Seafarers are required under the MLC 2006 and STCW Conventions to undergo medical examinations and hold a medical certificate. The ILO/IMO medical examination Guidelines aim to ensure protection of seafarer rights and the environment, safety of life and property, and that medical certificates “provide maritime administrations with an internationally recognised set of criteria for use by competent authorities… and to help administrations establish criteria that will lead to equitable decisions about who can safely and effectively perform their routine and emergency duties at sea”. Ultimately, the aim of the Guidelines is to contribute to health and safety at sea. Under the new ILO/IMO guidelines on the medical examination of seafarers, a medical certificate issued will meet the requirements of the amended IMO STCW Convention and the ILO MLC, 2006.
A quick explanation of the Guidelines: Part 1 summarises the purpose and scope and identifies the main features of a framework for medical examinations and the issue of a medical certificate to a seafarer. Part 2 provides information relevant to competent authorities to assist with framing of national regulations that will be compatible with relevant international instruments on the health and fitness of seafarers. Part 3 provides information relevant to those who are carrying out seafarer medical assessments. Part 4 includes appendices on standards for different types of impairing conditions, recordkeeping and the contents of the medical certificate. It is suggested that the whole of the Guidelines be taken into consideration to ensure that all topics and information are taken into account, to ensure consistency.
A brief history of the Guidelines: In 1997, the ILO and WHO published the first international guidelines concerning the medical examinations of seafarers, which provided detailed information on the conduct of seafarer medical examinations. However, they did not- with the exception of vision- assist by proposing the appropriate criteria to be used when deciding whether a medical certificate could be issued for other conditions.
Since 1997 there have been important changes in the diagnosis, treatment and prognosis of many medical conditions, and the need for revision was recognised by all stakeholders involved. In 2006, the ILO recommended a revision, as did the IMO, in its review of the STCW conventions in 2008. The ILO and the IMO subsequently agreed to create a joint working group to develop revised Guidelines.
The aim of the medical examination is to ensure that the seafarer being examined is medically fit to perform his duties and is not suffering from any medical condition likely to be aggravated by service at sea. Wherever possible, any conditions found should be treated prior to returning to work at sea. If this is not possible, the abilities of the seafarer should be assessed and recommendations made on what the seafarer is able to do and whether any reasonable adjustment could enable him or her to work effectively. In some cases, problems will be identified that are incompatible with duties at sea and cannot be remedied. Appendices A-E provide information on the medical conditions which are not likely to prevent duties being performed, those which require adaptation or limitation to duties and those which result in unfitness to work at sea.
Medical examination findings are used to decide this, and consistent decision- making needs to be internationally applied. The Guidelines provide the basis for establishing national arrangements which are complaint with the relevant international Conventions.
The medical certificate is a confirmation that the seafarer is expected to be able to meet the minimum requirement s for performing the routine and emergency duties specific to their post at sea safely and effectively during the period of validity of the medical certificate. Hence, routine and emergency duties must be known to the examining medical practitioner.
The ability to safely and effectively perform duties depends on both a person’s current degree of fitness and on the likelihood that they will develop an impairing condition during the validity period of the medical certificate. The examining medical practitioner should base the decision to issue a medical certificate on whether criteria for minimum performance requirements are met in the areas of vision, impairment from medicine use and recent medical history.
Competent authorities may differentiate between those persons seeking to start a career at sea and those seafarers already serving at sea and between different functions on board, bearing in mind the different duties of seafarers.