Olaf Jensen, Centre for Maritime Health & Society, Institute of Public Health, Southern Danish University, Esbjerg Denmark IMHA WORKSHOP TENERIFE EU MASTER IN MARITIME HEALTH With particular regard to: -research In the footsteps of James Lind

WHO 1948 Basis teaching The globe cccccccccccccccc Maritime health has mainly been concentrated on the early diagnosis and Treatment – but in order to reach the goals of health, primary prevention is also needed. WHO definition of Health Health is a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity.

WHO 1948 In maritime health we have mainly concentrated on the early diagnosis and Treatment and no strategy for all stages of health Definition of Prevention The definition of prevention drawn up by the World Health Organisation (WHO) in 1948 identifies three successive stages covering the means to be set up to prevent pathologies, therapy and, if possible, the social reintegration of patients

Secondary prevention Directive 92/29/EEC - medical treatment on board vessels of 31 March 1992 on the minimum safety and health requirements for improved medical treatment on board vessels Objective The objective of this directive is to improve medical assistance at sea since a vessel represents a workplace involving a wide range of risks. There has never been any primary prevention directive for health at sea – but overall EU regulation as health for all will be the basis International Medical Guide for Ships, Third Edition

DO WE NEED A SPECIFIC MARITIME HEALTH MODEL?

Alma Ata Declaration 1978 In maritime health We have no specific declaration of health for all seafarers! The Declaration of Alma-Ata was adopted at the International Conference on Primary Health Care (PHC), Almaty (formerly Alma-Ata), Kazakhstan (formerly Kazakh Soviet Socialist Republic), 6-12 September [Primary Health CareAlmatyKazakhstan Kazakh Soviet Socialist Republic [ It was the first international declaration underlining the importance of primary health care. The primary health care approach has since then been accepted by member countries of the World Health Organization (WHO) as the key to achieving the goal of "Health For All".primary health careWorld Health OrganizationHealth For All

xxxxx Model of cuasation

EU RULES as BACKGROUND FOR PRIMARY PREVENTION TRANING xxxxxxxxxxxxxx Health prevention: The Maastricht Treaty The Lisbon Treaty The Luxembourg Declaration Amsterdam treaty Enviromental contamination: The Gotemborg treaty IMO MARPOL Convention

DEBATE STRATEGIES FOR HEALTH Internat. Marit. Health, 2007, 58, 1 – 4 STRATEGIES TOWARDS HEALTH PROTECTION IN MARITIME WORK ENVIRONMENT INVOLVING THE ROLE OF HEALTH PROMOTION – INVITATION TO JOIN IN DISCUSSION IRENA LESZCZYNSKA, BOGDAN JAREMIN, MARIA JEEWSKA The aim is to present problems, limitations and advantages of strategies adopted for health protection at sea, with particular regard to health promotion.

DEBATE Integrated prevention at sea Int J Integr Care Jan-Mar; 10 Integrated occupational health care for seafarers across the continuum of primary, secondary and tertiary prevention Olaf C. Jensen, Eliseo Lucero-Prisno III, Luisa Canals,Olaf C. JensenEliseo Lucero-Prisno IIILuisa Canals As a basis for the integration of curative and primary health care programmes for seafarers, an analysis has been further actualised, as the European Commission recently launched ‘An Integrated Maritime Policy for the European Union’ However, an adequate policy for the health and safety care at sea is so far missing. ‘Superconvention’ or ‘Seafarers’ Bill of Rights', 2006 underscores the need for occupational health and safety promotion programmes, but no specific policy has been established

There is no similar model developed for seafarers? XXXXXXXXXXXXXXXXXXXXXXXXX XXX

Methods in the EU Maritime Master RESEARCH BASED: EPIDEMIOLOGY PUBLIC HEALTH EVIDENCE BASED OCCUPATIONAL HEALTH HEALTH PROMOTION HEALTH IMPACT ASSESSMENT LIFELONG EDUCATION QUALITY SHIPPING GLOBAL HEALTH

MODULES Proposals … Introduction Definitions and objectives Epidemiology and evidence based health research Early diagnosis and prevention Health examinations and research needs Individual/group research work 1: choice and outlines Work process risk assessment & prevention The use of ISO standards Maritime Health Economy Maritime Health management Environmental pollution and health risk Fatigue related health and safety risk assessment Infectious disease risk and prevention Non communicable disease risk assessment & prevention Burn-out and stress risk assessment and prevention The research work 2

The EU Directive from 1992 covers only secondary prevention There is a lack of a maritime primary prevention strategy – “health for all seafarers” However the EU calls for a strategy with primary prevention in all areas The proposed new EU master is research based to respond the requested competences CONCLUSIONS

Thank you very much