B) Maritime Industry

B.1.2 Passenger shipping

EILIF DAHL, SIRI STRANDENES, BOB BRIDGER MARAGARETHA HOLTENSDOTTER LÜTZHÖFT

Whereas shipping dominates world international cargo transport, passenger transport has met strong competition from air travel. As a result, the traditional intercontinental passenger liners thus have largely disappeared. Current passenger shipping segments include:

  • cruise vessels
  • regional and coastal ferries
  • high speed passenger craft

Cruise vessels

EILIF DAHL, SIRI STRANDENES

Before World War II (WWII) the fastest transatlantic transport of people and mail was a matter of national pride (1). Prior to the advent of airliners, ocean liners were the primary mode of intercontinental travel and in the off-season some liners would do leisure cruises to a variety of ports. However, by the mid-1960s more people were crossing the Atlantic by airplane than by ship and passenger overcapacity caused many luxury liners to be converted to full-time cruise ships, offering pleasure and adventure trips only.

By the end of the 1960s ships were built exclusively for cruising, starting the boom that turned cruising into mass tourism. In 2019, several hundred ships with multinational officers and crew cruised to more than 500 destinations all over the world, and in 2019 they carried 29.7 million passengers - 15.4 million from America and 7.7 million from Europe (2). The largest market is still the Caribbean with 34,2% of the capacity and the Mediterranean is second with 17,3% (2).

Cruise ships target different traveller groups and vary in size – from exploration ships with up to a few hundred adventure-seeking persons on board to mass tourism megaships with more than 8000 persons, including 2500 crewmembers.

While ports have been competing hard for cruise visits, many popular but small destinations, like Venice and the Geiranger fjord, both environmentalists and locals consider such ports overwhelmed in peak season. Passengers may leave more than their footprints but not enough money.

Ferries

SIRI STRANDENES

Ferries range from small passenger ferries crossing rivers and fiords to big Ro-Ro (Roll-on Roll-off) ferries.  The smaller ferries operate, for example on the Hudson River in New York, in Hong Kong harbour and in Norwegian fjords. The bigger Ro-Ro ferries with a capacity to carry 3000 passengers and 650 cars cross the English Channel. North Sea ferries and the Hurtigruten (3) resemble cruise vessels. They carry fewer cars/lorries but have capacities for up to 2000 passengers. In later years, Color Line (4), a major operator back and forth from Norway to Denmark and Germany, has invested in vessels with capacities in passengers and cars similar to the channel ferries. In 2019, Color Line carried more than 3,8 million passengers, 961,000 private cars and almost 180,000 freight units (5). The ocean liners, although mostly of the past, were also called transatlantic ferries. Hence, the differences between passenger ships, liners, cruise ships and ferries are sometimes indistinct.

High-speed passenger craft

SUE STANNARD

High-speed craft (HSC) operate in many of the world’s busiest shipping lanes and travel nationally between islands or internationally. Most serve as passenger ferries but the largest also carry cars and larger vehicles. They include, among others, air-cushion vehicles (such as hovercraft) and hydrofoil boats. Many new types of HSC were developed in the 1980s and 1990s and the International Maritime Organisation adopted new international regulations dealing with the special needs of this type of vessel (6). This requires that all passengers are provided with a seat and that no enclosed sleeping berths are provided for passengers.

Super yachts

SPIKE BRIGGS

A superyacht is a large and luxurious pleasure vessel. There are no official or agreed definitions for such yachts, but this term is regularly used to describe professionally crewed motor or sailing yachts, ranging from 24 metres (79ft) to more than 180 metres (590ft) in length. Number of crew range from below 10 to over 60.

Superyachts are often available for charter with staff that cater for guests at a high standard of comfort. They may be designed to emphasize comfort, speed, or expedition capability. Depending on the season, superyachts may be most frequently found in the Mediterranean and the Caribbean, but also increasingly across the Pacific and high latitudes. Many are available for charter at prices that exceed €250,000 per week. Larger yachts may have more than one swimming pool, they may carry a variety of water toys, other tenders and even submarines, and some carry a helicopter.

Crewing on passenger vessels

BOB BIRDGER, MARGARETHA HOLTENSDOTTER LÜTZHÖFT

Passenger vessels differ in their crewing from other merchant vessels. In addition to the required deck and engine crew present on all vessels, they also carry a variable number of passenger service staff. The number of seafarers employed and the roles they fulfil vary hugely depending upon the route, length of time at sea, number of passengers and type of vessel. Roles may include

  • Restaurant and bar staff - waiters, wine waiters, Maitre D’.
  • Reception staff – front desk, tours staff, managers
  • Shop staff – including canteen staff and specialist staff for high end goods on cruise ships
  • Spa staff – hair dressers, beauticians, massage therapists
  • Medical staff – doctors, nurses or other health care professionals
  • Entertainment staff

In addition, the increased numbers in persons on board and the facilities available mean that there is the need for an increased number of staff such as cooks, kitchen assistants, waste disposal staff, pool staff etc.

Unlike seafarers in the deck and engine departments, these seafarers tend not to be ‘career seafarers’ but rather have a career ashore that they wish to pursue on board a ship for a variable length of time. They are not covered by the STCW requirements for eyesight etc. that apply to deck and engine staff and in many countries are not required to complete any safety training before going to sea. In others, they are required to complete a Personal Survival course. All of these factors can lead to a difference in their approach to life at sea, the risks involved and the environment in which they are living and working.

Medical care in passenger shipping (Dahl)

From a medical perspective, there are distinct differences between ocean liners, cruise ships and ferries. Traditionally, intercontinental liners had to have a doctor aboard if the ship carried 13 or more passengers. They carried many people in what was frequently rough weather for many days without evacuation possibilities (1). Most had rather well equipped infirmaries and emergency surgery was not unusual at sea.

These days most shipping companies follow the Maritime Labour Convention 2006 (MLC 2006) (7) which states that ships carrying 100 or more persons and ordinarily engaged on international voyages of more than three days duration shall carry a qualified medical doctor who is responsible for providing medical care. MLC 2006 does not specify details regarding the ship’s infirmary, medication, medical equipment or qualifications of the ships´ medical staff, but most cruise companies will – not least of all for legal reasons – follow or exceed  “The Health Care Guidelines for Cruise Ship Medical Facilities” by the American College of Emergency Physicians (ACEP)(8). These guidelines were initiated by American emergency physicians who had worked part-time as ship´s doctors and were frustrated by the lack of proper medical facilities and equipment aboard. They felt that emergency physicians rather than surgeons were needed at sea. Therefore, the focus of the ACEP Guidelines was on emergency medicine while only minor surgery skills were considered necessary. The guidelines have been regularly revised since 1995 and are actively promoted by the world´s most influential cruise trade organization, Cruise Lines International Association (CLIA) (2).

Most ferries do not engage in international trade of more than three days, thus a seafarer who has “satisfactorily completed training in medical first aid” provides medical care (7). Even international ferries with more than 2000 persons aboard and spending 20 hours at sea between Norway and Germany do not carry a ship´s doctor, but do have a paramedic on duty (9). As ferry traffic increases and passenger expectations keep rising due to the continuous improvement of care on cruise ships, ferry companies may have to consider employing medical staff also on smaller ferries doing shorter trips.

More information on passenger health and cruise ship medicine can be found in Chapter 2.12 and 2.13

  1. Maxtone-Graham J. The only way to cross. Collier Books, New York 1972.
  2. https://cruising.org/-/media/research-updates/research/global-cruise-impact-analysis---2019-final.ashx Accessed May 2021
  3. http://www.hurtigruten.no/ Accessed May 2021
  4. colorline.no/ Accessed May 2021
  5. https://www.colorline.no/polopoly_fs/7.134280.1616613882!/CG-CA21-01%20A%CC%8Arsrapport_2020_EN_spread.pdf Accessed May 2021
  6. International code of safety for high-speed craft (HSC Code) : (un.org) Accessed May 2021
  7. International Labour Conference. Maritime Labour Convention, 2006. https://www.ilo.org/global/standards/maritime-labour-convention/text/WCMS_763684/lang--en/index.htm Accessed May 2021
  8. American College of Emergency Physicians. Cruise Ship Medicine Section. Health Care Guidelines for Cruise Ship Medical Facilities. https://www.acep.org/patient-care/policy-statements/health-care-guidelines-for-cruise-ship-medical-facilities/#sm.00001oz1nz0cjff0owcs23qt8vjno Accessed May 2021
  9. Holt T-E, Tveten A, Dahl E. Medical emergencies on large passenger ships without doctors: the Oslo-Kiel-Oslo ferry experience. Int Marit Health 2017; 68, 3:153-158.

B.1.1 Merchant Shipping

SIRI PETTERSEN STRANDENES

Global seaborne transport

Shipping is essential to the functioning of the global economy and the related international merchandise trade. Shipping facilitates trade by moving goods from production to consumption sites.    

Raw materials and finished goods are traditionally the main cargoes in international trade.  They include foodstuffs, chemicals, oil, whitegoods, clothing, cars etc. In later decades, trade in intermediate goods for further processing has grown steeply and in parallel with the so-called fragmentation of the production processes.  Fragmentation is the splitting of the production process between several locations to produce each component where the production conditions and costs are most favourable.  International trade in these components constitutes an important share of seaborne trade.

World seaborne trade rises with economic growth.  Economic growth is measured by world gross domestic product (GDP) and the seaborne cargo flows show this growth.

Sources: Based on data from (1)[1] and(2)[2]

[1] Clarksons Shipping Intelligence London 2018. Updated 2018 https://sin.clarksons.net/

[2] http://unctadstat.unctad.org/wds/TableViewer/tableView.aspx

Major cargoes in seaborne trade

The major commodities in seaborne trade are crude oil, oil products, liquefied gas, chemicals, coal, iron ore, grain, phosphate, alumna, plus intermediary and finished goods. Finished and intermediary goods move in containers, whereas the other main cargoes move in bulk. That is, these cargoes are loaded directly into the hull of the vessel. In addition, special shipping segments employ vessels specially designed to transport cargoes like cars, refrigerated cargoes and heavy cargoes. The offshore fleet supports offshore oil production installations. Offshore emerged as an important shipping segment with the growth in offshore oil and gas exploration.

Source: Based on data from Clarksons Shipping intelligence London 2018 (1)

Transport costs have fallen over the years.  The reduced transport cost partly explains the strong growth in interregional trade since World War II.  Stopford (3) points out that oil freight amounted to 30% of the value of a barrel of Arabian Light Oil in 1960.  In 2004, the freight was less than 5% of the value of the oil. However, this relationship varies with both oil price fluctuations and freight rate variations. The costs of transporting intermediary and finished goods have also fallen dramatically, mainly because of containerisation and the accompanying rise in cargo handling efficiency.

 

 

Trade costs

Cargo type

Route

2010

2015

2017

Container

USD/TEU*

Shanghai - Europe

1771,00

620,00

876,00

Iron ore USD/tonne

Tubarão - Rotterdam

13,66

5,55

7,84

Crude oil

USD /barrel

West Africa – US Gulf (VLCC)

1,62

2,35

1,21

Crude oil

USD /tonne

West Africa – US Gulf (VLCC)

11,87

17,17

8,81

 

* TEU (Twenty-foot equivalent unit) One TEU refers to the dimensions of a twenty-foot container and is used as a standard unit of measure in container shipping.

Source:  Calculated based on information from (1)

Sailing areas

The major deep-sea trades cross the Atlantic or the Pacific in the northern hemisphere and reflect the location of the highly developed economies. The developed economies engage most in international trade.  The container and car trades are typical for this trading pattern. Trading patterns of course change over the years and the main changes since the 1990s are the rising share of world trade back and forth to China and the growth of the inter-Asian trades.

The trade patterns differ among the main bulk cargoes since raw materials, such as crude oil, coal, iron ore, grain, phosphate, and alumna are located in different areas across the globe.  Some of the larger trades like iron ore from Brazil and coal from Australia originate in the southern hemisphere. UNCTAD[1],[2]. calculates that 42% of world seaborne trade originates in Asia, 17% in Europe, 21% in the Americas, 13%in Oceania and 7% in Africa.

Global shipping companies

The global nature of shipping and the shipping companies is best illustrated by a specific example.  In 2017 Star Bulk Carriers Corp. took delivery of the new bulk carrier MV Star Ariadne and registered her in Liberia.  Star Bulk Carriers Corp. is a large shipping company 

incorporated in the Marshall Islands with executive offices in Greece and Cyprus. Star Bulk Carriers Corp stocks trade at the Nasdaq Global Select Market in USA and at the Oslo Stock Exchange in Norway[1].  Their Manilla based, partly owned subsidiary Star Ocean Manning Philippines Inc[2]. provides and manages crew for Star Bulk Carriers Corp.

MV Star Ariadne was built at the Chinese Shanghai Waigaoqiao yard and is classed by France based Bureau Veritas (BV)[3] .  The vessel is insured by the UK P&I Club[4].  Star Bulk Carriers Corp. does not own the vessel directly, but leases her from CSSC Leasing, a leasing arm of China State Shipbuilding Cooperation. The ship is equipped with an MAN B & W engine from the German / Danish engine manufacturer.

Examples of MV Star Ariadne’s assignments are one voyage lifting 190 000 tonnes iron ore from Tubarão in Brazil to Qingdao in China followed by one sailing with iron ore from Port Hedland in Australia to Qingdao after a ballast[5] trip from Qingdao to Port Hedland.  The charterer CARGILL, a US company with global presence,[6] paid 13,20 USD per tonne cargo for the first transport service. The next trip was chartered by the Australian FMG[7] at 9,10 USD per tonne cargo[8].

Ship operations

Companies in the shipping industry may choose widely different organisational structures in ship owning and operation Firms operating vessels on scheduled routes, typically container vessels, announce the schedule up front and then work to fill the cargo carrying capacity of the vessel on each leg of the trip.

In bulk shipping, there are three main alternatives:

  • A ship owner may choose to invest in ships and let other firms operate the vessels. Then the ship owner lets his vessel on a so-called demise or bareboat charter for several years. This resembles a financial investment since the owner finances the vessel but does not operate it nor provide the crew. Hence, the responsibility for the crew may not always rest with the owner of the vessel.
  • Ship owners may charter the vessel out on a time charter for some months or several years. If so, the ship owning firm operates the vessel, provides crew, and secures maintenance, whereas the hiring firm directs the vessel’s sailing and decides on what cargoes the vessel carries.
  • The third alternative is the fully integrated shipping firm that finances the vessel, provides crew and maintenance and finds cargoes for the vessel to lift by agreeing with a cargo owner on a voyage (or spot) charter for a specific trip or voyage., The shipping firm offers the vessel in the market for single cargo trips or makes an agreement with a cargo owner for a few consecutive voyages.

Shipping companies differ widely in size from small entities operating a few ships to large integrated companies operating a large fleet of vessels. The large ship owning companies often operate diverse types of vessels and offer transport services in several segments of the shipping industry. Examples include Maersk[1], the world largest container ship operator and Wallenius Wilhelmsen Logistics[2], the market leader in car carriers.

Some firms in the shipping industry specialise in technical or commercial management without investing in ships. Technical management implies providing crew, maintenance, and ensuring that the operations satisfy rules and regulations. These firms charter vessels on bareboat charters and let them out on time charters.  Commercial management, on the other hand, implies securing cargo and thus the revenue from operating the vessel. In this case, the firms charter vessels on time charters and fix them on voyage charters. 

We also see combinations of these operational alternatives within individual shipping companies. The firm may choose to have a mix of vessels owned and operated and vessels hired in from other firms on either bareboat or time charters.

To further underline the diversity, we point at the many “one-ship” firms that may own only one vessel. Such “one-ship” firms typically are subsidiaries of a holding company. The holding company may register vessels, and the ship owning “one-ship” firm in different countries. 

A global market for officers and crew

The Baltic and International Maritime Council (BIMCO) estimated the seafaring workforce in 2015 to be 1 647 500 persons of whom 774 000 are officers and 873 500 ratings[1]

The same publication estimates the demand for officers in 2015 at 790 500 and for ratings 754 500, implying that there is a 2.1% shortage of officers and a 15.8% surplus of ratings. The shortage of officers is expected to increase to 18,3 % by 2025.  A more recent assessment by(4) on the other hand anticipated that the officer shortfall will disappear by 2024.  

The top five supply countries are China, the Philippines, the Russian Federation, Ukraine, and India. Hence, the global aspect lies not in the number of countries supplying seafarers but more in the fact that these seafarers sail in vessels flying flags of the many open ship registers of the world, i.e., the many registers that do not require nationals on board the vessels.  Several firms specialise in recruiting seafarers for example: Naess Shipping Philippines INC.[2], Wallem Group[3] Hong Kong, Wilhelmsen Ship Management[4] Singapore and OSM Maritime[5] Norway and several websites publicise jobs for seafarers, for example Seamanjobsite[6]

Manning of vessels

In the 1960s and 1970s, the introduction of open ship registers led to national crews being replaced by crews from low labour cost countries, thereby turning the labour market for seafarers away from the national markets of the ship-owning firms.

Crew cost is still the main element of vessel operating costs, whereas fuel is the main component of vessel voyage costs. Shipping firms seek to reduce operating costs by new technology.  Rationalisation and automation have dampened the effect of the rising crew cost after World War II and this resulted in fewer seafarers on board.  However, seafarers stay on board for shorter periods than before, and thus, the number of seafarers needed to operate the vessels did not shrink proportionally.

Older vessels may have larger crews than newer vessels resulting from the higher need for maintenance and repair. This difference may also reflect less automation in older vessels. 

Hence, changes in the average age of the fleet may influence the demand for the crews.  The heavy contracting in the boom stopped by the financial crisis in 2008 led to delivery of several new vessels and this increased the share of modern vessels in the world fleet, thus reinforcing the change in demand for crews towards fewer but more educated seafarers.  

Further information on the recruitment of seafarers is available in Chapter 4.1.1.

Ship type

Officers

Ratings

Tankers*

7 - 13

8-19

Dry cargo carriers*

8-10

8-14

Container vessels

8-10

8-14

LNG carriers

9-14

12-18

Offshore PSV** size vessels

6-9

5-7

*The highest on the largest vessels. ** PSV=Platform supply vessel

Source: (4)

References

1.         Clarksons. Shipping Intelligence Network London2018 [updated 10 28.

2.         UNCTADStat. 2018 [updated 10 28.

3.         Stopford M. Maritime Economics. London: Routledge; 2009.

4.         Drewry. Ship operating costs. Annual Revies and Forecast, Annual Report 2019/20. London: Drewry Maritime Research; 2020.

[1] http://www.ics-shipping.org/docs/default-source/resources/safety-security-and-operations/manpower-report-2015-executive-summary.pdf?sfvrsn=16

[2] http://naess.com.ph/our-services/

[3] https://www.wallem.com/about/

[4] https://www.wilhelmsen.com/ship-management/

[5] https://osm.no/

[6] https://seamanjobsite.workabroad.ph/.

 

[1] https://www.maersk.com/solutions/shipping

[2] https://www.walleniuswilhelmsen.com/about

 

[1] https://www.starbulk.com/

[2] http://www.starocean.com.ph/

[3] https://group.bureauveritas.com/

[4] https://www.ukpandi.com/

[5] Sailing in ballast is sailing without any cargo

[6] https://www.cargill.com/about/company-overview

[7] http://www.fmgl.com.au/

[8] https://sin.clarksons.net/

[1] https://unctad.org/en/Pages/Publications/Review-of-Maritime-Transport-(Series).aspx

[2] https://unctad.org/en/pages/PublicationWebflyer.aspx?publicationid=2245

 

B.1 Sectors of the Maritime Industry

Global seaborne transport

Shipping is essential to the functioning of the global economy and the related international merchandise trade. Shipping facilitates trade by moving goods from production to consumption sites.

Raw materials and finished goods are traditionally the main cargoes in international trade.  They include foodstuffs, chemicals, oil, whitegoods, clothing, cars etc. In later decades, trade in intermediate goods for further processing has grown steeply and in parallel with the so-called fragmentation of the production processes.  Fragmentation is the splitting of the production process between several locations to produce each component where the production conditions and costs are most favourable.  International trade in these components constitutes an important share of seaborne trade. 

World seaborne trade rises with economic growth.  Economic growth is measured by world gross domestic product (GDP) and the seaborne cargo flows show this growth.

B.8 History

-

B.2 The Regulatory Framework

TIM CARTER, KRIS DE BAERE

Introduction

As shipping is an international industry, consistency in the way it is regulated in all maritime nations is important. The regulatory control of shipping was preceded by a growing body of contract law, which was mainly aimed at financial aspects and related topics such as the insurance of hulls and cargoes. From the middle ages, ports also had legal controls on vessels and quarantine arrangements to reduce the risk of importing diseases.

Governments in the traditional maritime nations of Europe and North America became active in the regulation of safety and health aspects of shipping during the second half of the 19th century. This was in response to public concerns about the increasing scale and complexity of shipping with the introduction of steamships, the growth in the expression of seafarer concerns through maritime trade unions and the loss of life at sea.

Regulations, especially when concerned with maritime safety, were usually similar across nations, with one leading – often the USA or UK – and others following. Some issues, such as conventions on navigation lights and on port health controls were agreed more formally at international meetings. As shipping became ever more international, with ownership, registration, crewing and voyage patterns no longer tied to the traditional maritime nations, these arrangements became ever less effective.

During the 20th century, three bodies that are now United Nations Agencies became the major forums through which international regulations for maritime safety and health were developed. These are the International Labour Organisation (ILO), the International Maritime Organisation (IMO) and the World Health Organisation (WHO). Formal law making remains with the states in which ships are registered (flag state control) or where they trade (port state control), but these laws now have to align with the conventions agreed at meetings of the international agencies.

International legal instruments

The UN Agencies have a range of legal instruments that they adopt as the basis for common international standards.

  • Conventions are the most binding form of instrument. A convention is an agreement worked out by interested parties (see below) at a series of meetings. It represents a set of requirements that the national governments that are ‘parties to the convention’ (i.e. take part in decision taking at Agency meetings) have to adopt into their national law (often in the form of ordinances or regulations) before they can ratify the convention. A Convention then comes into force when a sufficient number of nations has ratified it. Once this occurs, countries that have not adopted the necessary laws and therefore not ratified the Convention, can find there are barriers to their ability to trade internationally.
  • Recommendations propose methods by which conventions are implemented. They may be incorporated in a convention as a subsidiary code or published separately by the Agency, often when insufficient agreement is reached to produce a Convention.
  • Guidelines cover detailed aspects of the implementation of a convention or recommendation, for instance the training requirements needed to ensure competence or fitness.
  • Technical standards produced by other organisations may be adopted by Agencies as the basis for agreements. These often relate to engineering or analytical methods.
  • Regulations are used by some Agencies such as the World Health Organisation, where essential actions to secure protection involve many different parts of the public and private sectors and where rapid international action may be needed. On such example is an epidemic infection.

The International Labour Organization (ILO)

Established in 1919, the ILO sits in Geneva. It was incorporated as the first Agency of the United Nations in 1946.[1] Several of its early conventions were concerned with the health of seafarers, and as the sector became more international with increasing concern about the health, safety and welfare of seafarers, its maritime programmes widened in scope. The core purpose of the ILO is to ensure that workers have decent working conditions in terms of risk reduction, fair employment practices and the absence of discrimination.

All its work is on a tripartite basis, with representatives of governments, employers and workers participating in the development of Conventions and Recommendations.[2] Other organisations, such as those representing professions, trade associations and other interest groups may attend and contribute but do not have any voting rights.

Towards the end of the last century, the multiple instruments concerned with seafarers were seen to be inconsistent, overlapping and, in many cases poorly implemented. It was agreed that a single consolidated Convention on maritime working conditions was needed and the Maritime Labour Convention (MLC) was agreed in 2006. Ratification by maritime nations took several years as national laws were adjusted or made in order to meet the Convention’s requirements. It is now in force and forms the basis for many aspects of maritime health practice.

Maritime Labour Convention, 2006.

The main parts of MLC relevant to maritime health are:

1.2 Medical Certificate

2.3 Hours of rest and work

3.1 Accommodation and recreational facilities

3.2 Food and catering

4.1 Medical care at sea and ashore

4.3 Health and safety protection and accident prevention

4.4 Access to shore based welfare facilities

4.5 Social security

The MLC specifically includes:

  • the requirement for seafarers to carry a valid medical certificate
  • the requirement for ships to carry medical guides.
  • recommendations regarding the medical supplies and equipment carried on board, and the necessary training for seafarers to use them,
  • occupational safety and health
  • hours of rest and work,
  • food, accommodation and other matters directly or indirectly relevant to seafarers safety and health.  

Supplementary guidelines are published for a number of these requirements, for instance: medical examination and certificate issue (jointly with the International Maritime Organisation)[3]; the training of ship cooks[4]; health protection and accident prevention[5].

The broadly similar Work in Fishing Convention, 2007 (Number 188) provides similar protection for this sector. However it has only recently come into force as ratification by members has been slower.[6]

Some other ILO Conventions also have some relevance such as Occupational Health Services, 1985 (number 161).[7]

The International Maritime Organization (IMO) 

The International Maritime Consultative Organisation was established as a UN Agency in 1948, becoming the IMO in 1982.[8] It sits in London and its mission is summarised as ‘safe ships and clean seas’. It has agreed a series of Conventions to further these aims[9] and several have direct implications for maritime health practice:

  • SOLAS (safety of life at sea) includes arrangements for responding to maritime incidents and disasters, including search and rescue service, medical evacuation arrangements and telemedical advisory services. The International Safety Management (ISM) code was introduced to supplement this convention with the aim of improving safety practices on board ships.
  • MARPOL (marine pollution) also covers arrangements, including risk management and emergency medical and other responses, to incidents involving dangerous cargoes.
  • STCW (standards for training, certification and watch keeping) outlines the competencies required for maritime duties, with specified training arrangements, including the training courses in first aid and medical care at sea. This includes standards of medical fitness (overlap with ILO MLC, 2006) A broadly similar Convention covers the fishing sector (STCW(F)).

These three conventions, together with the MLC are often termed the four pillars of maritime safety and health.

At IMO the voting representatives are from the maritime authorities of member countries, in practice virtually all maritime nations. Employers, trade unions and professional or trade bodies have ‘consultative status’. This means they can speak or make proposals for agenda items, but do not vote on them. In addition, the secretariat plays a less active role in developing agendas and proposals than is the case with ILO. At IMO it is usually the members who initiate (and sometimes block) new proposals.

IMO works mainly by updating and extending existing conventions. This means that they do not need to go through the slow process of ratification that characterises the adoption of ILO instruments.

The International Safety Management (ISM) Code

The human factor is generally regarded as one of the most important causes of accidents at sea, as exemplified by the capsize of “Herald of Free Enterprise” on  6th March 1987, the Scandinavian Star disaster on  7th  April 1990 and the capsize of “Estonia” on 28th September 1994.

In 1989 the IMO adopted “Guidelines on management for the safe operation of ships and for pollution prevention”. In the following years the International Management Code for the Safe Operation of Ships and for Pollution Prevention (the ISM Code) was developed. Adopted in 1993 by the IMO, it became mandatory for all member nations from 1998.

The purpose of these Guidelines was to provide those responsible for the operation of ships with a framework for the proper development, implementation and assessment of safety and pollution prevention management in accordance with good practice.

The objective was to ensure safety, to prevent human injury or loss of life, and to avoid damage to the environment, in particular, the marine environment, and to property. 

 (http://www.imo.org/en/OurWork/HumanElement/SafetyManagement/Pages/Default.aspx

A safety management system (SMS) must be established by "the Company", which is defined as the ship owner or any person, such as the manager or bareboat charterer, who has assumed responsibility for operating the ship.

The Company must also establish a policy for achieving the objectives, including the necessary resources and shore-based support. One or more designated persons ashore shall have direct access to the highest level of management. Procedures shall be documented and compiled in a Safety Management Manual, a copy of which should be kept on board.

Effective implementation of the ISM Code should lead to a move away from a culture of "unthinking" compliance with external rules towards a culture of "thinking" self-regulation of safety - the development of a 'safety culture'. The safety culture involves moving to a culture of self-regulation, with every individual - from the top to the bottom - feeling responsible for actions taken to improve safety and performance.

The requirements of the ISM Code lead to the production of a wide range of documents and reports as a part of the ship’s safety management system (SMS) – documents which also have the potential to incriminate those who produced them. In recent years this has been discussed as a potential conflict of interest.

World Health Organisation (WHO)

Created as a UN Agency in 1948, the WHO has its headquarters in Geneva. [10]There had been earlier international health bodies as well as a long history of multilateral, international collaboration over the control of epidemic infectious diseases. Members of the WHO are national governments, represented by their health ministries. WHO has a limited and decreasing involvement in occupational and maritime health, now that infectious diseases feature less prominently as risks.  Its major impact is through the International Health Regulations, which determine port health clearance procedures.[11] It is also an important source of advice on the current status of infectious diseases in different parts of the world.

The WHO is also the publisher of the current International Medical Guide for Ships (IMGS), and the list of medications and medical equipment that go with it.[12] [13]It is a statutory requirement (under MLC) for ships to carry either the International Guide or an equivalent national guide approved by the flag state of the vessel.

As can be seen from the descriptions in 12.3-5, maritime health practice is at the interface between three different UN Agencies, each with their own working methods and priorities.  This means that it can be difficult to ensure a holistic view is taken about the best way to deal with any health risk. It can also mean that the pace of action is glacial as political boundaries between the ILO, IMO and WHO often have to be re-visited and agreed before any work is initiated.

Regional bodies - European Maritime Safety Agency (EMSA)
[14]

EMSA was founded following the catastrophic oil pollution incidents caused by the loss of the tankers Erika and the Prestige. It is a European Union agency charged with reducing the risk of maritime accidents, marine pollution from ships and the loss of human lives at sea by helping to enforce the pertinent European Community legislation.

EMSA 'inspects the inspectors' of classification societies, assesses Port State Control systems, tracks problem ships, and safeguards the standards of on board equipment. For example, EMSA developed the THETIS tool to support the New Inspection Regime (NIR) for Port State Control of the Paris Memorandum of Understanding.

EMSA helps Europe respond better to major oil spills by maintaining 17 fully equipped stand-by oil spill response vessels around Europe, analysing satellite images to identify polluting vessels, and ensuring that ships comply with environmental rules.

Shipping accidents happen, and when they do, accident investigation can help identify problems, and to learn lessons that may prevent accidents in future. EMSA manages the European Union's (EU) European Marine Casualty Information Platform (EMCIP) database for sharing marine accident investigation information, and it is helping to improve standards in accident investigation across coastal states. Since 2007, EMSA has published an annual Maritime Accident Review.

To date EMSA has not been active on health issues. However, the EU does have a number of directives that determine aspects of maritime health in member states, such as EU 92/29 on the minimum safety and health requirements for improved medical treatment on board vessels.[15] 

[1] ILO history  https://www.ilo.org/global/about-the-ilo/history/lang--en/index.htm

[2] ILO working methods  https://www.ilo.org/global/about-the-ilo/how-the-ilo-works/lang--en/index.htm

[3] ILO/IMO Guidelines on the medical examinations of seafarers https://www.ilo.org/sector/Resources/codes-of-practice-and-guidelines/WCMS_174794/lang--en/index.htm

[4] ILO Guidelines on the training of ships cooks https://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---sector/documents/normativeinstrument/wcms_218575.pdf

[5] ILO Guidelines for implementation of the occupational safety and health provisions of the Maritime Labour Convention, 2006 https://www.ilo.org/wcmsp5/groups/public/---ed_dialogue/---sector/documents/normativeinstrument/wcms_325319.pdf

[6]ILO Convention 188, work in fishing https://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C188

[7] List of ILO Conventions and Recommendations https://www.ilo.org/dyn/normlex/en/f?p=1000:12020:::NO:::

[8] http://www.imo.org/en

[9] The IMO does not make its conventions and other instruments freely available on the web. These need to be ordered and paid for. Catalogue at http://www.imo.org/en/Publications/Pages/Home.aspx

Summaries, but not the full text, of conventions can be found at http://www.imo.org/en/About/Conventions/ListOfConventions/Pages/Default.aspx

[10] WHO home http://www.who.int

[11] WHO International Health Regulations http://www.who.int/ihr/publications/9789241580496/en/

[12]WHO International Medical Guide for Ships http://apps.who.int/iris/bitstream/handle/10665/43814/9789240682313_eng.pdf?sequence=1

[13]WHO IMGS Quantification Addendum (for medical stores) http://apps.who.int/iris/bitstream/handle/10665/44341/9789241547994_eng.pdf?sequence=1

[14] European Maritime Safety Agency  http://www.emsa.europa.eu/

[15] EU Directive 92/29 https://osha.europa.eu/en/legislation/directives/17