Medical training of seafarers: International Maritime Health Foundation (IMHF) Expert Panel Consensus Statement.

BACKGROUND: Medical emergencies and on-going medical conditions on board may seriously impair seafarers' health and safety, and also negatively impact on future work prospects for seafarers. When a seafarer gets ill or injured on a ship, medical treatment often relies on the competences on his colleagues on board. The aim of this project was to establish a consensus-based minimum standard for medical education for seafarers, in order to ensure competency for adequate management of ill-health on board. MATERIALS AND METHODS: International Maritime Health Foundation (IMHF) conducted a workshop on medical training of seafarers. A research-based approach to gain consensus on core learning outcomes/competences developed by the Tuning Project, has been used. This method was used by Tuning (Medicine) to gain consensus on core learning outcomes for primary medical degrees (Master of Medicine) across Europe. RESULTS: The result of the project is a set of learning outcomes/competences in medical training for merchant seafarers. CONCLUSIONS: The project resulted in a set of learning outcomes/competences on medical training of the seafarers that will be submitted to the relevant bodies of International Maritime Organization (IMO) in the process of the development of model courses 1.13, 1.14 and 1.15.

Establishment of the International Maritime Health Foundation: the next step in scientific publishing in maritime health.

The Bulletin of the Institute of Maritime and Tropical Medicine (IMTM) was published first time in 1948 as a preliminary publication. Since then it has developed and from 1999 it is known as International Maritime Health (IMH). Initially it was published by the Institute of Maritime and Tropical Medicine (IMTM) in Gdynia. From 2009 it was published by the Polish Society of Maritime, Tropical and Travel Medicine (PSMTTM) in cooperation with the International Maritime Health Association (IMHA) and the Norwegian Centre for Maritime Medicine (NCMM), later the Norwegian Centre for Maritime and Diving Medicine (NCMDM) at the Department of Occupational Medicine, Haukeland University Hospital, Bergen. After a couple of years of planning and discussions on how to take the journal forward, the International Maritime Health Foundation (IMHF) was established under Polish Law, 21st June 2018. This article discusses the process from the very beginning of the journal, until the establishment of the IMHF as well as the foundation's objectives and way forward.

A Medical Support in Offshore Racing - Workshop on Medical Kit Inventory in Offshore Yacht Racing, 12-13 May 2017, Lorient, France.

No abstract.

Decision aid for the use of additional tests during the pre-employment medical examination (PEME) of seafarers.

No laboratory tests and imaging techniques are recommended for routine use in the ILO/IMO Guidelines on the Pre-Employment Medical Examination (PEME) of Seafarers that form the basis for statutory certification. However, they are widely used as components of the PEME protocols developed by insurers, employers and national maritime authorities in an attempt to predict and reduce the risks from illness whilst working at sea. This may be justified on scientific, safety, economic or professional grounds. We propose a rational approach for deciding if and when tests can be justified for routine use in assessing a seafarer's fitness for work at sea. This is based on well-established methods for determining the validity of screening tests in public health as well as the seafarer demographics. We do not address the well-established use of similar tests where illness is suspected but only when they are used for routine PEME screening of all seafarers.

Standards for quality assurance of pre-employment medical examinations of seafarers: the IMHA Quality experience.

Standards to assess the quality of doctors and clinics performing pre-employment medical examinations (PEMEs) were developed for International Maritime Health Association (IMHA) Quality, a not for profit organisation, created to provide an ethically sound and professional accepted accreditation system that would benefit seafarers having PEMEs and employers, insurers and national maritime authorities seeking valid assessments of seafarers' fitness for duty. These standards followed a format widely used in other healthcare settings, where assessment of clinical performance is desirable. Uptake of these standards by doctors and clinics was not as expected, as they did not see sufficient business benefits coming from accreditation to justify the costs. This was, at least in part, because there was some antagonism to a professionally based accreditation system from commercial interest groups such as insurers, while national maritime authorities did not come forward to use the system as a recommendation or requirement for approval of doctors. The IMHA Quality accreditation system has now been closed and for this reason we are making the standards publicly available. Those who helped to develop them hope that doctors and clinics will now use them as a means of improving the quality of their practice when performing PEME.

Loss of health certificates among offshore petroleum workers on the Norwegian Continental Shelf 2002-2010.

BACKGROUND: A health certificate is required to work on the offshore petroleum installations of the Norwegian Shelf. Loss of health certificate (loss of licence, LOL) may cause economic problems for the individual worker. A private compensation system (OSO) was established for Norwegian offshore workers in 2002, comprising 8000-11,000 individual members of workers organisations: approximately one third of the population offshore. This study aims at describing the reasons for compensation of offshore workers who have lost their certificates. MATERIALS AND METHODS: Of 595 workers who applied for compensation in the period 2002-2010, 38 declined to participate in the study. Of the remaining 557, 507 were granted and 50 were denied compensation. All medical records held by the scheme concerning the 507 compensated applicants were examined. Health data were systematically extracted, analysed, and compared with general population statistics. RESULTS: Musculoskeletal conditions were the most frequent conditions causing LOL for both sexes (42.5%), followed by psychiatric, neurological, and malignant diseases for women, and cardiovascular (19%), neurological, and psychiatric conditions for men. Musculoskeletal disorders were more prevalent than in the general population, and the prevalence of knee problems was particularly high. Among malignant diseases we found a high proportion of brain tumours and renal cancer. The causes are unknown and warrant further investigation in this population. Among women granted compensation, 78% were catering workers, while 50% of the men were process workers, reflecting the gender distribution in these working groups. CONCLUSIONS: Musculoskeletal conditions were the most frequent cause of application for LOL compensation for both sexes, followed by psychiatric, neurological, and malignant diseases for women, and cardiovascular, neurological, and psychiatric conditions for men. The cause of the higher incidence of musculoskeletal diseases, brain tumours, and renal cancer found in this study compared to the general population warrants further investigation.

Crew accidents reported during 3 years on a cruise ship.

STUDY OBJECTIVE: To register and analyze data from all crew injuries reported to the medical center of a cruise ship with a median crew of 630 during a three-year period and to determine high risk areas, equipment and behavior. METHODS: All crew injuries reported to the medical center aboard were registered on a standardized form at first visit. An injury was classified at follow-up as 'lost time accident' (LTA) if it caused the victim to be off work for more than one day and/or to be signed off for medical attention (medical sign-off). RESULTS: During 3 years, 361 injuries (23% women) were reported aboard. Thirty percent were LTA. The marine department accounted for 14% (deck 5%; engine 9%), the hotel'department for 79% and contractors for 7% of the reports. Filipinos comprised half the crew, reported 35% of the accidents, and their rate of serious injuries were lower than non-Filipino crew (p<0.01). Hotel crew had a higher rate of LTA occurring during work than marine crew (p<0.05). The dancers' rate of serious injuries was higher than other hotel crew (p<0.05) and marine crew (p<0.01). The upper extremity was the most frequently injured body part (51%), open wounds the most common injury type (37%), and galleys the most common accident location (30%). Less than one in ten reported injuries caused medical sign-off. KEY MESSAGE: Well-equipped, competent medical staff aboard can after crew injury effectively reduce time off work, as well as number of referrals to medical specialists ashore, helicopter evacuations and ship diversions, and medical sign-off.