CELEX: 51991PC0065
Language: en
Date: 1991-02-27
Title: AMENDED PROPOSAL FOR A COUNCIL DIRECTIVE ON THE MINIMUM HEALTH AND SAFETY REQUIREMENTS FOR IMPROVED MEDICAL TREATMENT ON BOARD VESSELS

COMMISSION OF THE EUROPEAN COMMUNITIES
                                        C0M(91)   65 f i n a l - 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)
 ---pagebreak---                           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.
 ---pagebreak---                                           - 1 -
 I n i t i a l prejmeJ by the Commission     Amended proposa! pursuant     A r t i e s 14S>?:
                                             EEC
 Proposal for a Council Directive on the     (Where no alternative version !a gr/en in
 minimum Health and safety requirements for  this column, the text h
 Improved medical treatment on board
 vessels
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       Whereas a vessel is a workplace which
requires special attention on account of    requires special attention on account of
its mobility, its geographical isolation,    its mobility, its geographical isolation
and the potentially high risks to the       and the wide range of risks to the safety
safety and health of the workers on board;  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;
 ---pagebreak---                                     . - ... 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
 ---pagebreak---                                            - 3 -
  Initial proposal by the Commission          Amended proposal pursuant to Article 149(3)
                                              EEC
 Member States shall take the measures        Member States shall take the measures
 necessary to ensure that the vessels under   necessary to ensure that:
 their jurisdiction always have at least      a) vessels always have medicai supplies of
one medicine or one item of medical                the type specified in Annex M for tho
 equipment in each of the categories set           category of vessel to which they
out in Annex II for the category of vessel         belong. The quantities of medicines
 to which they belong.                             and médical equipment to be carried
                                                  must take account of the features of
The quantities to be carried must take             the trip (distance, ports of call,
account of the nature and destination of          destination, duration, etc), the
 the trip and the number of crew members.          type(s) of work to be carried out
                                                  during the trip, the nature of the
The contents of the medical supplies shall        cargo carried and the number of crew
be detailed on a checklist as shown in            members. The contents of the medicai
Annex V.                                          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;
 ---pagebreak---                                            - 4 -
 Initial proposal by the Commission           Amended proposal pursuant to Article 149(3)
                                              EEC
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     2)  the medical supplies are maintained in
    good condition and replenished where          good condition and replenished and/or
    necessary, as soon as port conditions         renewed as soon as possible and in
    permit.                                       every instance as a priority part of
                                                  normal revictua11ing procedures.
 ---pagebreak---                                          - 5 -
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     In order to ensure that workers receive
more centres to provide any data which may  better emergency treatment, the Member
be required to improve emergency treatment  States shall designate one or more centres
for crew members. The transmission system   to provide workers on board with medicai
used must ensure that such data remain      advice by radio free of charge
confidential.
                                            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.
 ---pagebreak---                                           - 6 -
 Initial proposal by the Commission          Amended proposal pursuant to Article 149(3)
                                             EEC
                  Inspection
                  Article 7
Member States shall take appropriate         Member States shall take appropriate
measures to ensure that a competent          measures to ensure that a competent
authority carries out annual checks on all   authority carries out annual checks on all
vessels under their jurisdiction to          vessels under their jurisdiction to
determine whether the medical supplies       determine whether the medical supplies
carried correspond to the checklist          carried comply with the minimum
provided for pursuant to Article 2.          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.
         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.
Tne Commission shall adopt the measures
envisaged if they ara in accordance with
the opinion of the committee.
 ---pagebreak---                                           - 7 -
 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.
 ---pagebreak---                                              - 8-
 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                A  B  C  D
    med i c i nes
-   Circulatory                  +  + +
    analeptic
-   Anti-angina                  +  + +
-   Diuretic
-   Anti-haemorrhagic
2) Gastrointestinal              A  B  C  D
    system
-   Medicines for
    gastric and
    duodenal disorders
-   Antiemetic
                                                                      A B C
                                                       Laxatives      +  + +
-   Laxatives
-   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.
 ---pagebreak---                                                   - 9 -
 I n i t i a l proposal by the Commission            Amended proposa    pursuant to A r t i c l e 149(3)
                                                     EEC
 3) Analgesics                         A  B  C  D
 - Analgesics,                         +  +  +  +
      antipyretics and
      ant i-infIammatory
 - Morphine
      analgesics
 4)   Nervous system                   A B  C  D
 -     Anxiolytic                      + +
 -     Neuroleptic                     + +
-      Antihistaminic H1               +  + +
5) Hormone system                     A  B  C  D
- Glucocorticoids                     +  +  +
6 ) Respiratory system                A  B  C  D
- Medicines used in                   +  +  +
      cases of
      bronchospasm
- Antitussives                        +  +  +
- Medicines used                      +  +  +
      for colds and
      s i nus i t i s
7) Anti-infection                     A  B  C  D
- Antibacterial                       +  +  +
      antibiotics and
      sulphamides
- Urinary
      ant isept les
- Antiparasitics                      +  +  +
- Vaccines, a n t i -                 +  +
      tetanus
     gammaglobulins
8) Compounds                          A  B  C  D    8)   Compounds                  C   D
     promoting                                           promoting
     rehydrat ion and                                    rehydration and
     caloric or mineral                                  calor ic or mineral
     salt intake                                         salt intake
9 ) Medicines for                     A  B  C  D
     external use
- Skin medicines                      +  +  +
- Eye medicines                       +  +  +
- Ear medicines                       +  +
- Medicines for                       +  +  +
     oral and throat
      infections
                                      A  B  C  D                             A   B  C   D
LocaI anaesthetIcs                    +  +               Local anaesthetics +    +  +
11.         Med IcaI equ i praent and A  B  C  D
            dressings
1. Resuscitation                      +  +  +
     equipment
2. Dressings                          +  +  +  +
 ---pagebreak---                                           - 10 -
 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                                 2)   Equipment
    - Necessary for the administration of        - Necessary for the administration of
    oxygen                                       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
 ---pagebreak---                                           - 11 -
 Initial proposal by the Commission          Amended proposal pursuant to Article 149(3)
                                             EEC
    Toxic substances
     Infectious substances
                                                 radioactive 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.
                                             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:
 ---pagebreak---                                          - 12 -
 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
 ---pagebreak---                                                                                ISSN 0254-1475
                                                                   COM(91) 65 final
                                                      DOCUMENTS
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                                                              ISBN 92-77-69582-X
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