PRE-EMPLOYMENT MEDICAL EXAMINATION (PEME) OF … · 2019. 3. 19. · PRE-EMPLOYMENT MEDICAL EXAMINATION (PEME) OF SEAFARERS IN THE PHILIPPINES. The Donsö Maritime Conference WITH

PRE-EMPLOYMENT MEDICAL EXAMINATION (PEME) OF SEAFARERS IN THE PHILIPPINES

The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES

EVOLUTION OF PEME

Medical Examination of Young Persons Sea Convention, 1921

Medical Examination Seafarers Convention, 1946

International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978

Guidelines for Conducting Pre-Sea and Periodic Medical Fitness Examinations for Seafarers, by ILO and

WHO, 1997

International Labour Convention / Maritime Labour Convention, 2006

International Labour Organization / International Maritime Organization Medical Examination Guidelines

for Seafarers, 2013

SEAFARERS(ILO / WHO)

CLAIMSEXPOSURE

(Protection and Indemnity Clubs)

SAFETY OFNAVIGATION/ENVIRONMENT

(Flags of Registry)

• Standards of Training, Certification and Watchkeeping for Seafarers (STCW)

– Hearing

– Vision

• International Labor Organization / International Maritime Organization standards

• Flags of Registry

• Protection and Indemnity (P and I) Clubs

• Ship Owners and Ship Managers

• Department of Health


PEME STANDARDS

• Average of at least 30dB (unaided) in the better ear and an average of40dB (unaided) in the less good ear within the frequencies 500, 1000,2000 and 3000 Hz

• “Hearing aids are only acceptable in serving seafarers where it has beenconfirmed that the individual will be capable of safely and effectivelyperforming the specific routine and emergency duties required of them onthe vessel that they serve on throughout the period of their medicalcertificate”


MINIMUM IN SERVICE HEARING STANDARDS FOR SEAFARERS

Reference: International Labor Organization - Guidelines on the medical examination of seafarers 2013 – appendix B


MINIMUM IN SERVICE EYESIGHT STANDARDS FOR SEAFARERS

Category of Seafarer Distance Vision Aided

One eye Other eye

Masters, deck officers and ratings required to undertake look-out duties

0.5(20/40)

0.5(20/40)

All engineer officers, electrotechnical officers, ratings or others forming part of engine-room watch

0.4(20/50)

0.4(20/50)

GMDSSRadio Operators

0.4(20/50)

0.4(20/50)

The minimum in-service eyesight standards in each eye for unaided distance vision should be at least 0.1 (20/200)Reference: STCW CODE 1978 and International Labor Organization - Guidelines on the medical examination of seafarers 2013

• Three colour vision standards:

– Normal colour vision

– Defective colour vision A where those with a mild color vision deficiency can demonstrate their ability to see and recognize coloured signal lights, and

– Defective colour vision B where those with defective colour vision can demonstrate their ability to recognize surface colour codes at a short distance, such as those used on colour coded computer scenes


COLOR VISION STANDARDS

Reference: Commission Internationale de L’eclairage (CIE) - International Recommendation for Colour Vision Requirements for Transport


P&I CLUB PEME PACKAGE

1Comprehensive Medical History Taking and Physical Examination

2 Audiometry

3 Ishihara Test

4 ECG

5 Dental examination

6 Visual Acuity

7 Digital Chest X-ray

8 Urinalysis

9 FECT (for food handlers only)

10 Complete Blood Count

11 Blood Typing

12 VDRL

13 HIV 1 & 2

14 Hepatitis A screening

15 Hepatitis B screening (HbsAg)

16 Hepatitis C Test

17 HbA1c

18 Pulmonary Function Test

19 BUA

20 Total Cholesterol

21 HDL Cholesterol

22 LDL Cholesterol

23 Triglyceride

24 Creatinine

25 SGPT/SGOT/GGTP

26 Total protein

27 Albumin/Globulin/AG ratio

28 Whole Abdomen Ultrasound

29 Stress Test

30 Cardio profile

31 Drug Screening (Methamphetamine and Cannabinoids)


MINIMUM DOH PEME PACKAGE - PHILIPPINES

1. Complete Medical History & Physical Examination

2. Dental Examination

3. Visual Acuity

4. Color Perception (Ishihara 24-plates)

5. Audiometry

6. ECG

7. Chest X-ray

8. Blood Typing

9. CBC

10. Syphilis test (VDRL)

11. Urinalysis

12. Pregnancy Test (for female crew members)


2018 PEME DATA

Filipino Sailors 399,24824%

Other Nationalities 1,248,252

76%

SEAFARER POPULATION WORLDWIDE1,647,500


SUPERCARE 2018 PEME DATA

SuperCare PEME 29%

Other Clinics71%

FILIPINO SAILORS399,248

SuperCare

PEME

7%

Other Sailors93%

WORLDWIDE SAILORS

1,647,500


SUPERCARE 2018 PEME SUMMARY

2018 No. Percentage

Total No. of PEME 117,303 100.00%

No. of FIT 113,892 97.09%

No. of UNFIT / T. Unfit 3,411 2.91%

Total No. of Repatriation 2,028 1.72%


SUPERCARE 2018 PEME – TURN AROUND TIME

Days from PEME to Day declared FIT/Unfit

Percentage

1 day 30%

2 days to 1 week 40%

> 1 week to 1 month 30%


SUPERCARE 2018 PEME – TOP 10 MEDICAL FINDINGS

Rank MEDICAL FINDINGS PERCENTAGE

1 Dyslipidemia 70.14%2 Hemorrhoids 39.24%

3Gastrointestinal Findings: Gallbladder Stones/polyps and Fatty Liver

36.36%

4 Transaminitis 26.67%

5 Varicose Veins 25.29%

6 Anemia 23.86%

7 Dental Findings 16.95%

8 Hyperuricemia 16.65%

9 Hypertension 13.56%

10 Obesity 12.31%


SUPERCARE 2018 PEME – COMMON CAUSES OF UNFITNESS

MEDICAL FINDINGS PERCENTAGE

Hypertension, Uncontrolled 12.42%

Diabetes Mellitus, Uncontrolled 7.78%

Tuberculosis 7.28%

Visual Acuity do not meet STCW standards 6.02%

Color Deficiency 2.51%

Hearing Loss 2.28%

Chronic Hepatitis B 2.26%

Multiple Medical Conditions 0.90%


MEDICAL REPATRIATION INCIDENCE 2018

TOP TEN REASONS FOR MEDICAL REPATRIATIONPERCENTAGE of

REPATRIATED PATIENTS

1 Various kinds of Injury (Fracture, dislocation, ligament tear) 20%

2 Inguinal Hernia s/p Repair 4.3%

3 Gallbladder stone s/p Cholecystectomy 3.7%

4 Musculoskeletal (Back pain, muscle pain, muscle strain) 3.5%

5 Urolithiasis (Nephrolithiasis and Ureterolithiasis) 2.7%

6 Hemorrhoids s/p Hemorrhoidectomy 2.5%

7Acid Related Disease

(Gastritis, Esophagitis, Gastric/Duodenal Ulcer)2.3%

8 Infection (Abscess, various) 2.1%

9 Gouty Arthritis 0.83%

10 Hypertension 0.73%

Documents

PRE-EMPLOYMENT MEDICAL EXAMINATION (PEME) OF … · 2019. 3. 19. · PRE-EMPLOYMENT MEDICAL EXAMINATION (PEME) OF SEAFARERS IN THE PHILIPPINES. The Donsö Maritime Conference WITH