ALF MAGNE HORNELAND
Pre-employment selection of seafarers probably have been carried out for as long as people have been employed for service on board ships, based on the master’s intuition and sovereignty considering ability to work rather than taking care of the individual sailor’s health.
In this chapter, we will look at some of the general principles that apply to medical selection, rather than looking at specific conditions and how to assess them. For more detailed guidance on how to assess a seafarer against the criteria and standards, we refer to the guidance documents issued by national maritime authorities, P&I Clubs, manning agencies and employers, as well as to the international guidelines from the International Labour Organisation (ILO) and International Maritime Organisation (IMO) and regional requirements, i.e. from the European Union (EU). The ‘Handbook for seafarer medical examiners’  covers how medical assessment should be carried out in single cases in accordance with the IMO/ILO guidelines. Norway has issued similar Guidance to the Norwegian regulations.
Seafarers work on ships of all sizes, from the smallest fishing boats to the biggest super-tankers. They may work solo, or they may work on passenger ships where the number of crewmembers can be several thousands. Work spans from domestic voyages on lakes and rivers, via local and regional coasting to unrestricted voyages. Work encompasses bulk cargo carriers, oil and gas transportation on tankers, both small and massive container ships, passenger ferries and cruise ships. They work with fish catching on small boats in sheltered waters or on big industrial trawlers in distant, sometimes icy waters. They work with naval warfare on submarines, small patrol boats and big aircraft carriers, and they work in the offshore petroleum industry with seismic investigation, drilling or production, in workplaces that could be on mobile or fixed ships or units.
Seafarers may work on deck and bridge, in the engine department, in the galley or with other catering duties. On some ships there is specialised work such as entertaining passengers, carrying out research studies, i.a. specialised operations using Remotely Operated Vehicles (ROVs), mapping the seabed or what is below it, investigating marine life or climate changes.
It will fall beyond the scope of this chapter to cover all the different job positions, work places, ship types and sailing areas where seafarers could possibly work. Instead, the chapter will cover principles for medical selection, using the merchant navy as an example, whilst always keeping in mind the need for individual risk assessment according to position, job tasks, ship type and trade area.
In the end of the chapter, emphasis will be given to some special characteristics for other types of seafaring than merchant shipping. Furthermore, some of the examples in the text will be Norwegian, due to my background from Norway.
 P&I Clubs are insurance companies covering Protection and indemnity insurance. Whereas a marine insurance company provides "hull and machinery" cover for ship-owners, and cargo cover for cargo owners, a P&I club provides cover for open-ended risks that traditional insurers are reluctant to insure
 Carter T. Handbook for seafarer medical examiners, http://www.ncmm.no/publications/handbook-for-seafarer-medical-examiner . Free access publication.
 Guidance to Regulations on the Medical Examination of Employees on Norwegian Ships and Mobile Offshore Units. https://www.sdir.no/contentassets/4d82128b4fd649e9921993d2073fc2f0/veiledning-til-helseforskriften.pdf?t=1570602969050. Free publication.
 Remotely operated underwater vehicles