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These Operational Guidelines are issued in order to implement the functions of the Bureau of Health Facilities and Services under Executive Order 102, s. 1999 and the Memorandum of Agreement among the Department of Health, Department of Labor and Employment, and the Maritime Industry Authority. These guidelines are promulgated in order to establish, regulate, and upgrade the standards of medical services and examination of overseas land-based workers and seafarers for inter-island/overseas employment to ensure that only occupationally qualified and those physically and medically fit workers/seafarers participate in the inter-island/overseas employment program.

In view of the current advances in the medical diagnostic procedure, there is a need to update and further enhance the rules and regulations governing the conduct of pre-employment medical examination of overseas workers and seafarers in order to cope with the changes and development.

II. Definition of Terms

Accredited medical facility — a clinic that passed the accreditation requirements of the Department of Health to conduct Pre-Employment Medical Examination for land-based overseas workers and seafarers on inter-island and overseas employment.

Agency — private recruitment entity, employment agency or manning agency duly authorized/licensed by the Philippine Overseas Employment Administration, and Department of Labor and Employment to recruit and deploy workers overseas.

BHFS — acronym for Bureau of Health Facilities and Services. A regulatory body under the Department of Health. It shall exercise regulatory function under these rules and regulations.

PEME — acronym for Pre-Employment Medical Examination. Refers to the complete medical examination being conducted to an applicant as a requirement for screening to determine whether physically and mentally fit to work abroad.

Seafarers:

1. Inter-island seafarers — sailing/working within the Philippine sea
2. Overseas seafarers — sailing/working outside the country

Secondary category laboratory — provides the following:

1. Routine hematology (complete blood count or CBC) — includes hemoglobin mass concentration, erythrocyte volume fraction (hematocrit), leucocytes number concentration (white blood cell or WBC count) and leucocytes type number fraction (differential count), qualitative platelet determination.
2. Routine urinalysis
3. Routine fecalysis
4. Blood typing — hospital based
5. Quantitative platelet determination — hospital based
6. Routine clinical chemistry — includes blood glucose substance concentration, blood urea nitrogen concentration, blood uric acid substance concentration, blood creatinine concentration, blood total cholesterol concentration.
7. Cross marching — hospital based

Shipping company — any Philippine registered shipping company engaged in local and foreign trade.

III. Conduct of Pre-Employment Medical Examination

The following guidelines shall govern the conduct of PEME for landbased overseas workers and seafarers for inter-island and overseas employment:

1. General Guidelines

1.1 PEME of land-based overseas workers and seafarers both for inter-island and overseas employment shall be conducted only by medical facilities duly accredited for the purpose.

1.2 The PEME of overseas workers and seafarers for inter-island and overseas employment shall be conducted only after the agency or its principal/shipping company has interviewed, trade tested and finally decided to accept the applicant for employment. This acceptance shall be stated in a referral slip for pre-employment medical examination, duly accomplished stating the name of the worker. It shall be addressed to the accredited medical facility where the PEME shall be conducted. Any violation of the agency shall be reported to the Philippine Overseas Employment Administration.

1.3 In the event the employer rejects the applicant or terminates the employment of the worker within a period of three (3) months from the date of examination due to medical reasons, the cost of repatriation shall be shouldered by the medical facility. For such event, the medical facility shall file with the applicant’s agency or company and the DOH, an affidavit of undertaking to that effect. This includes major cardiac cases, pulmonary tumor, tuberculosis, bronhiectasis and other illnesses, the program or state of which could have been detected during the PEME.

1.4 The cost of repatriation shall be taken from the cash bond posted at the DOH by the accredited facility.

1.5 In cases of non-deployment within ninety (90) days from the date of PEME, the applicant shall undergo another PEME to ensure that no infections or illnesses that are prevailing in the land were acquired from the time of last PEME.

2. Specific Guidelines

2.1 Unless otherwise stated in the PEME referral slip, the pre-employment medical examinations shall include the following:

• complete history taking and physical examination
• chest x-ray using plates not smaller than 11" x 14"
• complete blood count — includes hemoglobin determination, hematocrit, WBC, RBC and differential count and platelet determination (qualitative and quantitive)
• blood typing
• routine urinalysis
• routine fecalysis
• dental examination
• psychometric evaluation
• electrocardiograph examination-if applicant is forty years old and above

2.2 Seafarers shall undergo all of the above examinations plus visual acuity and color perception test specifically using Ishihara Test. Hearing and audiometric testing are also required for all seamen regardless of position.

2.3 Test for HIV antibodies or hepatitis B antigen or VDRL as required by country of destination or per principal’s request shall be done.

2.4 Medical examinations not included in the scope of the PEME, as defined above, may be conducted on land-based workers and seafarers upon request by the agency or its principal/shipping company.

2.5 Result of the PEME shall be submitted to the referring agency or its principal/shipping company within seventy-two (72) hours after completion of required PEME test. In the event that medical findings indicate the need for certain minor ailments to be treated, the clinic shall advise the agency/company of the estimated period/time that said treatment shall be undertaken so that the same may be referred to the agency/company for his acquiescence.

2.6 In order to standardize the PEME of workers/seafarers, the medical facility shall use the prescribed medical rating system as stipulated in Administrative Order No. 176, s. 2001 for seafarers and the Bureau Circular No. 5, s. 1990 for overseas land-based workers. Similarly, the prescribed Medical Examination Record Form shall be used.

2.7 A full time psychologist registered with BHFS shall take the full responsibility of the psychological screening and evaluation which includes: 

2.7.1 battery of psychological tests:

• Draw a Person Test/or House Tree Person Test
• Sack Sentence Completion Test
• Bender Gestalt Motor Visual Test
• Raven’s Progressive Matrices or Purdue Non-Language Test

2.72 An autobiography 

2.73 Comprehensive interview

2.8 PEME Results 

2.8.1 The medical facility shall guarantee the integrity of its examination results. 

2.8.2 The PEME results shall be valid up to the end of the contract in land-based workers. While following the International Labor Organization guidelines, seabased workers shall have two years for its validity period of the PEME Certificate in a continuous sea based service on board. In cases of extension of contract per decision of the hiring vessel, a medical examination shall be conducted in the nearest port health examination center. Effectivity of PEME results shall be considered by all agencies in cases of transfer to another agency as long as it is within the prescribed validity period. 

2.8.3 The medical facility must have a Master Logbook, duly registered and stamped by the BHFS.

IV. Repealing Clause

All previous Orders inconsistent in part or in whole to this Administrative Order are hereby rescinded or amended accordingly.

V. Effectivity

This Order takes effect immediately.

Adopted: 2 Jan. 2003

(SGD.) MANUEL M. DAYRIT, MD, MSC
  Secretary of Health