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Maritime industry medical standards enforcement needs more work, Part 1

While the U.S. Coast Guard has made more of an effort to enforce medical standards among merchant mariners, compelling evidence shows that there’s still much work to be done.

At a July 8th, 2009 Congressional hearing on “National Maritime Center and Mariner Credentials,” the Coast Guard reported that between January 1st and July 2nd, 96 mariners were denied credentials because they were deemed to be medically unfit for employment.

In each case, the rejected mariners had checked a box on their physical exam forms stating that they were “competent” for duty.

Still, too many unfit mariners are falling through the cracks and being allowed to report for duty, all the while putting passengers and crew at risk.

For too long, the industry has been derelict in enforcing medical standards, often relying on an honor system from mariners to divulge any issues which may have precluded them from being qualified workers. All too often, the examining physicians would accept that word at face value.

A recent San Francisco Examiner article by John Upton entitled “Bar Pilots Might be Unfit for Duty,” offers a scathing indictment of medical enforcement upon pilots’ associations. The story reports how California State Auditor Elaine Howle found that the State Board of Commissioners representing the San Francisco Bay Area pilots have failed to adequately enforce medical standards.

Under new regulations, Bay Area Bar pilots are required to undergo a physical exam once a year by an approved physician. However, according to the Auditor’s report, of seven new bar pilots, three of them were issued licenses before they even took their physicals. One of the new pilots even guided 18 vessels in 28 days before taking a physical.

The audit also finds that six out of 14 pilots surveyed received new licenses or renewals even though their physical exams were conducted by non-approved physicians.

Bay Area pilots have come under scrutiny since the November 7th, 2009 Cosco Busan incident, where pilot John Cota was found to be in poor health and possibly impaired by multiple prescription drugs, circumstances potentially contributing to the allision on the Bay Bridge which resulted in 53,500 gallons of heavy fuel oil being spilled into the Bay.

Merchant Mariner Physical Examination Report, OMB 1625-0040, is the official title of the form U.S. mariners must complete in order to be issued credentials for the right to work. The examination may be administered by a licensed physician, physician’s assistant or nurse practitioner. The form states that an exam must be “completed to ensure that all holders of Licenses and Merchant Mariner Documents are physically fit and free of debilitating illness and injury.”

In addition to basic height/weight information, recorded vital signs, hearing and color vision testing, the individual must list medical history and prescription drug usage.

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