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PRE-EMPLOYMENT MEDICAL EXAMINATION (PEME) OF SEAFARERS IN THE PHILIPPINES
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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)
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• 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
The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
PEME STANDARDS
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• 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”
The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
MINIMUM IN SERVICE HEARING STANDARDS FOR SEAFARERS
Reference: International Labor Organization - Guidelines on the medical examination of seafarers 2013 – appendix B
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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
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• 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
The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
COLOR VISION STANDARDS
Reference: Commission Internationale de L’eclairage (CIE) - International Recommendation for Colour Vision Requirements for Transport
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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)
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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)
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
2018 PEME DATA
Filipino Sailors 399,24824%
Other Nationalities 1,248,252
76%
SEAFARER POPULATION WORLDWIDE1,647,500
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
SUPERCARE 2018 PEME DATA
SuperCare PEME 29%
Other Clinics71%
FILIPINO SAILORS399,248
SuperCare
PEME
7%
Other Sailors93%
WORLDWIDE SAILORS
1,647,500
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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%
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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%
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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%
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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%
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES
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%
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The Donsö Maritime Conference WITH PERSPECTIVE FROM THE PHILIPPINES OPTIMIZING YOUR RESOURCES