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.

Women seafarers' health and welfare survey.

BACKGROUND: This is a collaborative study from the International Maritime Health Association, International Seafarers' Welfare and Assistance Network, International Transport Workers' Federation and the Seafarers Hospital Society. The aim of the study was to look at the health and welfare needs of women seafarers and how organisations can best make or campaign for improvements to the health information and services available to women seafarers. MATERIALS AND METHODS: A pilot study was conducted in July 2014 and following review of the data and revision of the questionnaire the study was launched in December 2014, running until the middle of March 2015. Results collected from the survey are also supported by qualitative data obtained from two focus groups run during February and March. RESULTS: 595 responses were received from a range of nationalities, ages and positions on board ships. The findings suggest that joint/back pain, stress/depression/anxiety and headache seem to be the most common symptoms reported by women seafarers and that 55% felt that they are related to their work. 48% state that they have problems with seeking medical care and offer suggestions to improve this. Routine wellness checks, nutrition and information on joint and back pain are the main areas that women seafarers stated health screening/services/information would be most useful to improve their health and wellbeing. They suggested this could best be received directly from health professionals, or alternatively by reading leaflets or from online websites/an app. Significantly 37% of women seafarers also stated that they do not have access to sanitary bins within the toilet and 18% say that sexual harassment is an issue. CONCLUSIONS: The responses received highlight a small number of areas where relatively simple and low-cost interventions might improve the health and welfare of women seafarers. Specifically these include the production and appropriate distribution of gender-specific information on back pain, mental health and nutrition in addition to gynaecological complaints, to all women seafarers; the introduction of means for disposing of sanitary waste for all female crew on all ships and the improved availability of female specific products e.g. sanitary products in port shops and welfare centres worldwide. Additional work is needed to investigate these areas more fully and to look at the issue of confidence in medically trained staff, medical confidentiality and sexual harassment. Any further work and interventions will require the support of all of the main stakeholders and we plan a briefing meeting to publicise the findings to date and to identify support for further work in this area.