The practice of medicine is an art and a science, and is evolving daily as new discoveries are made. Each individual medical provider is responsible for the individual medical care provided to each patient. Each provider must assess the patient and determine the specific clinical needs and most appropriate treatment for that patient.
“The need for medical care has been a constant since the day the first merchant ship sailed centuries ago. Concern for the health of merchant mariners has, from the beginning, been a part of our nation’s history.
Fortunately, for the health of all merchant seamen and others at sea, the world has changed. Modern technology allows for nearly continual “real-time” communication between the ship and shore. With this, real-time access to medical consultation is nearly always available. In today’s world, serious medical problems underway will be managed via communication with shore-based physicians and other medical resources. More sophisticated tele-medicine capabilities, often including video as well as audio components, are also continually being expanded.
Prevention, of both acute and chronic disease, will improve the quality of the merchant mariner’s life while at sea, and also many years into retirement. Prevention will also maximize the productivity of the crew and its ability to meet its missions.
History, Physical Examination And Basic Supportive Care
Care of the health impaired sea-goer is a challenge for the health care provider,especially when there are miles separating the ship from shore. Some ships are equipped with well-trained health personnel and very sophisticated equipment while others rely on those with comparatively minimal training. This will describe some approaches and procedures to provide initial care and comfort until professional health personnel and equipment are available to provide more definitive care.
Creating The Sickbay Environement
When the sea-goer, or patient, has a health complaint, it may range from a minor problem, such as a common head cold, to a more serious problem, such as appendicitis. The environment in which the patient is cared for should be a quiet spot, away from the main corridor of activity and noise; yet visible at all times to those caring for the patient. The ambient temperature should be comfortable. It should be away from any areas where noxious fumes may be present. Preferably, the area should also be a relatively safe spot, that is, an area not near the storage of gasoline or explosives, especially if oxygen is needed in the care of the patient. The area should be well-lit allowing observation of any changes in skin-color or behavior, yet an area which will allow the patient to obtain needed rest as well.The environment should contain an area where the patient can lie down, if needed. If a formal sickbay is available, clean linens and blankets should be part of the standard equipment. Other standard equipment should include :thermometers (both one for routine fever measurement and a rectal thermometer capable of low readings), blood pressure cuff and sphygmomanometer, stethoscope, otoscope, ophthalmoscope, tongue blades, flashlight, gloves and lubricant, reflex hammer, several wash basins,(with water supply) and scale.
The traditional history and physical examination is comprehensive and complete.The purpose of conducting an assessment is to collect and use data in clinical decision making. special emphasis will be placed on the problem-focused health history, which is used when collecting data about a specific problem system or region.
Normally, patients seek initial assistance from the health care provider for a health complaint, called the “chief complaint”. The patient begins by describing the problem.The history
interpretations. This story provided by the patient provides some of the most important information in determining what is likely to be wrong with the patient.
Problem – Focused Health History
The extent of the problem-focused health history will be determined by the circumstances. It should be recorded legibly and in detail to provide an official medical record on lined or unlined writing paper or in a formal chart and kept in a safe, secure place to preserve the patient’s confidentiality. It should be made accessible only to health care providers or other individuals who have a right and a need to know specific information about the patient’s condition or care.
The record includes and should record: the date, time, and other identifying data,such as age, sex, race or ethnicity, birthplace, and occupation. Generally, the history will be targeted to a specific chief complaint. The “chief complaint” is a short statement, recorded in the patient’s own words and recorded in quotation marks. It indicates the purpose for the patient’s request for health care. It is not a diagnostic statement. It should contain a notation of the problem’s duration as well.
The “chief complaint” is followed by the “history of present illness” (HPI) section that describes the information relevant to the chief complaint. the setting in which it developed, duration, precipitating factors, its manifestations, and any past treatments and data about all major, current health-related information ;allergies, habits (such as alcohol ingestion, use of tobacco, drugs, and caffeine), medications taken regularly (prescription and over-the-counter medications), diet, exercise and sleep patterns, general health of the patient’s blood relatives, and immediate family including spouse and children, identify any illnesses of an environmental, genetic, or familial nature.
The principal symptoms should be described in terms of location, quality, quantity or severity, timing, the setting in which they occur, factors that aggravate or relieve them, and any other associated manifestations.
Finally the review of systems (ROS) begins with a general review of the usual state of health, such as usual weight, any weakness, fatigue, fever.Then it progresses in a head to toe manner, reviewing each body system(general, skin, head, eyes, ears, nose and sinuses, mouth and throat, neck, breasts, respiratory, cardiac, gastrointestinal, urinary, genital, peripheral vascular, musculoskeletal, neurologic, hematologic, endocrine, and psychiatric).
In the problem-focused health history, emphasis will be on the system involved in the chief complaint unless otherwise indicated.
Common conditions ;which might be asked about each body system include:
*General: Usual weight, weight changes i.e. clothing fitting differently, weakness,
*Skin: Rashes, lumps, sores, itching, dryness, color changes, changes in hair or nails,
*Head: Dizziness, headaches, trauma to head, pain, faintness.
*Eyes: Vision, cataracts, changes in visual fields or vision, pain, double or blurred vision, spots, glaucoma, infections, redness, drainage, date of last eye examination,glasses or contact lenses.
*Ears: Hearing acuity, infections, earaches, buzzing or ringing, hearing devices, pain,vertigo, and discharge.
*Nose and sinuses: Smelling ability, discharge, nose bleeds, sinus infections,frequency of colds, hay fever, nasal stuffiness.
*Mouth and throat: General condition of teeth and gums, bleeding or swelling of gums, dryness, difficulty swallowing, change in voice, hoarseness, sore throats,dentures, sore tongue, lesions, (i.e., sores, wounds, injuries or unusual tissue changes), unusual odors.
*Neck and nodes: Lumps, node enlargement, pain with movement or palpation,swelling, tenderness, stiffness in neck.
*Breasts: (for men and women) Lumps, pain, discharge from nipples, dimples,discharge, masses.
*Respiratory: Cough, sputum, bloody sputum, past diagnoses of respiratory diseases,dyspnea (difficulty breathing), number of pillows needed to sleep at night, and wheezing.
*Cardiac: Chest pain, high blood pressure, past diagnosis of cardiac diseases,swelling in ankles or legs, date of last electrocardiogram (EKG).
*Gastrointestinal: Difficulty swallowing, appetite, regurgitation (vomiting or spitting up),
changes in bowel habits, past diagnosis of gastrointestinal diseases, abdominal pain,constipation, diarrhea, indigestion, infections, jaundice, nausea, vomiting, rectal
bleeding, rectal pain, changes in stool color, hemorrhoids.
*Urinary: Frequency of urination, changes in stream, painful or burning on urination. flank pain, blood in urine, urination at night, large amounts of urine, stress incontinence, urgency, urine odor changes, past diagnosis of urinary tract diseases,stones.
*Peripheral vascular: Leg cramps, varicose veins, clots in veins, pain, hot red areas on legs, swollen, edematous ankles.
*Musculoskeletal: Muscle or joint pain, stiffness, arthritis, gout, backache, redness,heat, limitation of range of motion, fractures.
*Neurological: Fainting spells, blackouts, seizures, weakness, numbness, tingling,loss of consciousness, changes in speech patterns, tremors, past diagnosis of neurological diseases.
*Endocrine: Thyroid trouble, heat or cold intolerance, diabetes, excessive thirst or hunger.
*Genital: Depends on age and gender of patient.The extent to which each system described above is reviewed will depend on the problem identified in the problem-focused health history.
Four basic assessment techniques are involved in the physical examination that is,inspection, palpation, percussion, and auscultation. All four are employed in the head to toe systematic physical examination of the patient.
1-Inspection is the act of a thorough visualization, or looking at the patient’s body parts.
2-Palpation involves the use of the examiner’s own hands to augment and verify the data gathered in inspection. The examiner uses the most sensitive parts of his or her own hands and may assess individual structures within the body cavities for position, size, shape,consistency and mobility. Detection of masses is done with the examining hand, as well. It is important to remember to always palpate painful and tender areas last.
3-Percussion involves striking an object to elicit a sound or reaction of a body part. It may involve use of both hands at the same time, or the hand as a fist, or a percussion hammer. The sound that is produced is due to the vibrating structures underneath indicating the state of the structure being struck.
4-Auscultation is the act of listening to the sounds produced by the human body, particularly those produced by the lungs, heart, and abdominal organs. This is normally done with a stethoscope. The bell-type head with a diaphragm stethoscope is recommended.
The physical examination begins with an initial survey or general inspection of the patient. The health care provider observes the general state of health, level of consciousness, stature, symmetry, weight and nutritional status, mental status,speech, general skin condition, any signs of distress or disorder.
Maintaining hydration is usually taken for granted. However, the availability of adequate fluids is essential to maintain normal body functioning. Although a person can go without food or nutrition for a fairly long period of time, no one can survive very long without fluids.
Dehydration is a progressive loss of body fluids and electrolytes (body salts) altering the internal chemical environment of the body. Since the human body only operates within narrowly defined limits of chemical and fluid balances, these alterations lead to decreasing ability to function.
If left untreated, dehydration results in a downward spiral that further depletes essential fluids and electrolytes (primarily water,potassium, sodium chloride and bicarbonate and resulting changes in acid-base balance). These fluids and electrolyte shifts can lead to altered mental status,headaches, weakness, cramping, fainting, convulsions, shock, coma and even death. Dehydration is common in people laboring in hot environments such as those found in the working areas inside of a ship. Such individuals are often at least 3percent dehydrated and do not easily replace fluid lost by exertion, in spite of the availability of customary fluids to drink. Much of this fluid and electrolyte loss can be explained by the sweating process which can account for fluid loss of up to 1.5liters/hour. Sodium and potassium are also lost by sweating, but because of the lost water’s effect on circulating blood volume, the loss of water is usually more acutely important than is the loss of electrolytes.
Additional common causes of dehydration include vomiting, severe diarrhea, chronic or acute blood loss, alcohol withdrawal, burns, diabetic ketoacidosis, hyperventilation,sweating and increased insensible losses secondary to high body temperatures.
Another common cause of dehydration is simply inadequate fluid intake due either to non-availability, inconvenience, or severe illness.In a marine environment,prolonged exposure to elements or immersion in seawater can also result in dehydration.
In the adult, assessment of hydration status is often based on observation of clinical signs and symptoms. The heart rate and respiratory rate both increase.Urine output, skin turgor, mental status and muscular strength decrease. The patient frequently complains of feeling weak or dizzy when in the upright position. The specific gravity of the urine increases with dehydration as the urine becomes more concentrated until urine output stops as a fluid saving adaptation by the kidneys.
The most specific test for determining fluid status is postural vital signs(Measurement of the blood pressure and pulse when a patient is first lying, then sitting, and finally standing). This is because changing from a lying to a standing position tends to cause pooling of circulating fluid volume in the large blood vessels of the legs and trunk. A normal,non-volume depleted person rapidly adapts to these postural changes by vasoconstriction of the vessels where blood tends to pool. This adjustment is not possible for the volume depleted person whose vasoconstriction potential has already been utilized to maintain adequate circulation in the face of substantial fluid loss.
Treatment of Dehydration:
Once a patient has become dehydrated the two available routes of fluid replacement are oral and intravenous.
Hypothermia And Hyperthermia
With frequent exposure to water, sun, and weather, the sea-goer risks serious and potentially fatal effects from a body temperature which may become too high or too low. Prevention is the best medicine. The sea-goer must dress appropriately for the conditions, be vigilant and respond to changing weather and seas. This includes outfitting the vessel with all recommended safety gear and appropriately using it, a complete first aid kit including blankets, knowing how to get medical assistance,eating nutritious foods, drinking adequate non-dehydrating fluids, avoiding alcohol and minimizing caffeine, and maintaining good overall health.
The normal body temperature is 37° Centigrade or 98.6° Fahrenheit. Hypothermia refers to a body temperature below the normal level. Hyperthermia refers to a body temperature above the normal level. However, every person is different and there is a range within which the temperature may still be considered normal. A temperature of 36.5° Centigrade (97° Fahrenheit) to 37.2° Centigrade (99°Fahrenheit) is generally considered normal variation.
The body has three(3) general temperature zones.
1- The superficial zone is thetemperature of the skin and is influenced by the air temperature. 2-The intermediate zone is the temperature of the muscle and tissue under the skin.
3-The core zone is the innermost zone and the temperature of the body’s inner organs including the heart, liver, kidneys, and brain.
The core zone can be several degrees higher than
the superficial zone. When assessing the body’s temperature, the core zone should
be assessed. All temperatures in this section refer to core temperatures (e.g. rectal,
esophageal, gastric or tympanic.) Of these, the esophageal temperature correlates
most closely with the heart temperature, although the rectal temperature is more
Hypothermia occurs when a person’s body temperature drops below the normal
range. It is a serious condition and can endanger the life of a person, if left untreated.
People at sea can become hypothermic when they get wet and cold, and when they
are in cool or windy places without proper clothing or protection.
There are three stages of hypothermia with differing signs and symptoms in each
one. The elderly and those individuals who are intoxicated may not demonstrate
symptoms or signs reliably.
People at sea can become hypothermic when they get wet and cold, and when they
are in cool or windy places without proper clothing or protection. Hypothermia often
accompanies drowning. Some medical reasons for hypothermia include
environmental exposure, hypoglycemia (low blood sugar), diseases of the adrenal
glands and pituitary gland, poor nutrition, Parkinson’s disease, alcohol toxicity,
medications for depression and sedation, some illicit or “street” drugs, rapid infusion
of cold intravenous fluids, and stroke.
It is important to treat the hypothermic patient very gently to prevent
abnormal heart rhythms. Check the ABCs, or the airway, breathing, and circulation
of the patient. It may be difficult to detect a pulse. See current recommendations.
Hypothermic patients have very slow pulses and slow shallow breathing. Do not
begin chest compressions if the patient has any heart beat or pulse, even if it is very
slow. This could cause dangerous abnormal heart rhythms and further
complications. If it is necessary to begin CPR, continue until the patient’s
temperature is brought up to normal range and as long as there are still no pulse or
respirations. . This may be a very long time to continue CPR, so whenever possible,
obtain the assistance of another person.
Prevent additional heat loss by protecting the patient from exposure to cold. Move
the patient to a warm sheltered area as soon as possible. Remove any wet or cold
clothing. Dry the patient and replace with dry warm coverings over and under the
patient and around the head. Examine the patient. Obtain the pulse and respiratory
rate. If possible, take the blood pressure. If a low temperature scale thermometer is
available, take the temperature. Carefully check the entire body for injuries and
As soon as possible, contact shore medical personnel for further assistance. Gather
as much known information about how the patient got into this situation.
Prevention: Remember, prevention is the best medicine for hypothermia. Always
be alert to changing weather and sea conditions. Never ignore shivering–it is a
warning sign that the body is getting too cold. Prepare for the weather by wearing
the proper clothing and staying dry. Keeping one’s energy level up through proper
nutrition, drinking adequate fluids, and avoiding alcohol are important preventive
measures to observe. Getting adequate rest is also important. Obtain a special low
reading thermometer especially if there is a risk for hypothermia. Keep warm
blankets and hot water bottles aboard. Most important, plan ahead!
Hyperthermia occurs when the body’s temperature rises above the normal range of
37.2o C or 99o F. Whereas hypothermia slows the body’s metabolic processes and
in some cases even acts as a protective mechanism, hyperthermia acts essentially
just the opposite and speeds up the metabolic processes leading to organ distress
and irreversible organ damage. Prolonged periods of moderate to critical levels of
hyperthermia can cause nerve dysfunction, the breakdown of body proteins, coma,
and even death.
Some causes of hyperthermia include infection, hormonal dysfunction, thyroid crisis,
reactions to medications and anesthesia. At sea, the most likely causes of
hyperthermia in a person who was previously well are fever associated with the
body’s natural response to illness and infection, exposure to sun and weather, and a
hot working environment. For this reason, fever, heat cramps, heat exhaustion, and
heat stroke will be dealt with here. But first, a review of some information about the
general effects of hyperthermia on the body will be covered.
When the body temperature is too high or too low, serious conditions and
complications can arise to quickly become a life threatening emergency, and onshore
consultation is critical. The seriousness of these conditions cannot be
overemphasized because permanent damage and even death can occur. The seagoer
must be continuously aware that there is nothing better in the ship’s medicine
chest than prevention.
Everyone aboard ship should expect and find sanitary facilities, supplies, and
healthful conditions in his or her shipboard environment. All crewmembers have a
responsibility for the state of that environment. Proper sanitation is impossible unless
each member cooperates. The Master should ensure the good sanitary conditions of
the vessel through periodic inspections.
Ensuring the health and safety of persons aboard a ship requires knowing and
understanding the various factors on the ship that affect health. Preventing and
controlling environmental health and safety problems will help to ensure the safety of
the crew and the ship. This section will cover those factors, including food sanitation,
potable water, pest management, laundry, barbershops, habitability, thermal stress,
hazardous materials, respiratory protection, and confined spaces. By making the
described practices an integral part of the ship’s routine, the Master and crew can
contribute to the health, safety, and success of each journey.
Today, most foodborne illness is related to infectious disease. Foodborne illness can be especially serious aboard ship, since nearly everyone eats from the same mess and contamination can infect an entire crew. There is much that can be done to prevent a foodborne illness from occurring. Proper food procurement, storage, and preparation, along with personal hygiene, and sanitary food preparation areas go along way to ensuring the safety of the food served in the galley. All personnel who are assigned to work in the galley, even for a short period of time, must be trained in
food sanitation and personal hygiene.When an outbreak of disease is occurring aboard ship, even if the source of the outbreak cannot be determined, interrupting the most likely route of transmission may prevent further spread to uninfected shipmates.
The Food Handler
In addition to cross contamination (discussed later under “Food Preparation and Handling”), galley workers can inadvertently contaminate food if they do not follow proper personal hygiene. Frequent hand washing is the key to preventing contamination. A separate hand washing sink with hot and cold running water, a sanitary soap dispenser, and disposable towels should be provided in the galley.
Personnel must wash their hands after each use of toilet facilities, after eating,drinking, or smoking, and after handling raw food.
Galley workers must bathe at least once a day. Clothing must be maintained in a clean and sanitary condition and soiled clothing must not be allowed in the galley.
Aprons should only be used while working in the galley and be replaced each day, or more often if necessary. Disposable gloves should be worn when handling food.Gloves do not change the need for hand wahing.
Food handlers should have a thorough physical examination at least once a year. At all times, they should be free of any infectious disease. Respiratory diseases and those transmitted by the fecal-oral route are especially hazardous. Any galley worker who is sick must be removed from all galley duties and be evaluated prior to reassignment to the galley. Skin infections and open wounds also prevent personnel from working in the galley until the skin is completely healed.
Food Service Facilities, Equipment, and Utensils
All food service facilities aboard ship should conform to the minimum requirements:
surfaces of all decks and bulkheads in the food processing, serving, and storage areas should be corrosion-free, smooth, easy to clean, and maintained in a clean condition
all surface materials, equipment and utensils coming into contact with foods should be corrosion-resistant, non-toxic, nonabsorbent, smooth, durable, easy to clean, and approved by the National Sanitation Foundation (NSF)
equipment must be maintained in a good state of repair and condition.
cutting and piercing parts of can openers must be kept sharp to minimixe the creation of metal fragments that can contaminate food when a container is opened.
surfaces used for cutting food must be able to be effectively cleaned and
sanitized or must be discarded
all galley areas, especially the cooking areas, should be fire-protected, and provided with adequate ventilation to readily remove smoke, steam, odors, and gases
all galley equipment should be permanently mounted
adequate space for cleaning should be available behind and under any permanently mounted equipment
back-siphonage must be prevented
all drains must be trapped and should have easily accessible “clean outs”
waste, particularly food scraps, should be kept in tightly covered sturdy garbage cans
all galley water must be potable
maintain adequate lighting in the galley areas
all cleaning supplies and chemicals should be stored away from food preparation areas
Food Selection and Procurement
To prevent unnecessary discarding of food, menus should be developed and food ordered according to shelf life and anticipated use. Care should be used in selecting food distributors, especially in overseas ports, to assure purchased products are not contaminated.
Upon receipt, ensure the following:
food containers are in good condition (no dents in cans, no holes in plastic or
dry goods are inspected for indications of insect infestation
frozen food is completely frozen and has no indications of being thawed and refrozen
fresh seafood is properly labeled.
all refrigerated items are delivered at or below 41 F
produce is in good condition with no rotting pieces.
Once procured, food should be appropriately stored in areas protected from contamination. Non-refrigerated dry and canned goods should be stored in a location that is clean and dry, free of exposure to splash, dust, or other contamination, at least 15 cm (6 inches) above the floor, and secured for sea.
Food should not be stored in areas such as living areas, mechanical rooms, near water or sewage lines, or where other sources of contamination are prevalent.
Liquids should be stored on lower shelves so other foods will not be damaged if there is a leak. All food should be used “first-infirst-out” to prevent discarding of expired food. Once non-refrigerated foods areremoved from the dry stores area and original protective packaging is removed, they must be protected by storage in easily-cleaned vermin-proof containers or bins. Perishable food must be refrigerated or frozen. Reefers must be maintained at or
below 41o F and freezers must be at or below 0o F. Reefers and freezers must have a highly accurate thermometer for temperature control.
Food Preparation and Handling
Safe food preparation relies on several principles. The three principles are :
(1)maintaining proper temperatures during thawing, cooking, and holding,
(2) cleaning of utensils and surfaces to prevent cross contamination,
(3) proper personal hygiene of food service personnel. There are also some foods that require special attention. Foods, especially animal products, must be properly thawed. Ideally, products should be thawed in a reefer.
temperatures have been established so that the most common organisms are killed.Raw animal foods such as eggs, fish, beef, pork, and poultry must be cooked tothese minimum internal temperatures to ensure the safety of served food. The table below provides safe internal temperatures for some common animal products:
|for additional, less common, food types can be found in the Food Code.|
|Any food cooked in a microwave||165ºF (74ºC)|
|All foods previously served and cooled
that are reheated
|165ºF (74ºC)with 2 hrs|
|All poultry and game birds||165ºF (74ºC)|
|Stuffed meats||165ºF (73.9C)|
|Stuffing containing meats||165ºF (73.9C)|
|Pork, ham, and bacon||155ºF (68ºC)|
|Beef roasts (rare)||130ºF (54.4ºC)
for two hrs
|Beef steaks (rare)||130ºF (54.4ºC)|
|Commercially raised game animals||145ºF (63ºC)|
|Unpasteurized shell eggs (not for
|Unpasteurized shell eggs (not for
|Food held for serving (after cooking)||140ºF (60ºC)|
Throughout history, safe drinking water has been an essential maritime requirement.Even today, many diarrheal disease outbreaks aboard ship have been traced to contaminated drinking water, often obtained in foreign ports. Care should be taken when procuring drinking water to make certain it is safe. If the ship has potable and non-potable water sources, they should be clearly separated and not interchanged.
Nonpotable water may be used for activities such as bathing, cooling and fire protection. Drinking water supplies should be tested daily for chlorine content and checked weekly for possible biological activity.
Plumbing systems should be designed to prevent backflow. This is especially important in galley areas. Cross contamination between drinking water and sewage plumbing systems have lead to disease outbreaks and should be prevented. All sounding tubes and deck water
connections should be capped and locked when not in use.
Potable Water Tanks
Potable water tanks must have a suitable lining and should be cleaned and sanitized at least once a year. To sanitize the tanks, the system should be super-chlorinated with 100 (mg/l) of chlorine for four hours. The system must be flushed with potable water prior to refilling. Any pipes, valves, pumps, etc. that have been dismantled, repaired or replaced must be sanitized in this same method. Tanks should be sanitized after any maintenance, cleaning, or entry for any other reason. If more than one tank requires sanitizing, the highly chlorinated water from the first tank may be used in subsequent tanks, but additional chlorine may need to be added to ensure the 100 mg/l chlorine level is maintained. All parts of the water system must be super-chlorinated after any positive biological testing.
Potable Water Hoses
Potable water hoses should be labeled as such and not used for any other materials.When not in use, the hoses should be stored in a locked locker in a clean area to assure they are not used for other purposes. The ends must be capped or connected to each other to prevent contamination. Prior to first use or any time contamination is suspected, they should be sanitized as described for water tanks.
Pest management is important to the health and well-being of shipboard personnel and is needed to protect property and resources. Ideally, ships should seek to minimize reliance on chemical pest control procedures and the adverse health effects of pesticides.
Pesticide applicators should be trained and certified when Environmental Protection Agency (EPA) restricted-use pesticides are being applied. A log and/or file should be maintained to indicate the type, quantity, and location applied for any pesticides used onboard.
Rats on a ship are a health menace and a nuisance. They cause extensive damage to cargo and food, and rat droppings contain organisms which produce diseases.
Rats carry fleas which may transmit plague and murine typhus. Because of these dangers, ships heavily infested with rats must be fumigated, and fumigation is a laborious, expensive, and dangerous procedure. It can be avoided through adequate rat-control measures. A deratization(eradication of rodents) exemption certificate provided after an inspection that demonstrated the ship was rodent-free is required for some ports.The ship’s agent should be able to make arrangements for an inspection to receive this certificate.
Despite reasonable precautions by the ship’s personnel and port authorities, some rats may get aboard. However, infestation can be avoided. The following are guidelines to prevent and control rodents onboard ship:
when moored, use approved and properly installed rat guards on all shipshore lines to prevent rodents from getting aboard via these lines
frequently inspect for signs of rat life (trails or runs marked by dirt or droppings) and take quick action if evidence is found
rat proofing the ship, thus “building out” the rats by elimination of their living places or harborages
keeping all food protected and avoiding accumulation of food scraps and garbage, thus “starving out” the rodents
killing them by trapping or expert fumigation by personnel from authorized agencies (general use of rodenticide is not recommended as rats will ingest poison and likely die in an inaccessible area and cause additional sanitation problems and odors)
Pests in Stored Products
These pests (cockroaches, beetles, moths, ants, mites, silverfish, spring tails)damage clothing and rugs and ruin many millions of dollars worth of stored foods annually. They reproduce and transmit human diseases. The primary control method is good sanitation and thoroughly inspecting food products when they are delivered. Store foods and products in an orderly, sanitary manner in a cool, dry room on racks up above the floor, use old stocks first, inspect stocks regularly and dispose of any found to be infested. Be careful when using insecticides around food,even in storage areas. Vapors from pesticides can infiltrate packaging and contaminate food products.
Liquid and solid wastes are generated during regular ship operations. Wastes must be properly stored and discharged according to environmental regulations. Garbage and trash should be stored separately. Care should be taken so that other ship areas are not contaminated. Receptacles should be covered to prevent entry of flies and other insects. Geographic-specific ocean dumping regulations for liquid and solid wastes must be followed. When practical, paper, cans, bottles and other items should be recycled.