No C 183/6 Official Journal of the European Communities 24. 7. 90 
II 
(Preparatory Acts) 
COMMISSION 
Proposal for a Council Directive on the minimum health and safety requirements for improved 
medical treatment on board vessels 
COM(90) 272 final — SYN 278 
(Submitted by the Commission) 
(90/C 183/04) 
THE COUNCIL OF THE EUROPEAN COMMUNITIES, 
Having regard to the Treaty establishing the European 
Economic Community and in particular Article 118A 
thereof, 
Having regard to the Commission's proposal drawn up 
after consultation with the Advisory Committee on 
Safety, Hygiene and Health Protection at Work, 
In cooperation with the European Parliament, 
Having regard to the opinion of the Economic and 
Social Committee, 
Whereas the Commission communication on its 
programme concerning safety, hygiene and health at 
work (') envisages measures to ensure medical treatment 
at sea; 
Whereas a vessel is a workplace which requires special 
attention on account of its mobility, its geographical 
isolation, and the potentially high risks to the safety and 
health of the workers on board; 
Whereas there is a need for vessels to have on board 
adequate medical equipment and medicines, properly 
maintained and checked at regular intervals, to permit 
the effective treatment of the crew and, in certain cases, 
avoid disembarkations at sea or diversions of vessels, 
which are not only costly but can also delay treatment; Whereas, in order to improve medical treatment at sea, it 
is desirable to promote training in and information on 
the use of medical supplies and of the various remote 
medical consultation facilities; 
Whereas there is a need to provide for additional 
measures for medical assistance at sea in order to take 
account of technological and medical progress and thus 
ensure better protection of the health and safety of the 
workers, 
HAS ADOPTED THIS DIRECTIVE: 
Definitions 
Article 1 
For the purposes of this Directive, the following terms 
have the meanings hereafter assigned to them: 
— vessel: 
any vessel flying the flag of a Member State, which is 
operated at sea or in adjacent waters accessible to 
sea-going vessels and is publicly or privately owned, 
excluding warships and pleasure boats used for 
non-commercial purposes. Vessels fall into four 
categories in accordance with Annex I; 
— worker: 
O OJ No C 28, 3. 2. 1988, p. 3. any person who is employed or retained in whatever 
capacity on board a vessel, including trainees and 
apprentices, but excluding pilots; 
24. 7. 90 Official Journal of the 
— medical supplies: 
medical equipment and medicines, including any 
antidotes that may be required under the terms of 
Article 3 (1); 
— antidote: 
a substance or means used to prevent or treat a 
harmful effect or effects, direct or indirect, of one or 
more substances included in the list of dangerous 
substances in Annex III. 
Medical supplies 
Article 2 
Member States shall take the measures necessary to 
ensure that the vessels under their jurisdiction always 
have at least one medicine or one item of medical 
equipment in each of the categories set out in Annex II 
for the category of vessel to which they belong. 
The quantities to be carried must take account of the 
nature and destination of the trip and the number of 
crew members. 
The contents of the medical supplies shall be detailed on 
a checklist as shown in Annex V. 
Dangerous substances 
Article 3 
Member States shall take the measures necessary to 
ensure that: 
1. any vessel under their jurisdiction carrying any of the 
dangerous substances listed in Annex III has medical 
supplies, including the appropriate antidotes listed in 
Annex II, and that to this end its captain is kept 
informed of the dangerous substances loaded on 
board, in order to protect the health and safety of the 
workers; 
2. for ferry-type vessels, whose conditions of operation 
do not always allow them to know well enough in 
advance the nature of the dangerous substances being 
transported, all the antidotes listed in Annex II are 
carried on board. However, on a regular route where 
the crossing is due to last less than two hours, the 
antidotes may be limited to those which have to be 
administered within a period of time not exceeding 
the duration of the crossing. European Communities No C 183/7 
Allocation of responsibilities 
Article 4 
Member States shall take the measures necessary to 
ensure that: 
1. the provision and replenishment of all the medical 
supplies of any vessel under their jurisdiction are 
undertaken at the responsibility and exclusively at the 
expense of the owner, without any expense to the 
workers; these supplies are to be placed under the 
responsibility of the captain of the vessel who may, 
without prejudice to this responsibility, delegate the 
use and maintenance of the supplies to one or more 
workers specially designated by reason of their 
competence; 
2. the medical supplies are maintained in good condition 
and replenished where necessary, as soon as port 
conditions permit. 
Information and training 
Article 5 
Member States shall take appropriate measures to ensure 
that: 
1. the medical supplies are accompanied by a guide to 
their use, including instructions for the use of the 
antidotes required pursuant to Article 3; 
2. during their professional maritime training all persons 
intending to work on board are given instruction in 
the medical and emergency measures to be taken 
immediately in the event of an accident or serious 
emergency; 
3. the captain and the worker or workers to whom he 
delegates the use of the ship's medical supplies 
pursuant to Article 4 of this Directive have received 
special training, taking into account the specific risks 
and needs connected with the different categories of 
vessels and in accordance with the general guidelines 
set out in Annex IV. 
Article 6 
The Member States shall designate one or more centres 
to provide any data which may be required to improve 
emergency treatment for crew members. The trans­
mission system used must ensure that such data remain 
confidential. 
No C 183/8 Official Journal of the European Communities 24. 7. 90 
Inspection 
Article 7 
Member States shall take appropriate measures to ensure 
that a competent authority carries out annual checks on 
all vessels under their jurisdiction to determine whether 
the medical supplies carried correspond to the checklist 
provided for pursuant to Article 2. 
Adaptation of the Annexes 
Article 8 
For the purpose of making technical changes to the 
Annexes of this Directive in the light of technical 
progress, changes in international regulations or specifi­
cations and new findings in this field, the Commission 
shall be assisted by a committee composed of the repre­
sentatives of the Member States and chaired by the 
representative of the Commission. 
The representative of the Commission shall submit to the 
committee a draft of the measures to be taken. 
The committee shall deliver its opinion on the draft 
within a time limit which the chairman may lay down 
according to the urgency of the matter. 
The opinion shall be delivered by the majority laid down 
in Article 148 (2) of the Treaty in the case of decisions 
which the Council is required to adopt on a proposal 
from the Commission. 
The votes of the representatives of the Member States 
within the committee shall be weighted in the manner set 
out in that Article. The chairman shall not vote. The Commission shall adopt the measures envisaged if 
they are in accordance with the opinion of the 
committee. 
If the measures envisaged are not in accordance with the 
opinion of the committee, or if no opinion is delivered, 
the Commission shall, without delay, submit to the 
Council a proposal relating to the measures to be taken. 
The Council shall act by a qualified majority. 
If, on the expiry of a period of three months from the 
date of referral to the Council, the Council has .not 
acted, the proposed measures shall be adopted by the 
Commisson. 
Final provisions 
Article 9 
1. Member States shall bring into force the laws, 
regulations and administrative provisions necessary for 
compliance with this Directive by 31 December 1993. 
They shall immediately notify the Commission thereof. 
The provisions adopted pursuant to the first 
subparagraph shall make express reference to this 
Directive. 
2. Member States shall notify the Commission of the 
text of the regulations under national law which have 
already been adopted or will be adopted in the area 
governed by this Directive. 
Article 10 
This Directive is addressed to the Member States. 
24. 7. 90 Official Journal of the European Communities No C 183/9 
ANNEX I 
CATEGORIES OF VESSEL REFERRED TO IN ARTICLE 1 
A. Sea-going or sea-fishing vessel, with no limitation on length of trips. 
B. Sea-going or sea-fishing vessel, making trips of between 100 and 200 nautical miles from the nearest 
port. 
C. Sea-going or sea-fishing vessel making trips of less than 100 nautical miles from the nearest port ('). 
D. Harbour vessels, boats and craft staying very close to shore or with no cabin accommodation other than 
a wheelhouse. 
(') This category may be extended to vessels of less than 50 gross register tons or to those which remain continuously 
within range of helicopter rescue services. 
ANNEX II 
MEDICAL SUPPLIES REFERRED TO IN ARTICLE 2 
I. Medicines 
Categories of vessel^) 
1. Cardiovascular medicines 
— Circulatory analeptic 
— Anti-angina 
— Diuretic 
— Anti-haemorrhagic 
2. Gastrointestinal system 
— Medicines for gastric and duodenal disorders 
— Antiemetic 
— Laxatives 
— Anti-diarrhoeal 
— Intestinal antiseptic 
— Haemorrhoid preparations A 
+ 
+ 
+ 
+ 
+ 
+ B 
+ 
+ 
+ 
+ 
+ 
+ C 
+ 
+ 
+ D 
+ 
+ 
(') + indicates that this type of medicine must be carried on board the category of vessel in question. 
No C 183/10 Official Journal of the European Communities 24. 7. 90 
3. Analgesics 
— Analgesics, antipyretics and anti-inflammatory 
— Morphine analgesics 
4. Nervous system 
— Anxiolytic 
— Neuroleptic 
— Antihistaminic HI 
5. Hormone system 
— Glucocorticoids 
6. Respiratory system 
— Medicines used in cases of bronchospasm 
— Antitussives 
— Medicines used for colds and sinusitis 
7. Anti-infection 
— Antibacterial antibiotics and sulphamides 
— Urinary antiseptics 
— Antiparasitics 
— Vaccines, anti-tetanus gammaglobulins 
8. Compounds promoting rehydration and caloric or 
mineral salt intake 
9. Medicines for external use 
— Skin medicines 
— Eye medicines • 
— Ear medicines 
— Medicines for oral and throat infections 
— Local anaesthetics A 
+ 
•f B 
+ 
+ C 
+ 
+ D 
+ 
A 
+ 
+ 
+ B 
+ 
+ 
+ C 
+ D 
A 
+ B 
+ C 
+ D 
A 
+ 
+ 
+ B 
+ 
+ 
+ C 
+ 
+ 
+ D 
A 
+ 
+ 
+ 
+ B 
+ 
+ 
+ 
+ C 
+ 
+ D 
A 
+ B C D 
A 
+ 
+ 
+ 
+ 
+ B 
+ 
+ 
+ 
+ 
+ C 
+ 
+ 
+ D 
24. 7. 90 Official Journal of the European Communities No C 183/11 
II. Medical equipment and dressings 
1. Resuscitation equipment 
2. Dressings 
3. Instruments 
4. General medical equipment 
5. Immobilization equipment 
6. Disinfection — disinsectization — protection 
III. Antidotes 
1. Medicines 
— General 
— Anti-infective 
— Cardiovascular 
— Respiratory system 
— Gastrointestinal system 
— Nervous system 
— For external use 
2. Equipment 
— Necessary for the administration of oxygen A 
+ 
+ 
+ 
+ 
+ 
+ B 
+ 
+ 
+ 
+ 
+ 
+ C 
+ 
+ 
+ 
+ 
+ 
+ D 
+ 
+ 
+ 
ANNEX III 
DANGEROUS SUBSTANCES REFERRED TO IN ARTICLE 3 
Explosive substances and objects 
Gases: compressed, liquefied or dissolved under pressure 
Inflammable liquids 
Inflammable solids 
Inflammable solids, substances liable to spontaneous combustion 
Inflammable solids, substances which, on contact with water, give off inflammable gases 
Combustible substances 
Organic peroxides 
Toxic substances 
Infectious substances 
Corrosive substances 
Various dangerous substances, i. e. any other substances which experience has shown or may show to 
be dangerous, so that the provisions of Article 3 need to be applied. 
l^oCt^Bl^ C^ffici^lJour^^ofthe^urooe^nCornrnuniu^ ^.^,^0 
MEDICALTRAININC OF THE CAPTAIN AND OTHER PERSONS, AS REFERRED TO IN 
ARTICLED 
^asic understanding of phvsiologv^svmptomatologv and therapeutics. 
Detailed knowledge of ho^ to use the various remote medical consultation facilities. 
Ahilitv to perform basic tvpes of treatment and supervise emergence disembarkation at sea. 
Theabovementionedtraining shouldtakeaccount of the programmesofinstructiondetailed in relevant 
recent international documents. 
CHECKLIST FOR VESSELS'MEDICAL SUPPLIES AS REFERRED TO IN ARTICLED 
t. De^Iso^tlie vessel 
Name^ 
Flag^ 
Homeport^ 
^.Me^c^s^^es 
ves no 
^.t. Medicines 
— cardiovascular (0 (0 
— gastrointestinal svstem 00 00 
— analgesics (0 CO 
— nervous svstem 0^ OO 
— hormone svstem Co (^ 
— respiratorv svstem (0 (0 
— antPinfection (0 (0 
— rehydration Co eO 
— external use (O 0^ 
mother (0 (0 
^.Antidotes B 
— general ^0 00 
— antiinfection CO CO 
— cardiovascular (0 (0 
— respiratorv svstem 00 CO 
— gastrointestinal svstem CO (0 
— nervous svstem 00 (0 
24. 7. 90 Official Journal of the European Communities No C 183/13 
yes no 
— external use 
— other O O 
— necessary for the administration of oxygen O O 
2.3. Equipment 
— resuscitation equipment O O 
— dressings O O 
— instruments O O 
— general medical equipment O O 
— immobilization equipment O O 
— disinfection; disinsectization; protection O O 
— other equipment O O 
(Date) (Signature of captain) 
Stamp of the competent authority 
\