Navigare 3 - 2019

news
english translation from page 46
The importance of health requirements for
What is the purpose of health requirements, and why are they important to safety at sea?
The provision aims to maintain safety on ships. Health certification is an important part of
the HSE work on board.
Hege Sofie Imsen
Overlege ved Norsk senter for maritim
medisin
Working on a ship is quite different from
having a workplace on shore due to:
• limited access to medication, equipment
and medical treatment in the event of
illness or injury, which would make it more
challenging for a patient to get ashore to
receive proper healthcare;
• limited number of employees on board and
no access to deputies, so that some
employees on board have to complete their
own tasks in addition to the tasks of crew
members who are prevented from working
due to illness or injury;
• the 24-hour society which is limiting
people›s opportunities for alone time or
recreation, or which may result in isolation
due to the lack of group identification on
board and homesickness;
• heavy workload and shift arrangements that
may cause sleep deprivation;
• safety-critical duties that must be
maintained and the risk of disastrous events
when failing such duties;
• harsh weather conditions, etc.
Even though the work takes place in an area
within the reach of a search and rescue
helicopter, these resources may not be
available when the need arises. We are well
prepared in Norway. However, in unstable
weather conditions or in situations where the
helicopter is engaged in other operations, the
helicopter may not be available. There are
many countries where the density of
helicopters is lower than in Norway, and
access may be limited. We must also not
forget that there is a risk related to
evacuations, for the patient as well as the
rescue personnel.
Working on a ship involves risk, and
potential health failure is one of the identified
risk factors. What could happen if seafarers›
state of health is not satisfactory?
The worst-case scenario involves loss of
life or permanent health problems due to
restricted access to healthcare, crew injury
caused by sudden disability or loss of
attention in working situations that could lead
to accidents at work. Accidents may occur,
such as a collision with another vessel due to
operational errors or miscommunication.
Satisfactory eyesight, hearing and health
are important requirements in order to
prevent loss of lives and health problems at
sea.
Some conditions may involve obvious
safety risks, for example if the navigator is
visually impaired. Most health issues,
however, have less obvious consequences with
regard to safety. Individual assessments are
used to evaluate medical fitness. The
Regulations on medical examination of
employees on Norwegian ships and mobile
offshore units include guidelines for several
conditions that the doctor must relate to. For
example, in the event of a head injury the
patient must be observed for a period of 12
months post injury before the doctor can
assess whether the health requirements have
been met or not.
It is possible to apply for exemption from
the requirements if an employee is considered
unfit for duty due to health issues. The
appellate body for health cases is responsible for
processing applications for exemptions, and the
appellate body may grant exemptions, apart
from the vision requirements representing an
international minimum standard. The appellate
body is subject to the statutory objective set out
in the Regulations on medical examination of
employees on Norwegian ships and mobile
offshore units and may only give exemptions if
the exemption does not present a risk to the
person involved, other people on board or to
maintain a safe operation of the vessel.
The decision made by the appellate body is
based on an individual risk assessment in each
scenario. Extensive information about duties
and responsibilities is just as important as
medical information. The doctor encloses
relevant medical information when preparing
for the case. The doctor should provide
detailed information about the working place,
including specifications from the employee and
the employer, giving an account of specific
descriptions of duties, responsibilities and
safety functions, crew, shift schedule, sailing
areas, etc. It is important to include
information about other crew members on
board that have the skills to take on tasks when
needed. Ideally the employer performs a
separate risk assessment and encloses it in the
application for exemption.
The application for exemption must be
well-founded, and all relevant records must be
enclosed during submission. During the
application process the appellate body will try
to evaluate the likelihood of the applicant
getting significant symptoms when working on
board the vessel, and which consequences could
be the result for the applicant, other people on
64 | Navigare 3 - 2019