“SHIPSAN ACT, un progetto europeo a tutela della salute ...€¦ · “SHIPSAN ACT, un progetto europeo a tutela della salute dei viaggiatori marittimi” Dr. Mauro Dionisio ‘Elementi

“SHIPSAN ACT, un progetto europeo a tutela della salute

dei viaggiatori marittimi”Dr. Mauro Dionisio

‘Elementi di Sanità Marittima ed Aeroportuale e Attività di Polizia Sanitaria’

Cecina (LI) 28 maggio 2015

SHIPSAN TRAINET

DURATA: 35 Mesi

Inizio: Novembre 2008

Fine : Ottobre 2011

(15 EUMS)

SHIPSAN

DURATA: 24 Mesi

Inizio: Dicembre 2006

Fine : Dicembre 2008

(6 EUMS)

Hello and welcome to all of you: those who were readers of this newsletter already in the previous SHIPSAN project as well as those who areapproaching SHIPSAN for the first time. After a years break, due to the end of SHIPSAN TRAINET, we are here to resume the publication of thenewsletter with the new name of “EU SHIPSAN ACT Newsletter”. I am glad and honored to have been indicated as the new Editor, for this year, fromthe SHIPSAN ACT Coordination Team during the kick-off meeting. A few words about me: after graduating as medical doctor in Naples - Italy, Iattended the post-graduated school in internal medicine and, then, in hygiene and preventive medicine. During the past 2 decades I have worked asport and airport doctor in 2 different Italian regions: Puglia and Sicily. I have also dealt with implementation of new International Health Regulations(IHR 2005). At the moment I work at the Ministry of Health in Rome – General Directorate for prevention - with the objective, among others, to followthe development of SHIPSAN ACT Joint Action. As most of you know, on 1st February the new SHIPSAN ACT - EU Joint Action (JA) - started followingthe successful and fruitful activities of SHIPSAN and SHIPSAN TRAINET projects (2006-2011) implemented with the support of EU Commission in theprevious SHIPSAN project. Our aim has not changed and, as the acronym suggests, we will continue to focus on ships and sanitation, but our field ofinterests has been enlarged: in this and in the next newsletters you will discover how! Also the number of partners, either ‘associated’ or‘collaborating’ has incremented: SHIPSAN ACT involves today 14 Organizations from 10 countries (Greece, Germany, Ireland, Lithuania, Slovenia,Spain, UK, Bulgaria, Iceland and Italy) as ‘associated partners’ and 16 Organizations from 15 countries (Belgium, Cyprus, Estonia, Netherlands,Portugal, Switzerland, USA, Poland, Austria, France, Malta, Norway, Romania, Slovakia and Croatia) as collaborating partners. The development of thewhole Joint Action has been divided in 9 different work packages (WP), each leaded by an Organization as follow:

• WP1 (Coordination)-Laboratory of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece;

• WP2 (Dissemination)-Laboratory of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece;

• WP3 (Evaluation)-General Directorate for Prevention, Ministry of Health, Italy;

• WP4 (State of the art)-Health Service Executive, Naas, Ireland;

The aim of this newsletter, as well the next ones, is to disseminate the SHIPSAN ACT JA activities. We hope to rouse yours and all stakeholders’interest and we expect to receive your active feedback. We also wait for your contribution toward the ‘port of the month’ section, and for any newsof common interest. Arduous challenges are awaiting for us, I know. All the wishes for the success of SHIPSAN ACT, for a wide dissemination of theoutcomesand for the sustainability of the EU SHIPSAN ACT JA also in the future!

Mauro Dionisio

Ministry of Health, Italy

Programma integrato

EU SHIPSAN

Manuale per la

Sorveglianza e le Ispezioni

Commmunication

Web - BasedPort to Port

Materiale di formazione e Formazione

Modulare per operatori

sanitari di Porto e marinai

Training network con

scienziati esperti

SHIPSAN ACT

SHIPSAN Manual References- Risultati progetti Shipsan

- Risultati della recensione della letteratura

- Legislazione EU esistente

- Regolamento Sanitario Internazionale 2005 (IHR)

- EUMS Guida alla sicurezza alimentare (UK, Irlanda,

Grecia, Olanda, etc …)

- Linee guida WHO vigilanza sanitaria delle navi

- Manuale WHO per il rilascio SSCS

- CDC – VSP

- Analisi descrittiva dei dati relativi a pratiche

attuate dagli Stati membri EU

Manuale

Il Manuale è diviso in 2 parti

La parte A include i seguenti punti:

punto 1: Strutture mediche

punto 2: Sorveglianza delle malattie trasmissibili a bordo

delle navi

punto 3: Sicurezza del cibo

punto 4: Sicurezza dell’acqua potabile

punto 5: Sicurezza dell’acqua per attività ricreative

punto 6: Pest control

punto 7: Sicurezza Housekeeping

punto 8: Sostanze pericolose

punto 9: Rifiuti

punto 10: Acque di zavorra

Manuale

La parte B include le seguenti linee guida:

Prevenzione e controllo delle ILI (influenza-like illness)

Prevenzione e controllo delle gastroenteriti

Prevenzione e controllo della legionellosi

EU SHIPSAN ACT Joint Action

Integrated inspection Programme


(2011) & 2013-2014 2015

Announced inspections by trained port health officers accompanied by a SHIPSAN ACT trainer

Short notice inspections by trained port health officers

Voluntary participation of passenger shipping companies

Non voluntary participation of passenger shipping companies

Pilot Inspections


May – November 2013 May – November 2014*

Inspections 48 full inspections and 2 re-inspections

50 inspections

Ports 22 32

Countries

13(Germany, Greece, Cyprus, Estonia, Italy, Netherlands, Spain, Malta, Iceland, Ireland, United Kingdom, Lithuania and Belgium)

17 (16 EUMS and 1 non – EUMS)(Belgium, Croatia, Cyprus, Estonia, Germany, Greece, Iceland, Ireland, Italy, Lithuania, Malta, Romania, Slovakia, Spain, The Netherlands, Turkey, United Kingdom)

Cruise lines (sea-going) 9 13

Ferry companies 5 5

Cruise lines (inland) 0 1

SHIPSAN inspectors 20 49 (The pool of SHIPSAN inspectors

consists of 57 inspectors)

Trainers 7 3

“inspectors-in-training” 77 68 (Inspectors in training for both

years 110)

Pilot Inspections

• In 2013: 50 inspections conducted on 48 passenger ships in 22 ports from 13 EUMS based on EU standards by trained inspectors.

• In 2014: 50 inspections conducted on 50 passenger ships in 32 ports from 16 EUMS and 1 non – EUMS based on EU standards by trained inspectors.

2011 2013 2014

Inspection Reports 42 48 50

Corrective Action Statements 20 31 out of 46 requiring Corrective

Action

35

Number of Deficiencies 393 517 689

� Non compliances with requirements of the EU legislation

41 84 106

� Non compliances with recommended standards of the Manual

282 360 524

� Notations 70 73 59

From May until November 2013

Pilot Inspections

Chapter in the

SHIPSAN Manual

Category of non-compliance

% of total*Requirements of EU

legislation

Recommended

standardsNotations

Frequency % of total* Frequency % of total* Frequency % of total*

Medical facilities 2/517 0.39% 19/517 3.68% 1/517 0.19% 4.26%

Communicable

disease surveillance4/517 0.77% 3/517 0.58% 0/517 0% 1.35%

Food safety 58/517 11.22% 125/517 24.18% 35/517 6.77% 41.97%

Potable water safety 2/517 0.39% 89/517 17.21% 3/517 0.58% 18.18%

Recreational water

safety 0/517 0% 51/517 9.86% 10/517 1.93% 11.90%

Pest management 1/517 0.19% 13/517 2.51% 4/517 0.77% 3.48%

Housekeeping 3/517 0.58% 43/517 8.32% 15/517 2.90% 11.90%

Hazardous substances 6/517 1.16% 5/517 0.97% 2/517 0.39% 2.51%

Waste management 8/517 1.55% 12/517 2.32 3/517 0.58% 4.45%

Ballast water

management0/517 0% 0/517 0% 0/517 0% 0%

Total 84/517 16.25% 360/517 69.63% 73/517 14.12% 100%

Pilot Inspections

Evaluation of pilot inspections 2013 – positive feedback

�249 questionnaires to 97 inspectors, 7 trainers, 48 Captains/ship crew and 14 shipping companies

�109 completed questionnaires:

For all 48 inspections conducted, at least one completed evaluation questionnaire was received

6 out of 9 participating cruise shipping companies completed the evaluation questionnaires and none from the ferry shipping companies

�All responding shipping companies: this kind of inspections is necessary provides a verification of companies’ standards

helps to address issues of inconsistency and weakness in inspectoral approach and of response to communicable diseases events

� All except one of the 18 responding Captains and ship crew reported that the SHIPSAN inspection performed was useful for their ships

� >90% of inspections were rated by inspectors, trainers and Captains/ship crew as excellent or satisfactory in terms of usefulness/effectiveness and conformity to objectives


Ship Sanitation Certificate (SSC-IHR)

This subsystem http://ssc.shipsan.eu/ aims at:

• holding and sharing information on ship sanitation inspections

• issuing the Ship Sanitation Certificates under the IHR:

- Ship Sanitation Control Exemption Certificate (SSCEC)

- Ship Sanitation Control Certificate (SSCC)

It addresses all types of ships.

It is used by the MS authorized Port Health / Competent Authorities and predictably by more authorities all over Europe.


Integrated Inspection Programme

�SHIPSAN ACT Joint Action will facilitate IHR implementation by:

� Delivering European and national training courses focused on IHR (2005) and the issuance of Ship Sanitation Certificate (SSC) by using the WHO Learning Programme

� Running the web based SHIPSAN ACT information system for recording and issuing Ship Sanitation Certificates

Inspections in all types of ships for SSCsStandards: WHO Handbook for inspection of ships and issuanceof Ship Sanitation Certificates

Tools: SHIPSAN ACT Information System for recording andissuing Ship Sanitation Certificates under theInternational Health Regulations 2005, for all types of ships sailing in EU. http://ssc.shipsan.eu


Integrated Inspection Programme

EU SHIPSAN ACT Information system for recording and issuing SSC

•190 registered inspectors from 12 European

countries

• A total of 6364 Ship Sanitation Certificates have

been issued and recorded in the SHIPSAN information system based on the WHO Handbook for inspection of ship and issuance of SSCs


*until 06/05/2015

Training activities

e-learning Webinars

Face to face training courses On the job

training


Training Platform


Training Platform


Courses focused on IHR (2005) and the issuance of Ship Sanitation Certificate (SSC) by using the WHO Learning Programme

• 1 training course for lead inspectors (EU level)

• 2 training courses on IHR and issuance of Ship Sanitation Certificates (National level) (http://extranet.who.int/ihr/training)

Courses focused on the SHIPSAN Manual and the SHIPSAN ACT Information System

• 1 introductory course on the SHIPSAN Manual (EU level)

• 2 advanced courses focused on water safety (EU level)

• 4 introductory courses on the SHIPSAN Manual (National level)

Pool of trainers


No Countries Number of applications

EU countries

1 Belgium 1

2 Croatia 1

3 Cyprus 2

4 Estonia 1

5 France 1

6 Germany 6

7 Greece 13

8 Iceland 1

9 Ireland 6

10 Italy 3

11 Netherlands 3

12 Norway 2

13 Poland 1

14 Slovenia 2

15 Spain 14

16 Sweden 1

17 UK 16

NON EU countries

18 Australia 1

19 Canada 1

20 USA 12

Training material


• For port health officers

- Case studies

- Exercises

- Debates

- Practical training on board ships

- Issuance of IHR-SSCs following WHO guidelines

• For seafarers

- Case studies

- Problem solving exercises

- Simulation exercises

- Debates

- Inspection findings

On the job training


1st Training course


“Hygiene & Health Practices on Passenger Ships”Location: Italy Duration: 3 days Date: October 2013

Trainees: A total of• 16 seafarers

• 6 cruise companies, • 1 ferry company • 1 ship management

company • 13 port health officers

Evaluationof the responding trainees: course

met their expectations and would recommend the training course to others.

of trainees found the usefulness of e-learning for “face to face training course” good or excellent.

Some comments from participants:

• “Great training, I learned a lot and felt very

comfortable. The atmosphere and choosing

training methods created a very beneficial

learning experience”

• “ I would not tell others about the course

cause I want to come again and participate”

2nd Training course


Location: Piraeus – cruise ship

Duration: 4 days

Date: 5-7 March 2014

Trainees:113 trainees

• 52 seafarers from the industry (cruise ship and

ferry companies, and consultancy companies)

• 61 port health officers: 55 trainees from 19 EU MS

and 6 trainees from 4 Non EU countries (Brazil,

Israel, Montenegro and Turkey)

Pre and post assessment scores of knowledge showed an increase of 65% for the professional seafarers and 52% for the port health officers.

3 Training course


Advanced training course for water safety on shipsA training course for seafarers and shipping industry professionals

Location: Athens Duration: 3 days Date: 17-19 June 2014

• 65 trainees participated in the training course:

• 38 seafarers from the industry (cruise ship and ferry companies, and consultancy companies)

• 7 port health officers from 11 EU Member States

Timetable of trainig courses


Training course Location MonthEuropean training courses

TC1: European introductory training course for the

SHIPSAN manual for seafarers

Tivoli Terme,

Rome, Italy8-10 October 2013

TC2: European introductory training course for the

SHIPSAN manual for port health officers (PHO)Piraeus, Greece 5-7 March 2014

TC3: Advanced focused training course for water safety

(1)Piraeus 17-19 June 2014

TC4: Advanced focused training course for water safety

(2)Piraeus October 2014

TC5: European training course for lead inspectors on IHR

SSCs (+ training for chemical and radiological, + training

for inland)

Slovenia June 2015

National training coursesTC6: National training courses for IHR SSCs (with support

of SHIPSAN ACT) -1 Ireland June 2015

TC7: National training courses for IHR SSCs (with support

of SHIPSAN ACT) -2Bulgaria September 2015

TC8: National introductory training course for the manual

and SIS for PHO (with support of SHIPSAN ACT) -1Greece October 2015


and SIS for PHO (with support of SHIPSAN ACT) -2Italy November 2015


and SIS for PHO (with support of SHIPSAN ACT) -3Spain December 2015


and SIS for PHO (with support of SHIPSAN ACT) -4Croatia September 2015

Webinars


• The webinar on “Ebola Virus Disease and maritime transport sector” was broadcasted on 22nd April 2015.

• A total of 109 participants from 20 countries registered to view the webinar.

Occupational Health and hygiene in maritime transport


• Risk assessment tool for occupational and public health risks per cargo ship type

• The risk assessment tool will be developed using the Online Interactive Risk Assessment (OiRA)

tool developed by the European Agency for Safety and Health at Work (EU-OSHA)

• Opportunities for collaboration will be identified between port health and occupational health

authorities.

• Public health risks of international concern will be identified according to the type of cargo ship.

• Survey on the current status of implementation of ILO Maritime LabourConvention, 2006.

• Model for a Memorandum of Understanding between port health and port state control authorities on issues related to occupational health and ship inspections

• to be implemented by the EU MS in their own context and according to national and local rules.

Chemical and radiological incidents on ships


�Guidelines for competent authorities on risk assessment and response to chemical/radiological events (accidental/deliberate release)• in support to their risk assessment and response

to chemical and radiological incidents on ships while the ship is at port.

�Training material will be developed on dealing with chemical and radiological incidents.

�Table top exercises will be used to pilot test the guidelines.

Guidelines will strengthen current

approaches to safeguard the health of travellers and crew on

passenger ships and cargo vessels

Dissemination of result


EU SHIPSAN ACT Joint Action was presented in:

• 20 national conferences within EU MS related to: � hygiene inspections,

� occupational health,

� travel medicine

� communicable disease surveillance

• Events at non EU countries

• European Events and Conferences (EC, ECDC)

• International meetings (WHO global meetings, ANVISA)

• Chief Medical Officers’ Meeting in the framework of the Greek Presidency

• By 2016 to be presented in >20 national conferences

1. Communication Networkhttp://www.shipsan.eu/comnetaims at:

� surveillance on board passenger ships

� sharing epidemiological information among competent authorities at ports in a standardized and confidential way

� sharing inspection results

� Inspection report

2. Ship Sanitation Certificate (SSC - IHR)http://ssc.shipsan.eu


SHIPSAN ACT INFORMATION System (SIS)

Communication Network

Communication Network forms

1. Communicable Diseases Surveillance

Routine Recording Form

2. Case/ Outbreak Recording Form

3. Maritime Declaration of Health

4. Corrective Action Statement

5. Passenger Ship Registry Form

6. Port Registry

7. Port Health Officers (Inspectors)

Registry

8. Other Competent Authority Registry

9. Competent Authority Communication

Alert Form

10. Network Communication Form

11. Inspection Report

Completed by the ship

Completed by Port Health Authorities


Comunication Network Platform


Functions:

maintaining registries (ports, ships, competent authorities and inspectors)sharing epidemiological information in a standardized and confidential wayrecording information for risk assessmentexchanging information during an outbreak investigation

Comunication Network Platform


Date Type of event Country

16/1/2015 Varicella Spain

14/10/2014 Legionella disease Spain

29/9/2014 Chickenpox Malta

26/2/2014 Measles Spain

26/9/2013 GI Spain

20/9/2013 TBC Spain

5/9/2013 Legionnaire's disease Greece

27/3/2013 TBC Spain

21/12/2012 GI Spain

16/11/2012 Dengue Spain

12/11/2012 GI Spain

12/11/2012 Legionnaires’ disease Spain

5/11/2012 GI Spain

23/10/2012 GI Spain

7/10/2012 Meningitis Italy

18/6/2012 Legionnaire's disease Spain

10/5/2012 GI Spain

20/2/2012 GI (varicella) Spain

25/1/2012 GI Spain

24/12/2011 Legionella pneumophila Germany

12/10/2012Neisseria meningitis type

C Italy

19/8/2011 Measles Italy

EU SHIPSAN ACT communication platform

events have been followed

up by using the communication network platform

5 countries have created alerts:

Spain (16)Germany (1)Italy (3)Greece (1)Malta (1)

www.shipsan.eu/comnet

Communication network platform

Public health events

Disease Events Ships Number of casesGI 8 5 1631Varicella 2 2 8Legionellosis 5 5 5Measles 2 2 32Dengue 1 1 1Meningitis 1 1 4TBC 2 2 2Chickenpox 1 1 1TOTAL 22 19 1684


European directory of authorised ports to issue Ship Sanitation Certificates under IHR 2005


• The contact details of the authorised ports of EU countries for issuing Ship Sanitation Certificates under IHR (2005) available via the EU SHIPSAN ACT Joint Action website.

• The aim is to create the first contact list for authorised ports of EU countries responsible for issuing Ship Sanitation Certificates under IHR (2005) that will:

• facilitate port to port communication,

• strengthen the network of port health officers in Europe and

• further facilitate communication of the ship directly with the appropriate port health authorities when desiring to ask for a Ship Sanitation Certificates renewal.

Contact details


http://www.shipsan.eu/Inspections/AuthorisedportstoissueSSC.aspx


19,553 visits(August 2013 –

April 2015)

For further infomation: www.shipsan.eu

Also available on the website:

• Q&A section about Ebola on Maritime

Transport

• European Manual

• Leaflet

• Advice to international travellers for a

healthy voyage

• Updates on News and Events

• Publications & Bibliography

• Links to European and international

Institutions

• Webinars

• Subscribe to the bimonthly e-newsletter


www.shipsan.eu/comnet• Communication Network Platform

• Database for recording inspections conduced using the SHIPSAN Manual

http://ssc.shipsan.eu• SHIPSAN ACT Information System for recording and issuing Ship

Sanitation Certificates

www.shipsan.eu• Web portal of the EU SHIPSAN ACT Joint Action

http://elearning.shipsan.eu/• SHIPSAN ACT e-learning platform

SIS web service related MDH


• MDH historical data for every ship will be stored on the SIS.

• MDH data archive on SIS after a specific time period (3 or 6

months).

• Online standardized analysis web services will be provided on SIS.

• Extraction data web tools will be provided to authorised users (e.g.

Port Health Authorities).

• Advanced online search facilities e.g by IMO, Ship name,

Embarkation-Dissembarkation date.

• Port Health Authorities (Local and National) will be authorised to

access SIS and view the MDH records.

SHIPSAN Information System (SIS)




Ship OVERVIEW Information



SSC Inspection



SSC



SSC Inspection Areas



Inspections based on the European Manual



Inspections based on the European Manual



Port Communication Form



Ship Communicable Diseases Surveillance Routine Recording Form



Ship Communication Form



MDH

Conclusions – EU SHIPSAN ACT JA Impact on Health policy


• Contribute to protect the EU population against health threats and improve citizens' health security.

• Help countries to preparedness planning, response to events in a coordinated manner by developing contingency plans and to develop IHR core capacities.

• Protects health of ship travelling passengers in EU by:

• strengthening compliance of ships with MS/and EU legislation, standards and guidelines related to hygiene, CBRN events management and ;

• implementing an integrated strategy for epidemiological investigation;

• Protects health of crew working on ships, by providing training on ILO MLC health related issues.

• Strengthens EU’s capacity to monitor and respond to health threats by:

• developing EUMS cooperation

• facilitating rapid ship-to-port and port-to-port information exchange using web-based tools.

• Provides risk assessment data and implementation of response measures at the port level to existing monitoring and early warning mechanisms at local, national and EU levels.

Documents

“SHIPSAN ACT, un progetto europeo a tutela della salute ...€¦ · “SHIPSAN ACT, un progetto europeo a tutela della salute dei viaggiatori marittimi” Dr. Mauro Dionisio ‘Elementi