COMMISSION OF THE EUROPEAN COMMUNITIES 
C0M(91) 65 final - SYN 278 
Brussels, 27 February 1991 
Amended proposa I for a Counc iI D irect i va 
on the minimum health and safety requirements 
for improved medical treatment on board vessels 
(presented by the Commission pursuant to Article 149(3) 
of die liEC-Treaty) 
EXPLANATORY MEMORANDUM 
Proposal for a Council Directive on the Minimum health and safety 
requirements for improved medical treatment on board vessels. 
Following the opinion of the Parliament on a first reading, issued on 
25.1.1991, the Commission is forwarding to the Council an amended 
proposal for a directive pursuant to Article 149(3) of the EEC Treaty. 
The amended text mainly strengthens provisions in three areas: 
Improvements have been made with regard to the types of medical 
supplies to be carried and Member States are now required to 
quant i fy such supplies. Spec i f i c prov i s i ons have a I so been laid 
down governing arrangements for checking supplies. 
Provisions have been introduced on equipping life rafts and life 
boats with minimum medical supplies. Finally, for some categories 
of vessels, the amended proposal requires a sick bay to be made 
available for medical treatment and the presence of a doctor among 
the crew. 
New requirements have been introduced on the management of medical 
supplies, and in particular their renewal and maintenance. 
The article on the provision of medical advice by radio for workers 
on board has been redrafted to give further details of how the 
system should work and what its purpose is. 
The Commission's amended proposal thus has the same general structure 
and objectives as the initial proposal, but develops and clarifies some 
of the more important provisions. 
- 1 -
Initial prejmeJ by the Commission Amended proposa! pursuant 
EEC Arties 14S>?: 
Proposal for a Council Directive on the 
minimum Health and safety requirements for 
Improved medical treatment on board 
vessels (Where no alternative version !a gr/en in 
this column, the text h 
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 
Pari lament, 
Having regard to the opinion of the 
Economic and Social Committee, 
Whereas the Commission communication 
(88/C28/02) on its programme concerning 
safety, hygiene and health at work (1) 
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 a vessel is a workplace which 
requires special attention on account of 
its mobility, its geographical isolation 
and the wide range of risks to the safety 
and health of the workers on board; 
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; 
. - ... 0 — 2 -
initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
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 p'easure 
boats used for non-commercial purposes. 
Vessels fall into four categories in 
accordance with Annex I; 
worker: 
any person who is employed or retained 
in whatever capacity on board a vessel, 
including trainees and apprentices, but 
excluding pi lots; 
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 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
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. Member States shall take the measures 
necessary to ensure that: 
a) vessels always have medicai supplies of 
the type specified in Annex M for tho 
category of vessel to which they 
belong. The quantities of medicines 
and médical equipment to be carried 
must take account of the features of 
the trip (distance, ports of call, 
destination, duration, etc), the 
type(s) of work to be carried out 
during the trip, the nature of the 
cargo carried and the number of crew 
members. The contents of the medicai 
supplies shall be detailed on a 
checklist as shown in Annex V; 
b) all vessels have, for each of their 
life rafts and life boats, a water­
tight medicine chest whose contents 
fulfil the requirements laid down in 
Annex II for category D vessels. The 
contents of these medicine chests sha 
also be detailed on the checklist 
referred to in (a); 
c) all vessels of more than 500 gross 
register tonnes with a crew of 15 or 
over on trips of more than three days 
duration have a sickbay where medical 
treatment can be provided under 
satisfactory, hygienic conditions. 
d) any vessel with a crew of 100 or more 
engaged on international voyages of 
more than 3 days' duration carries a 
doctor on board. 
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; 
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Initial proposal by the Commission Amended 
EEC proposal pursuant to Article 149(3) 
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. 
Allocation of responsibilities Management of medical supplies 
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. 2) the medical supplies are maintained in 
good condition and replenished and/or 
renewed as soon as possible and in 
every instance as a priority part of 
normal revictua11ing procedures. 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
3) In an emergency, any medicines not 
available on board are obtained as 
quickly as possible for the workers 
concerned. 
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 transmission system 
used must ensure that such data remain 
confidential. In order to ensure that workers receive 
better emergency treatment, the Member 
States shall designate one or more centres 
to provide workers on board with medicai 
advice by radio free of charge 
Doctors providing their services for these 
centres shall be trained to familiarize 
them with the special conditions obtaining 
on board vessels. 
In order to provide the best possible 
advice, the centres may, with the agreement 
of the workers concerned, keep details of 
personal medical data. Such data shall 
remain confidential. 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
Inspection 
Article 7 
Member States shall take appropriate 
measures to ensure that a competent 
authority carries out annual checks on 
vessels under their jurisdiction to 
determine whether the medical supplies 
carried correspond to the checklist 
provided for pursuant to Article 2. all 
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 
specifications and new findings in this 
field, the Commission shall be assisted by 
a committee composed of the 
representatives 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. 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 comply with the minimum 
requirements laid down in this Directive 
and whether the checklist provided for in 
Article 2 has been filled out correctly. 
When carrying out such checks, the 
competent authority shall also ensure that 
the supplies are kept in suitable 
conditions and that they have not passed 
their expiry dates, where appropriate. 
Tne Commission shall adopt the measures 
envisaged if they ara in accordance with 
the opinion of the committee. 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
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 
Commission. 
Final provisions 
Article 9 
1. Member States shall bring into force 1. Member States shall bring into force 
the laws, regulations and the laws, regulations and 
administrative provisions necessary for administrative provisions necessary for 
compliance with this Directive by 31 compliance with this Directive by 31 
December 1993. They shall immediately December 1992. They shall immediately 
notify the Commission thereof. 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 
Direct ive. 
Article 10 
This Directive is addressed to the Member 
States. 
ANNEX I 
Categories of vessel referred to in 
Article 1 
A. Sea-going or sea-fishing vessel, with 
no limitation on length of trips. 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
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 (1). 
D. Harbour vessels, boats and craft 
staying very close to shore or with no 
cabin accommodation other than a 
wheeI house. 
(1) 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. Med i cInes 
Categories of vessel (1) 
1) Cardiovascular 
med i c i nes 
- Circulatory 
analeptic 
- Anti-angina 
- Diuretic 
- Anti-haemorrhagic 
2) Gastrointestinal 
system 
- Medicines for 
gastric and 
duodenal disorders 
- Antiemetic 
- Laxatives A B C D 
+ + + 
+ + + 
A B C D 
Laxatives ABC 
+ + + 
- Anti-diarrhoea I + + + + 
- Intestinal + + 
ant iseptic 
- Haemorrhold + + 
preparations 
(1) + indicates that this type of 
medicine must be carried on board 
the category of vessel in question. 
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Initial proposal by the Commission Amended proposa 
EEC pursuant to Article 149(3) 
3) Analgesics 
- Analgesics, 
antipyretics and 
ant i-infIammatory 
- Morphine 
analgesics 
4) Nervous system 
- Anxiolytic 
- Neuroleptic 
- Antihistaminic H1 A B C D 
+ + + + 
A B C D 
+ + 
+ + 
+ + + 
5) Hormone system 
- Glucocorticoids A B C D 
+ + + 
6) Respiratory system 
- Medicines used in 
cases of 
bronchospasm 
- Antitussives 
- Medicines used 
for colds and 
s i nus i t i s A B C D 
+ + + 
+ + + 
+ + + 
7) Anti-infection 
- Antibacterial 
antibiotics and 
sulphamides 
- Urinary 
ant isept les 
- Antiparasitics 
- Vaccines, anti­
tetanus 
gammaglobulins 
8) Compounds 
promoting 
rehydrat ion and 
caloric or mineral 
salt intake A B C D 
+ + + 
+ + + 
+ + 
A B C D 8) Compounds 
promoting 
rehydration and 
calor ic or mineral 
salt intake C D 
9) Medicines for 
external use 
- Skin medicines 
- Eye medicines 
- Ear medicines 
- Medicines for 
oral and throat 
infections A B C D 
+ + + 
+ + + 
+ + 
+ + + 
LocaI anaesthetIcs A B C D 
+ + A B C D 
Local anaesthetics + + + 
11. Med IcaI equ i praent 
dressings 
1. Resuscitation 
equipment 
2. Dressings and A B C D 
+ + + 
+ + + + 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
3. Instruments 
4. General medical 
equipment 
5. Immobilization 
equipment 
6. Disinfection -
dis insectization 
protection 
III. Antidotes + + + + 
+ + + 
+ + + + 
+ + + 
1) Medicines 
- General 
- Anti-infective 
- Cardiovascular 
- Respiratory system 
-Gastrointestinal system 
- Nervous system 
- For external use 
2) Equipment 
- Necessary for 
oxygen the administration of 2) Equipment 
- Necessary for the administration of 
oxygen (including maintenance) 
ANNEX 111 
DANGEROUS SUBSTANCES REFERRED TO IN 
ARTICLE 4 
The substances listed in this Annex are 
covered irrespective of their form when 
taken on board, including waste. 
Explosive substances and objects 
Gases: compressed, liquefied or 
dissolved under pressure 
Inflammable liquids 
Inflammable sol ids 
Inflammable solids, substances liable 
to spontaneous combustion 
Inflammable solids, substances which, 
on contact with water, give off 
inflammable gases 
Combust IbIe substances 
Organic peroxides 
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Initial proposal by the Commission Amended proposal 
EEC pursuant to Article 149(3) 
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 applled. 
ANNEX IV 
MEDICAL TRAINING OF THE CAPTAIN AND OTHER 
PERSONS, AS REFERRED TO IN ARTICLE 5(3) 
Basic understanding of physiology, 
symptomatology and therapeutics. radioactive substances; 
Knowledge of basic health protection, 
particularly personal and collective 
hygiene, and of basic prophylactic 
measures. 
Detailed knowledge of how to use the 
various remote medical consultation 
facilities. 
Ability to perform basic types of 
treatment and supervise emergency 
disembarkation at sea. 
The abovementioned training should take 
account of the programmes of instruction 
detailed in relevant recent international 
documents. 
ANNEX V 
CHECKLIST FOR VESSELS' MEDICAL SUPPLIES AS 
REFERRED TO IN ARTICLE 7 
1. Details of the vessel 
Name: 
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Initial proposal by the Commission Amended proposal pursuant to Article 149(3) 
EEC 
Flag: 
Home port: 
2. Medical supplies yes no 2. Medical supplies 
yes no nominal remarks 
quant 11 i es 
carried 
o o 0 
2.1 Medicines 
- cardiovascular o o 
- gastrointestinal system o o 
- analgesics o o 
- nervous system o o 
- hormone system o o 
- respiratory system o o 
- anti-infect ion o o 
- rehydration o o 
- external use o o 
- other oo 
2.2 Antidotes 
- general o o 
- ant I-Infect ion o o 
- cardiovascular o o 
- respiratory system o o 
- gastrointestinal system o o 
- nervous system o o 
- external use o o 
- 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 
- immobiIization equipment o o 
- disinfection; 
dis insectization; protection o o 
- other equipment o o 
Date: 
Signature of captain: 
Stamp of the competent authority 
ISSN 0254-1475 
COM(91) 65 final 
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