Fishing communities globally continue to face poor health and safety outcomes, driving the expansion of fisheries occupational health and safety (OHS) interventions. However, narrowly focused OHS interventions that neglect the social and structural determinants of health may have unintended consequences. We illustrate this problem through a case study from the UK where a recent OHS intervention, the introduction of compulsory medical certificates to all commercial fishers, led to unforeseen negative impacts. Through analysis of data from interviews, focus groups and a participatory workshop in Cornwall, UK, we highlight three key findings. First, while seeking to improve safety at sea, the regulatory change actually had negative consequences for fishers' health, their access to healthcare and potentially even their safety. Second, a mismatch between the requirements of the regulation and fishers' lived experience undermined the efforts of health promotion and outreach activities. Third, a failure to account for the implications for different sectors of the fleet has contributed to mistrust that may have ramifications for future fisheries governance activity. Our research brings to the fore important implications for the design of OHS regimes in fisheries. These include the broadening of OHS approaches to consider fishers' wider health and well‐being; engagement of fishers in the development and implementation of OHS interventions to account for their lived experiences of health and safety at sea and better integrate their knowledge; support for bottom‐up fisher‐led initiatives aimed at managing health and safety at sea; and improved coordination between agencies responsible for different areas of fisheries governance.

中文翻译：

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渔业健康和安全干预措施的意外后果


全球渔业社区继续面临不良的健康和安全结果，推动了渔业职业健康和安全（OHS）干预措施的扩大。然而，忽视健康的社会和结构决定因素的狭隘职业健康与安全干预措施可能会产生意想不到的后果。我们通过英国的一个案例研究来说明这个问题，英国最近的一项职业健康与安全干预措施，即向所有商业渔民引入强制性医疗证书，导致了不可预见的负面影响。通过对采访、焦点小组和英国康沃尔郡参与式研讨会的数据进行分析，我们强调了三个关键发现。首先，在寻求提高海上安全的同时，监管变化实际上对渔民的健康、他们获得医疗保健的机会、甚至可能对他们的安全产生了负面影响。其次，法规要求与渔民生活经验不匹配，影响了健康促进和外展活动的效果。第三，未能考虑对船队不同部门的影响导致了不信任，这可能会对未来的渔业治理活动产生影响。我们的研究对渔业职业健康安全制度的设计具有重要意义。其中包括扩大职业健康与安全方法，考虑渔民更广泛的健康和福祉；让渔民参与职业健康与安全干预措施的制定和实施，以考虑他们在海上健康和安全的生活经验，并更好地整合他们的知识；支持由自下而上的渔民主导的旨在管理海上健康和安全的举措；改善负责不同渔业治理领域的机构之间的协调。