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    Medical Guidelines for Offshore Workers

    In 1998, the ILO and WHO adopted the Guidelines for Conducting Pre-sea and Periodic Medical Fitness Examinations for Seafarers. These guidelines outline specific examples of the unique nature of the shipboard environment and dictate that a medical examiner must consider the following when issuing a "fit-for-duty" medical certificate:

    • Seafarers should be medically fit to perform their normal duties correctly and to be able to respond to emergency situations (e.g., fighting fires, lowering lifeboats, assisting passengers, etc.)

    • Seafarers should be able to adjust to the often violent motions of the ship, to be able to live and work in sometimes cramped spaces, to be able to climb ladders and to lift heavy weights and to be able to withstand exposure to harsh weather conditions on deck or excessive heat in the machinery spaces."

    These guidelines as well as the U.K. Merchant Shipping Notice 1712 (M), for example, also outline minimum vision and hearing requirements for crew members and list certain medical conditions which might render a potential seafarer temporarily or permanently "unfit-for-duty." These include, but are not limited to, "any disability impairing muscle power, balance, mobility and coordination." Certain contagious and infectious diseases are also covered.

    Offshore oil, seismic, and support workers are non-seafarers. They differ from seafarers in that they are not assigned emergency duties, are not responsible for assisting others in an emergency, and are not required to receive any specific emergency training such as firefighting. During an emergency, these non-seafarers are assigned to a muster station located in specific sections on board the vessel.

    Non-seafarers are required to be given information regarding how to recognize the emergency alarm, what actions to take in the event of an emergency alarm, how to don their life jackets, how to get to their muster station, and other general safety information. They are also required to participate in an emergency drill where this information is repeated and explained. Non-seafarers are not required to receive any further safety or emergency training.

    Non-seafarers are not covered by these international agreements. As a result, groups in several countries such as Canada, Australia, and the UK have published their own medical screening guidelines for offshore workers. The utility of these guidelines for US employers, however, is questionable. U.S. employers must ensure that their medical screening guidelines are developed in accordance with the Americans with Disabilities Act as well as other civil rights legislation and the decisions of US Courts.

    To facilitate this responsibility, MED-TOX has devised a model for conducting the preplacement medical examination that requires an individualized assessment of the entering candidate's physical capabilities in relation to the specific physical tasks and environmental hazards of the offshore environment. In making this assessment, function is more important than diagnosis and individual case-by-case determination is more important than broad exclusions based on diagnosis. Risk to coworkers, the company, and the candidate (job applicant) is an important feature of this determination. Some of the factors considered in developing the guidelines for offshore workers include:

    • Offshore employees work far offshore or in inaccessible areas. As a result, it is very difficult to replace workers who become injured or ill. The typical vessel will have only the minimal number of persons on board necessary to perform the offshore tasks. Thus the incapacitation of even one employee may place a substantial additional burden on his or her coworkers.


    • While many offshore vessels are equipped with basic medical supplies and nursing personnel. Nevertheless, it is quite expensive and quite difficult to transport sick or injured workers ashore where they can be treated by physicians. It is therefore inadvisable and often unsafe to allow persons with certain medical conditions to work offshore.


    • All persons assigned to offshore duties should be medically fit to perform their normal duties correctly. The individual should be able to adjust to the often violent motions of the vessel, to be able to live and work in sometimes cramped spaces, to be able to climb ladders and to lift heavy weights and to be able to withstand exposure to harsh weather conditions including excessive heat and humidity. As they often travel by jet and helicopter to reach and return from their assigned vessel, offshore workers should not suffer from conditions which are exacerbated by air travel.


    • Offshore workers must be able to live and work closely with the same people for weeks at a time and under occasionally stressful conditions. They should be capable of dealing effectively with isolation from family and friends and interacting with persons from diverse cultural backgrounds.


    These factors, and many other factors, guided the physician experts who developed the MED-TOX Offshore Worker Medical Screening Manual. The Manual is the most comprehensive occupational medical screening manual ever developed for assessing job applicants for offshore work.

    For each medical condition, the Medical Screening Manual for Offshore Workers describes the job-related factors (physical abilities and working conditions) that should be evaluated by the examining physician prior to making a placement recommendation. Expert occupational medical advice and guidance for the evaluation of a wide variety of conditions likely to be present in the applicant population. Detailed coverage is given to recurring issues in medical screening such as appropriate vision and hearing requirements, assessment of persons with diabetes, musculoskeletal injuries, HIV+ status, seizure disorders, and a multitude of other complex issues.

    The Medical Screening Manual for Offshore Workers covers the following:

    Chapter I:   MEDICAL SCREENING UNDER THE ADA

    • The Preplacement Examination

    • The Americans with Disabilities Act (updated to 2002

    • Evaluating Risk

    • Reasonable Accommodation

    • Job Analysis Information

    • Summary

    • References

    Chapter II:   PREPLACEMENT EXAMINATION PROTOCOL

    • Recommended Procedures and Tests

    Chapter III:   MEDICAL GUIDELINES

    • Dermatological System

    • Ears, Nose and Throat

    • Eyes and Vision

    • Ears and Hearing

    • Pulmonary System

    • Cardiovascular System

    • Endocrine System

    • Gastrointestinal System

    • Genitourinary System

    • Hematopoietic System

    • Musculoskeletal System

    • Neurologic System

    • Oncology

    • Infectious Disease

    Chapter IV:   APPENDICES

    • Medical History Questionnaire

    • Clinical Examination Form


    The Medical Screening Manual for Offshore Workers has been designed to assist examiners in closely focusing on the actual physical demands and working conditions of the job. This linkage allows for an individualized assessment of the individual in relation to the job as required by law.

    Contact MED-TOX to determine how this manual can be customized for your organization to assist you with evaluating potential and injured workers in the offshore industry.


    © 2003 MED-TOX HEALTH SERVICES