1.3 Isolation facilities Ships should have: an isolation room or the capability to provide isolation of patients; the capability to provide quarantine. ST 1.4 Ventilation Medical rooms should be well ventilated. ST 1.5 Washing facilities Medical facilities should have toilet and hand washing facilities, which should be supplied as described in section 7.2. ST 1.6 Medical waste management Medical facilities must have appropriate sharps and biomedical waste capability. Contaminated, out of date damaged medicines should be replaced and not used. ST 1.7 Temperature measuring devices Temperature measuring devices must be provided and maintained in proper operational condition for patients. 1.8 Medical procedures The following procedures are considered to be the minimum required on board: maintenance for all medical equipment; a medical record system with: well organised, legible and consistent documentation of all medical care, a system of appropriate medical records and communication confidentiality; code team (crash team) trained and updated regularly; manuals for operation of medical equipment; Medical Operations Manual as required by the International Safety Management Code requirements; Emergency Preparedness Plan as required by the International Safety Management Code. 1.9 Hygiene Plan A Hygiene Plan for medical facilities should be implemented. ST
diseases: reporting and restriction Item Details /ST Health of food handlers 3.2.5 Diseases Food handlers who are infected by pathogenic microorganisms transmissible through food must be excluded from food handling activities. 3.2.6 Medical permission Supervisors should ask the medical staff or other designated crew written for food handlers to return to their duties after recovery. ST A record of the written to return to work should be maintained for 12 months and be available for inspection. ST 3.2.7 Reporting symptoms Food handlers must report any symptoms of infectious disease transmissible through food to their supervisor. These usually include: fever38°C100°F abdominal cramps diarrhoea sore throat with fever any discharges from their nose persistent coughing and sneezing visible sores on their hands, arm or face jaundice 3.2.8 Covering of wounds Crew working in food handling areas should cover wounds which have the potential to contaminate food (on hands or other exposed parts of the body) with waterproof dressings. ST Hygiene practices and personal hygiene of food handlers Item Details /ST Food hygiene 3.2.9 Hygiene practices Food handlers must prevent food by working hygienically.
3.3.3 Easy to clean surfaces Decks must be easy to clean. In galleys or other highrisk food areas, it is recommended that decks are coved at bulkheads to facilitate cleaning. ST 3.3.4 Repairing Decks must be kept in good condition. 3.3.5 Construction The construction of decks should prevent the accumulation of dirt and debris and allow for adequate surface drainage. ST Bulkhead surfaces 3.3.6 Bulkhead surfaces and fixtures such as bulkhead electrical sockets must be made of materials that prevent accumulation of dirt and undesirable substances such as mould. The materials used for bulkhead surfaces should be impervious, non-absorbent, cleanable and non-toxic. ST Suitable materials may include: stainless steel ceramic tiles washable painted steel PVC epoxy resin and similar coatings. ST Bulkhead surfaces must be smooth. 3.3.7 Defects Bulkhead surfaces should be free of obstructions, holes and other obstacles or recesses in which dirt can accumulate. ST 3.3.8 Cleanable surfaces Bulkhead surfaces should be cleanable to a height at which they may be soiled with food particles during normal use. ST Deckheads 3.3.9 Deckheads and overhead fixtures (e.g. lights) must be made of materials that prevent the accumulation of dirt and undesirable substances such as mould. Suitable materials may include among others stainless steel and smooth washable painted steel. ST In order to prevent the accumulation of dirt direct fixed deckheads or suspended deckheads should be installed. ST
3.4.12 Good storage practices Food and stored ingredients must be located away from sources of contamination (e.g. from odours or pollution). Exposed foodstuffs should be covered, or otherwise protected, to prevent contamination ST and ingredients name of the product item .
ST Dry storage 3.4.14 Dry stores standards Dry stores should be cool, dry and clean. ST Foodstuffs should be kept elevated off the decks. ST Dry food packages should be handled with care to prevent damage to the packing. ST Foodstuffs from cans and jars that are damaged, swollen or leaking should not be used. ST When foodstuff packaging has been damaged after delivery then loose dry foodstuffs (flour, rice etc.) should be decanted and stored in sealed labelled containers. ST Humidity should be controlled (for example through sufficient airflow or air changes) because moisture can affect the safety of food products. ST Cans and jars may be placed in dry stores but once opened some products (mustard, mayonnaise etc.) require refrigeration where stated by the manufacturers. ST 3.4.15 Dates of durability 3.4.16 First in first out Stored food should be rotated and used on a First In First Out (FIFO) system taking into account the durability date. ST
water at a minimum temperature of 77°C (171°F) or above for at least 30 seconds (manual washing) or 82°C (179.6°F) (this is dish washing machine water temperature at the manifold (steam can be unsuitable for machines and systems containing plastic materials which are destroyed by high temperatures chemical disinfectant in accordance with manufacturer’s instructions. Personal Protective Equipment (PPE) should be used where necessary in order to avoid scalding. ST Cleaning equipment 3.6.7 Maintenance Cleaning equipment should be kept clean and well maintained. ST Use of cleaning equipment 3.6.8 Safety of cleaning chemicals Cleaning and disinfection chemicals used in food areas be food safe and designed for use on food contact surfaces 3.6.9 Correct use of cleaning chemicals Cleaning chemicals should be used in accordance with the manufacturer’s instructions (e.g. contact time, concentration, doses etc.). ST Surfaces to which cleaning chemicals have been applied should be rinsed with clean water. Some cleaning chemicals can be left on surfaces when this is indicated in the manufacturer’s instructions. ST Disinfectants do not have cleaning properties and they should not be used as detergents. However, some cleaning chemicals such as detergent-sanitisers may do both tasks and this will be indicated in the manufacturer’s instructions. ST Storage of utensils and equipment 3.6.10 Storage Only utensils and equipment for food preparation and service should be stored in food handling and preparation areas. ST 3.6.11 Protection Loose and portable equipment should not be stored in direct contact with the deck. ST The utensils and equipment should be kept clean and dry. ST Utensils and equipment should be kept covered or otherwise protected from dirt and condensation. ST
cross connection with technical, black or grey water systems; poor temperature control or inadequate disinfection 4.9 Contamination through distribution system Contamination of potable water or microorganism growth in the distribution system, in particular due to: backflow poor design and construction of piping system components; existence of deadlegs in the distribution system; damaged pipes; chemical contamination through the use of the wrong distribution construction materials; contamination during maintenance or the repair of piping system; biofilm growth in pipe work and fittings contributing to contamination with Legionella, Pseudomonas aeruginosa, Mycobacterium spp. or amoebae; contamination due to stagnant water in infrequently used outlets or other part of the water system where water remains stagnant for more than days . ST Control measures 4.10 Control measures Suitable control measures should be identified for each potential hazardous event. ST source 4.11 Supplier water quality reports Where available and supplied to the ship any supplier water quality/safety reports should be checked for compliance with the Directive 98/83/EC requirements, before loading potable waterAnnex ST 4.12 Water quality tests basic water quality tests (pH, free , E. coli test) should be performed before bunkering . ST production (potable water 4.13 Filtration of sea water Sea water should be filtered to remove particulate matter before it is ST
sewage or tanks holding liquids tanks holding non-potable liquids. The system should be protected against by either preventers (e.g. vacuum breakers) or air gaps ST Testable backflow should be tested after installation and at least every 12 months or in accordance with the manufacturer’s instructions. ST 4.42 Disinfectant halogen residual The disinfectant halogen residual should be maintained at a minimum of 0.2mg/L and not more than 5.0mg/L of free chlorine in all sites of the distribution system (see also item 4.45). Alternative means of disinfection can be acceptable provided a scientific assessment is conducted to ensure its efficacy is established. ST 4.43 Coating materials Coating materials used in the piping system should not introduce toxic substances the potable water ST 4.44 Maintenance Hygienic practices and procedures for maintenance and repair work should be used. During maintenance or repair the workers should have written procedures for maintenance of piping systems. The relevant section of the system needs to be disinfected following any repair works. ST 4.45 Maintenance of temperature in cold water distribution system In cold water distribution systems, water temperatures should ideally be maintained at less than 25°C (77°F) throughout the system to provide effective Legionella control. However, this may not be achievable in all systems, particularly those in hot climates. Maintaining residual disinfection at >0.5mg/L free chlorine, or alternative disinfection methods and technology, will contribute to the effective control of Legionella in such circumstances. ST
4.58 Inspection of potable water tanks Potable water tanks should be inspected after installation and at least once every 24 months in order to identify potential defects or inadequate functioning. Operational of dirt inside the tank water does not appear turbid inspection covers are not damaged and are in place absence of cracks in tank structure cross connections not found. ST of storage tanks Potable water storage tanks should be Operational cleaning procedures observed. ST 4.60 Testing of backflow prevention prevention assemblies should be tested after each installation and at least every 12 months or in accordance with the manufacturer’s instructions. Operational defects in the backflow prevention assemblies spotted during testing. ST 4.61 Inspection of the piping system Visual inspections of the potable water distribution (pipes, connections) should be conducted routinely ideally every 12 months where during routine maintenance. Operational of leakage, corrosion or cross connections ST 4.62 Repair and maintenance of piping system The maintenance. Operational maintenance and repair procedures observed. ST ST Management Plan Item Details /ST Corrective actions 4.64 Corrective actions When operational monitoring shows that the existing control measures are not operating effectively, corrective actions should be taken to ensure the system is functioning safely again as soon as possible. ST Verification monitoring 4.65 Microbiological indicator The microbiological quality of the water supplied for human consumption on passenger ships must be verified on a regular basis.
sampling and testing procedures (test kits etc frequency of sampling and recording corrective actions in case of adverse results. standards for monitoring are given in items 5.245.31. 5.4 Cleaning Plan A Cleaning Plan or procedures containing a cleaning programme for each RWF (see items 5.325.33). ST 5.5 Maintenance Plan A Maintenance Plan or procedures containing a maintenance programme for each RWF (see items 5.345.37). ST 5.6 Emergency Plan An Emergency Plan or procedures containing the response plan for emergencies such as accidental injuries (first aid kit and auxiliary equipment). ST 5.7 Accidental Faecal/Vomit Release Plan There should be a plan or procedures for dealing with vomit or faecal accidents (e.g. based on the model version in ). ST 5.8 Record keeping RWF records should be kept on board and be available to inspectors for at least 12 months A complete list for record keeping is given in (page Operational Mode of RWFs 5.9 Water source The water source for recreational water facilities be either sea water or potable water ST 5.10 Potable water pools and sea water recirculating pools When either potable water or recirculated sea water is used the water should be circulated through an appropriate treatment system that contains at least filtration coagulation and halogenation or alternative means of disinfection. ST 5.11 Turnover period For RWFs in recirculating mode the circulation rate of water should be such that the turnover period does not exceed the values given below ST
e. Addition of fresh water 5.23 Addition of fresh water (dilution of pollutants) The treatment process should also include the addition of fresh water at frequent intervals. The recommended rate is 30 L per bather per day. ST Monitoring 5.24 Water quality parameters The water quality parameters which are listed in Table (page 104) and Table (page 105) should be monitored according to the given frequency and should be within the acceptable ranges. ST 5.25 Test kits Test kits for measuring free halogen residual, pH and total halogen should be available (a cyanuric acid test kit is also required when using a cyanurate for disinfectant stabilisation). The test kits should be cared for and used by trained individuals. ST
Item Details /ST Hand washing 7.4.1 Hand washing The recommended hand washing method is set out in Annex ST Services 7.4.2 Use of razors New, single-use, disposable razor blades should be used for each customer. ST 7.4.3 Use of cosmetics A new batch of depilatory waxes and lotions should be made for each customer. ST , lotions, waxes and gels should not be reused and should be administered with either a disposable, or clean and disinfected, applicator. ST Treatment of wounds 7.4.4 Wounds treatment Minor wounds should be treated according to the company policy. In the case of more serious wounds, medical advice should be sought. ST Cleaning and disinfection 7.4.5 Cleaning of equipment All items such as combs, brushes, scissors, clippers, manicuring and pedicure instruments and make-up equipment should be cleaned and disinfected or sterilised when necessary and between each customer. ST Waste disposal 7.4.6 Sharps disposal Waste materials, including any sharps, be removed from hairdresser and beauty salon areas according to Chapter Waste Management, section 9.5. Gym 7.4.7 Characteristics of gym equipment Gym equipment should be kept clean. ST Disposable disinfecting sprays, swabs/paper towels, or sanitary wipes/washable rags should be made available for use by customers. ST
systems used are appropriate. 9.2.4 Receptacle construction specifications Garbage receptacles or containers must be of an appropriate material and design, be kept in sound condition, be non-absorbent, durable, leak-proof, be easy to clean and, where necessary, to disinfect. They must not attract pests. 9.2.5 Cleaning procedures Soiled food waste bins and recyclables receptacles should be cleaned (when empty) in specific areas designated only for this purpose away from food areas. These areas should have access to water, detergent, and suitable drainage. ST Garbage handling in galleys 9.2.6 Avoiding contamination Garbage must not be a direct or indirect source of contamination (e.g. through contact with surfaces that food is prepared on, or by attracting pests). 9.2.7 Garbage accumulation Garbage must not be allowed to in food preparation or serving areas beyond the end of any work shift, to avoid contamination of food or the creation of conditions favourable for pest infestations. 9.2.8 Transportation Interiors of garbage lifts, garbage chutes, sorting tables or any other surfaces in the galley coming into contact with garbage should be made of easily cleanable, corrosion-resistant, and durable materials. ST Drains should be installed at the bottom of all garbage lift shafts including provision platform lifts and dumbwaiters. ST Garbage waste storage room 9.2.9 Garbage room Garbage waste, bins and recyclables receptacles should be stored in a designated garbage storage room separate from food handling operations. ST 9.2.10 Garbage room size Each ship must have a garbage storage space of adequate size to accommodate the maximum quantity of waste produced between the most distant unloading periods, or when unloading is prohibited. 9.2.11 Garbage room specification The garbage room should: be constructed and maintained so as to be pest-proof; ST
When infectious medical waste is incinerated, it must be placed straight in the furnace, without first being mixed with other categories of waste and without direct handling. If infectious waste has been disinfected, it can join the garbage collection and disposal mechanism. ST 9.5.8 Sharps disposal Sharps (unused, contaminated or opened) be disposed of ashore or incinerated as infectious medical waste. 9.5.9 Liquid medical waste disposal Liquid medical waste, with the exception of chemical and pharmaceutical waste or any waste that can affect the operation of the sewage system, may be disposed of by discharging them into the sewage system. 9.5.10 Non-infectious, non-hazardous waste can be handled and stored as garbage not requiring steam disinfection or special handling. ST legislation International Regulation (EC) No 852/2004 on the hygiene of food stuffs Directive /EC on waste Regulation (EC) No laying down health rules animal by-products not intended for human consumption on emissions
Annex : Influenza-like illness log (recommended log) This log is designed for possible use by passenger shipping companies and ships with no designated recording and reporting systems for ILI. Ship name: Voyage number: Dates From: __/__/__ To: __/__/__ Page: of Total number of passengers on board: Total number of ill passengers: Total number of crew on board: Total number of ill crew: Visit date (mm/dd/yy) Name (Last, First) Unique Number Identifier** Date on ship (mm/dd/yy) Date off ship (mm/dd/yy) Age M/F Pax/Crew Cabin No. CREW: country where hired Pax Meal Seat /Crew Pos. Illness Onset Cough Malaise Fever Shore throat Shortness of breath Headache Coryza Myalgia Rapid Flu Test CXR Flu Vaccine During Past Year Flu Vaccine Date Medications (Y/N) case (Y/N) Reportable case Specify (Case Under Investigation / /Confirmed) Underlying illness Complications Date Time Y/N Y/N Y/N °C/F Y/N Y/N Y/N Y/N Y/N ND/P/N* ND/P/N* Y/N/U (mm/dd/yy) *ND = test Not Done, PPositive test result or +CXR infiltrates, NNegative test result or +CXR infiltrates, UUnknown **This number rather than the name may be reported to competent authority to protect patient confidentiality
Table : Examples of the system assessment procedure for the ship potable water system This is not a complete system assessment procedure, but for illustration only and should not be used. Each ship should do own assessment. PROCEDURE Possible hazardous event Likelihood Consequences Control measures Operational limits Operational monitoring Corrective actions Record keeping SOURCE WATER Source contaminated with microbiological hazards C Unlikely 3 Major 1. Check the water quality reports and certifications from the supplier before loading 2. Continuous chlorination at the time of bunkering 1. Absence of microbiological hazards in the collected reports 2. Chlorine residual no less than 2mg/L Measurement of disinfectant residual Filtration and disinfection or use of an alternative source All water quality reports should be kept on the ships records for 12 months. Free chlorine measurement records should be kept on the ships records for 12 months. BUNKERING Filling hose contamination B Moderate 2 Moderate Routine cleaning and disinfection Proper storage and labelling Handlers training No defections detected during inspection Routine inspections Cleaning and disinfection Repair or replace Inspection records Repair records Cleaning and disinfection records STORAGE Corrosion of storage tanks A Likely 1 Minor Routine cleaning and maintenance No corrosion detected during inspections Routine inspections Cleaning and disinfection Coating Inspection Records Cleaning and disinfection records DISTRIBUTION Cross connection between potable water and water C Unlikely 3 Major Cross connection control programme (identification of cross connection, installation of the proper backflow prevention assemblies) No defections on the backflow prevention devices Routine inspection and annual testing of backflow prevention assemblies Repair or replace backflow prevention assemblies Inspection and testing records