[PDF] [PDF] MSN 1839 (M) - GOVUK MSN 1839 (M) (Corrigendum) MARITIME

Maritime and Coastguard AgencyMERCHANT SHIPPING NOTICEMSN1839(M)(Corrigendum)MARITIME LABOUR CONVENTION, 2006MedicalCertificationSeafarer Medical Examination System andMedicalandEyesight Standards: Application of the MerchantShipping (Maritim e Labou r Convention)(MedicalCertification)Regulations2010Notice to all shipowners, ship operators and ship managers; employers ofseafarers;master, officers and seafarers on sea-going ships ordinarily engaged in commercialoperationsThis Notice should be read with MIN564 (M)SummaryThe following corrections should be notedto MSN 1839(M):iAllreferences to HWB lantern tests in MSN 1839 are replaced by a reference to theMCAColour Assessment andDiagnosis (CAD)test.iAnnex B amendedfrom Lantern test centres in Marine Officesto CAD test centrecontact detailsiMinor revisions to the medical fitness standards in Annex A.1.Background1.1In 2018, the MCA will be ceasing to conduct Holmes Wright B Lantern (HWB) supplementarytests for colour vision.See MIN564 (M)for the background to this change, and anexplanation of the new arrangements.1.2In addition, the MCA Chief Medical Advisor has reviewedthe medical fitness standardsfollowing enquiries from Approved Doctors and advice from experts. Minor amendmentshave been made to a small number of medical conditions. The most significant change is tothe standard forrenal or uretic calculus, which should allow for more seafarers to continueto work at sea.

2.List of corrections:The following corrections are made to MSN 1839(M):Summary: 3rdbullet point, final sub-bulletoAddresses ofcentres where MCA Colour Assessment and Diagnosis (CAD)tests are held (Annex B).1.IntroductionParagraph 1.4The opportunity has also been taken to make some minor corrections and updates to themedical standards at Annex A, and to update the list ofcentres where seafarers can take asupplementary colourvision test at Annex B.5. Statutory Standards of Medical Fitness (Regulation 8)Paragraph5.3.25.3.2A deck applicant who fails the Ishihara plate test may arrange for their colour vision to bere-tested at an MCA approved CAD test centre (listed at Annex B). The CAD test centre willcharge a fee for the CAD test, which is payable directly to the test centre. Failure in this test willmean that a medical certificate may only be issued with a restriction precluding lookout dutiesat night. Trainee Deck officers however will be made permanently unfit. Other deck candidatesapplying for their first MCA Certificate of Competency (CoC), Able Seafarer Deck Certificate ofProficiency or Rating Certificate who have failed the Ishihara plate test will only be considered ifthey have subsequently passed the MCA HWBlanternor CAD test and hence carry norestrictionon their seafarer medical certificates precluding lookout duties.iExisting deck seafarers who have failed the Ishihara plate test but passed the MCA HWBlantern test and have evidence of this willstill be consideredto meet the colour visionstandards and do not need to undertake a CAD test.iExisting deck seafarers who have failed the Ishihara plate test and passed the HWBlantern test but do not have evidence of this will need to take the MCA CAD test. If theydo not take the test, or fail it, they may continue working in their current roles. They willbe given an ENG 1 noting that they do not meet the colour vision standards with anappropriate restriction.iExisting deck seafarers who wish to qualify for an MCA CoC for the first time, or a higherCoC, will have to meet the colour vision standards (i.e. Ishihara plates or MCA CAD testpassed, or provide evidence that they have previously passed the MCA HWB lanterntest). Their seafarer medical certificate must not have any restriction on lookout duties.After 5.3.4 add5.3.5Attending for a supplementary colour vision test:The seafarer must take the following documents to theCADtest centre:A referral document, which can be anyoneof the following;ian ENG 3 form(MSF 4106)ia letter from the Approved Doctorian ML5 form (MSF 4112)

iApplication for a seafarer vision test sight test form (MSF 4100) if visual acuity andtheIshihara testwereconducted by an optometristThe seafarer will also need to take;iAny normal glasses or contact lenses worn to correct for refractive errors(colourcorrecting lensesorglasses are not permitted)iA statutorily issued form of photo identification document (ID) such as a passport, drivinglicence or seafarer discharge book. A photocopy or scanned copy isnotacceptable.`Annex Amedical and eyesight standards for seafarersThose medical standards that have been amended are included in the Table of Standards(Amendments), Annex A (amended ) to this corrigendum.Amendmentsare in italics.Forunamended standards, refer to the full Table of Standards in MSN 1839(M) of July 2014.ArevisedAppendix 1 to Annex A isalsoattached.Appendix 2 to Annex A is unchanged-see MGN 1839(M) of July 2014.Annex BAnnex Bhas been completely replaced.This is included in this notice and provides thecontact and booking details for MCA Colour Assessment and Diagnosis (CAD ) TestCentres. CAD testing willnotbe undertaken at Marine Offices or conducted by MCA personnel.OnlyCAD tests conducted by centres approved by the MCA will be accepted.More InformationSeafarer Safety & Health BranchMaritime and Coastguard Agency,Bay2/17Spring Place,105 Commercial Road,Southampton,SO15 1EG.Tel :+44 (0) 203 8172835e-mail:seafarer.sh@mcga.gov.uksWebsite Address:www.gov.uk/government/organisations/maritime-and-coastguard-agency.General Enquiries:infoline@mcga.gov.ukFile Ref:MC 18/03/159Published:January 2018Please note that all addresses andtelephone numbers are correct at time of publishing.© Crown Copyright 2017Safer Lives, Safer Ships, Cleaner Seas.

Annex A (Amended)TABLE OF STANDARDS (AMENDMENTS)RefNoConditionRationale, riskbasis/JustificationAdvice to seafarers andmaritime industry.Preventative measuresNew diagnosisor currentcondition (see note 11above)Fitness category after investigation/resolutionReasonable adjustments6.0DISEASES OF THENERVOUS SYSTEM6.2Syncopeand otherdisturbances ofconsciousnessAD Guidance 7Recurrence causinginjury or loss of control3-until investigated and control ofunderlying condition demonstratedSimple faint(see AD guidance):1-unless frequent attacks lead to incapacity, then3-until resolved or treatedLoss of consciousness or altered awareness with nohigh risk markers(see AD guidance):2-Time limited and restricted toUK near-coastal watersand no lone watchkeeping, then if no recurrences after 3months (deck or engine roompersonnel) or 4 weeks(other)-1Loss of consciousness or altered awareness with highrisk markers(see AD guidance)3-pending investigation and treatment.(a) No cause found:3-6 months with no recurrence, then2-time limited for six months and restricted toUK near-coastal waters and no lone watchkeeping.After one year with no recurrences-1(b) Cause found and successfully treated:3-for one month, then2-time limited for three months and restricted toUKnear-coastal waters andno lone watchkeeping; then ifnorecurrences or treatment problems-1Loss of consciousness or altered consciousness withseizure markers(see AD guidance)Go to 6.3 or 6.4See AD Guidance7

7.0CARDIO-VASCULARSYSTEM7.1Heart-congenital andvalve disease, includingsurgery for theseconditions.Heart murmurs notpreviously investigatedAD Guidance 9Risk of progression,limitations on exercise.Bacterial endocarditisriskAdvice on prophylaxis forinfections3-untilinvestigated or treatedHeart murmurs1-whereunaccompanied by other heart abnormalitiesAND considered benign by a specialist cardiologistfollowing examination.Other conditions:Case by case assessment based on specialist-SConsider implicationsof any prescribed prophylacticantibiotics.4-if exercise tolerance limited OR episodes ofincapacity occur.See AD Guidance 15 if antithrombotic medication used.Surveillance may be needed7.2HypertensionAD Guidance 8Risk factor forischaemicheartdisease, eye andkidney damage andstroke. Risk of acutehypertensive episodesScreening at medical. Earlyassessment/treatment ofraised blood pressureNormally 3-if >170 systolic or >100diastolic mm Hguntil investigatedand treated inaccordance with BritishHypertension Society (or otherappropriate) Guidelines.1-iflowest reading is(a) <140 systolic and <90 diastolic mm Hg OR(b) <150 systolic and <95 diastolic mm Hg, under regularsurveillance, compliant with recommendedtreatmentand free from side effects.1 time limited or 3-if additional surveillance needed toensure level remains <170 systolic and <100 diastolicmm Hg4-ifpersistently>170 systolic or > 100 diastolic mm Hgwith or without treatment.Case by case assessment to include side effects ofcondition and treatment.Surveillance required C.See AD Guidance87.9Deep vein thrombosis/pulmonary embolusAD Guidance 15Risk of pulmonaryembolus from deepvein thrombosis-causing sudden lossof capability,recurrence andtemporary limitationson mobility. Risk ofrecurrence ofembolus. Risk ofbleeding from anti-coagulant treatment.

3-until investigated and treated1-if full recovery AND off anticoagulantsCase bycase assessment on return to duties aftertreatment completed.Consider fitness for long haul air travel.2-If on long term anticoagulants with <2% risk offurther DVT or PE, see AD Guidance 15.4-if recurrent OR persistent OR onpermanentanticoagulantswith >2% risk of further DVT or PE.

8.0RESPIRATORY SYSTEM(Consider fitness towear breathingapparatus if this formspart of emergencyduties)8.5Pneumothorax-spontaneousortraumaticAcute disability fromrecurrence3-normallyfor 12 months after initialepisodeor shorter duration asadvised by specialistBased on advice of treating specialist-S4-after recurrent episodes unless pleurectomy orpleurodesis performed10.0GENITO-URINARYCONDITIONS10.5Renal or uretericcalculus,symptomaticor asymptomaticPain and disabilityfrom renal colicAdvice on fluid intake3-until investigated and treated1-following case-by-case assessment by specialist ifstone free, with normal renal function andmetabolicevaluation including 24 hour urine collection, withoutrecurrence. If remains stone free after 2 years, repeatscan 5 yearly.Consider2-if concern about ability to work in tropics orunder high temperature conditions. Case by caseassessmentforUKnear-coastal duties.4-if recurrent stone formation11.0PREGNANCY11.1PregnancyComplications, latelimitations on mobility.Risk to mother andchild in the event ofpremature delivery atseaAdvice on risks and limitationsin advance and during earlystages of pregnancyUncomplicated pregnancy-SeeMarine Guidance NoteMGN 522Abnormal-3on diagnosisCase by case assessment if there are risk factors orcomplications. Seafarer must make informed personaldecision about excess risks from premature delivery atsea.13.0MUSCULO-SKELETAL13.3Limb prosthesisMobility limitationaffecting normal oremergency duties.4-normally but consider2-if general fitness requirements atAppendix 2 are fullymet. Arrangements for fitting prosthesis in emergencymust be confirmed1-in exceptional cases where all fitness requirementsdemonstrably met without prosthesis

MSN1839(M) Appendix 1 to AnnexA(Amended)EYESIGHT STANDARDS FOR SEAFARERSGENERALEyesight testing is carried out at every seafarer medical examination.No person should be accepted for training or sea service ifirremediable morbid condition of either eye,or the lids of either eye, is present and liable to the risk of aggravation or recurrence.Binocular vision is normallyrequiredfor all categories of seafarers.Case by case assessment may beappropriate in certain circumstances. See AD Guidance 14.In all cases where visual aids (spectacles or contact lenses) are required for the efficient performance ofduties, a spare pair must be carried when seafaring. Where different visual aids are used fordistantandnear vision, a spare pair of each must be carried.Individuals who wish to go to sea as deck or engineer personnel or who are considering dualqualifications are strongly advised to have their eyes tested by an optometrist before embarking on theircareer, in view of the particular importance for them of good sight.COLOUR VISIONDeck officers and ratings-Colourvision should be tested by the Approved Doctor with Ishihara plates,using the introductory plate, and all the transformation and vanishing plates. Those used should berecorded on the medical report form (ENG 2). Candidates who fail the Ishihara colour plate test mayapply to one of the MCA"s nominated Colour Assessment and Diagnosis (CAD) test centres listed atAnnex C to this MSN, to have their colour vision re-tested by undertaking a CAD Test. Refer to ADGuidance 14Electro Technical Officers(ETO)-should have their colour vision tested by theApproved DoctorusingIshihara plates (as for deck department). Those who fail the Ishihara test may apply to any registeredoptician for confirmatory testing using the Farnsworth D15 test or City University test.Refer to ADGuidance 14Engineer and radio department personnelshould have their colour vision tested by theApproved Doctorusing Ishihara plates (as for deck department). Those who fail the Ishihara test may apply to anyregistered optician for confirmatory testing using the Farnsworth D15 test or City University test.Refer toAD Guidance 14In all cases where a follow-up test has been undertaken, a report showing the result must be returned totheApproved Doctor, on the basis of which he/she will decide whether it is appropriate to fail thecandidate or issue a full or restricted medical certificate, reflecting the duties the seafarer will berequired to undertake.Any decision relating to subsequent colour vision testing should be officially recorded by theCAD testcentreor optometrist and retained by theseafarer with the ENG 1 to avoid the necessity for repeatedsecondary testing.Other personnelshould be tested for colour vision, where relevant for the duties to be undertaken, usingthe Ishihara plates.

Table-SUMMARY OF STANDARDS REQUIREDCategoryof SeafarerBasic Visual AcuityStandard (unaided)Higher Visual AcuityStandard (aided ifnecessary)Near Vision(both eyestogetheraided orunaided)ColourVisionVisual FieldDeck ordual careerBettereye 6/60Othereye 6/60Bettereye6/6Other eye6/12N8Ishihara orCADNopathologicalfield defectEngineer/Radio6/606/186/18N8Ishihara orFarnsworthD15 or CityUniversitySufficient toundertakedutiesefficientlyOthersSufficient to undertake duties efficientlyThose who become monocular in service with no evidence of progressive eye disease in the remainingeyeDeck6/60-6/6-N8Ishihara orCADNopathologicalfield defectEng/Radio6/60-6/9-N8Ishihara orFarnsworthD15 or CityUniversitySufficient toundertakedutiesefficientlyOthersSufficient to undertake duties efficientlyThere should be a sufficient period of adaptation after becoming monocular to enable stairs to be descendedrapidly and safely.Notes1.No diplopia,congenital night blindness, retinitis pigmentosa or any other serious or progressive eyedisease is permitted.2.If bifocal glasses are worn there should be a period of adaptation first because of the risk of falls.3.Where glasses or contact lenses areneeded to meet the vision standard, a spare pair (distance andnear vision if necessary) should be carried.4.Aids to colour vision e.g. red-tinted x-chroma, chromas lenses and chromagen lenses are notpermitted.5.Seafarers who suffer pathological fielddefects should have a field of vision at least 120oin thehorizontal measured by the Goldman perimeter using the iii/4 setting (or equivalent perimetry). Inaddition there should be no significant defect in the binocular field which encroaches within 20ooffixation above or below the meridian. Homonymous or bitemporal defects which come close tofixation whether hemianopic or quadrantopic are not accepted.

Annex BMCAColour Assessment and Diagnosis (CAD)Test CentresThe seafarer should contact thetest centre directly to make a booking for a test. There will be acharge for the test which the seafarer will need to pay directly to the test centre.City, University of LondonColour Research LaboratoryNorthampton SquareLondonEC1V 0HBcolourvision@city.ac.ukDirect booking and payment via website:http://www.city.ac.uk/avotThe AMS (London)Aeromedical Centre22 Upper Wimpole StreetLondonW1G 6NBTel: 01293 775336Email for bookings:reception@amsgatwick.comUniversity of BradfordSchool of Optometry & Vision SciencePhoenix South WestShearbridge RoadBradfordBD7 1DPTel :01274 234648 or 01274 234649 (eye clinic reception)Email for bookings:d.mckeefry@bradford.ac.ukSchool of PsychologyWilliam Guild BuildingRoom G35Kings College University of AberdeenAberdeenAB24 3FXTel: 01224 272387Email for bookings:vision@abdn.ac.uk