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Occupational health legislation and practices related to seafarers on passenger ships focused on communicable diseases: results from a European cross-sectional study (EU SHIPSAN PROJECT)

George Rachiotis1, Varvara A Mouchtouri1, Clara Schlaich2, Tobias Riemer2, Carmen Varela Martinez3, Gordon Nichols4, Christopher LR Bartlett5, Jenny Kremastinou6, Christos Hadjichristodoulou1* and the SHIPSAN partnership**

Author Affiliations

1 Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 22 Papakiriazi Str., Larissa, 41222, Greece

2 Hamburg Port Health Center, Institute of Occupational and Maritime Medicine, Seewartenstrasse 10 20459 Hamburg, Germany

3 National Centre of Epidemiology, Sinesio Delgado 6 28029, Madrid, Spain

4 Gastrointestinal, Emerging and Zoonotic Infections Department Health Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK

5 UCL Centre for Infectious Disease Epidemiology Department of Primary Care Population Sciences Royal Free and University College Medical, School Latchmoo Farm, Tile Barn Lane, Brockenhurst, SO42 7UE, UK

6 Department of Public and Administrative Health, National School of Public Health, 196 Leoforos Alexandras, 115 21 Athens, Greece

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Journal of Occupational Medicine and Toxicology 2010, 5:1  doi:10.1186/1745-6673-5-1

Published: 10 February 2010



Seafarers play an important role in the transmission of communicable diseases. The aim of the present study is to draw information and identify possible gaps on occupational health practices related to seafarers sailing on ships within the European Union Member States (EU MS) with focus on communicable diseases.


A structured questionnaire was sent to competent authorities from 21 EU MS. The questionnaire included questions about occupational health policies, medical certification of seafarers, communicable diseases reporting and relevant legislation. Descriptive analysis of the data was conducted by the use of Epi Info software: EU MS were categorized in four priority groups (A, B, C, D) based on: number of passenger ships visits, volume of passengers, and number of ports in each country. Moreover, EU MS were categorized to old and new, based on the date of entry in the EU.


All 21 countries with relevant competent authorities responded to the questionnaire. The existence of specific national legislation/regulation/guidelines related to vaccination of seafarers was reported by three out of the 21 (14%) responding authorities. Surveillance data of communicable diseases related to seafarers are collected and analyzed by 4 (19%) authorities. Five out of 21 of the responding countries (24%) reported that tuberculin test result is required for the issuance of seafarer's medical certificate while a great variety of medical examination is required for the issuance of this certificate among countries.

Gaps on occupational health services focused on communicable diseases related to maritime occupation have been reported by 33% of the responding countries.

Responding authorities from Group A and B had the highest percentage of reported gaps followed by groups C and D. Old MS reported a higher frequency regarding gaps on occupational health services in comparison to new MS.


Our results revealed heterogeneity regarding occupational health of maritime employees in EU MS. This work provides some evidence that further work at international and European level could be considered, in order to explore the potential for harmonized initiatives regarding occupational health of seafarers.