Outcomes of seafarer work fitness qualifications in the Netherlands.

Background: Seafaring is a dangerous profession involving high fatality rates and little research has been done to identify conditions that may lead to failing the seafarer's medical qualification (SMQ).

Aims: To determine the proportion of seafarers failing to pass the SMQ in the Netherlands during 2012, to analyse the outcomes of the SMQ according to qualification, age, duties and requirements of additional evaluations and to describe the reasons for considering a seafarer unfit for duty.

Methods: A retrospective descriptive study of SMQs registered in the Netherlands Shipping Inspectorate database.

Results: Less than 1% (46 cases; 0.6%) of the 7617 final SMQ candidates were considered unfit for duty with 53% (24) of these being temporarily unfit. Four per cent (276) of cases were classified 'fit with restrictions' and 1% (66) 'fit by exemption' (FEx). Re-examination was required in 2% (122) of cases. A second opinion from a medical referee was sought in 4% of cases. The highest rate of FEx was found in older seafarers (aged over 55) due to restrictions in hearing and vision in the majority (59%) of cases. The leading causes of unfitness were other medical reasons, mainly associated with cardiovascular conditions and morbid obesity, in 52% of cases and visual impairment in 34%.

Conclusions: The proportion of seafarers considered unfit in the SMQ carried out in the Netherlands in 2012 is relatively low. The proportion of FEx was higher in older groups, mainly due to hearing or visual impairments.