Telemedical maritime assistance over three decades in Denmark.

INTRODUCTION: Seafaring is associated with higher occupational hazards and health risks than shore-based work. Telemedical maritime assistance services (TMAS) provide remote specialist medical support to seafarers. In Denmark, a unified national TMAS, Radio Medical Denmark (RMD), was established in 1995. This study aimed to describe the 30-year development and clinical activity of the RMD. METHODS: This was a single-centre retrospective cohort study of all consultations provided by the RMD from 1 September 1995 to 31 December 2024. Data were extracted from annual reports based on original medical files, with organisational information from contracts and guidelines. No identifiable patient data were collected. RESULTS: The RMD assisted 49,999 seafarers over 30 years, with annual consultations increasing from 240 in 1995 to 4,829 in 2024. The proportion requiring disembarkation or evacuation declined from >10% at the outset to approximately 5% today. The most common diagnoses were musculoskeletal (18.8%), dermatological (14.6%) and abdominal (11.5%). Since 2014, the proportion of Danish seafarers decreased from 38% to 15.1%, while Indian and Filipino seafarers increased substantially. Merchant vessels accounted for 55.7% of contacts, predominantly in the North Sea. CONCLUSIONS: RMD has evolved into one of Europe's largest public TMAS providers. Centralisation within an academic emergency department, combined with structured training and research, has supported sustained growth, improved decision-making and reduced evacuation rates. FUNDING: None. TRIAL REGISTRATION: Not relevant.