Health risk classification patterns among Filipino seafarers: A 5-year review

Understanding the distribution of risk classifications among seafarers can help in identifying health issues and implementing appropriate preventive measures and interventions. This research presents an exploration of the health risk classification patterns observed in seafarers who underwent preemployment medical examinations or PEME at the Nordic Medical Clinic from 2018–2022. The distribution of risk classifications is examined in relation to demographic and occupational characteristics. The PEME performed in these seafarers are enhanced with a battery of tests and is similar to a complete medical health check.

Furthermore, we conducted an Analysis to investigate the relationship between risk classification and PEME to Fit to Work Durations. Risk classification of seafarers were inspired by the guidelines provided by the labor department in the Philippines.

The study included risk classes with fit to work status namely class A, class B and class C.

• Risk class A included seafarers without any medical issues who could be immediately deemed fit to work.
• Risk class B consisted of seafarers with medical issues that could be resolved by short-term medical management.
• Risk class C encompassed seafarers with chronic illnesses who could be deemed fit to work once their conditions were controlled, as well as seafarers requiring specialist care to be rendered fit to work (i.e. Diabetes, hypertension)

Upon classifying the seafarers based on risk, it was observed that medical risk class C (48.16%) comprised the largest group of seafarers who underwent the PEME at the Nordic Medical Clinic. Risk class B (47.82%) closely followed in terms of the number of seafarers, while only a small number of seafarers were classified as risk class A (4.02%). The results revealed a  high prevalence of high-risk classifications, with risk class C comprising the largest proportion (48.16%) among all risk categories.

Fit-to-work duration was significantly associated with risk classification, with lower-risk classes having shorter fit-to-work times and higher-risk classes requiring longer fit-to-work durations. This is significant in the timeliness of crew change and the logistics it entails for all stakeholders

The risk class C would comprise mainly of: Older age, male gender, married status and higher ranks exhibited higher proportion of risk class C. As for the ranks, higher rank of deck and engine officers correlate to age as well, i.e. a master or chief engineer would most commonly be around at least late 40’s to 50’s up to the upper 60’s

The high proportion of risk classification C that is revealed in the study reflect the current health of the seafarers. The findings indicate that a significant proportion needs a medical attention or intervention for them to become fit to work. The higher prevalence of risk class C among older seafarers indicates the need for increased medical surveillance and interventions targeting age-related health conditions.

As seafarers advance in age, they may experience a higher burden of chronic diseases that can affect their fitness for work. Therefore, Implementing more frequent health screenings and preventive measures specific to age-related conditions can help mitigate the impact of these health issues and ensure the continued well-being of older seafarers.

Gender disparity is also observed in the distribution of risk classes, with higher proportion of males in higher risk class. This finding agrees with the observation that males have higher risk for several diseases including cardiovascular and metabolic diseases. Additionally, specific stressors associated with occupational positions may also contribute to the poorer risk class.

Conclusions

It is evident that a significant proportion of seafarers in this population fall into higher risk classifications, with risk class C being the most prevalent. The analysis also revealed a strong association between risk classification and pre-employment medical exam to fit-to-work durations with higher-risk classes requiring longer durations to be fit to work. This requires longer crew planning in hiring seafarers to go on board.

Demographic and occupational characteristics such as age, sex, marital status, and position on board have differential distribution of risk classifications among seafarers. These findings emphasize the importance of comprehensive risk assessment and management strategies in the maritime industry.

Given the results of the study, we, the authors of this paper, would like to inspire the leaders of the maritime healthcare industry, and the following recommendations are proposed:

•  there is a need revisit and for further studies on the standards on proper pre-boarding medical screening of seafarers that is holistic and tailor-fit for the nature of the specific role at sea, type of vessel and voyage, length of contract and location of work at sea;
•  given an understanding of the medical risk classification, a vessel-specific, work location-specific or role-specific medical class could be applied similar to the military or pilot medical certification class;
•  shorter work contract duration and deployment in near coastal waters could present as an option for seafarers with a pre-existing but controlled medical condition, especially when they have a unique set of skills that is difficult to find among a small pool of specialized maritime workers;
• implementing more frequent health screenings and preventive measures specific to age-related conditions can help mitigate the impact of these health issues and ensure the continued well-being of older seafarers;
•  tailored health promotion strategies and occupational health programmes for seafarers are necessary preventive approaches to health and safety at sea.

The art of the sailor is to leave nothing to chance 

For the industry’s most valuable asset, our seafarers, we do not want to leave these health risks to chance. We’ve presented the data and our recommendations, and we look forward to partnership and collaboration of all stakeholders for healthier seafarers of the future. 

Above article has been edited from Dr. Christian Angelo P. Lubaton’s presentation during the 2023 SAFETY4SEA Manila Forum.

Explore more by watching his video presentation here below

The views presented are only those of the author and do not necessarily reflect those of SAFETY4SEA and are for information sharing and discussion purposes only.