Design and evolution of the Seafarer's Health Passport for supporting (tele)-medical assistance to seafarers.

BACKGROUND: Seafarers undergo periodic medical examination for their employment. This information inmost cases is not effectively used when requesting for medical assistance during service on board ships.The medical history of an individual is important for provision of medical care and can be critical to theoutcome. There is growing adoption of digital applications and electronic health records that are addinggreat value to the care provided. The Seafarer's Health Passport (SHP) is an application specifically designedfor improving the quality of medical assistance provided to seafarers both through telemedicineor classic medical check-ups in ports/hospitals worldwide. The SHP provides a secure and unique way toarchive and retrieve the seafarer's medical history in an electronic support. MATERIALS AND METHODS: The SHP that we have developed is a product with specific hardware and softwarespecifications. The basic features of this software are Linux operating system Debian/Ubuntu, ApacheWeb server 2.x, Server database MySQL/Maria DB PHP programming language 5.6.xx, and secure connectionin https. RESULTS: The SHP represents a helpful hint to physicians providing medical advices to seafarers enablingthem to make more decisions that are informed and curtailing possible complications due to misdiagnosis. CONCLUSIONS: Provision of high quality medical assistance requires knowledge of patient's medical history.The availability of an easy access and friendly use system of own medical history is useful for a populationof travellers, such as seafarers to guarantee a reasonable level of medical care at any time.

Food safety on board tankers. Results of analysis from 'Healthy Ship' project.

BACKGROUND: Microbiological monitoring of surfaces used for food preparation, as required by the Hazard Analysis and Critical Control Points (HACCP) plan, is important in risky conditions as those observed in the kitchens of ships. Limits to introduce a classification of risk levels and methods to adopt in conditions as those occurring in tankers have not been investigated. This paper presents the results of the "Healthy Ship" project on HACCP monitoring of surfaces used in food preparation on Italian flag tankers. MATERIALS AND METHODS: Microbiological monitoring was carried out on 19 tankers between 2013 and 2017. Food handlers were also trained on board ship according to HACCP standards. Contact plates (ISO 18593:2004 compliant) were used to determine the colonies and bacterial charge according to the Wirtanen and Salo's method. RESULTS: A total of 1074 samples, 108 before the first course, 168 after the first course, 390 during the period of refresher (2015-2016), and 408 after the refresher training, were obtained from the three main kitchen surfaces: the worktop, cutting board, and kitchen sink. A good level of hygiene was observed in 56.9% of all samples, 0.1% were classified as adequate, and the remaining 43% as poor. The highest contamination was observed on the cutting board and kitchen sink and involved the total aerobic count. The only surface with inadequate levels of hygiene was the worktop. A reduction of contaminated samples was noted after training. CONCLUSIONS: Our results suggest that continuous training should be provided for personnel responsible for handling foodstuffs on board ships.

Recommendations for assessing water quality and safety on board merchant ships.

INTRODUCTION: Health and diseases on board ships may depend on water. Interventions to improve the quality of water may bring to significant benefits to health and water stores/supply and should be controlledto protect health. This paper has reviewed the main regulations for the control of water safety and qualityon board ships and presents some practical recommendations for keeping water healthy and safe in passenger and cargo merchant ships. METHODOLOGY: The main international regulations and guidelines on the topic were analysed. Guidelines forWater Quality on Board Merchant Ships Including Passenger Vessels of Health Protection Agency, World Health Organisation (WHO) Guide to Ship Sanitation, WHO Guidelines for Drinking Water Quality, WHO Water Safety Plan and the United States Center for Disease Control and Prevention Vessel Sanitation Program were examined. Recommendations for passenger and, if available, for cargo ships were collected and compared. Recommended questionnaire: A questionnaire summarising the main information to collect for assessingthe enough quality of water for the purposes it should be used on board is proposed. The need of havinga crew member with water assessment duties on board, trained for performing these activities properlyis discussed. CONCLUSIONS: Water quality on board ships should be monitored routinely. Monitoring should be directedto chemical and microbiological parameters for identifying possible contamination sources, using specifickits by a designed crew member. More detailed periodic assessments should be under the responsibility ofspecialised personnel/laboratories and should be based on sample collection from all tanks and sites of waterdistribution. It is important to select a properly trained crew member on board for monitoring water quality.

The Psychological General Well-Being Index (PGWBI) for assessing stress of seafarers on board merchant ships.

BACKGROUND: In their working activity, seafarers are exposed to high levels of stress that should be accuratelyinvestigated, measured, followed up and, if possible, countered. This is also required by regulations recently entered into force such as the Maritime Labour Convention 2006, recommending to consider special physiological or psychological problems created by the shipboard environment. The choice of the tools for this evaluation is challenging, and a common basic standard usable in a large scale should be identified. AIM: The aim of this study was to evaluate: 1) the suitability of the Psychological General Well-Being Index (PGWBI) questionnaire conducted on board for assessing stress in the sailing seafarers, 2) The presenceof stress in seafarers of different categories (deck officers, engine officers, deck crew, engine crew, chiefstewards/catering staff) monitored by the PGWBI. MATERIALS AND METHODS: 162 male seafarers on board of 7 tankers belonging to the same shipping companywere evaluated through the PGWB questionnaire. Analysis of variance (ANOVA) was used to analyse thedifferences in the scores of the questionnaire. RESULTS: Engine officers exhibited significantly higher anxiety levels than the deck or engine crew, andshowed lower satisfaction than the deck crew. Deck and engine officers revealed higher self-control levelsthan the engine crew. Chief stewards/catering staff showed lower vitality levels than the deck crew. CONCLUSIONS: Deck or engine officers should achieve a greater self-control than the crew and this is documentedby the present study. Our findings support the view that management responsibility is more often associated with higher levels of stress. In our opinion, the PGWB questionnaire is a reasonable compromise forobtaining a global evaluation of psychological conditions, including stress of seafarers. It should be therefore considered as a large scale tool for assessing the well-being and eventual stress levels of sailing seafarers.