SKIN HEALTH
of fishermen
DERMATOLOGISTS Fred Bernardes Filho Marco Andrey C. Frade Loan Towersey Omar Lupi
contributors DERMATOLOGISTS Fred Bernardes Filho FMRP-USP
Marco Andrey C. Frade
support http://www.fiperj.rj.gov.br/
FMRP-USP
Loan Towersey
Ministério da Saúde
Omar Lupi
UNIRIO, PGRJ e CILAD
EDITORIAL COORDINATION Texto & Cia Comunicação www.textocomunicacao.com.br EDITORS Blanche Amancio MTb 20907 Daniela Antunes MTb 25679 ELECTRONIC EDITING Bruna Zanuto MTb 73044 ILLUSTRATIONS Cover and fisherman on page 8 infographic: Freepik Illustrative images: Fiverr
www.protetoresdapele.org.br
www.santacasadermatoazulay.com.br
www.fmrp.usp.br
sbdfl.com.br
TRANSLATION Fabio Pelegrinelli sbdrj.org.br
www.sbd.org.br
anm.org.br
www.aquariomarinhodorio.com.br
www.cilad.org
SKIN HEALTH
of fishermen In Rio de Janeiro, fishing is responsible for many jobs in coastal communities, in the areas of catching, processing and marketing. Despite the great number of commercial and recreational fishermen, there is little data about injuries and poisoning during the fishing activity. Many of the tropical-water animals in the state of Rio de Janeiro are potentially dangerous. Fishermen and bathers can fall victim to accidents with aquatic animals.
Booklet inspired by the research “Epidemiological profile of skin lesions and poisoning caused by aquatic animals to fishermen of the fishing colonies of Baía da Guanabara, Rio de Janeiro, Brazil”, performed between 2014 and 2016. Thanks to Vidal Haddad Junior, Universidade Estadual Paulista, for material consulted in the elaboration of this work
stay alert Research in the fishing colonies of Baía de Guanabara, between 2014 and 2016, unveiled worrisome data about the health of fishermen: ▪ 82.5 % of interviewed people said they never wore sunscreen to protect their skin. ▪ 79.6 % reported accidents with aquatic animals, fishing equipment or sharp/ pointy objects during the fishing activity. This booklet aims to warn these professionals so that they may adopt the correct measures in order to preserve their health. In many cases, it takes the fisherman a long time to discover some diseases that could have been treated with an early diagnosis. Always seek a dermatologist. Go to a health center. The doctor will evaluate the need for a vaccine or anti-tetanus serum.
first aid
accidents with aquatic animals Popular treatment methods are dangerous and may put your health at risk.
Catfish
Stingray
FISH STING Do not attempt to remove the sting. This must be done at a hospital under local anesthesia and by a doctor. If you have some strong scissors or pliers, try carefully to cut the sting, so as to separate it from the animal. It is necessary to clean the wound. Immerse the affected area in hot water for at least 40 minutes (around 122 ยบF as to avoid burning).
FISH BITE Swordfish is one of the fish that attack by biting. There are others besides it. Lesions are generally traumatic. In case of a bite, it is necessary to clean the wound and the doctor must evaluate the need for stitches. Swordfish
Accidents with mangangรก or stonefish may cause poisoning, leading to fever, nausea and vomit. The stings on the dorsal and pectoral fins are covered by a sheath which protects the poison glands. 18% of interviewed fishermen reported accidents with this fish. Stonefish
There are no poisonous species in Brazil. It is necessary to thoroughly clean the wound. Seek a doctor in case of intense pain or a large wound.
Crustaceans (different crab species)
If there are accidents with these animals in the surroundings, stay alert and don’t enter the water. However, if you fall victim, apply cold sea water or ice bags for around 20 minutes and/or apply vinegar. Never use fresh water, alcohol or urine.
Jellyfish, Portuguese man o’ war, Medusozoa
Sea urchin
In case of sea urchin wounds, remove the stings preferably with tweezers. If there are too many stings, seek a doctor. Warning: some species are poisonous! Immerse the wound in hot water (around 122 ºF) for at least 30 minutes. After removing the stings and the decrease of pain, wash the wound with water and soap so as to avoid infection. A doctor must be sought in order to prescribe a treatment against pain and infection.
careful
pollution causes accidents and serious diseases Garbage can clog manholes and gutters, cause floods and put life at risk. Garbage in the sea or river ends up floating or on the sand of the beach. There is marine litter even on desert beaches. Accidents with sharp materials, abandoned objects at beaches or accidents with marine animals and insects may cause pain, swelling (edema), redness (erythema), fever, headache, increased heart rate (tachycardia), nausea and/or vomit, purple marks (bruises), enlarged lymph nodes (adenopathy), blister and somnolence. What is marine litter? Toys disposed on the beach, flipflops, light bulbs, packages, PET bottles, plastic bags, cigarette butts, leftover fishing material such as lines and nylon nets, and much more! The image on the left shows how long it takes for each material to disappear in the environment. Until it decomposes, it continues to cause harm to the health and nature.
tire
600 years
condom 300 years
cigarette butt
Aluminum can plastic bottle
undetermined
glass
4.000 years
400 years
nylon thread 650 years
styrofoam board 8 years
wooden toothpick
bottle cap 150 years
6 months
paper
3 to 6 months
Careful with fishing hooks, lines, sinkers, glass, nails, wires, wooden or metal skewers, needles. Wounds caused by sharp and pointy objects are dangerous and may transmit many diseases. Seek a doctor.
Did you know that bee and wasp stings are common in mangrove swamps? Protect yourself.
skin cancer
find out what the signs are The main risk factor for skin cancer is the excessive exposure to the sun. Pay attention to skin lesions which may turn into a cancer, such as: red or white areas which may peel or bleed and not heal.
1 2 3
Highlighted: three different but common lesions in patients with skin cancer.
High doses of repeated sun exposure (intermittent) may cause the disease. Furthermore, high sun exposure throughout life is also a risk for skin cancer (cumulative effect). Pay attention to the types of lesions on the areas exposed to the sun: 1 – Rounded-edge lesions 2 – Lesion with wound in the center 3 – Presence of little red vessels
Types of lesions caused by skin cancer Asymmetry
Borders
Color
Diameter
Image D: 6mm diameter corresponds to the tip of a pen Evolution
A - ASYMMETRY Asymmetrical – Malignant Symmetrical - Benign
C - COLOR Two or more shades – Malignant Single shade - Benign
B - BORDER Irregular – Malignant Regular - Benign
D - DIAMETER Larger than 6 mm – Probably malignant Smaller than 6 mm – Probably benign
E - EVOLUTION Grows and changes color – Probably malignant Neither grows nor changes color – Probably benign
Source: Brazilian Society of Dermatology
tips
careful with the sun Strong sun over the skin and high temperatures are factors which harm the skin of fishermen. The skin is sensitive and may develop serious diseases, even for fishermen who spent their entire lives working under the sun without protection. Sunstroke, Dehydration and skin cancer are a risk for people who do not take the necessary precautions. Get information from a doctor about the most appropriate sunscreen for your type of skin. How to apply sunscreen Apply it at least 15 minutes prior to sun exposure Double-layer application rule After usual application, immediately reapply the product Teaspoon rule Use a teaspoon as measurement
Quantity equivalent to 1 shallow teaspoon
Face, head and neck 1 teaspoon Arm and forearm 1 teaspoon Chest and back 2 teaspoons for each side Thigh and leg 2 teaspoons for each side
APPLY MOISTURIZING CREAM ON YOUR SKIN We need around 30-40 mL/Kg/day of water – a 70 Kg person (154 lbs.) must drink from 2.1 to 2.8 L (0.55 to 0.74 Gal) of water. Protect yourself with hats, caps, sunglasses and avoid damp T-shirts under the sun – the water increases the transference of radiation through the fabric. There is already oral photoprotection – caplets that protect against the harming effects of the sun.
There already are clothes which offer photoprotection.