The medical fitness examination in maritime medicine aims to ensure that the worker will be fit for work and able to perform the tasks given by his position. This also includes the ability to cope with an emergency situation. Furthermore it is also important that the worker will not represent a risk to the vessel, to himself or to other crew members.
As compared to the usual concerns in clinical medicine, where prophylaxis, diagnosis, treatment and hygiene are essential parts, the medical examination of workers is quite a different task.
As an example of the way of thinking, we use the medical examination of seafarers below. The similarities to sea pilots, offshore workers and divers are obvious, although they have separate regulations, and the specific requirements will vary.
· To assess the fitness of workers on board in accordance with the Regulation of 19th October 2001 no. 1309 concerning the medical examination of employees on ships it is necessary for the medical examiner to assess two different aspects:The worker shall be able to meet the job demands
1. in ordinary operastions
2. in emergency situations
· The worker shall not be a safety risk to self, others on board, or the safe operations of the shipwhich means that he/she should not
1. Have an unacceptable risk of acute illness leading to an overburdening of other crew members, need of medical care on board, need of MEDEVAC, deviation or replacement
2. Be a risk to others by his/her behaviour
In the assessment, the medical examiner should take into account the following different aspects:
1. The position on board and the job description
2. The composition and size of the crew
3. The type of ship
4. The trade area
Limitations and restrictions
The medical examiner can decide that certain limitations or restrictions shall apply to the health certificate with regards to
1. Position to be held, especially regarding
2. Nautical personnel participating in the bridge watch or lookout function
3. Personnel with safety functions
5. Validity period of the health certificate
6. This is usually 2 years, and 1 year for individuals below the age of 18 or above the age of 50 years.
7. Individualized requirements, like follow-up, medicines to be used, and other conditions.
If the medical examiners receives information calling for an assessment of probable unfitness, he or she shall declare the worker as temporarily unfit. The worker is then obliged to have a new assessment from an approved medical examiner.
If a worker is on sick leave for mor then 8 weeks, he or she is obliged to have a new assessment from an approved medical examiner.
If the worker has reasons to believe that he or she might not meet the criteria for health requirements in the regulations, he or she shall see an approved medical examiner and get a new examination.
A master or shipping management who has reason to believe that the worker no longer meet the health requirements, shall demand a new health certificate.
If the worker has got a declaration of permanent unfitness and applies for an exemption, he or she has the right to ask for a postponement of the effectuation of the declaration, and may be granted such postponement if
· The medical examiner think it is safe and reasonable
· The Master or the Management agrees to it, after being duly informed
The body of appeal
According to the Regulations, the Body of Appeal (Appellate Body) has the right to grant exemptions from the regulations. In doing this work, the Body of Appeal assesses whether the requirements of Article 1 of the Regulations is met, even if the detailed requirements of the attachement to the regulations are not met.
The Body of Appeal will never grant exemptions from Article 1 of the regulations.