Textbook of Maritime Medicine

A very prominent feature of the shipping industry is its international character. Many different countries are involved in the construction, ownership, operation, manning, survey and inspection of ships. Likewise, the field of maritime medicine is probably the most international of all the different fields of medicine.

National regulation of the shipping industry is not sufficient. As there is no supranational authority, it is quite necessary to cooperate and reach consensus across national boundaries – which means – establishing multilateral treaties or conventions that can be followed by all shipping nations.

The international organizations are important forums for discussions, negotiations and contract formations between seafaring nations, resulting in mutual binding regulations for the shipping industry. This is of special importance to several fields of maritime medicine. In the following some of the most important international organizations will be discussed.

Furthermore, the organizations cooperate closely. On many publications in the field of maritime medicine you will find the symbols of World Health Organization (WHO), International Labour Organization (ILO), and International Maritime Organization (IMO).

It started as early as in 1948, with the “ILO/WHO committee on the Health of Seafarers”. Since then a number of recommendations about medical examination, medical chest, accommodation, food supplies, hospital treatment, rehabilitation, social welfare, venereal diseases etc. have been developed on a joint basis. 

The first “International Medical Guide for Ships” (IMGS) in 1967 was a result of a join venture between WHO, ILO and IMO. Since then it has been revised in 1982 and 2007 by the same parties. The final discussions on the IMGS in 2007 also included International Transport Worker’s Federation (ITF), International Shipping Federation (ISH) and International Maritime Health Association (IMHA).

The IMO/WHO/ILO Medical First Aid Guide for Use in Accidents Involving Dangerous Goods (MFAG) was developed in the same way, first published in 1982.

Another example is the WHO/ILO/IMO International Guielines on Pre-sea and Periodic Medical Examinations of Seafarers from 1997,  currently undergoing revision.

Without this cooperation, it would probably have been very difficult to establish international guidelines and regulations on maritime health issues. The different responsibilities and points of view of these three important UN Agencies on health, working conditions and maritime industry, together with the employers’ and employees’ organizations and the professional medical association, are important and different aspects to take into account in a process aimed at giving the world a tool-kit for maritime health.

In the following the different organizations responsibilities and special character will be described to give an introduction and an overview for the maritime physician and other worker in the field of maritime health.