The Medico-Legal and Social Aspects of the Eligibility Examination for Enrolment in the Seafarers Registry: A Single-Center Retrospective Study

Background: Working on board presents unique healthcare challenges for maritime personnel. Italian Law mandates a medical fitness assessment for seafarers registry enrolment. The Port Health Officer assesses seaworthiness and, against this judgment, the applicants can appeal to the First-degree Medical Commission. Studies on maritime personnel's medical fitness are limited and primarily focus on the health conditions of individuals already employed in the maritime sector. Methods: A retrospective study reviewed 459 medical reports of 361 seafarers from Naples' Port Authority First-degree Medical Commission (2013-2022). Characteristics such as sex, age, diseases, and suitability judgments were analyzed. Results: Out of the 361 candidates, most were male with an average age of 28.67 years. A total of 160 (44.32%) were deemed suitable for matriculation in both the first and second categories, 79 (21.88%) were approved for one category, 53 (14.68%) were found not suitable, and 69 (19.11%) are still under assessment. Eye diseases were most common (50.83%), followed by cardiovascular and orthopedic conditions. Applicants with poorly controlled diabetes mellitus, epilepsy, psychiatric disorders, and advanced tumors were declared unsuitable. Conclusion: Our study provides opportunities to improve applicants' awareness of the physical requirements for pursuing a career in navigation and to update the list of illnesses and physical impairments used for this medico-legal evaluation.