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Med. Sci. Forum, 2022, SHIPSAN 2022

Public Health Congress on Maritime Transport and Ports 2022: Sailing to the Post-COVID-19 Era

Athens, Greece | 21–22 October 2022

Volume Editors:
Despena Andrioti Bygvraa, University of Gothenburg, Sweden
Sebastian Crespi, Biolinea Int., Spain
Miguel Dávila Cornejo, Ministry of Health, Spain
Lieselotte De Marez, Food Chain Safety and Environment, Belgium
Christos Hadjichristodoulou, University of Thessaly, Greece
Volker Harth, University Medical Center Hamburg-Eppendorf, Germany
Pavle Jelicic, Croatian Institute of Public Health, Croatia
Jørn Klein, University of South-Eastern Norway, Norway
Antonios Michaelakis, Benaki Phytopathological Institute, Greece
Varvara Mouchtouri, University of Thessaly, Greece
Nina Pirnat, National Institute of Public Health, Slovenia
Andrea Smith, Association of Port Health Authorities, UK
Carmen Varela Martínez, Health Institute Carlos III, Spain
Thijs Veenstra, National Institute for Public Health and the Environment (RIVM), The Netherlands
Thomas Von Muenster, University Medical Center Hamburg-Eppendorf, Germany

Number of Papers: 34
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Cover Story (view full-size image): The EU SHIPSAN ASSOCIATION organized, in collaboration with CLIA and MedCruise, the international Public Health Congress 2022 on Maritime Transport and Ports: sailing to the post-COVID-19 era [...] Read more.
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Editorial

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2 pages, 195 KiB  
Editorial
Statement of Peer Review
by Despena Andrioti Bygvraa, Sebastian Crespi, Miguel Dávila Cornejo, Lieselotte De Marez, Christos Hadjichristodoulou, Volker Harth, Pavle Jelicic, Jørn Klein, Antonios Michaelakis, Varvara Mouchtouri, Nina Pirnat, Andrea Smith, Carmen Varela Martínez, Thijs Veenstra and Thomas Von Muenster
Med. Sci. Forum 2022, 13(1), 34; https://doi.org/10.3390/msf2022013034 - 4 Apr 2023
Viewed by 731
Abstract
In submitting conference proceedings to Medical Sciences Forum, the volume editors of the proceedings certify to the publisher that all papers published in this volume have been subjected to peer review administered by the volume editors [...] Full article

Research

Jump to: Editorial, Other

3 pages, 199 KiB  
Abstract
Multiple Varicella Outbreaks on Cruise Ships Belonging to the Same Company
by Miguel Dávila, Iratxe Moreno, Lourdes Oliva, Rocío Palmera, Sergio Béjar, Patricia López, Inmaculada Vera, Concepción Sánchez, Gloria González, Raquel Ruiz, Irene Wijers and Fernando Carreras
Med. Sci. Forum 2022, 13(1), 1; https://doi.org/10.3390/msf2022013001 - 21 Nov 2022
Viewed by 897
Abstract
Transmission of infectious diseases on passenger ships is a well-known fact and efforts have been made to fight against it for years [...] Full article
2 pages, 181 KiB  
Abstract
Occupational Diseases and Injuries on Board Ships: A Preliminary Analysis for an Epidemiological Observatory of Seafarers
by Getu Gamo Sagaro, Ulrico Angeloni, Marzio Di Canio, Claudia Marotta, Giovanni Rezza, Andrea Silenzi and Francesco Amenta
Med. Sci. Forum 2022, 13(1), 7; https://doi.org/10.3390/msf2022013007 - 28 Nov 2022
Viewed by 1023
Abstract
Workers on board ships have a higher rate of mortality, injuries, and illnesses than their counterparts ashore due to their particularly risky working conditions [...] Full article
2 pages, 181 KiB  
Abstract
A Review on COVID-19 and Coastal Management
by Lee Shin Yun and Cherdvong Saengsupavanich
Med. Sci. Forum 2022, 13(1), 8; https://doi.org/10.3390/msf2022013008 - 28 Nov 2022
Viewed by 830
Abstract
COVID-19 pandemic highlighted the intricate relationships between human health, the social-ecological system, and coastal management in an era of climate and global change [...] Full article
2 pages, 172 KiB  
Abstract
Remote Monitoring of Ship Pharmacy: An Experience of Maritime Telepharmacy
by Giulio Nittari, Antonio Arcese and Francesco Amenta
Med. Sci. Forum 2022, 13(1), 10; https://doi.org/10.3390/msf2022013010 - 28 Nov 2022
Viewed by 959
Abstract
The ship is not only a workplace [...] Full article
2 pages, 173 KiB  
Abstract
Monitoring for Native and Invasive Mosquitoes at the Limassol Port in Cyprus
by Angeliki F. Martinou, Katerina Athanasiou and Kevin Shawcross
Med. Sci. Forum 2022, 13(1), 21; https://doi.org/10.3390/msf2022013021 - 7 Dec 2022
Cited by 1 | Viewed by 923
Abstract
Throughout human history, human mobility between ports has been responsible for the transcontinental spread of vector-borne diseases such as the bubonic plague and vectors such as fleas, sandflies, and mosquitoes being transported even to small oceanic islands [...] Full article
2 pages, 163 KiB  
Abstract
Seafarers’ Health and Wellbeing during COVID-19: Lessons Learned
by Margarita Kanaki, Despoina Andrioti Bygvraa and George Charalambous
Med. Sci. Forum 2022, 13(1), 28; https://doi.org/10.3390/msf2022013028 - 19 Dec 2022
Viewed by 1321
Abstract
The maritime industry has long been a significant mode of transportation. It is essential since it contributes to 80% of the global trade. Nevertheless, the COVID-19 pandemic has affected the maritime sector and its workforce. Many countries implemented strict prevention measures like the [...] Read more.
The maritime industry has long been a significant mode of transportation. It is essential since it contributes to 80% of the global trade. Nevertheless, the COVID-19 pandemic has affected the maritime sector and its workforce. Many countries implemented strict prevention measures like the No Sail Order, the closing of ports and movement restrictions. The study explored the potential effects of the COVID-19 restrictions on the health and well-being of seafarers with an aim to offer insight for policy recommendations. The study was cross-sectional. It took place during the period January–April 2021. The questionnaire developed by Stella Maris was used with permission. It was distributed to shipping companies and work unions and, through them, to seafarers. The sample was 106 individuals. The study features the findings of the questionnaire which were analyzed by descriptive and inferential statistics. SPSS was used for the analysis. Chi-square test and Fisher’s exact test were performed. Logistic regression was used to assess the impact of COVID-19 on physical, mental and financial aspects of seafarers’ lives. Multivariate logistic regression analysis was performed using the forward (conditional) stepwise regression method with probability for stepwise entry set at 10%. Statistical significance was considered at p < 0.05. Seafarers were affected physically (38%), mentally (53%), and financially (40%) by the pandemic. The country of origin, the time onboard and the number of supportive family members had an influence on those effects. Among the participants, those who worked on tankers and officers with more than three family members were more likely to face mental, physical or financial problems. In addition, the study showed that only 24.5% of the respondents were on regular contracts, 16% had their contracts extended, 14.2% were about to be deployed but were grounded due to the pandemic, while about half of the sample 41.5% was waiting for a new contract. The results of this study may be used as a starting point by International Organisations including IMO and ILO, flag states, ports and the industry to increase emergency preparedness and to inform outbreak response plans in the event of future infectious disease outbreaks in the shipping domain. Full article
1 pages, 170 KiB  
Abstract
COVID-19 at Dumai Sea: One Year Study on a Commerce Ship
by Firman and Suyanto Suyanto
Med. Sci. Forum 2022, 13(1), 29; https://doi.org/10.3390/msf2022013029 - 30 Jan 2023
Viewed by 637
Abstract
Background: Being highly contagious through person-to-person transmission, COVID-19 can easily spread within multinational populations of ships and to land communities. The purpose of this study is to report on the prevalence of COVID-19 infections in the Commerce fleet over a two year period [...] Read more.
Background: Being highly contagious through person-to-person transmission, COVID-19 can easily spread within multinational populations of ships and to land communities. The purpose of this study is to report on the prevalence of COVID-19 infections in the Commerce fleet over a two year period and to discuss measures to prevent and overcome the outbreak of COVID-19 on ships. Materials and methods: All possible cases of COVID-19 among crew on six merchant vessels were registered during 2021 by onboard medical facilities. The patients remained isolated for up to 6 days after taking a PCR test. Vulnerable contacts were identified and offered post-exposure measures. The nationality of the crew, the number of contacts vaccinated, and the cost of direct treatment were noted. Results: Across the year of 2021, there were six ships with registered COVID-19 cases (132 crew), and one out of the six ships had COVID-19 cases appearing less frequently than 1 per day, consisting of a total of 12 patients. This ship sails under the flag of the Indonesian state. Of the other five ships, among the crew, 111 caught COVID-19 (85.1% of crew cases were from Indonesia, and 21 (15.9%) of were from subtropical/tropical countries, namely India). Conclusions: All ships have to deal with cases of COVID-19 or outbreaks on board every few years. Any case of COVID-19 could start an outbreak, and thus trigger time-consuming and expensive containment measures, including isolation and mass vaccination of susceptible contacts. Mandatory pre-contract proof of COVID-19 immunity from all seafarers or from subgroups, noting their position or nationality may be worth considering. In order for sailors to be immune to COVID-19, they must be able to get COVID-19 vaccinations and valid documentation when sailing. Full article

Other

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4 pages, 1265 KiB  
Proceeding Paper
Developing a Framework for Health Risk Assessment, by Integrating Infection and Spreading Aspects into RBD
by Nikolaos P. Ventikos, Panagiotis Sotiralis, Manolis Annetis and Frank Roland
Med. Sci. Forum 2022, 13(1), 2; https://doi.org/10.3390/msf2022013002 - 23 Nov 2022
Cited by 1 | Viewed by 1001
Abstract
Communicable diseases pose a significant threat for passenger vessels, as norovirus, influenza, food, waterborne diseases, and lately COVID-19 have caused several public health events. To manage the risks deriving from communicable diseases, this work focuses on ship design by developing a framework for [...] Read more.
Communicable diseases pose a significant threat for passenger vessels, as norovirus, influenza, food, waterborne diseases, and lately COVID-19 have caused several public health events. To manage the risks deriving from communicable diseases, this work focuses on ship design by developing a framework for health risk assessment. This framework is based on the risk-based design, an emerging design process for which safety is considered as a design criterion, by also integrating infection and spreading aspects. The framework shall allow the assessment of various design solutions, as risk control options, aiming at minimizing the spread of diseases and, thus, its consequences. Full article
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4 pages, 573 KiB  
Proceeding Paper
MMVFs Onboard Ships: From an Observational Study to the Development of MMVFs Safety Plans
by Margherita Congiu, Antonio Collovà and Antonio Salzano
Med. Sci. Forum 2022, 13(1), 3; https://doi.org/10.3390/msf2022013003 - 23 Nov 2022
Viewed by 876
Abstract
Man-made vitreous fibers (MMVFs) are widely used in shipbuilding. Some MMVFs are “suspected of causing cancer” in Annex VI of Regulation (EC) 1272/2008 and can be easily found in ships (asbestos free or not ones). This study is an overview of the conditions/confinement [...] Read more.
Man-made vitreous fibers (MMVFs) are widely used in shipbuilding. Some MMVFs are “suspected of causing cancer” in Annex VI of Regulation (EC) 1272/2008 and can be easily found in ships (asbestos free or not ones). This study is an overview of the conditions/confinement of MMVFs onboard ships, focusing on the measures taken to reduce the risk of exposure and on the perception of risks, in analyzed ships. We suggest to improve on-board MMVFs safety plans (as for asbestos risk-management) and to strengthen National and European Authorities’ supervision/network on this theme also by the EU SHIPSAN ACT Joint Action’s tools. Full article
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3 pages, 205 KiB  
Proceeding Paper
The Soft Power Approach to Ship Sanitation
by Luis Alfredo Bautista, Iratxe Moreno and Miguel Dávila
Med. Sci. Forum 2022, 13(1), 4; https://doi.org/10.3390/msf2022013004 - 24 Nov 2022
Viewed by 901
Abstract
Soft power is a geopolitics concept that implies achieving what one wants through non-coercitive measures. In the context of ship sanitation, port health authorities can provide “hard” and coercitive mandates, and also non-coercitive recommendations. Herein we examine the presence of soft power in [...] Read more.
Soft power is a geopolitics concept that implies achieving what one wants through non-coercitive measures. In the context of ship sanitation, port health authorities can provide “hard” and coercitive mandates, and also non-coercitive recommendations. Herein we examine the presence of soft power in ship sanitation literature, the advantages and limitations of hard power, and the importance of the legal framework. Soft power often requires investing time in dialogue and mutual understanding and maintaining a good image; but in any case in the context of ship sanitation awareness and collaboration of all involved parts is necessary for long-term success. To conclude we recommend a careful combination of hard power and soft power. Full article
4 pages, 687 KiB  
Proceeding Paper
COVID-19, Travel Companion: The Spanish Experience on Cruise Ships
by Iratxe Moreno Lorente, Rocío Palmera Suarez, Lourdes Oliva Íñiguez, Miguel Dávila Cornejo, Sergio Béjar Serrano, Patricia López Pereira, Inmaculada Vera Gil, Concepción Sanchez Fernández, Gloria González Díaz, Irene Wijers and Fernando Carreras Vaquer
Med. Sci. Forum 2022, 13(1), 5; https://doi.org/10.3390/msf2022013005 - 25 Nov 2022
Viewed by 802
Abstract
Spain is a country with an important flow of cruises in Europe. Since the restarting of cruise activity, 1,106 events with 12,134 confirmed cases of COVID-19 were reported from 21 ports. 72.3% of cases and 73.7% of events were registered in the Balearic [...] Read more.
Spain is a country with an important flow of cruises in Europe. Since the restarting of cruise activity, 1,106 events with 12,134 confirmed cases of COVID-19 were reported from 21 ports. 72.3% of cases and 73.7% of events were registered in the Balearic Islands, Barcelona, Tenerife and Las Palmas, ports with the highest number of layovers and passengers. The events reported increased from October 2021, with a peak in January and April 2022. The cases raised later, in December 2021 with two peaks in January and April and a substantial increase in June 2022. The peak of January coincides with the peak of COVID-19 cases registered in Spain and Europe. The increases in April and June 2022 coincides with the Easter period and the beginning of summer holidays. Full article
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3 pages, 194 KiB  
Proceeding Paper
Pilot Implementation of SARS-CoV-2 Wastewater Surveillance on Cruise Ships Arriving at the Port of Piraeus from June to November 2021
by Michalis Koureas, Maria Kyritsi, Alexandros Vontas, Leonidas Kourentis, Charalampos Vasileiou, Varvara A. Mouchtouri and Christos Hadjichristodoulou
Med. Sci. Forum 2022, 13(1), 6; https://doi.org/10.3390/msf2022013006 - 25 Nov 2022
Viewed by 942
Abstract
This study evaluated the usefulness and validity of wastewater SARS-CοV-2 monitoring in passenger ships. Wastewater grab samples (n = 54) were collected from seven cruise ships arriving at the port of Piraeus from June to November 2021. Samples were analyzed for the presence [...] Read more.
This study evaluated the usefulness and validity of wastewater SARS-CοV-2 monitoring in passenger ships. Wastewater grab samples (n = 54) were collected from seven cruise ships arriving at the port of Piraeus from June to November 2021. Samples were analyzed for the presence of SARS-CoV-2 RNA with an RT-PCR based method. Results were compared against the number of cases detected on the ships before arrival. It was demonstrated that sewage monitoring can detect the presence of SARS-CoV-2, even with few cases on board. Future efforts should focus on the collection of more representative samples to increase the consistency and validity of the investigated practice. Full article
4 pages, 321 KiB  
Proceeding Paper
Advanced Telemedicine Solutions for High-Quality Medical Assistance at Sea
by Francesco Amenta, Marzio Di Canio, Antonio Arcese, Francesco Bajani, Ciro Ruocco and Fabio Sibilio
Med. Sci. Forum 2022, 13(1), 9; https://doi.org/10.3390/msf2022013009 - 28 Nov 2022
Cited by 1 | Viewed by 1202
Abstract
The medical assistance to seafarers was not always improved in parallel with advances in medicine and telecommunications. Today technology offers systems including digital devices helping in collecting symptoms to be referred correctly to remote physicians. CIRM SERVIZI, the spin-off of Centro Internazionale Radio [...] Read more.
The medical assistance to seafarers was not always improved in parallel with advances in medicine and telecommunications. Today technology offers systems including digital devices helping in collecting symptoms to be referred correctly to remote physicians. CIRM SERVIZI, the spin-off of Centro Internazionale Radio Medico (C.I.R.M.), and the Italian TMAS center, have developed an advanced system called CIRM PREMIUM. This aimed at offering extensive telemedicine solutions for the treatment of illnesses or injuries on-board ships. The objective of this paper is to present the results of offered service with CIRM PREMIUM and the standard basic TMAS service given by C.I.R.M. to ships not equipped with advanced technologies. We have considered 400 seafarers assisted on-board ships from 1 January 2020 to 31 December 2021 including 200 on-board ships equipped with CIRM PREMIUM (Test Group, TG) and 200 were on-board ships requiring the C.I.R.M. standard free telemedical assistance (Control Group, CG). The five most frequent different disorders assisted by C.I.R.M in the given period were considered. Diseases of the circulatory and respiratory systems were also considered to be the most frequent cause of medical emergencies on board. Data were analyzed comparatively by analysis of variance (ANOVA) and by the Chi-squared test. The average time for a patient’s complete recovery was 115.1 ± 12.8 h (4 to 5 days) in the TG group and 132.8 ± 14.4 h (5 to 6 days) in the CG group. From a temporal point of view, PREMIUM patients showed an improvement in 12–24 h from the first request for medical advice, versus 36–48 h for those using the standard medical service. The patients who fully recovered on board were 48.8% for the TG group and 27.46% for the CG. Telemedical assistance resulted in avoiding diversions in 73.7% of cases in the PREMIUM service and in 43.7% in the standard service. The results of our analysis revealed that the CIRM PREMIUM services provide a better and quicker outcome for patient conditions and cause significantly less ship diversions for medical reasons. This indicates that technological progress can offer relevant advantages for treating diseases or accidents on-board ships. The presence of telemedical devices on board, their larger and constant use and a closer collaboration from the ship will offer seafarers adequate health protection and will reduce the present disadvantage of being ill while at sea. Full article
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4 pages, 586 KiB  
Proceeding Paper
Seawater Contamination of Potable Water Shoreside during Freight Ferry Bunkering at an International Port
by Margaret M. Brennan, Louise Hendrick, Deirdre O’Brien, Stephen Burke, Máirín Boland and Helena Murray
Med. Sci. Forum 2022, 13(1), 11; https://doi.org/10.3390/msf2022013011 - 29 Nov 2022
Viewed by 842
Abstract
In January 2019, complaints of an intermittent salty taste in drinking water were received from locations in close proximity to an international seaport. Preliminary testing indicated the presence of seawater within the potable water system. A multi-disciplinary incident management team was immediately convened [...] Read more.
In January 2019, complaints of an intermittent salty taste in drinking water were received from locations in close proximity to an international seaport. Preliminary testing indicated the presence of seawater within the potable water system. A multi-disciplinary incident management team was immediately convened and a “Do Not Consume notice” was issued. Subsequent investigations revealed contamination was likely due to a mis-connection to the seawater firefighting system during freight ferry bunkering of potable water at the port. Following this incident, new procedures were introduced at the port to prevent reoccurrence of this issue. No associated cases of illness were reported. Full article
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4 pages, 1209 KiB  
Proceeding Paper
Mass Casualty Incident in the Port of Hamburg—Large-Scale Exercise during the COVID-19 Pandemic
by Lena Ehlers, Matthias Boldt, Birgit Grassl, Scarlett Kleine-Kampmann, Elisabeth Hewelt, Christina Stabenow, Kea-Sophie Weber, Jens de Boer, Kristina Militzer, Thomas von Münster, Jan Heidrich, Marcus Oldenburg, Volker Harth, Sinan Bakir and Martin Dirksen-Fischer
Med. Sci. Forum 2022, 13(1), 12; https://doi.org/10.3390/msf2022013012 - 30 Nov 2022
Viewed by 1019
Abstract
Within the framework of the interdisciplinary research project ARMIHN (Adaptive Resilience Management in the Port) a two-day large-scale exercise took place in the Port of Hamburg in October 2021. Due to the COVID-19 pandemic, the exercise could not be realized as a full-scale [...] Read more.
Within the framework of the interdisciplinary research project ARMIHN (Adaptive Resilience Management in the Port) a two-day large-scale exercise took place in the Port of Hamburg in October 2021. Due to the COVID-19 pandemic, the exercise could not be realized as a full-scale exercise with a large number of participants and actors as originally planned. Therefore, a hybrid exercise concept with virtual and live parts was developed. The project ARMIHN has shown that the planning, organization, and implementation of a hybrid large-scale exercise is demanding, resource- and time-intensive. On the other hand, the project showed the possibility for exercises to be conducted even when underlying conditions like the COVID-19 pandemic do not support a full-scale exercise in presence. Full article
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5 pages, 339 KiB  
Proceeding Paper
Communication of Public Health Events on Ships through the EU Common Ship Sanitation Database
by Leonidas Kourentis, Miguel Dávila Cornejo, Eleni Christoforidou, Nikos Bitsolas, Lemonia Anagnostopoulos, Christos Hadjichristodoulou, Varvara A. Mouchtouri and The EU HEALTHY GATEWAYS Partnership
Med. Sci. Forum 2022, 13(1), 13; https://doi.org/10.3390/msf2022013013 - 1 Dec 2022
Viewed by 848
Abstract
The coordination of public health events related to ships presents a challenge to the port health authorities, and communication means and routes are not well established. The EU Common Ship Sanitation Database provides a platform for port-to-port communication of public health events on [...] Read more.
The coordination of public health events related to ships presents a challenge to the port health authorities, and communication means and routes are not well established. The EU Common Ship Sanitation Database provides a platform for port-to-port communication of public health events on board ships. The last seven years of operation, 64 public health events were communicated through the system by port health authorities from seven EU countries. Although the usage of the platform has been appreciated, promoted, and legislated in several EU MSs, actions at the national and EU levels are needed to promote the use of the platform by all EU MS are necessary. Full article
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5 pages, 501 KiB  
Proceeding Paper
Using the Intra-Action Review Methodology at European Level to Assess Effectiveness of Measures for Cruise Ship Operations in the COVID-19 Context
by Lemonia Anagnostopoulos, Leonidas Kourentis, Miguel Dávila Cornejo, Iratxe Moreno Lorente, Mauro Dionisio, Claudia Marotta, Christos Hadjichristodoulou and Varvara A. Mouchtouri
Med. Sci. Forum 2022, 13(1), 14; https://doi.org/10.3390/msf2022013014 - 1 Dec 2022
Cited by 2 | Viewed by 888
Abstract
In response to the COVID-19 pandemic, the European Union Joint Action HEALTHY GATEWAYS developed guidelines for cruise operators and authorities to restart operations and provide common COVID-19 public health preparedness and response standards. In February 2022 under the Joint Action framework, a COVID-19 [...] Read more.
In response to the COVID-19 pandemic, the European Union Joint Action HEALTHY GATEWAYS developed guidelines for cruise operators and authorities to restart operations and provide common COVID-19 public health preparedness and response standards. In February 2022 under the Joint Action framework, a COVID-19 outbreak onboard a cruise ship was analysed, applying the Intra-Action Review (IAR) methodology at a European level. Participants included national public health authorities and local port health authorities involved in the event response, as well as cruise line representatives. Good practices and challenges observed during the COVID-19 event are presented. Moreover, we documented the lessons learned which provided the basis for proposed revisions to future versions of HEALTHY GATEWAYS guidelines. Full article
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4 pages, 363 KiB  
Proceeding Paper
Legionella spp. Colonization on Non-Passenger Ships Calling at Belgian Ports
by Leonidas Kourentis, Lemonia Anagnostopoulos, Zafeiris Tsinaris, Achilleas P. Galanopoulos, Diederik Van Reusel, Raf Van den Bogaert, Björn Helewaut, Inge Steenhout, Hasse Helewaut, Dion Damman, Christos Hadjichristodoulou and Varvara A. Mouchtouri
Med. Sci. Forum 2022, 13(1), 15; https://doi.org/10.3390/msf2022013015 - 1 Dec 2022
Viewed by 1006
Abstract
The association of cases of Legionnaires’ disease and ships has been well documented. Results from potable water samples collected for microbiological analysis during SSC inspections conducted from 2010 to 2018 at Belgian ports were analyzed in order to evaluate the level of colonization [...] Read more.
The association of cases of Legionnaires’ disease and ships has been well documented. Results from potable water samples collected for microbiological analysis during SSC inspections conducted from 2010 to 2018 at Belgian ports were analyzed in order to evaluate the level of colonization on non-passenger ships. Results indicate a high degree of colonization (77.2% of the ships were found to be colonized with Legionella spp. at least once) and further analysis is recommended to examine possible factors associated with colonization. Inspections for issuance of SSC should focus on water safety and prevention of Legionnaires’ disease. Full article
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3 pages, 221 KiB  
Proceeding Paper
Potable Water Quality on Non-Passenger Ships Calling Belgian Ports
by Leonidas Kourentis, Lemonia Anagnostopoulos, Zafeiris Tsinaris, Achilleas P. Galanopoulos, Diederik Van Reusel, Raf Van den Bogaert, Björn Helewaut, Inge Steenhout, Hasse Helewaut, Dion Damman, Christos Hadjichristodoulou and Varvara A. Mouchtouri
Med. Sci. Forum 2022, 13(1), 16; https://doi.org/10.3390/msf2022013016 - 1 Dec 2022
Viewed by 825
Abstract
Waterborne disease due to the microbial contamination of potable water onboard ships is a potential threat for seafarers. The results from the samples collected at Belgian ports from 2010 to 2018 during inspections of non-passenger ships are used to evaluate the microbiological and [...] Read more.
Waterborne disease due to the microbial contamination of potable water onboard ships is a potential threat for seafarers. The results from the samples collected at Belgian ports from 2010 to 2018 during inspections of non-passenger ships are used to evaluate the microbiological and chemical quality of potable water. A small proportion of the samples was found positive for indicator organisms (7.5%), indicating the lack of proper disinfection and possible contamination. Further analyses and risk assessments are recommended for examining possible contributing factors. Inspections for the issuance of SSC should focus on water safety and the prevention of waterborne diseases. Full article
4 pages, 206 KiB  
Proceeding Paper
EU HEALTHY GATEWAYS Joint Action—Contributions to European Public Health Preparedness and Response at Points of Entry
by Varvara A. Mouchtouri, Lemonia Anagnostopoulos, Mauro Dionisio, Martin Dirksen-Fischer, Janusz Janiec, Elina Kostara, Nikolaos Bitsolas, Jan Heidrich, Kristina Militzer, Brigita Kairiene, Doret de Rooij, Corien Swaan, Leonidas Kourentis, Eleni P. Christoforidou, Peter Otorepec, Nina Pirnat, Rita Ferrelli, Raquel Duarte-Davidson, Tom Gaulton, Christos Hadjichristodoulou and The EU HEALTHY GATEWAYS Partnershipadd Show full author list remove Hide full author list
Med. Sci. Forum 2022, 13(1), 17; https://doi.org/10.3390/msf2022013017 - 1 Dec 2022
Viewed by 877
Abstract
The joint action EU HEALTHY GATEWAYS (EUHG) aimed to support cooperation and coordinated action of MS to improve their preparedness and response capacities at PoE, for preventing and combating cross-border health threats from the transport sector. The aim of this study is to [...] Read more.
The joint action EU HEALTHY GATEWAYS (EUHG) aimed to support cooperation and coordinated action of MS to improve their preparedness and response capacities at PoE, for preventing and combating cross-border health threats from the transport sector. The aim of this study is to present how EUHG supported strengthening of core public health capacities at ports during routine operations and the COVID-19 pandemic. Methods used included surveys, literature reviews, in(tra)-action reviews, focus and expert working groups, site visits, exercises, inspection grading system methodology. In addition, the EU Common Ship Sanitation Database (EUSIS) was used as a tool to collect information on health conditions on board and to share information about public health events. EUHG network established the EUPOENET and implemented the European passenger ship inspections programme implementation where 558 inspectors in the EU SIS recorded 33,184 Ship Sanitation Certificates, followed up >80 public health events via the port communication form out of which 22 were COVID-19 related, and recorded > 4600 hygienic deficiencies. EUHG developed a web-based, searchable catalogue of best practices, SOPs for mosquito surveillance and control, a model MoU describing cooperation among authorities at ports, a tool was produced for development/assessment of contingency plans (ports), a tool serving group-based discussions about what defines risk at port level. EUHG conducted training courses and European level multi-sectorial TTE. The EUHG network of experts supported EU’s COVID-19 response by developing 16 technical guidance documents, provided >40 expert consultations and conducted three site visits and short seminars, two national level IAR and a European level meeting using IAR methodology and produced over five scientific publications. The JA’s network contribution to the pandemic has been globally acknowledged, recognized and demonstrated, with the network immediately activated to support EC and MS requests, and transport restart operations in 2020–2021. Full article
5 pages, 229 KiB  
Proceeding Paper
SHIPSAN Routine Inspections between 2018 and 2022
by Leonidas Kourentis, Eleni P. Christoforidou, Mauro Dionisio, Miguel Dávila-Cornejo, Antonis Kantonis, Boris Kopilovic, Erika Grigorevičė, Iveta Dubrovova, Martina Pilková, Mairin Boland, Martin Dirksen-Fischer, Natalja Vozelevskaja, Raf Van Den Bogaert, Thijs Veenstra, Jaret Ames, Antonello Campagna, Nikolaos Bitsolas, Christos Hadjichristodoulou, Varvara Mouchtouri and the EU HEALTHY GATEWAYS Joint Action Partnership
Med. Sci. Forum 2022, 13(1), 18; https://doi.org/10.3390/msf2022013018 - 2 Dec 2022
Viewed by 1053
Abstract
The aim of the study is to describe the routine inspections conducted by competent Public Health Authorities (PHAs) on board passenger ships (cruise ships, inland vessels or ferries) sailing in European countries during the EU HEALTHY GATEWAYS joint action and according to the [...] Read more.
The aim of the study is to describe the routine inspections conducted by competent Public Health Authorities (PHAs) on board passenger ships (cruise ships, inland vessels or ferries) sailing in European countries during the EU HEALTHY GATEWAYS joint action and according to the hygiene standards set out in the European Manual for Hygiene Standards and Communicable Disease Surveillance on Passenger Ships (Edition 2nd, April 2016). From 2018 to the end of April 2022, 138 inspection reports were submitted by PHAs in 38 ports in SIS by 76 inspectors, three SHIPSAN experts, 16 inspectors in training and 31 observers, along with 130 Corrective Action Statements by shipping companies or officers of ships. Full article
3 pages, 1007 KiB  
Proceeding Paper
COVID on the Seas: SARS-CoV-2 in Commercial Shipping, Port of Rotterdam, The Netherlands, 2020–2021
by Edward Gebuis, Bruno Vieyra, Rob Slegtenhorst, Saskia Wiegmans, Bas van Dijk, Thijs Veenstra, Saskia Tejland, Ewout Fanoy, Annemieke de Raad, Marion Koopmans, René de Vries, Saskia van Leeuwen-Voerman and Jane Whelan
Med. Sci. Forum 2022, 13(1), 19; https://doi.org/10.3390/msf2022013019 - 2 Dec 2022
Viewed by 1266
Abstract
We analysed all proven cases of SARS-CoV-2 on sea-going vessels entering or present in the Port of Rotterdam to illustrate the burden of the corona pandemic on commercial shipping. We calculated the notification rate (NR) per arrival and attack rate per vessel and [...] Read more.
We analysed all proven cases of SARS-CoV-2 on sea-going vessels entering or present in the Port of Rotterdam to illustrate the burden of the corona pandemic on commercial shipping. We calculated the notification rate (NR) per arrival and attack rate per vessel and correlated outbreak sizes by vessel type over time during the pandemic using routinely gathered data from the port and public health (PH) authorities. Full article
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3 pages, 216 KiB  
Proceeding Paper
Developing an Interoperable Port Health Contingency Plan
by Robert Conway, Margaret M. Brennan, Paul Mullane, Cliodhna O’Mahony, Finán Gallagher, Gavin McDonnell, Brendan Lawlor, Darryl Coen, Regina Kiernan, Margaret B. O’Sullivan and Máirín Boland
Med. Sci. Forum 2022, 13(1), 20; https://doi.org/10.3390/msf2022013020 - 2 Dec 2022
Viewed by 943
Abstract
Contingency planning is a vital component of robust national emergency preparedness. In Ireland, the Health Service Executive Port Health Network engaged with Dublin Port from July 2021 to develop Ireland’s first interoperable port health contingency plan, with a view to rolling it out [...] Read more.
Contingency planning is a vital component of robust national emergency preparedness. In Ireland, the Health Service Executive Port Health Network engaged with Dublin Port from July 2021 to develop Ireland’s first interoperable port health contingency plan, with a view to rolling it out to other designated ports. The EU Healthy Gateways tool for public health emergency contingency plan development (2021) was utilized to support this project, ensuring public health emergency contingency planning across varied public health threats. The principles of this multi-agency approach to port contingency planning, as described, are applicable to other designated ports within Ireland and other jurisdictions. Full article
4 pages, 215 KiB  
Proceeding Paper
Prevention of Legionella Infections in Shipboard Medical Facilities: A Proposal to Include the Use POU Filters in the Preventive Plan
by Simone Latorre, Mattia Latorre, Federica Zedda and Antonello Campagna
Med. Sci. Forum 2022, 13(1), 22; https://doi.org/10.3390/msf2022013022 - 7 Dec 2022
Viewed by 741
Abstract
Legionella is a public health concern on passenger ships and the the need to implement a Legionellosis prevention plan is even more important in on-board hospitals that are frequented by higher risk people who are more susceptible to infection. In this paper we [...] Read more.
Legionella is a public health concern on passenger ships and the the need to implement a Legionellosis prevention plan is even more important in on-board hospitals that are frequented by higher risk people who are more susceptible to infection. In this paper we proposed a prevention plan specific for shipboard medical facilities derived by the Italian National guidelines for Legionellosis prevention. We presented also data of efficacy and performance specifications (field evaluation), on a Legionella point-of-use filter. The point-of-use filters when they are used in synergy with the others prevention methods can play an important role, cost–benefits ratio positive, to minimize the risk of growth and spread of Legionella and other waterborne pathogens on passenger ships in case of specific conditions. Full article
3 pages, 177 KiB  
Proceeding Paper
Maritime Public Health Cross Border Cooperation: Principality of Monaco and Italian Liguria Health Port Authority Best Practices
by Antonello Campagna, Marco Mela, Mattia Latorre, Federica Zedda, Thomas Althaus and Eric Voiglio
Med. Sci. Forum 2022, 13(1), 23; https://doi.org/10.3390/msf2022013023 - 9 Dec 2022
Viewed by 858
Abstract
The French and Italian Riviera are one of the most important areas in the world for yachting and cruise activity. Even though ports and airports of this area make up a single network, they insist on the territory of two different EU countries [...] Read more.
The French and Italian Riviera are one of the most important areas in the world for yachting and cruise activity. Even though ports and airports of this area make up a single network, they insist on the territory of two different EU countries (Italy and France), and of one non-EU (Principality of Monaco), that have different health systems and legislations. In this context, a collaboration between maritime port health authorities became essential to perform an effective public health action in order to prevent the spread of infectious diseases. In this paper are illustrated the best practices in the domain of maritime public health collaboration between Italy and Monaco during the Covid-19 pandemic, and programs for future developments that should be a benchmark for other cooperation programs between eropean health port authorities. Full article
5 pages, 198 KiB  
Proceeding Paper
Comprehensive Action to Address Seafarers’ Challenges since the COVID-19 Pandemic—A Pragmatic Approach to Human Rights at Sea
by Eva Lianne Veldkamp, Despoina Andrioti Bygvraa, Hannah E. Dawicki and Morgan G. Dawicki
Med. Sci. Forum 2022, 13(1), 24; https://doi.org/10.3390/msf2022013024 - 12 Dec 2022
Viewed by 905
Abstract
The COVID-19 pandemic exacerbated many underlying issues regarding seafarers in the maritime industry, known as the “human element” at the International Maritime Organization. The challenges were a result of a global crew change crisis and issues with repatriation as a result of travel [...] Read more.
The COVID-19 pandemic exacerbated many underlying issues regarding seafarers in the maritime industry, known as the “human element” at the International Maritime Organization. The challenges were a result of a global crew change crisis and issues with repatriation as a result of travel lockdowns, pay insecurity, mental health challenges, lack of digital access, and flaws within the Maritime Labour Convention (MLC) that resulted in serious questions of liability and rights and responsibilities for seafarers. The Center for Ocean Policy & Economics (COPE), hosted by the Northeast Maritime Institute’s College of Maritime Science, observed and participated in several initiatives to promote human rights at sea to improve the livelihood of seafarers. The initiatives underscore pathways and methods of improvement for maritime and ocean related issues. Full article
2 pages, 165 KiB  
Proceeding Paper
Psychological Safety, Bullying, Sexual Assault and Harassment in the Maritime Sector
by Eva Lianne Veldkamp, Despoina Andrioti Bygvraa, Hannah E. Dawicki and Morgan G. Dawicki
Med. Sci. Forum 2022, 13(1), 25; https://doi.org/10.3390/msf2022013025 - 12 Dec 2022
Viewed by 1045
Abstract
The adverse impacts caused by the COVID-19 pandemic reinforced and magnified issues of sexual assault and harassment (SASH) with consequences on seafarers’ mental health and wellbeing which in turn negatively affects recruitment and attrition rates of seafarers. The Center for Ocean Policy & [...] Read more.
The adverse impacts caused by the COVID-19 pandemic reinforced and magnified issues of sexual assault and harassment (SASH) with consequences on seafarers’ mental health and wellbeing which in turn negatively affects recruitment and attrition rates of seafarers. The Center for Ocean Policy & Economics (COPE) hosted by the Northeast Maritime Institute’s College of Maritime Science, which was established to tackle wicked problems in the maritime and ocean related fields, established a working group to aid the International Maritime Organization (IMO) to amend and develop training for SASH in IMO Model Course 1.21 Personnel Safety and Social Responsibilities. The working group facilitates global participation through digital accessibility to ensure diverse viewpoints on SASH in the maritime sector. Full article
5 pages, 980 KiB  
Proceeding Paper
Transformation of a Ferry in a COVID-19 Ship Hospital: Crew Occupational Safety and Health Issues According to the Experience of Liguria Public Health Port Authority
by Antonello Campagna, Paolo Cremonesi and Rosa Maria Russo
Med. Sci. Forum 2022, 13(1), 26; https://doi.org/10.3390/msf2022013026 - 15 Dec 2022
Viewed by 1002
Abstract
In March 2020, a ferry (Splendid G.N.V. Company, Italy) moored in the port of Genova (Northwest of Italy) was transformed into a medical care facility for COVID-19. The project intended to help infected patients that required low-intensity care, were discharged from hospitals in [...] Read more.
In March 2020, a ferry (Splendid G.N.V. Company, Italy) moored in the port of Genova (Northwest of Italy) was transformed into a medical care facility for COVID-19. The project intended to help infected patients that required low-intensity care, were discharged from hospitals in the Liguria Region and were not yet able to return home. The aim was to share some of the treatment burden of the completely overcrowded local ashore hospitals and to free up bed spaces for patients in the acute phase of the disease. In this work we highlighted under the health port authority perspective the safety issues that the crew faced resulting from the exceptional and very unusual allocation of ashore medical facilities on a passenger ship. Full article
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4 pages, 180 KiB  
Proceeding Paper
Cruise Ships and Ferries’ Medical Facilities’ Requirements: An Operative Guideline Used in Authorization
by Antonello Campagna and Rosa Maria Russo
Med. Sci. Forum 2022, 13(1), 27; https://doi.org/10.3390/msf2022013027 - 15 Dec 2022
Viewed by 889
Abstract
Adequate medical facilities on passenger ships are essential to ensuring the quality of medical care and public health actions. Their design and construction is complex, as they have to comply with several regulations and recommendations from different authorities (IMO, ILO, EU, WHO), national [...] Read more.
Adequate medical facilities on passenger ships are essential to ensuring the quality of medical care and public health actions. Their design and construction is complex, as they have to comply with several regulations and recommendations from different authorities (IMO, ILO, EU, WHO), national flag legislation and advices from scientific societies. Therefore, proper authorization procedures become very important. The working guideline, developed in the light of our experience gained in new Italian cruise ships/ferries’ medical facilities’ authorization processes is presented. Innovative points are the participative continuous approach “from the board to the sea” and the Dynamic-Planning Method based on “what if” scenario model. A careful balance of the required features and standards against costs without compromising the quality of care is possible. The guidelines are open to be continually reviewed, updated, and expanded with the contribution of stakeholder’s. Readers are encouraged to provide feedback and to contribute material for further updates. Full article
3 pages, 188 KiB  
Proceeding Paper
Y.A.C.H.T.: Yes, A Challenging Tool to Perform a Ship Sanitation Exemption Inspection on Yacht
by Mattia Latorre, Simone Latorre and Antonello Campagna
Med. Sci. Forum 2022, 13(1), 30; https://doi.org/10.3390/msf2022013030 - 30 Jan 2023
Viewed by 802
Abstract
The public health surveillance of yachts and pleasure boats is relevant to avoid and prevent the spread of infectious diseases. With the entry into force of the International Health Regulations 2005, the Ship Sanitation Exemption Certificate (SSEC) become an important tool to prevent [...] Read more.
The public health surveillance of yachts and pleasure boats is relevant to avoid and prevent the spread of infectious diseases. With the entry into force of the International Health Regulations 2005, the Ship Sanitation Exemption Certificate (SSEC) become an important tool to prevent the risk of the international spread of disease through international maritime travel. The WHOs existing international guidelines mainly refer to large ships, so the aim of this work was to create a concise checklist applicable to the yachting world. In order to facilitate and standardise the inspection procedures on board yachts, a summary checklist was therefore drawn up. A summary of mainly non compliance founded in the 2021 is also provided. Full article
4 pages, 219 KiB  
Proceeding Paper
Quarantine Vessels and Irregular Migration: New Public Health Measures against SARS-CoV-2
by Laura Pecoraro, Salvatore Zichichi, Emanuela Maria Frisicale, Claudia Marotta, Domenico Stabile, Claudio Pulvirenti, Ulrico Angeloni, Giorgia Battaglia, Giovanni Rezza and Fabrizio Stracci
Med. Sci. Forum 2022, 13(1), 31; https://doi.org/10.3390/msf2022013031 - 8 Feb 2023
Viewed by 888
Abstract
During SARS-CoV-2 pandemic irregular migrants coming by sea to Europe were required to observe a period of isolation or quarantine on-board dedicated ferry vessels, converted into protected isolation system according to Technical Guidelines written by the Italian Ministry of Health. Migrants were accommodated [...] Read more.
During SARS-CoV-2 pandemic irregular migrants coming by sea to Europe were required to observe a period of isolation or quarantine on-board dedicated ferry vessels, converted into protected isolation system according to Technical Guidelines written by the Italian Ministry of Health. Migrants were accommodated according to their health conditions and swab tests results in different color zones. 20 “Ship Missions” were performed with an average operating time of 4.12 months in the sea. 60,086 migrants were hosted (positivity of 7.29%). This integrated management system showed some limitations but positively contributed to better manage irregular migration during the pandemic. Full article
3 pages, 1333 KiB  
Proceeding Paper
e-Healthy Ship: New Approaches for Improving Health Management on Merchant Vessels
by Lukas Belz, Dorothee Dengler, Chiara Reck, Thomas von Münster, Jan Heidrich, Volker Harth and Marcus Oldenburg
Med. Sci. Forum 2022, 13(1), 32; https://doi.org/10.3390/msf2022013032 - 16 Mar 2023
Viewed by 673
Abstract
On Merchant vessels, there is usually no physician on board. Health management there is a great challenge for the responsible nautical officers. To simplify health administration on board diverse electronic health modules including a medical logbook and pharmacy module were developed in cooperation [...] Read more.
On Merchant vessels, there is usually no physician on board. Health management there is a great challenge for the responsible nautical officers. To simplify health administration on board diverse electronic health modules including a medical logbook and pharmacy module were developed in cooperation with an IT company. These modules are integrated in an existing fleet management system. The medical logbook and pharmacy modules were designed to offer more functions than just classic documentation and allow quick access to patient information. The included functions can support the nautical officer in his healthcare duties on the vessel. Full article
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2 pages, 184 KiB  
Proceeding Paper
Occupational Health on Merchant Ships during COVID-19
by Kristina Militzer, Franziska Labe, Martin Dirksen-Fischer, Matthias Boldt, Birgit Grassl, Christina Stabenow, Volker Harth and Jan Heidrich
Med. Sci. Forum 2022, 13(1), 33; https://doi.org/10.3390/msf2022013033 - 16 Mar 2023
Viewed by 515
Abstract
The COVID-19 pandemic burdened the working and living conditions of seafaring personnel with particular challenges. The present study investigated the health and occupational burden of 301 multinational seafarers from merchant ships using self-administered questionnaires. The survey was carried out between September and November [...] Read more.
The COVID-19 pandemic burdened the working and living conditions of seafaring personnel with particular challenges. The present study investigated the health and occupational burden of 301 multinational seafarers from merchant ships using self-administered questionnaires. The survey was carried out between September and November 2021 on the occasion of SARS-CoV-2 vaccinations at the Port of Hamburg, Germany. Participants generally reported good physical and mental health status while general burden perception increased compared to pre-pandemic levels. Three-quarters of seafarers reported experiencing shore-leave denial at least once throughout the pandemic. In summary, the study reveals the substantial impact of the COVID-19 pandemic on the perceived occupational burden of seafaring personnel. Full article
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