The responses received highlight a small number of areas where relatively simple and low-cost interventions might improve the health and welfare of women seafarers. Specifically these include the production and appropriate distribution of gender-specific information on back pain, mental health and nutrition in addition to gynaecological complaints, to all women seafarers; the introduction of means for disposing of sanitary waste for all female crew on all ships and the improved availability of female specific products e.g. sanitary products in port shops and welfare centres worldwide. Additional work is needed to investigate these areas more fully and to look at the issue of confidence in medically trained staff, medical confidentiality and sexual harassment. Any further work and interventions will require the support of all of the main stakeholders and we plan a briefing meeting to publicise the findings to date and to identify support for further work in this area.
No laboratory tests and imaging techniques are recommended for routine use in the ILO/IMO Guidelines on the Pre-Employment Medical Examination (PEME) of Seafarers that form the basis for statutory certification. However, they are widely used as components of the PEME protocols developed by insurers, employers and national maritime authorities in an attempt to predict and reduce the risks from illness whilst working at sea. This may be justified on scientific, safety, economic or professional grounds. We propose a rational approach for deciding if and when tests can be justified for routine use in assessing a seafarer's fitness for work at sea. This is based on well-established methods for determining the validity of screening tests in public health as well as the seafarer demographics. We do not address the well-established use of similar tests where illness is suspected but only when they are used for routine PEME screening of all seafarers.
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