Chris Adams, LP Director, Steamship Mutual focused on ‘‘Best Practices in Crew Health” at the 2015 SAFETY4SEA Athens Forum. He highlighted the persistent cost of P&I crew claims, and examined the causes of these, many of which are regrettably recurrent. In the context of injury, failure to adhere to well established best practice regularly results in death or injury when entering enclosed spaces. In view of this, the current PSC concentrated inspection campaign on this issue is a welcome intervention. He also introduced and explained the objectives of the Club’s latest loss prevention DVD which addresses crew health and fitness and highlights why physical fitness for seagoing employment is vitally important.
My presentation focuses on loss prevention in the context of crew claims with the aim to make clear why loss prevention is important and necessary.
Unfortunately, when we look into maritime incidents, we find that, with disappointing regularity, they arise from causes that are eminently avoidable. In order to understand why loss prevention activity in this area is important, it is quite informative to look at the numbers. The following table shows Steamship Mutuals crew claims experience over the last three years (2012-2014). The majority of claims are what we describe as routine claims, claims below 250.000 dollars, but what is striking is that the total cost is considerable. We are talking of an average of about 20.000.000 dollars per year; in the three years prior to that it was 30.000.000 dollars per year. Therefore, it is easy to see that if we could save a few percentage points through a loss prevention initiative, this would have quite significant financial benefits.
Looking at injuries claims, we find that there are recurrent causes of injury. Tokyo MOU and Paris MOU are currently conducting a concentrating inspection campaign on enclosed space issues, looking at ships with regard to the familiarity with the enclosed space entry and rescue drill procedures. It will be interesting to see what the overall outcome will be. The focus on drills in relation to enclosed space emergencies is also important; the following chart shows the effect of a depleted oxygen atmosphere and it should be taken into serious consideration. The chart shows the time of useful consciousness, thus the period of time to which useful functions is lost in oxygen depleted environment.
What is alarming from this chart is that as oxygen depletion or as the oxygen concentration decreases, the time of useful consciousness diminishes very rapidly, once the level falls below 5% you can measure that in seconds. Many people may think that if they go into an enclosed space and there is a problem with the atmosphere, they will be in a position to deal with it. However, they will not. The two important messages to take away from this is first of all do not expose yourself to danger in the first place, try to recognize what constitutes a potentially dangerous enclosed space as it may not be as obvious as it seems. The second important thing is speed of evacuation; if the oxygen concentration shoud be less than 5%, survival time is measured in minutes, so the speed of getting somebody out of that enclosed space is vitally important.
Moving on to illness claims, again in a similar way to the injury claims, we find there are recurrent causes of crew illness, and obesity is a significant contributory factor. Obesity is measured by something called the body mass index, which is a function of height and weight. The health problems of obesity are the following:
- Decreased lung function
- Arterial stiffness
- High blood pressure
- Diabetes
- High bad cholesterol
- Increased risk of heart attack or stroke
- Arthritis
One of the main causes of obesity is eating too much and moving too little, and of course the remedy for that is obvious, eat less and move more. But putting that into a seagoing context, the safety implications of obesity for a seafarer are as follows:
- Shortness of breath and more easily tired after physical exertion because of the extra weight being carried
- Difficulty getting PPE to fit and to put PPE on quickly
- Impaired ability to undertake emergency duties increases risk for you and others
- Reduced capacity to operate with emergency breathing apparatus
- Physically too big to enter small spaces.
- High body mass makes rescue difficult for others
- More likely to have slips and falls and the consequences are more severe
- Likely to develop obstructive sleep apnoea which disturbs sleeping pattern and increases fatigue
The following picture shows the point where a seafarer lost his life. You can see how narrow this space is; imagine if you are a rescuer and you are obese.Even if you manage to get your PPE on, and your breathing apparatus, will you actually fit in that space? And also, if you are the casualty and you are obese and you are at the bottom of that space; and in this incident there were two of them, can you actually get this person out?
Another significant contributory cause of illness claims is high blood pressure, or hypertension. This is where your blood pressure is persistently at 140 over 90. The causes of that are similar to obesity and the two things are linked. The major problem is the risk of heart attack or stroke. If somebody suffers from heart attack or stroke at sea, the consequences could be fatal and the risks are not just to the individual, its to the other people on the ship as well. So, it is a serious issue. The causes of hypertension are generally within the control of the individual. It is lack of exercise, and poor dietary choices. We are all familiar with the good foods we should be eating; plenty of fresh fruit and vegetables, wholemeal breads and fibre, seafood and lean meat etc. The reverse of that coin in the dietary context is the bad food to avoid. The foods that contain empty calories, too much saturated fat, the foods that contain too much hidden sugar for example a can of carbonated soft drink can contain the equivalent of up to 8 teaspoons of sugar. Water is the best thing to drink. particularly for those who may be dehydrated, as it helps to prevent kidney stones. There is also no excuse for lack of exercise onboard simply because the ship may not have a gym.Thats irrelevant, as there are a series of exercises that can be undertaken without the need for any equipment whatsoever.
Steamship Club’s latest loss prevention DVD entitled ”Fit for Life” focuses on the following important issues:
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With this product we want to make seafarers aware why it is important to be fit for service at sea; you do not know when an illness is going to strike or where the ship is going to be at that time. It explains to them the issues that cause unfitness and illness and the lifestyle choices they can make to improve things.It also encourages them to take a more positive view of the pre-employment medical examination process. Many seafarers see this as an obstacle to employment. What we want them to do is to view it positively, to use it as a tool, something that will give them a snapshot of the health at any particular point in time with which they can then monitor the progress of that through their regular examinations. In that way, they can prolong their life at sea for the good of themselves and their families.
Above article is an edited version of Mr. Adams presentation during the 2015 SAFETY4SEA Forum which successfullyconcluded on Wednesday 7thof October 2015in Eugenides Foundation Athens attracting1100 delegates from 30 countries representing a total of 480 organizations.
Click here to view his presentation video