Study finds health risks, care gaps for Down East fishermen

A clam harvester digs in the mud off the shore of Freeport. Again injuries are among the most frequent problems for shellfish harvesters, according to an approaching study. Picture by Annie Ropeik/The Maine Watch

A soon-to-be-produced examine from the College of Maine at Machias finds that Down East clammers and lobstermen facial area steep obstacles to health care access, in spite of larger dangers of occupation-relevant injuries and other health concerns that can often lead to substance use issues.

Tora Johnson, the direct writer and an associate professor, claimed the study is one of the 1st of its sort to aim on Down East Maine, where by fisheries are major economic motorists.

“It’s rather clear from the success below that harvesters are battling to address suffering, and they encounter a large amount of it, and they get nominal enable from the overall health care sector in treating that discomfort properly,” she claimed. “And so it is very apparent that we will need some new solutions.”

The research, now staying drafted for publication, analyzed surveys and interviews with 83 shellfish harvesters and lobstermen, as nicely as wellness care vendors, in Washington and Hancock counties in 2022.

It represents a small portion of the fishermen operating in these counties, which have the most energetic professional harvesters across all species in the condition. In 2021, there ended up close to 2,000 fishermen in Washington County and 1,700 in Hancock County, which has fallen from the top rated place in the past 5 several years, in accordance to condition data. The vast vast majority fish for lobster, with softshell clams a distant next.

Johnson, who co-chairs the Environmental and Organic Sciences division at UMaine-Machias, claimed her examine was finished on a pilot scale that provides a design for long term, much larger investigation assignments.

Most harvesters the workforce surveyed documented sustaining an harm while fishing in the previous calendar year. In particular common had been back again, neck, shoulder, arm and hand accidents, which could consist of frostbite, cuts and abrasions, or difficulties from falls or repetitive motions.

But as a single respondent reported, “unless it’s sticking out or incredibly, really bloody, we perform by way of it.” Some harvesters mentioned they would stitch up their individual accidents in the discipline, or use duct tape as a makeshift bandage. Self-prescribed relaxation or exercising were widespread treatment options.

Less than one-3rd of harvesters surveyed reported they frequented a healthcare practitioner or received a prescription to handle on-the-position injuries. And 70{e538325c9cf657983df5f7d849dafd1e35f75768f2b9bd53b354eb0ae408bb3c} of the harvesters described actively steering clear of the physician, primarily since of superior expenses or a deficiency of totally free time.

Instead, lots of respondents explained they relied on Tylenol or other about-the-counter soreness medicines, which 19{e538325c9cf657983df5f7d849dafd1e35f75768f2b9bd53b354eb0ae408bb3c} documented taking “most times.” Self-medication with alcoholic beverages was also anecdotally common. Around a quarter of harvesters claimed self-medicating with marijuana, opioids or other medicine, and researchers say this is probable an underestimate.

Specific varieties of injuries depended on the fishery, Johnson said. Lobstermen appeared extra at chance of falls and injuries from hefty equipment on their vessels, or could get damage by rope or spiny bait.

Clammers tended to experience from frostbite or neuropathy, which results in pain and tingling in the extremities. They could harm their backs or legs trudging via deep mud, carrying major masses and commonly bending around, or reduce by themselves on shells or other debris in the mud when hand-digging for clams without the need of gloves, risking harmful infections without appropriate cure.

‘TIP OF AN ICEBERG’

Johnson stated fishers’ large risk of damage can make a slippery slope to addiction, comorbidities or accidental overdoses, all prevalent themes in anecdotes relayed by participants. “Not every single harvester finishes up in those forms of straits,” she stated, but their work put them at increased risk.

“We also discovered a lot of aggravation, sadness, anguish, damaged marriages, individual bankruptcy, homelessness,” Johnson stated. “The overdose(s) and the fatalities that have been greatly noted are the tip of an iceberg.”

Clammers left footprints in a tidal mudflat off Freeport. Shellfish harvesters confront substantial threats of accidents that normally go untreated, in accordance to a forthcoming examine. Image by Annie Ropeik/The Maine Watch

Johnson famous that the review doesn’t make in depth conclusions about how prevalent distinct well being issues are among fishermen. In its place, it offers a sample of activities, showing broad areas where by variations in public wellbeing methods could assistance.

Those improvements could include things like delivering wound kits to fishermen, increasing to start with-support materials or cellular health units on operating waterfronts, or deploying neighborhood health employees or navigators to help wounded fishermen accessibility appropriate therapies.

Programs to help harvesters obtain insurance policy at lessen charges, in particular previously in their occupations, could also enable. Members in the study reported that it’s typical for harvesters to go with out coverage for the reason that of substantial prices.

Johnson programs to get business feedback on her exploration at the Maine Fishermen’s Discussion board in early March at Rockport. She hopes to get the job done with condition officials and advocacy teams on prospective injuries prevention plans, insurance coverage reforms and other new methods.

A BARRIER TO SUSTAINABILITY

The study focuses on strategies health care vendors can do extra to assistance fishermen relatively than placing the onus on fishermen on their own. She saw a will need for cultural competency education to aid medical practitioners superior converse with fishermen and satisfy them on their personal terms.

“Some suppliers ended up definitely on it, and they realized to prepare hrs all-around the tides and they knew by no means to say to harvesters, ‘just relaxation,’ ” Johnson explained. “But some of them were being, like, truly hostile and indignant and belligerent about harvesters who didn’t adhere to their assistance – and their tips generally was, ‘just never fish.’ And they really do not recognize that what they are expressing is, ‘just really don’t feed your loved ones.’ ”

Injury and addiction are not the only threats putting stress on Maine shellfish harvesters and their health and fitness. In the softshell clam fishery, harvesters encounter rising issue accessing land routes to clamming grounds as new house entrepreneurs purchase up far more of the shoreline. This can direct to more time walks to harvesting regions, or pressure clammers to come into the mudflats by boat, which signifies they might have to keep out in the components more time to follow the tide cycle.

All of these improvements, Johnson explained, produce a lot more possibilities for harm and fewer time for treatment. What’s more, as The Maine Observe reported in late January, the clam fishery is underneath heavy pressure from weather alter, as warming waters cause a increase in populations of clam-eating environmentally friendly crabs.

Johnson sees health and fitness struggles as a barrier to getting care of these fisheries in other critical ways. Clammers who just cannot find the money for professional medical treatment or begin to battle with addiction may possibly be fewer capable to make investments in or experiment with new harvesting procedures that, investigation claims, may be needed to make the sector sustainable.

This story was initially published by The Maine Monitor, a nonprofit and nonpartisan information business. To get normal protection from the Monitor, sign up for a cost-free Observe newsletter below.