OCCUPATIONAL SAFETY AND life and a lifetime of career

HEALTH opportunities, earnings potential, and

general well-being.
What is Occupational Health and Safety?  The economic cost. Poor occupational
safety and health practices cost an
 Occupational safety and health is the estimated 4% of global gross domestic
discipline for preventing work-related product annually, almost 3 trillion US
injuries and diseases and protecting dollars. While these estimates are
and promoting workers ' health. based primarily on the economic cost
 It aims to improve working conditions to businesses and government, when a
and the environment. young worker is injured, years of
 Members of many professions (e.g., productivity and investment in
engineers, physicians, hygienists, education and training are lost.
nurses) contribute to "occupational
safety, occupational health, THE MOST DANGEROUS SECTORS
occupational hygiene, and
improvement of the working Manufacturing
environment."
 Many young workers transition
Safety and health at work: Why are youth directly from education to
at risk? employment in manufacturing. Young
workers comprise almost 10% of all
 Many young job seekers feel pressure workers in manufacturing in Africa and
to accept their first job offer, often 20% in Eastern Europe and Central and
without considering if the working Western Asia.
conditions put their health and safety  In many developed countries, it is the
at risk. sector with the highest proportion of
 Young workers suffer from injury and occupational accidents involving
illness on the job at far higher rates young workers.
than their adult counterparts.
Construction
Defining young workers
 This sector attracts high numbers of
 The United Nations defines "youth" as young workers in many developing
anyone between 15 and 24. countries and has one of the highest
 They include students who work in rates of occupational injury and
their spare time, apprentices, interns, illness.
young people who have finished or  This is due to the hazardous nature of
dropped out of compulsory education, the work but also due to a lack of job
young workers in family businesses, training for a high number of
young employers, and self-employed inexperienced, seasonal, and migrant
workers. workers.

Injury and illness for young workers Agriculture

 Globally, 374 million workers suffered  This sector is a significant employer of

non-fatal occupational injuries in 2014. young people in developing regions.
 According to the European Agency for  Like the construction sector,
Safety and Health at Work, young agriculture is among the most
people in Europe are up to 40% more hazardous sectors for workers of all
likely to suffer a work-related injury ages due to the nature of the work and
than older workers. the frequent lack of job training for the
high number of low-skilled, seasonal,
Why does it matter? and migrant workers.
 Nearly half of all adolescents in
 Occupational safety and health is a hazardous child labor work in
fundamental human right, but there is agriculture.
more to this.
 The human cost. The high rate of injury
among young people is of particular
concern, as one accident can destroy a
 TECHNICAL AND ETHICAL GUIDELINES FOR 3.13. Post-employment medical examinations
WORKERS' HEALTH SURVEILLANCE may be necessary to assess health effects and
ensure early diagnosis and treatment.
Organization of workers' health surveillance 3.14. Medical examinations protect workers'
health, work access, and compensation
1. Workers' health surveillance should entitlement without substituting for hazard
consider workplace hazards, health prevention measures.
requirements, available resources, and 3.15. Periodic examinations help verify
legal regulations, with surveillance protection levels from exposure limits and
levels based on thoroughly identify the health effects of changes in
investigating work-related factors working conditions.
affecting health.
2. Workers' health surveillance can occur Biological tests and other investigations
at various levels and through different
entities, including occupational health 3.16. Biological tests and investigations,
services within or outside the integral to medical examinations, require
enterprise, ensuring qualified workers' informed consent and adherence to
professionals conduct it. professional standards to detect potential
3. A comprehensive workers' health health issues.
surveillance system includes individual 3.17. Biological tests and medical
and collective health assessments, investigations, supervised by physicians, must
injury and disease recording, sentinel ensure medical confidentiality and relevance
event notification, and action to worker health with consideration of their
components like feedback, guidance accuracy and predictive values.
on health policies, early warning 3.18. Non-invasive methods should be
capabilities, and evaluation of follow- preferred, and invasive procedures should be
up actions for improving working justified based on the benefits to the worker,
conditions and health. avoiding risks to their health, and being careful
regarding insurance claims.
Assessments of workers' health 3.19. Biological monitoring tests, such as blood
and urine tests, are valuable for worker health
3.4. Workers' health surveillance may be surveillance but should complement
mandatory or voluntary and can be regulated environmental assessments, prioritizing
by law. environmental criteria over physical limits.
3.5. Health assessment and medical 3.20. Genetic screening for work-related
examinations are crucial for workplace purposes is generally considered excessive,
prevention programs. lacking sufficient scientific basis for
3.6. Medical examinations serve various occupational health use.
purposes, including evaluating control
measures and assessing fitness for work. Sickness monitoring
3.7. Occupational physicians provide vital
information during medical examinations to 3.21. Monitoring sickness absence aids in
promote worker health and appropriate job identifying potential workplace health hazards
placement. related to ill health or absence.
3.8. Medical examinations should be 3.22. Occupational health professionals should
purposeful, selecting relevant tests and provide medical advice on sickness cases while
periodically reviewing for effectiveness. maintaining confidentiality, but they shouldn't
3.9. Examination procedures involve personal be involved in administrative management or
history, clinical exams, questionnaires, and verifying reasons for absence.
tests relevant to workplace hazards. 3.23. Occupational health physicians require
3.10. Medical examinations, ideally conducted full access to worker health and absence data
before or shortly after employment, serve as a to identify links between ill health and
baseline for future health monitoring. workplace hazards, sometimes necessitating
3.11. Pre-employment medical examinations collaboration with a worker's family doctor
should be adapted to job requirements and with the worker's consent and access to their
consider possibilities for improving working medical report.
conditions.
3.12. Periodic medical examinations during Recording and notification systems
employment should align with occupational
risks and may occur after prolonged absences 3.24. National authorities establish systems to
or job changes. monitor occupational injuries and diseases,
often within prevention, compensation, or 3.37. Hospital discharge records and trauma
benefit programs, sometimes following ILO registries provide comprehensive surveillance
guidelines. data for injuries, while disease registries and
3.25. Workers' compensation data provide exposure registries aid in monitoring diseases
valuable surveillance information on with long latency periods.
occupational disorders, aiding in monitoring 3.38. Workplace records of injuries and
trends and identifying high-risk jobs for diseases, manufacturer records, and trade
targeted action. union data can complement surveillance
3.26. Addressing the underestimation of efforts, offering valuable insights into workers'
occupational injuries and diseases requires health status.
utilizing epidemiological data and improving 3.39. Laboratory tests of biological samples
disease recognition through diagnostic criteria help assess workers' exposure to toxic
development and physician training. substances, serving as indicators of disease
status for surveillance purposes.
Surveys, voluntary programs, and inspections 3.40. Leveraging existing major surveys
conducted by government agencies can be a
3.27. Epidemiological surveys and cost-effective way to gather data for workers'
occupational health research are valuable for health surveillance, enhancing the
disease surveillance, guided by ethical understanding of occupational disorders.
principles and confidentiality. 3.41. Surveillance of occupational hazards and
3.28. Individual health surveillance can detect mapping can provide valuable information for
potentially work-related disorders, justifying health surveillance and prevention efforts,
targeted programs or surveys for specific identifying known and unknown hazards in the
health issues or exposed groups. workplace.
3.29. Sentinel events help identify high-risk
jobs and disease causes, complementing Collection, processing, and communication
traditional reporting systems. of health-related data
3.30. Incident reporting systems aid in hazard
identification and preventive measures, with 4.1. Workers' health data should be collected
near-accident data supplementing injury with the aim of enhancing health and safety,
surveillance. aligning with occupational health objectives.
3.31. Occupational health professionals' 4.2. Information technology use in health
surveys and inspections pinpoint hazards surveillance should be carefully controlled to
warranting specific health assessments. prevent data misuse, with specific guidelines
3.32. Medical inspections by labor authorities for electronic health records.
ensure compliance with health surveillance 4.3. Proper documentation is crucial for
regulations, with inspectors collaborating with effective workers' health surveillance, with
health professionals and recommending health professionals contributing relevant
targeted surveys when necessary. information to personal health files.
4.4. Collection of workers' medical data should
Other data sources adhere to medical confidentiality and
occupational health principles.
3.33. Routine health and disease data 4.5. Personal health data under medical
collected nationally or regionally can confidentiality should be stored separately
efficiently contribute to monitoring workers' and accessed only by medical professionals.
health, including occupational injuries and 4.6. Workers have the right to access their
diseases. health records, ensuring accuracy and
3.34. It's important to weigh the pros and cons facilitating corrections of any errors.
of using existing data for worker health 4.7. Confidentiality must be maintained
surveillance and evaluate their suitability for throughout the workers' health surveillance
ongoing prevention programs. process, with secure storage and adherence to
3.35. National administrative data offer cost- legal requirements.
effective insights into the distribution of 4.8. Medical information should only be
deaths, diseases, and injuries across disclosed according to confidentiality rules and
industries, aiding in identifying areas of with the worker's informed consent.
concern and estimating workers' health status. 4.9. General health information should be
3.36. Mortality data from death certificates, shared with employers and workers'
medical examiners' reports, and morbidity representatives for prevention and protection
data from hospital records are valuable for purposes, implying an obligation for action.
surveillance, providing insights into causes of 4.10. Attention should be paid to the design of
death and disease occurrences. forms and questionnaires, ensuring relevance
and confidentiality, with revision if necessary services, and determine qualifications for
by health professionals. personnel.
4.11. Sophisticated investigations in health 6.5. The competent authority should
surveillance should be limited to necessary undertake Supervision, advisory roles, and
purposes and transparently communicated to dissemination of information on workers'
build trust in occupational health health surveillance practices.
professionals' advice. 6.6. National practices on workers' health
surveillance should be reviewed, priorities
Use of health-related data established, and a cost-effective approach
adopted without compromising quality.
5.1. Workers' health data should aim to 6.7. A list of occupational diseases subject to
protect the physical, mental, and social well- surveillance, periodically reviewed, should be
being of workers both individually and established by the competent authority,
collectively. aligning with international conventions.
5.2. Fitness for employment should be 6.8. Provisions safeguarding workers' privacy
assessed based on the specific demands of the and preventing discriminatory use of health
job and the worker's abilities, with surveillance data should be adopted, along
consideration for potential adaptations and with an appeals procedure for disputes over
rehabilitation. fitness for specific occupations.
5.3. Fitness criteria should focus on "no
medical contra-indication" to a specific job, Employers
avoiding oversimplification and ensuring
compatibility with occupational health 6.9. Employers must arrange for workers to
principles. have access to health surveillance during work
5.4. Health assessments should inform hours and at no cost, integrating these
measures for worker and employer advice, arrangements into the workplace safety
including lifestyle adjustments, individually system.
adapted protective equipment, and workplace 6.10. Employers should ensure that workers
adaptations. have access to health surveillance tailored to
5.5. If a worker's health condition poses a risk the risks they face at work.
to others, clear communication and necessary 6.11. Employers can request medical exams
remedial actions must be taken to safeguard for current or potential employees, but there
everyone's safety. must be a valid reason, and for recruitment,
5.6. When an occupational disease is detected, exams should occur after a preliminary job
remedial actions should prioritize hazard offer.
removal and improving working conditions, 6.12. Employers, with input from workers'
with consideration for alternative representatives, may provide medical
employment if necessary to protect the surveillance and health promotion programs,
worker's health. ideally through organized occupational health
services.
Responsibilities, rights and duties 6.13. Employers can seek anonymous health
information from occupational health
Competent authority professionals for prevention purposes and
must be provided with relevant information to
6.1. A national policy on occupational health, protect workers' health.
including workers' health surveillance, should 6.14. If a job is deemed medically unfit for a
be developed in consultation with relevant worker, the employer should make efforts to
stakeholders and line with international find alternative employment or provide
conventions. support such as retraining or access to
6.2. Laws should support this policy, ensure benefits.
worker coverage, coordinate resources
efficiently, and integrate workers' health Workers
surveillance into prevention programs.
6.3. The competent authority should establish 6.15. Worker representatives and safety
Minimum standards for workers' health committees, where present, should receive
surveillance, ensuring access and collective health surveillance reports, ensuring
comprehensive assessments. personal data confidentiality.
6.4. The competent authority should 6.16. Workers or their representatives should
encourage the establishment of occupational have a say in organizing health surveillance,
health services, designate specific medical collaborating with health professionals to
prevent work-related health issues.
6.17. Workers must actively participate in professionals should maintain a network of
health surveillance, following guidelines, connections to provide comprehensive
respecting instructions, and attending medical occupational health care.
exams as needed. 6.30. Occupational health professionals should
6.18. Workers undergoing health assessments integrate workers' health surveillance with
should be informed beforehand about the health promotion programs, environmental
purpose and consequences of the assessment, health initiatives, and epidemiological
receiving clear and understandable research, adhering to ethical guidelines.
explanations tailored to their comprehension
level.
6.19. Informed consent is required before any
medical examination, with workers having the
right to individual health advice and the option
to appeal examination conclusions.
6.20. Worker representatives or safety
committees can request collective health
assessments when occupational health issues
are suspected, while workers have the right to
request health assessments if they believe
they have work-related health problems.

Occupational health professionals

6.21. Occupational health professionals should

assist employers, workers, and their
representatives in fulfilling their health and
safety obligations and tasks, adhering to
relevant laws and professional ethics.
6.22. Strict medical confidentiality should be
maintained by occupational health
professionals regarding workers' health
assessments, preventing unauthorized use of
examination results.
6.23. Occupational health professionals must
notify the competent authority of
occupational accidents and diseases as
required by law, providing necessary
information to prevent recurrence.
6.24. Occupational health professionals should
possess and update necessary competence,
making informed decisions regarding workers'
fitness for specific jobs.
6.25. Only qualified physicians or nurses under
their supervision should conduct medical
examinations of workers, ensuring health
assessments are performed by competent
professionals.
6.26. Occupational health professionals may
request additional health assessments beyond
legal requirements to ensure comprehensive
worker health care within the enterprise.
6.27. Upholding professional independence,
occupational health professionals should have
a contract clause on ethics and the right to
contact competent authorities if needed.
6.28. Occupational health professionals should
regularly review their practice, contribute to
referral systems, and adhere to national and
international codes of ethics.
6.29. Facilitating multidisciplinary
cooperation, occupational health
Understanding OSH principles
and their application in the maritime sector 2.5. Continuous improvement in OSH policies
and programmes involves updating risk
2.1. Understanding OSH principles involves assessments with changes in technology,
defining hazards and risks, where a hazard is processes, and incidents to ensure a safe
the potential to cause harm, and a risk is the working environment for seafarers.
likelihood of harm occurring if exposed to a
hazard, with balancing benefits and costs of The responsibilities of the competent
risk-taking. authority of the flag State
2.2. Risk assessment in OSH aims to prevent
accidents and diseases by identifying hazards, 1. Flag States are primarily responsible
using methods like the five-step risk for implementing occupational safety
assessment process, and adapting preventive and health (OSH) provisions of the
measures based on gathered data. MLC, 2006, with national legal
frameworks guiding their
Five-step risk management process responsibilities.
2. Flag States' responsibilities under the
Step 1. Identify the hazards MLC, 2006, include ensuring seafarers'
Step 2. Identify who might be harmed and how health protection and providing safe
Step 3. Evaluate the risk – identify and decide working environments on ships flying
on the safety and their flag, developing national
health risk control measures guidelines for OSH management, and
Step 4. Record who is responsible for establishing laws and standards for
implementing which control accident prevention.
measure, and the time frame 3. Each Member State must develop and
Step 5. Record the findings, monitor and publish national guidelines for OSH
review the risk assess- management on ships flying their flag,
ment, and update when necessary following consultations with relevant
stakeholders and considering
2.3. Preventive principles in OSH prioritize international recommendations and
combating risks at the source, with a hierarchy standards.
of control measures including elimination, 4. Consultations involving shipowners,
substitution, and technical or organizational seafarers, and relevant bodies should
measures, while personal protective actively contribute to the
equipment is a last resort. development of national OSH
guidelines, ensuring tripartite review
(1) elimination; of policies and legislation.
(2) substitution; 5. Representative shipowners' and
(3) isolation or combating of risk at the source; seafarers' organizations should
(4) technical or engineering controls; and advocate for the implementation of
(5) organizational measures. national OSH management guidelines
on ships, promoting safety and health
2.4. OSH management systems, based on the practices.
PDCA approach, involve planning,
implementing, checking, and acting to The responsibilities of the competent
continuously monitor performance and adapt authority of the flag State
to changing circumstances.
(a) information sessions;
(1) Plan involves the setting of an OSH policy, (b) on-board safety guidelines;
including the allocation of resources, (c) systematic risk assessment processes;
acquisition of skills and organization of the (d) national or local joint OSH protection and
system, and hazard identification and risk accident pre-
assessment. vention committees or ad hoc working parties;
(2) Do refers to the actual implementation and and
operation of the OSH program. (e) on-board safety committees which include
(3) Check means measuring the program's seafarers’
active and reactive performance. representatives.
(4) Act closes the cycle with a review of the
system for the purposes of continual 1. Guideline B.4.3.1, paragraph 2,
improvement and priming of the system for outlines the topics to be included in
the next cycle. national guidelines for managing OSH,
 with detailed information available in 14. The competent authority must ensure
Chapter 6. the confidentiality of seafarers'
2. The competent authority can either personal data in reporting and
create national guidelines itself or investigating OSH matters, in line with
delegate the task to recognized national laws and ILO guidance.
organizations, ensuring the guidelines' 15. Seafarers should be protected against
development responsibility remains coercion or intimidation during
with the authority. maritime investigations, with
3. The MLC, 2006, mandates Member entitlement to repatriation,
States to establish laws, regulations, accommodations, wages, benefits, and
and programs for occupational safety medical care.
and health (OSH) to prevent accidents, 16. Seafarers making safety and health
injuries, and diseases among seafarers. complaints should not face
4. Existing policies and laws may need victimization, and safety
adjustments to meet the MLC, 2006, representatives must be protected
requirements, sometimes overlapping against dismissal for fulfilling their
with International Maritime duties.
Organization (IMO) conventions.
5. National laws should cover all aspects The responsibilities of shipowners and
of seafarers' safety and health, seafarers
including reporting systems for
accidents and diseases, specifying 1. The MLC, 2006, and ISM Code outline
reporting responsibilities. shipowners' obligations to establish
6. National laws should ensure safe and occupational safety and health (OSH)
hygienic ship environments, policies and programs, emphasizing
preventive measures, continuous the safety and health of seafarers
improvement, and safety committees under 18.
onboard, among other provisions. 2. Shipowners are responsible for
7. Research, dissemination of findings, ensuring that masters have adequate
publication of statistics, and support to manage OSH effectively
promotion by shipowners' and onboard.
seafarers' organizations are essential 3. Establishing a safety culture onboard
for advancing safety and health requires planning, organization, and
initiatives. collaboration between management
8. Shipowners' and seafarers' and seafarers.
organizations should actively support 4. Shipowners must consult with
safety and health initiatives. seafarers, establish OSH policies
9. International cooperation is crucial for consistent with international
harmonizing actions and standards in standards, form safety committees,
promoting OSH, with consultation of conduct investigations, and provide
relevant ILO codes and international safe accommodations and recreational
standards. services.
10. The ILO, IMO, and WHO have 5. Guidance to shipowners includes
developed joint standards and designing workplaces for safety,
convened expert meetings to enhance supporting safety committees,
safety and health in the maritime providing resources for safe
sector. conditions, and ensuring proper
11. Regular reviews of national policies communication and training for
and programs should occur in seafarers.
consultation with stakeholders to 6. IMO Circular 3 of 2006 provides
ensure continuous improvement and guidance on basic elements of
relevance. shipboard OSH programs.
12. Regulatory systems must be 7. Shipowners should recognize the
periodically reviewed to adapt to connection between shipboard safety
technological advancements and and decent living conditions, including
evolving work methods. management practices and
13. Addressing identified problems, communication.
incorporating new developments and 8. Shipowners should establish incident
technology, and promoting continuous reporting systems, analyze incidents,
improvement are essential for and encourage seafarers to report
effective safety and health policies. unsafe conditions.
 9. Masters are responsible for problems, and provide training, among
implementing shipowners' OSH other duties.
policies, fostering a safety culture, 7. Safety committee members should
assigning suitable tasks, providing receive sufficient training in OSH,
clear instructions, maintaining safety covering policies, committee tasks,
equipment, and conducting drills. rights and roles, risk assessment,
10. Masters may delegate responsibility incident investigation,
for OSH policy implementation and communication, and commitment to
compliance to specific individuals. promoting a safe working
11. Seafarers are responsible for environment.
promoting safety culture, cooperating 8. Safety committee members should
with masters and shipowners, also have specific expertise in risk
attending OSH meetings, using assessment and management,
protective equipment, reporting providing advice on safety concerns,
hazards, and removing themselves incident investigation, and supervision
from dangerous situations. of safety tasks, with resources
12. Seafarers should not interfere with allocated for their training and
safety devices or processes unless development.
authorized and must communicate
effectively about safety risks. Reporting and investigation of occupational
accidents, injuries and diseases
The safety committee

1. Safety committees aim to foster Reporting, analyzing, and investigating

collaboration between shipowners occupational accidents aim to identify causal
and seafarers to develop and promote factors, implement preventive measures, and
safety and health onboard ships, integrate lessons learned for continuous
facilitating the implementation of OSH improvement.
policies and programs. (a) The objectives include effective
2. Functions of safety committees may investigation of causal factors, implementing
include cooperating with preventive measures, and
management, planning safe working (b) integrating lessons learned into OSH
conditions, investigating accidents, policies for continuous improvement.
proposing preventive measures, (c) It assists in identifying regulatory issues,
staying updated on OSH provisions, (d) setting up legal frameworks, and
and making recommendations for (e) promoting uniform procedures for
safety equipment and training. reporting accidents.
3. Safety committees should include the (f) The goals are to improve data collection for
master or a designated person reliable statistics,
responsible for OSH, safety (g) raise awareness among seafarers and
representatives, and members health-care providers, and
representing all crew levels and (h) minimize the recurrence of accidents and
departments, with the composition diseases.
reflecting effective representation.
4. Safety committee meetings should be Reporting of occupational accidents and
held regularly, in compliance with injuries
regulations, to ensure continuous
improvement and address safety The competent authority should establish
issues, with additional meetings reporting systems and involve relevant
convened after serious accidents or national authorities for occupational accidents
incidents. and injuries.
5. Shipowners should appoint or elect (a) Reporting systems should define
safety representatives who participate responsibilities,
in safety committee meetings, have (b) involve national health authorities, and
access to information, contribute to (c) have defined timelines for investigations
risk assessments, and receive and reporting.
appropriate training and instructions. (d) Shipowners must discuss reports and
6. Safety officers, if appointed, should preventive measures at safety committee
implement OSH policies, conduct risk meetings, while
assessments, promote safety culture, (e) statistics should record details and research
improve awareness of OSH, investigate trends.
(f) Separate injury reports for each seafarer (e) Assessment of problems arising from
ensure confidentiality and proper follow-up, technological advancements and their impact
and on crew composition.
(g) progressive development of recording (f) Examination of problems originating from
procedures should be promoted. human errors.

The competent authority must specify the Reporting and investigating occupational
minimum information required in reports for diseases:
occupational accidents and injuries.
(a) It should include ship details like name, (a) Establishing procedures for shipowners to
IMO number, and flag state. report recognized occupational diseases
(b) The type of ship involved should be related to onboard work conditions.
mentioned. (b) Developing a list of reportable occupational
(c) Date and time of the accident or injury must diseases for seafarers based on international
be recorded. or national standards.
(d) The geographical position where the (c) Recommending health surveillance and
incident occurred should be noted. reporting systems based on risk assessments.
(e) Seafarer details such as name, rank, (d) Monitoring and analyzing severe health
nationality, and gender are necessary. issues in seafarers in collaboration with
(f) Nature of injuries sustained by the seafarer national health authorities.
should be described. (e) Investigating suspected new health
(g) The outcome of the incident, whether problems or clusters of diseases among
death, recovery, or expected long-term seafarers.
effects, if known, must be reported. (f) Disseminating reports on emerging seafarer
(h) Environmental conditions like lighting, health risks and preventive measures.
weather, and temperature at the time of the (g) Supporting the development of
incident should be documented. investigation skills for seafarer health risks.
(i) The specific location on board where the (h) Raising awareness among healthcare
injury occurred needs to be identified. providers regarding seafarer health risks and
(j) Activities the seafarer was engaged in ensuring proper reporting and investigation
during the incident must be documented. procedures.
(k) The seafarer's hours of work or rest in the
72 hours prior to the incident should be Confidentiality of data:
recorded. Maintaining confidentiality of data as outlined
(l) Details of any other seafarers affected by in section
the incident must be included.
(m) A brief description of the events
surrounding the incident should be provided.

The facts leading up to the incident should be

analysed to
identify possible causal factors and should be
reflected accurately
in the report. The investigation should focus
upon:
(a) what happened;
(b) how it happened; and
(c) why it happened.

Primary points:
(a) Various aspects of the working
environment affecting safety and health.
(b) Analysis of occupational accidents and
injuries across different age groups.
(c) Identification of physiological or
psychological issues due to shipboard
conditions.
(d) Addressing physical stress issues, especially
related to workload.