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This contribution is intended to fertilise the current discussion of ship's doctors qualifications required for cruise ships. Therefore 10 points are added to the debate containing different considerations focussing on the recommendations of the German Society of Maritime Medicine, the American College of Emergency Physicians (ACEP's) Health Care Guidelines for Cruise Ship Medical Facilities and the different skills a ship's doctor should have from the perspective of the recruiter.

Introduction: Health and diseases on board ships may depend on water. Interventions to improve the quality of water may bring to significant benefits to health and water stores/supply and should be controlledto protect health. This paper has reviewed the main regulations for the control of water safety and qualityon board ships and presents some practical recommendations for keeping water healthy and safe in passenger and cargo merchant ships., Methodology: The main international regulations and guidelines on the topic were analysed. Guidelines forWater Quality on Board Merchant Ships Including Passenger Vessels of Health Protection Agency, World Health Organisation (WHO) Guide to Ship Sanitation, WHO Guidelines for Drinking Water Quality, WHO Water Safety Plan and the United States Center for Disease Control and Prevention Vessel Sanitation Program were examined. Recommendations for passenger and, if available, for cargo ships were collected and compared. Recommended questionnaire: A questionnaire summarising the main information to collect for assessingthe enough quality of water for the purposes it should be used on board is proposed. The need of havinga crew member with water assessment duties on board, trained for performing these activities properlyis discussed., Conclusions: Water quality on board ships should be monitored routinely. Monitoring should be directedto chemical and microbiological parameters for identifying possible contamination sources, using specifickits by a designed crew member. More detailed periodic assessments should be under the responsibility ofspecialised personnel/laboratories and should be based on sample collection from all tanks and sites of waterdistribution. It is important to select a properly trained crew member on board for monitoring water quality.

A general practitioner decided that a first-time Scandinavian seafarer with hyperactivity disorder, reasonably well-regulated on dextroamphetamine, was fit for unrestricted work at sea. Carrying amphetamine across US borders is drug smuggling, and when the cruise ship could not supply his medication from local ports, his behaviour became so erratic that he had to be signed off. Doctors providing medical fitness certificates for work at sea must understand the special requirements of seafaring life, know details about medicine use restrictions aboard, and be familiar with international import bans and national prescription regulations for controlled substances.

The work activity developed on board is of great importance in our nearby environment, and it has a series of peculiarities that determine the service rendering of sea workers. On the other hand, work at sea is developed on an international basis. Nowadays such work becomes a completely globalised industrial sector in relation to the elements that make up the ship's operation, including manpower. For that reason several relevant international organisations have paid attention to this industrial sector and have adopted a broad regulation on this matter. In the case of the European Union, the Community procedure emphasises enormous interest in providing specific and comprehensive training to seafarers, as well as in regulating working time on board with the aim of minimising the safety problems caused by fatigue. In the present article a schematic presentation of regulations on workers' health and occupational safety protection derived from the European Union, the International Maritime Organisation, and the International Labour Organisation has been done. Also it shows what parts of these regulations are not applicable to the work on board, and it reveals how the workers of fishing and maritime transport sectors are under-protected with regard to the guarantee of their health and occupational safety compared to workers in other sectors.

Nowadays the labour sector is experiencing an important increase in the application of risk prevention policies. Although these policies are very significant due to their repercussions in the health of workers, we noticed important legal gaps in maritime sector regulations. Frequently sea workers are legally abandoned, by exclusion or omission, at the moment of claiming for the improvement of their working environment and the reduction of the negative consequences derived from this negligence over their safety and health. In the present paper we try to shed some light on this topic by analysing and examining minutely the Spanish applicable risk prevention legislation for this sector. Moreover, the recommendations of the International Maritime Organization are compared with the current application of the law. At the same time, we present some possible solutions to such problems from an objective point of view.

The paper describes how the Icelandic fleet increased from 1980 to 2005, as well as the number of fishermen employed in the various sections of the fleet. All categories of the fleet have increased considerably in tonnage, while the number of fishermen has declined. At the same time the catch per man-year at sea has increased, rendering the Icelandic fisheries among the most efficient in the world in terms of catch and value per manpower. The number of fatalities in the Icelandic fisheries has declined steadily in this period. In absolute numbers these accidents are most common on decked vessels under 45m, but when weighed against man-years, fishermen on open boats are in greatest danger of losing their lives. The most common cause of fatalities is foundering of the vessel, which may cause multiple fatalities, then is man-over-board, followed by drowning in harbour and miscellaneous accidents. The reduction in the number of fatal accidents at sea may have several reasons. Mandatory safety and survival training of all fishermen, improved working conditions at sea, better telecommunications, constant VMS surveillance and a 24hr availability of airborne rescue teams have all helped to reduce fatalities in the Icelandic fishing fleet from 1980 until 2005.

During the past 12 years fishery managers responsible for federal fisheries off Alaska have developed and implemented three new fishery management limited access/quota share programs in place of traditional open access management. The three limited access programs are unique but each provides for the allocation of quota shares to individual participants in the halibut and sablefish longline fishery, in the Bering Sea pollock trawl fishery and in the Bering Sea king and Tanner crab fishery, respectively. New management programs are briefly described and contrasted with traditional management. For each of the three fisheries, management changes over time have generated substantial changes in fishing fleets, their operations, crew employment, economics and safety records. Under quota share management, fleet consolidations have occurred, particularly in the more over capitalized fisheries. The intense speed and inflexible timing associated with open access fisheries have greatly lessened as have the risk taking and incentives to maximize fishing power. Active vessel economic viability has strengthened due to a combination of increased efficiency, higher product yields, reduced costs, greater crew stability and safer operations.