Skuld Club: Top medical conditions causing unfitness

A recent article by the Skuld P&I Club summarizes five years (2020–2024) of data from Halcyon Health Network, Inc. (Halcyon) on seafarers’ pre-employment medical examinations (PEMEs) conducted under Skuld standards. The article analyzes health trends and medical conditions to assess the effectiveness of these evaluations.

Over the five-year period, fitness rates have steadily increased, reaching 94.6% in 2024. The percentage of unfit cases declined to 2.1%, while expired PEMEs fluctuated, peaking at 3.4% in 2024. An “expired PEME” refers to instances where crew members were unable to complete their medical examinations within the required timeframe.

These delays can occur for various reasons, such as the need for weight reduction or the management of medical conditions like high blood pressure or elevated blood sugar. These issues must be brought under control to acceptable limits before a seafarer can pass the examination. In some cases, post-operative recovery may also delay completion. Until these concerns are resolved, the PEME remains expired.

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The Skuld highlights the following top conditions that may cause unfitness onboard

Gallbladder stone
Hypertension with maintenance medication
Hypertension and type 2 diabetes mellitus, both requiring maintenance medications
Kidney stone
Hearing loss
Color vision deficiencies not passing the STCW code requirements
Tuberculosis of lung
Type 2 diabetes mellitus with maintenance medication
Abnormal results of cardiovascular function studies
Does not comply with the visual acuity standards in STCW code

Skuld Club: Top medical conditions causing unfitness — The top 10 illnesses causing unfitness for a Skuld PEME from 2020 to 2024 / Image Credit: Skuld Club

Chronic conditions like hypertension and diabetes remain prevalent, emphasizing the need for lifestyle interventions. Gallbladder and kidney stones highlight dietary concerns, while sensory impairments and tuberculosis underscore the importance of rigorous screenings.

A comprehensive medical examination is essential because it provides a thorough assessment of an individual’s overall health, going beyond the basics offered by a minimal package.

…the Club advises.

While a minimal medical package may cover routine tests, it often overlooks underlying or developing conditions that could pose serious health risks if left undetected. In contrast, a comprehensive examination evaluates a wider range of health indicators, allowing for the early detection of conditions such as hypertension, diabetes, heart disease, and other chronic illnesses.

Early identification of these issues enables timely intervention, which can prevent complications, reduce healthcare costs in the long run, and improve the individual’s quality of life.

Prioritizing a detailed health assessment ensures a more accurate picture of a person’s well-being, ultimately promoting better long-term health outcomes.