, and submariner before and aftersubmergin2.3Mental health evaluationMental examination on onshore personnel and submariner before and after submergedcontained psychological consulting and interviews; psychological cognitive function basicability test(hidden graphics, addition calculation, choose word matching, spot addition,identifier number); mental scale assessment (SCL-90, FS-14, PSQI scale), then comparedwith military norm, and compared submariner before submerged with onshore personnel,submariner before and after submerged. 3. Statistical methodsThe SPSS17.0software was used for statistical analysis. The main statistic methodsincluded chi-square test, fisher’s accurate test, analysis of variance, t test and Wilcoxonrank sum test, p<0.05was considered statistically significant.Results1. Survey results of the situation about disease treatmentWithin one month before submerging,100submariners consulted28times, the mostfrequent diseases included respiratory, digestive, musculoskeletal conditons and trauma,skin ear-nose-throat disoders, and proportions were32.1%,21.4%,17.9%,14.3%,7.1%,respectively. During one monthssubmerging, clinic visits were39cases. Muscle disease andtrauma proportion was the largest (28.2%), the second was respiratory system diseases(25.6%), the third was digestive system diseases (17.9%), the fourth was skin disease(12.8%), and the fifth was oral diseases (7.7%).2. Physical examination resultsAfter submerged Glu, TG, LDL-C And ALB levels(4.77±0.57mmol/L,2.09±1.52mmol/L,3.02±0.83mmol/L,52.16±1.82g/L)were significantly higher than the value beforesubmerged(4.54±0.40mmol/L,1.40±1.11mmol/L,2.79±0.71mmol/L,51.34±4.48g/L), P<0.05;After submerged HDL-C, UA, Scr levels(1.30±0.22mmol/L,381.36±71.69umol/L,85.71±7.70mmol/L）were significantly lower than the value before submerged (1.34±0.26mmol/L,415.43±74.62umol/L,96.61±8.73mmol/L), p<0.05.3. Mental examination resultsPsychological cognitive function basic ability assessment showed that spot additionafter submerging significantly reduced which compared with before submerging(p<0.05),and less than5; SCL-90survey showed that before submerging anxiety factor scoring ofsubmariner was significantly higher than onshore personnel (p<0.05), compared with beforesubmerging, somatization, depression, anxiety, terror factors were significantly higher aftersubmerging(p<0.05); FS-14survey found that after submerging, mental fatigue score (2.57±0.82) and fatigue total score (6.13±1.06) were significantly higher than beforesubmerging (0.06±0.24,3.42±0.59), p<0.05; PSQI scale survey found that sleep quality,sleep latency, sleep disturbances, daytime dysfunction factor scores and PSQI total scorewere significant difference between before submerged and onshore personnel(p<0.05), compared with before submerged all PSQI factor and total score were significantly higherafter submerged(p<0.05).ConclusionThe submarine airtight working environment is very complex. It can cause thesubmariner various levels of the impact, such as the situation about disease treatmentchanges, and some physiological indexes changes, as well as bring a variety of mentalhealth problems. So we should attach great importance to it, and further research is neededto provide more scientific assessment about physical and mental health of submariner andimprove the submarine combat effectiveness.