Textbook of Maritime Medicine

5.8.1        1997 Guidelines for Conducting Pre-Sea and Periodic Medical Examinations of Seafarers and their anchoring in international treaties 

The 1997 Guidelines for Conducting Pre-sea and Periodic medical examinations of Seafarers, are amended by both WHO, ILO and IMO.

Resolution No 9, Development of international standards of medical fitness for seafarers was adopted during the STCW Conference in 1995. This resolution invited the IMO in cooperation with ILO and WHO to develop international standards of medical fitness for seafarers.

AN ILO/WHO Consultation on the topic was held in Geneva November 1997, reviewing, finalizing a draft, followed by adoption of these Guidelines for Conducting Pre-sea and Periodic Medical Fitness Examinations for seafarers.  

The ILO Instruments concerning seafarers medical examination and health are

• The Medical Examination of Young Persons (Sea) Convention, 1921 (No. 16),
• The Medical Examination (Seafarers) Convention, 1946 (No. 73),
• set out international standards concerning medical examination of seafarers, including:

                                    - requirements for medical certificates,

                                     - frequency of medical examinations,

                                    - scope of the medical examination,

                                     - period of validity of the certificates,

                                     - exemptions,

                                     - appeal procedures and delegation by competent authorities of work related to medical examinations.

• The Health Protection and Medical Care (Seafarers) Convention, 1987 (No. 164), (requirements for medical report forms for ill or injured seafarers)
• The Ships' Medicine Chests Recommendation, 1958 (No. 105),
• The Medical Advice at Sea Recommendation, 1958 (No. 106), provision of medical care at sea.
• The ILO Occupational Health Services Convention, 1985 (No. 161), its accompanying Recommendation (No. 171) and the Technical and Ethical Guidelines for Workers' Health Surveillance (1997) are also relevant.
• The MLC 2006, which not has entered into force yet, but will be an important cornerstone for the guidelines, revising 37 different ILO coventions, among those No 16, No 73 and No 164 of this list.

The IMO instruments concerning medical requirements for seafarers are

• The International Convention on Standards of Training, Certification and Watchkeeping (STCW Convention), 1978, as amended in 1995, Regulation I/9, Medical standards

WHO mechanism concerning seafarers' health and medical service are

• Resolutions on the health of seafarers (WHA14.51, EB29.R10, WHA15.21, EB37.R25, EB43.R23), requesting to assist nations to improve the health of seafarers, to ameliorate the medical records of seafarers, to make available to seafarers in each port services where the necessary specialized medical care can be provided.
• Resolution of the Forty-Ninth World Health Assembly (WHA49.12) on WHO's Global Strategy for Occupational Health for All urges countries to give special attention to full occupational health services for the working population including groups at high risk, such as seafarers.²

The 1997 Guidelines are recommendations of minimum requirements for member nations, developing their own regulations. The 1997 Guidelines are more applicable than the STCW Code directly, but stand in need of being updated and revised.

The revision process of the STCW convention, with planned adoption in 2010, also includes the revision of the 1997 Guidelines.  The International Health Association (IMHA) has established a workgroup for this purpose after being asked for assistance by the IMO.  The intention is to make the guidelines more practical, as far as possible evidence based, and hopefully reach consensus with all cooperating partners, like ILO, IMO, WHO, EMSA.  Hopefully the new guidelines will be incorporated directly into the different national regulations of member nations.

The guidelines are developed under the viewpoint of safety for ships and the people on board ships. The requirements may vary according to trade, days at sea, distance from port, the character of the trade, cargo carried, position on board, size of manning, availability of medical service etc, just to mention some of the aspects that must be taken into account.