UK P&I Club’s crew health resources

The issue: crew health while on board  

There is increasing awareness of the health concerns crews face while on board. The UK P&I Club launched the first crew health scheme of its kind in 1996, after seeing increasing incidents of crew illness and limited accountability from clinics. Since then it has become one of the Club’s leading loss prevention initiatives. It has a preventative focus and an aim of reducing the volume of crew illness claims. When health concerns go unmanaged, it can impact on a seafarer’s ability to perform their role and potentially endanger the seafarer, as well as those working around them.  

For those who aren’t sure how to help seafarers in need, here is a selection of resources available from the UK P&I Club. 

Resource one: Pulmonary Tuberculosis 

The UK P&I Club offers a Pre-Employment Medical Examination (PEME) to provide enhanced pre sea medical examinations which are conducted by approved clinics. This service has been available for 24 years and more than 425,000 examinations have been conducted. 

Since inception, the screening program has detected 754 (10 per cent) cases of seafarer Tuberculosis (TB), with a recent case identifying the failure of a local department of health to pick up existing TB in the crew member, which resulted in the crewmember requiring six-month treatment.  

What is TB and why is it common at sea? 

Tuberculosis (TB) is a bacterial disease that can be caught by breathing in the bacteria. This happens when droplets from the cough of an infected person are breathed in. People can become ill within a few weeks, months, or years of breathing in the bacteria. Because seafarers are often visiting ports around the world, they are potentially exposed to a range of bacteria and diseases, including TB.  

Symptoms of TB include a cough, ongoing tiredness, loss of appetite, weight loss, fever, and night sweats. These symptoms are similar to a range of illnesses. Therefore, it’s essential for seafarers to alert their healthcare professionals when such problems persist.  

What happens in the case of a positive test? 

If a medical professional completes testing and a positive case is found, the person will be referred to a specialist who will provide suitable treatment such as antibiotics to treat the infection. The length of treatment will depend on the severity of the case.  

Learn more about TB in seafarers 

Resource two: Signs of heat stroke 

In 2017, the UK P&I Club reported the death of two crew members on a vessel, who’d suffered from heatstroke. The Club pointed out this was not an isolated incident. As ships sail through locations that are under high summer suns, it’s important to be aware of the serious impact of heat exhaustion and potential heat stroke.  

Heatstroke generally occurs when the body temperate is higher than 40 degrees Celsius (or 104 degrees Fahrenheit). According to the UK P&I Club, signs of impending heat stroke can be identified when milder symptoms occur. These might include body cramps, fainting and exhaustion. That said, heatstroke can also occur without warning.  

What is heat stroke? 

A person experiencing heatstroke may find themselves confused and disorientated, their skin might be dry or damp. A headache, dizziness and increased thirst may also occur. In the extreme, these symptoms can lead to respiratory concerns, seizures and kidney failure.  

How can seafarers prevent heatstroke? 

Perspiration is nature’s way of controlling the body’s intake of heat, but when you sweat, you lose salt and water, which must be replaced. Salt can be returned to the body via food or drinks containing salt. Regular water consumption is also essential.  

Seafarers should be particularly careful when working in extreme temperatures on deck or in engine rooms. Protective clothing that ensures air flow and sweat evaporation helps.   

The UK P&I Club’s tips for managing heatstroke  

• Move to a cool, shady, or air-conditioned place and remove any unnecessary clothing. 
• Lie down and raise their feet slightly. 
• Wrap the patient in a cold wet sheet until their temperature falls to at least 38°C(100.4°F). Measure this with a thermometer under their tongue or under their armpit. 
• If no sheet is available, use a fan or sponge with cold water to keep the patient cool. 
• Use ice packs and apply to the patient’s armpits, neck and back. Because these areas are rich with blood vessels close to the skin, cooling them may reduce body temperature. 
• Once their temperature seems to have gone back to normal, replace the wet sheet with a dry sheet. 
• While waiting for help to arrive, keep checking the patient's temperature, as well as breathing, pulse, and level of response. 
• Repeat the cooling process to lower their temperature to normal levels. 
• If loss of responsiveness occurs, open airway, check breathing and prepare to treat someone who has become unresponsive. 

Learn more about UK P&I Club’s tips for managing heat stroke 

Resource three: Supporting crew members suffering from Post-Traumatic Stress Disorder (PTSD) 

Traumatic events occur at sea far more frequently than we’d like. Those who suffer directly or witness traumatic events may experience serious psychological distress and feel anxious or disconnected from their colleagues. In the best-case scenarios, seafarers recover gradually, but when they don’t, they may be experiencing PTSD. 

Examples of traumatic events at sea that may lead to PTSD include: 

• Witnessing a serious workplace accident i.e. chemical explosion, fire onboard, collisions, ship groundings. 
• Witnessing the death or a serious injury of a co-worker onboard.   
• Being the victim of serious injury or repeated harassment or bullying onboard.  
• Witnessing, in person, a traumatic event as it occurs to another person.  
• Learning that a traumatic event occurred to a close family member or friend. 
• Experiencing repeated or extreme exposure to traumatic events such as: physical assault, mugging, sexual abuse, hostage situations, terrorist attack, piracy and torture. 

Identifying signs of PTSD 

According to the UK P&I Club, not everyone who is exposed to trauma will develop PTSD. In addition, the onset time can vary from hours to days, and in some cases may take months or years to manifest. Symptoms may appear out of nowhere or be trigged by something that reminds them of the event.  

If you think that you, or someone you know might be suffering from PTSD, here are some signs to look out for:  

• Difficulty concentrating  
• Being easily started  
• Behaving recklessly  
• Experiencing unwanted memories or vivid nightmares and flashbacks 
• Heart palpitations and breathing difficulties 
• Persistent negative emotions such as fear, anger, guilt, and shame 
• Low interest in activities  
• A sense of detachment 

Learn more about UK P&I Club’s support for those experiencing PTSD 

For more free health resources, visit UK P&I Club