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Volume 12, ECA 2022
 
 

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, 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

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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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Abstract
Multiple Varicella Outbreaks on Cruise Ships Belonging to the Same Company
Med. Sci. Forum 2022, 13(1), 1; https://doi.org/10.3390/msf2022013001 - 21 Nov 2022
Viewed by 217
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
Abstract
Occupational Diseases and Injuries on Board Ships: A Preliminary Analysis for an Epidemiological Observatory of Seafarers
Med. Sci. Forum 2022, 13(1), 7; https://doi.org/10.3390/msf2022013007 - 28 Nov 2022
Viewed by 95
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
Abstract
A Review on COVID-19 and Coastal Management
Med. Sci. Forum 2022, 13(1), 8; https://doi.org/10.3390/msf2022013008 - 28 Nov 2022
Viewed by 142
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
Abstract
Remote Monitoring of Ship Pharmacy: An Experience of Maritime Telepharmacy
Med. Sci. Forum 2022, 13(1), 10; https://doi.org/10.3390/msf2022013010 - 28 Nov 2022
Viewed by 111
Abstract
The ship is not only a workplace [...] Full article

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Proceeding Paper
Developing a Framework for Health Risk Assessment, by Integrating Infection and Spreading Aspects into RBD
Med. Sci. Forum 2022, 13(1), 2; https://doi.org/10.3390/msf2022013002 - 23 Nov 2022
Viewed by 164
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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Proceeding Paper
MMVFs Onboard Ships: From an Observational Study to the Development of MMVFs Safety Plans
Med. Sci. Forum 2022, 13(1), 3; https://doi.org/10.3390/msf2022013003 - 23 Nov 2022
Viewed by 126
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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Proceeding Paper
The Soft Power Approach to Ship Sanitation
Med. Sci. Forum 2022, 13(1), 4; https://doi.org/10.3390/msf2022013004 - 24 Nov 2022
Viewed by 131
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
Proceeding Paper
COVID-19, Travel Companion: The Spanish Experience on Cruise Ships
Med. Sci. Forum 2022, 13(1), 5; https://doi.org/10.3390/msf2022013005 - 25 Nov 2022
Viewed by 175
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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Proceeding Paper
Pilot Implementation of SARS-CoV-2 Wastewater Surveillance on Cruise Ships Arriving at the Port of Piraeus from June to November 2021
Med. Sci. Forum 2022, 13(1), 6; https://doi.org/10.3390/msf2022013006 - 25 Nov 2022
Viewed by 157
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
Proceeding Paper
Advanced Telemedicine Solutions for High-Quality Medical Assistance at Sea
Med. Sci. Forum 2022, 13(1), 9; https://doi.org/10.3390/msf2022013009 - 28 Nov 2022
Viewed by 122
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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Proceeding Paper
Seawater Contamination of Potable Water Shoreside during Freight Ferry Bunkering at an International Port
Med. Sci. Forum 2022, 13(1), 11; https://doi.org/10.3390/msf2022013011 - 29 Nov 2022
Viewed by 124
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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Proceeding Paper
Mass Casualty Incident in the Port of Hamburg—Large-Scale Exercise during the COVID-19 Pandemic
Med. Sci. Forum 2022, 13(1), 12; https://doi.org/10.3390/msf2022013012 - 30 Nov 2022
Viewed by 110
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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Proceeding Paper
Communication of Public Health Events on Ships through the EU Common Ship Sanitation Database
Med. Sci. Forum 2022, 13(1), 13; https://doi.org/10.3390/msf2022013013 - 01 Dec 2022
Viewed by 73
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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Proceeding Paper
Legionella spp. Colonization on Non-Passenger Ships Calling at Belgian Ports
Med. Sci. Forum 2022, 13(1), 15; https://doi.org/10.3390/msf2022013015 - 01 Dec 2022
Viewed by 94
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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Proceeding Paper
Potable Water Quality on Non-Passenger Ships Calling Belgian Ports
Med. Sci. Forum 2022, 13(1), 16; https://doi.org/10.3390/msf2022013016 - 01 Dec 2022
Viewed by 71
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
Proceeding Paper
EU HEALTHY GATEWAYS Joint Action—Contributions to European Public Health Preparedness and Response at Points of Entry
Med. Sci. Forum 2022, 13(1), 17; https://doi.org/10.3390/msf2022013017 - 01 Dec 2022
Viewed by 72
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
Proceeding Paper
SHIPSAN Routine Inspections between 2018 and 2022
Med. Sci. Forum 2022, 13(1), 18; https://doi.org/10.3390/msf2022013018 (registering DOI) - 02 Dec 2022
Viewed by 28
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
Proceeding Paper
COVID on the Seas: SARS-CoV-2 in Commercial Shipping, Port of Rotterdam, The Netherlands, 2020–2021
Med. Sci. Forum 2022, 13(1), 19; https://doi.org/10.3390/msf2022013019 - 02 Dec 2022
Viewed by 257
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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Proceeding Paper
Developing an Interoperable Port Health Contingency Plan
Med. Sci. Forum 2022, 13(1), 20; https://doi.org/10.3390/msf2022013020 - 02 Dec 2022
Viewed by 86
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
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