Tuberculosis among seafarers

Tuberculosis among seafarers
ATTY. DENNIS R. GORECHO |April 23,2019 https://cebudailynews.inquirer.net/229804/tuberculosis-among-seafarers

Seafarers by nature of their work are exposed to a variety of occupational hazards making exposure to biological agents and the concomitant risk of communicable diseases extremely high.

Because of their nature of work, seafarers are bound to visit many ports in different parts of the world and are thus exposed to various pandemic and epidemic diseases such as tuberculosis.

In Inter-Orient Maritime vs. Creer (G.R. No. 181921 September 17, 2014) , the Supreme Court pointed out that pulmonary tuberculosis is airborne and easily transmissible by infected patients. The risk of being infected, or acquiring, the tuberculosis infection is mainly determined by exogenous factors.

The probability of contact with a case of tuberculosis, the intimacy and duration of that contact, the degree of infectiousness of the case, and the shared environment of the contact are all important determinants of transmission.

On the other hand, the risk of developing the disease after being infected is largely dependent on endogenous factors. The tuberculosis bacteria may lie dormant in the infected person’s immune system for years before it becomes reactivated, or he may ultimately develop the disease within the first year or two after infection, depending on the innate susceptibility to disease of the person and level of immunity.

In ruling for the compensability of tuberculosis, the Supreme Court held in the case of BARKO vs. Alcayno (G.R. No. 188190 April 21, 2014) that a certification declaring the seafarer as fit to work contrary to a prior finding of tuberculosis can be considered as a ploy to circumvent the law intended to defeat the seafarer’s right to be compensated for a disability which the law considers as permanent and total.

The Supreme Court explained that tuberculosis is a contagious infection caused by the airborne bacterium Mycobacterium tuberculosis. It is usually transmitted by inhaling air contaminated by the bacterium. Active tuberculosis usually begins in the lungs (pulmonary tuberculosis). Tuberculosis that affects other part of the body (extrapulmonary tuberculosis) usually comes from pulmonary tuberculosis that has spread through the blood. Tuberculosis adenitis is a form of tuberculosis which affects the lymph nodes.

The court noted that under the POEA contract, “Pulmonary Tuberculosis” shall be considered as an occupational disease in “any occupation involving constant exposure to harmful substances in the working environment in the form of gases, fumes, vapors and dust.”

The seafarer’s daily tasks as an able bodied seaman were to paint and chip rust on deck or superstructure of ship and to give directions to crew engaged in cleaning wheelhouse and quarterdeck, which constantly exposed him to different types of hazardous chemicals, such as paints, thinners, and other forms of cleaning agents and harmful substances, that may have invariably contributed to the aggravation of his illness.

The Supreme Court noted the suspicious gesture of the company in having a medical certification declaring him as “fit to work” despite apparent clear knowledge that he has been subjected to a long period of medical treatment.

For a sick seafarer to be entitled to medical benefits under the POEA Contract, it is not sufficient to simply establish that the seafarer’s illness or injury has rendered him permanently or partially disabled; it must also be shown that there is a causal connection between the seafarer’s illness or injury and the work for which he had been contracted .

TB bacteria most commonly grow in the lungs, and can cause symptoms such as a bad cough that lasts three weeks or longer, pain in the chest and coughing up blood or sputum (mucus from deep inside the lungs). Other symptoms of TB disease may include weakness or fatigue, weight loss, no appetite, chills, fever, and sweating at night.

Since one of the requirement for an illness to be compensable is that the seafarer suffered said illness during the effectivity of the POEA contract, it is imperative that his condition or symptoms must be documented while he is on board the vessel.

Otherwise, his claim for disability benefits might be denied due to failure to prove that said illness occurred while his contract is still in force.