Cholelithiasis and fitness for work at sea.

The aim of the present study was to investigate the occurrence of cholelithiasis in the occupationally active population of seamen and deep-sea fishermen aged 20-60, to assess the impact of environmental and dietary factors upon its course and to evaluate the fitness for work at sea of persons with biliary stones. The study group comprised 36 seamen and fishermen who received surgical treatment because of symptoms and complications of cholelithiasis, and 1000 seamen and fishermen periodically examined among whom 34 cases of asymptomatic cholelithiasis were diagnosed. The diagnosis was based on the anamnesis, physical examination and usg examination of the gallbladder and biliary ducts, in selected cases supplemented by other examinations. It was demonstrated that the factors which are concomitant and stimulate the development of biliary stones in seamen and fishermen were obesity and alcoholism. No role of hyperlipidemia and the type of diet in the formation of biliary stones was confirmed. In the group of 36 patients, the indications for the surgical treatment were complications of choletithiasis, i.e. biliary duct stones, mechanical jaundice, acute hydrops or empyema of the gallbladder. They resulted in temporary unfitness for work at sea. Asymptomatic cholelithiasis in seamen and fishermen does not result in unfitness for work at sea and is not an indication for surgical treatment.