Health Offshore V2

Saipem health training
Health and Occupational

Medicine
Pre-travel
Counselling
HEALTH INFORMATION
FOR SAIPEM EMPLOYEES
TRAVELLING ABROAD
mercoledì 4 gennaio 2017

Destination
Offshore
mercoledì 4 gennaio 2017 2

Pre-travel Counselling
Travelling in the different countries where the company is active and present is a
big opportunity for professional interrelations, both in terms of human and social
relations and in terms of cultural comparisons and exchanges. Lifestyles, ethical
choices, customs and traditions: from food to hygiene habits, adapting to
different climates and environments.
The health information for Saipem employees assigned abroad, on business or on
contract, is called "Pre-travel counselling" and is organised by the company's
Medical Department in compliance with company Corporate Standards and
International Guidelines. Its main objective is to inform workers before departure
of potential health risks in their geographical destination through the
transmission of information, skills and competences likely to facilitate the
development of potential and the improvement of personal resources, facilitating
the fulfilment of needs and behavioural change.
UCSC
Pre-travel counselling activities and all the information

contained within the health information sections were
validated by the Institute of Occupational Medicine of
the UCSC University of Rome UNIVERSITY OF ROME
Institute of Occupational
Medicine
TABLE OF CONTENTS
Chapter 1 Chapter 2 Chapter 3
Before Drugs and Vaccinations

departure Alcohol & Outbreaks
Chapter 4 Chapter 5 Chapter 6
General Animal and Sexually

hygiene insect Transmitted
Precautions bites Diseases
Chapter 7
(STD)
The Climate Chapter 8 Chapter 9
Psychosocial The journey

Risks mercoledì 4 gennaio 2017 4
FLEET
In the Offshore Construction field, Saipem uses vessels with high lift capacities
(up to 14,000 t), with dynamic positioning (DP3), successfully completing the most
challenging offshore installation and construction works, dynamic and
conventional positioning means for laying pipelines with J-lay and S-lay techniques
in deep and shallow waters as well as vessels for developing offshore petroleum
fields using J-lay techniques and lifting up to 1000 t.
In the Offshore drilling field Saipem works with its own jack-up fleet; Tender
Assisted Drilling Barges; semi-submersible fourth and fifth generation vessels,
sixth generation semi-submersible vessels designed to work in compliance with
strict environmental requirements and Norwegian standards, drilling vessels able
to work at sea depths of 10 and 12,000 feet. Saipem has also designed and
currently manages FPSO units, floating units with storage capacities, first
processing and redistribution of crude oil.
S10000 Scarabeo 8 Castorone mercoledì 4 gennaio 2017 5 S7000

Health Care on Board
There is always a doctor on board all Saipem offshore vessels.

As soon as you come on board, introduce yourself to our medical staff.
All offshore operational sites are equipped and in line with the Saipem
Corporate Standard, the infirmary is manned 24 hours a day. There are three
levels of health facilities, with relative medical and pharmacological
equipment, called set-up A, B and C. The process of assessment of
indispensable requirements for assignment of a “set-up” is done by the medical
department, based on a “local health risk assessment”

Chapter 1
Before
departure

Health surveillance
Before leaving for an offshore destination, workers are given a medical check-up
to correctly assess their specific suitability for the assigned task and the
destination.
The certificate issued is the Medical
Fitness Certificate. Mandatory for
working offshore, it is issued in International
Maritime
compliance with International and ILO Organization
guidelines, at the time of employment

and thereafter periodically.
The adopted exam protocol includes:
occupational health check-up,
spirometry or chest x-ray, hearing test,
e.c.g., eye test and blood tests.
If during the check-up any specific medical
conditions are found, the Occupational Health doctor may request further exams
to correctly and fully assess the worker’s fitness for the job/destination and issue
any instructions the worker has to follow in order for fitness to be confirmed.
Before departure
 Be sure to have a copy of your current Medical Fitness
Certificate that was issued after your medical
examination,
 Ensure, by consulting your doctor, that your vaccines
are up-to-date for your country of destination. Bring
your yellow fever vaccine certificate, if necessary
(see slide on yellow fever);
 We recommend a full dental examination with your

dentist; (to avoid any problems on-board or on site)
 Make note of the emergency numbers in the

following slide;
 Bring a supply of prescription medication that you

take regularly (medication for hypertension,
diabetes, asthma, etc.,) along with the
prescription in English in your
hand luggage.

Emergency Card
MEDICAL ASSISTANCE
Saipem’s “Pronto Dottore” Service
In case of health problems abroad and

only in the absence of Saipem
on site medical service
please contact the 24/7
Saipem’s “Pronto Dottore” Service
+39 02 44234777
Saipem also has an agreement with europ assistance
to manage Health Emergencies and Advices 24/7 call
+33 170700911 identifying yourself as a Saipem employee

Medical repatriation
Medical Evacuation (MEDEVAC)
In the event of an illness or injury that requires medical repatriation, Saipem

will organize travel home for the employee or, if necessary, to the hospital
closest to their home.
After a medical repatriation, or in any case, after a serious illness the employee
must have another medical examination to ensure fitness to return to duties or
the specific destination.

Chapter 2
Drugs and
Alcohol

Drug And Alcohol Abuse
Alcohol and drugs are the cause of many industrial accidents (above all falling
from a height, road accidents, burns and drowning) with a variable percentage
of 10 to 30% according to the World Health Organisation, and between 10 and
16% according to the US National Institute on Alcohol Abuse and Alcoholism and
the International Labour Organisation (Gordis, 1987).
The problem appears of be of extreme importance at work, both due to the

social costs, and costs concerning the health, safety and well-being of
individual workers and their colleagues.
Control Of Drug Use And Alcoholism
In compliance with the Saipem Corporate documents and

International Guidelines, Saipem health surveillance also aims to
check the absence of drug abuse and alcoholism among its workers.
Workers assigned offshore are therefore subject to preventive
and periodic tests (usually annually), if there are
cause’/reasonable suspicion (usually reported by the employer or
his representative), Random testing may be carried out without
notice to confirm the substance-free status of theworkforce or
following an accident or incident”.

Effects Of Alcohol Abuse
Mental and physical Professional

Liver damage Behaviour that places your own safety,
Pancreas damage that of colleagues and the company at
risk
Gastric ulcers and haemorrhages
Bamage to brain functions Quality of work
Weakening of the immune system Incorrect decisions
Higher risk of cancer Professional development
Insomnia, panic attacks, Negative effect on the working climate
depression Negative effect on the internal
Greater propension to violence company image, between colleagues
and externally, with customers

CHAPTER 3a
Mandatory and Recommended
Vaccinations

Yellow Fever Vaccine
Mandatory for the following countries:
ANGOLA, BURUNDI, CAMEROON, CENTRAL AFRICAN REPUBLIC,
CONGO, GABON, GHANA, GUYANA, IVORY COAST LIBERIA,
MALI, NIGERIA, NIGER, RWANDA, SIERRA LEONE, TOGO
1 dose at least 10 days before travel; Valid for life (WHO: WHA67.13 82014).
Under the International Health Regulations, immunisation against yellow fever is a
condition of entry in these countries. Following vaccination the “International
Vaccination Certificate” is issued and must be kept with your passport and shown
at the airport on arrival

International Vaccination Certificate against Yellow Fever
This Certificate, issued after vaccination against Yellow Fever, must be

kept with the passport and the original copy must be shown to the Health
Inspector upon arrival in the Country where it is required.
Recommended vaccinations
Tetanus: is caused by the toxin produced by a bacteria which enters the skin
through the slightest cut or wound.
Diphtheria: transmitted via a toxin carried by saliva
The vaccines for Tetanus and Diphtheria are usually combined and so that their
doses and schedules are the same:
3 doses of the combined vaccine are given starting with the initial dose (day zero),
1 booster dose after 6-8 weeks from the initial dose and a second booster dose 6-
12 months after the first booster. A booster is necessary after 10 years
The vaccine is effective in preventing tetanus after the cycle has been completed
in almost 100 % of all cases.

Hepatitis A: is an acute infectious disease that affects the liver. It is found

globally, especially in Central America, South America, Africa, The Middle East,
Asia and The Indo-Pacific.
Cases are diagnosed among
travellers that use facilities
(hotels, restaurants or food
stalls) that do not comply with
even the most basic food
hygiene regulations. The
disease is spread by eating or
drinking contaminated food
and water, especially frozen
berries, vegetables and
undercooked or raw shellfish.
Vaccinations Two doses:
1 dose before departure and 1
booster dose 6-12 months later;
Protection lasts a lifetime; Vaccine effectiveness: very high (94-100%).
Hepatitis B: is an infectious disease that

affects the liver. It can develop into
cirrhosis, liver failure and liver cancer.
Transmission can occur due to even
minimal exposure to blood through direct
percutaneous, intravenous, intramuscular,
subcutaneous or intradermal contact
(tattoos and piercings); or from exposure
to body fluids during sexual intercourse.
Vaccinations: Three doses. The first two doses 1 month apart;

One booster dose 6 months after the second dose; Protection lasts a
lifetime; Vaccine effectiveness: very high (95%). mercoledì 4 gennaio 2017 21
Vaccinations against possible Specific Risks
Meningococcal meningitis: human to human transmission through food and saliva.

The bacterial form is much
rarer but much more dangerous
than the viral form and can be
fatal. Vaccination is B-C
A-B-C
recommended for anyone, of B-C-Y
any age, that will be going to

areas where the disease is
endemic during the period of B-C A - W135 - C - Y
seasonal transmission and who B-C
will be in contact with the B
local population.
Global Serotype Distribution
Vaccines:
 Trivalent meningococcal vaccine protects against meningitis caused by
meningococcal serotypes (A, C, W-135, Y), the most common in Africa.
Usually a single dose is enough, without the need for boosters.
 Vaccine against serotype B, two doses (one month apart).
Seasonal flu and H1N1
Human transmission of the flu virus occurs through tiny droplets made when
someone coughs or sneezes. Transmission can also occur through contact with
someone's hands that have these droplets on them. Due to the transmission
methods and characteristics of the disease, anti influenza vaccination is
highly recommended for offshore destinations.
Hygiene and individual protection measures: For this reason, good hygiene
(washing your hands, covering your mouth and nose when you sneeze or cough)
can play an important role in limiting flu transmission.
Vaccine: The Flu vaccine is an effective and sure method to prevent the
disease, its spread and complications.

CHAPTER 3b
Recent and Ongoing
Outbreaks

Recent Outbreaks
Risk Of Ebola
The Ebola virus disease is a dangerous
viral haemorrhagic fever often with a
fatal outcome; it is not an airborne
disease and, at the moment, there is no
specific and official cure.
Transmission: close contact with infected blood, secretions (sweat, saliva, sperm),
tissues, organs or body fluids.
Symptoms and progression of the disease Sudden onset and acute progress. No
description for an asymptomatic carrier. Latency period: 2-21 days.
Clinical signs: fever, severe weakness, migraine, arthralgia and myalgia, red eyes,
pharyngitis, vomiting, diarrhoea, and sometimes rash. The skin and visceral
haemorrhagic symptoms generally appear within the sixth-seventh day and are
fatal in 60-70% of all cases.
Treatment: There is no specific treatment. The treatment is symptomatic.
Prevention: The vaccine is at an experimental stage. The risk for travellers is very
low, provided that some basic precautions are taken, such as: avoid contact with
sick persons and/or their body fluids, avoid close contact with wild animals,
whether alive or dead, do not eat wild animal meat, wash yourmercoledì
hands often.
4 gennaio 2017 25
26
Ongoing Outbreaks
Risk Of MERS
Since April 2012, the Arabic

Peninsula has been affected by an
outbreak of the new coronavirus
(nCoV). The Middle East Respiratory
Syndrome (Mers-CoV) is an acute
infectious disease, caused by a new
coronavirus strain, which can affect
human beings and animals. In
humans, it can range from a
common cold to the Sever Acute
Respiratory Syndrome (SARS), but it
can also be asymptomatic.
Travellers coming from Jordan, Qatar,
United Arab Emirates and mainly Saudi Arabia have contributed to spreading the
disease in South Korea, China, and Europe. The patients who died from this virus,
approximately 40% of the reported cases, were mainly affected by heart diseases or
metabolic disorders (diabetes...), thus already considered groups at high-risk of
contracting a severe disease.
Ongoing Outbreaks
Risk of MERS
Source of the virus: The source of MERS-CoV is a

virus initially spread to human beings by
animals; it is believed to have originated in bats
and then transmitted to camels.
Transmission: There is clear evidence of limited
human-to-human transmission, through droplets
from a sneeze or cough and contact, but
additional research is required to better
understand the risk of transmission. The
coronavirus has a latency period of
approximately 12/14 days, during which it does
not seem to be transmittable.
Prevention on board: Hand and personal
hygiene, prevent direct contact with mucus or
saliva. Report any parainfluenza symptoms to
the doctor on board, or to primary care
physician, after returning home.

Chapter 4
General
hygiene
precautions

Invisible traces of blood, saliva, mucus,
vomit, urine or feces may be left,
unintentionally, on light switches,
handrails, banknotes, etc. If we touch
those surfaces and then touch our eyes,
nose or mouth directly, or indirectly via
our cell phone or coffee cup, then we too
become contaminated.
Think about that every time you walk
into a public restroom or crowded room.
Therefore:
 Always wash your hands before
eating. Wash your hands frequently
if you travel or work in crowded
environments;
 Where possible it is preferable to
use soap and water or, as an
alternative, hand sanitizer ;
 Dry your hands well and use the
towel to turn off the tap.
Food and water
All food and water on board offshore facilities are “safe”.

Procurement and storage of water on offshore vessels guarantees workers the
possibility to use tap water for personal hygiene without risk, while bottled
water is always available for for food preparation and drinking.
NB: Saipem policy and International Guidelines impose a total ban on the
consumption of alcohol on all offshore facilities.
Healthy Diet
The calorie content of your diet should correspond to your actual daily needs.
The consumption of animal fats should be drastically reduced; vegetable fats can
be consumed in moderation with a preference for monounsaturated fats (extra
virgin olive oil). You should limit your intake of salt and sugars and foods
containing them. Ask the doctor on board for support.
REMEMBER: sugary drinks* are major contributor to obesity and diabetes.
Pathological conditions caused by improper diet (obesity, dysmetabolic
syndrome, etc.) can lead to the issuance of Medical Fitness Certificate with
restrictions for the job or the specific destination.
Where possible, use the gyms available on board.
AVOID
sugary drinks*
* Sugary drinks are products that contain added sugar, corn or fruit-juice concentrates
and include carbonates, fruit drinks, sports drinks, energy and vitamin water drinks,
sweetened iced tea, and lemonade.
Outside of Saipem locations, we recommend that you be very careful with food
and water (both for consumption and hygiene), because they can be potential sources
of disease like: traveller's diarrhoea, typhoid fever, cholera, amoebiasis, hepatitis A.
Ask your colleagues which bars and restaurants are safe.
SAFE FOODS FOOD TO AVOID
Packaged milk Beverages Home-made ice-cream

with ice
"Dry" foods (bread, biscuits, etc.) Sauces and cold creams
Sealed bottled water and
Home-made beverages Street
beverages
(preferably carbonated) food
Beverages in cups Wild game

only if boiled!
Foods Cold
Well cooked eggs Salads
served foods
Well done meat hot
Raw or barely cooked foods
Canned foods Peeled

fruit Unwashed
(check expiry fruits and
dates) vegetables
Swimming in
streams and rivers The mud and
can expose you to sand may be home Do not forget that
parasitic diseases to parasite larvae drowning is the greatest
such as or may hide sharp risk when swimming:
schistosomiasis or dangerous
(bilharzia or snail Be aware of currents
objects: avoid
fever), leptospirosis and water temperatures -
walking barefoot do not swim in
and forms of
or with shoes that unsupervised waters and
diarrhoea.
offer little or no always tell someone when
We recommend that protection. and where you plan on
you avoid swimming
entering the water.
in not controlled
waters. mercoledì 4 gennaio 2017 34
Chapter 5
Animal and
insect bites

Animals
Offshore animal-borne hazards are remote.

The risk of insect bites exists only on a vessel in quay or
near the coast.
Onshore, during transfers, be careful of dogs, cats,
mosquitos, monkeys... (risk of rabies, skin diseases,
parasites, viral diseases, etc.),
 Never tease animals
 Do not dig through sand with your hands, there may be
poisonous animals or dangerous objects under the surface
 In heavily wooded areas wear closed shoes and long
trousers (tuck pant legs into socks or tighten around
ankles) and stamp your feet when walking (to make noise)
 Never swat insects that land on your skin, use specific
repellents
 In the event of bites or stings see the site doctor
immediately

Insects!
From November to January, in West Africa, it is: Acid bugs time!

Paederus Riparius, or “papa bug”, is a 10 mm long black insect with orange stripes,
carried by the Harmattam wind coming from the Sahara Desert.
If it lands on your skin
DO NOT SWAT IT!
Should you accidentally crush it...
(consequences are shown in the image below)
...wash the affected area with soapy water to remove the acid substance
emanated by the insect and go to the nearest infirmary. It really burns a lot!

Malaria Control Program
Upon arrival ON BOARD, go to our Medical Service.

For specific risky areas (see map), Saipem has developed a
Malaria Control Program, which involves an information course on
disease prevention led by the medical staff on site.
After participating in the program, you’ll receive a letter concerning malaria:
the purpose of this letter is to provide your family doctor with additional
information on malaria, on its symptoms and on the available treatments.

Malaria
Bites from the anopheles mosquito (active above all between dusk and dawn) can
transmit malaria. This disease, common to tropical and sub-tropical areas, can be
fatal if not correctly prevented or promptly diagnosed.
Mosquitoes are a minor problem offshore if the vessel is not in quay or is
operationg at less than 3 km from the coast. Take care when transiting from the
airport to the offshore site and when loading materials containing residual
rainwater, taking all precautions to avoid bites:
wearing long-sleeved tops and long trousers,
using insect repellent on all exposed body parts and, waiting for transfer,
staying in air-conditioned environments (airport waiting lounge or the hotel).

Repellents
Insect repellents, available on-site, can vary in their effectiveness
depending on the type of insect. Follow instructions on the package carefully:
 Apply only to exposed skin. Do not apply over cuts,
wounds, or irritated skin. Do not apply directly to
your face. Do not use under clothing;
 The protection times listed rarely correspond to
actual protection. The protection is affected by different variables including:
rubbing, sweating which dilutes the repellent and temperature.
 After returning indoors, wash treated skin with soap and water.
 If you have an allergic reaction to the repellent, wash the treated skin with
soap and water.
The concentration of the main active ingredient as established by the Italian
Istituto Superiore di Sanità (ISS) for use in areas where malaria is a risk, is: DEET
at 30% or Icaridin KBR at 20%. Lower concentrations are still effective but
require more frequent application
Measures that cannot be recommended for repelling insects: Bath oil;
Citronella oil-based repellents (these have very short durations of action);
Citrosa plant (geranium); Garlic: fresh or capsules; Vitamin B12 complex; Yeast
extract spread; Electronic (ultrasonic) buzzer devices; Vitamin B1 tablets;
Malaria
When working onshore in places with a risk of malaria, or if your offshore

vessel is in quay/harbor, in addition to physical prevention you must also considerer
the opportunity to take pharmacological precautions: chemoprophylaxis.
Chemoprophylaxis is a preventive treatment based on anti-malaria drugs.
Individual risk assessment takes into consideration the duration of stay in the
endemic area, the individual exposure, the seasonal transmission rates, and the
drug-resistance situation.
Anti-malaria medicine must be taken for the entire duration of the journey in the
Country where the risk of malaria is present, and the treatment must be continued
after returning from that area.
IMPORTANT: Protection against malaria is not 100% effective; therefore, even after
complying with the strictest prophylaxis you should CONSIDER THE POSSIBILITY OF
HAVING CONTRACTED MALARIA. If you have a sudden fever (> or = 38°), shivers,
headache, vomiting and diarrhoea, contact the doctor on board or the emergency
department in your home country!
Seasonality of Malaria

Malaria
Even if a rigorous prophylaxis

has been followed,
CONSIDER THE POSSIBILITY OF
HAVING CONTRACTED
MALARIA.
In case of sudden increase in
temperature, shivers,
migraine, vomiting and
diarrhoea, within 7/8 of arrival
in the risky area, up to several
weeks after returning home,
go to the nearest Saipem
medical centre or to the ER in
your Country

Dengue Fever, Chikungunya and Zika Virus
Aetiology
Dengue, Chikungunya and Zika are widespread in tropical and sub-tropical areas,
and are caused by viruses transmitted by mosquito (Aedes) day biting.
Worldwide the cases of Dengue Fever, Zika and Chikungunya are steadily
increasing. The period in which the risk of contracting the disease is higher during
the wet season.
About Dengue there are four
different virus serotypes
(DENV-1, DENV-2, DENV-3,
DENV-4) and, generally, being
infected with a different
serotype entails a higher risk
of serious complications.
The most common forms manifest
after a latency period of: 5-8 days for Dengue and 3-12 days for Chikungunya and
Zika. The patient suddenly suffers from high fever (sudden-onset fever), shivers,
migraines, muscular cramps and severe joint pain (Chikungunya = “contorting”).
In certain cases, the infection can be asymptomatic and go unnoticed.

Dengue Fever, Chikungunya and Zika Virus
Preventative measures and treatment
As for Malaria, the most effective preventative measure against these diseases,
is to avoid contact with virus-bearing mosquitoes, mainly active early in the
morning: use of repellents, protective garments, and periodic
fumigation of the environments are strongly recommended.
WHO: «There is scientific consensus
that Zika virus is a cause of Guillain-
Barré and microcephaly syndrome» in
particular registered among newborns Zika transmission
in South America. Pregnant women are
advised not to travel in the Countries with active local Zika
transmission: Central and South America, The Caribbean and The Pacific Islands.
Against these virus there is no specific therapy; current treatment includes
absolute rest, use of medication to lower the fever (avoid aspirin) and drinking
liquids to contrast dehydration. Early diagnosis and access to treatment are
essential. Dengue, for which a series of Stage III (advanced) vaccines are being
developed, can evolves as «haemorrhagic» forms.
In case of fever, especially when accompanied by joint pain, immediately refer
to the Saipem medical service or, after returning home, to the nearest ER.
Chapter 6
Risky
behaviour

Sexually Transmitted Diseases
￭ Every year there are over 340 million new cases of

sexually transmitted diseases. Bacterial or protozoan
infections occur all over the word, every year. Given social,
demographic and migratory tendencies, the population at
risk of sexually transmitted disease is likely to increase;
￭ STDs are widespread diseases but the rate of infection is
particularly high in developing countries where these types of
infections and their complications are among the top five
reasons why adults seek medical assistance;
￭ The most common sexually transmitted diseases are:
hepatitis B, HIV, syphilis, gonorrhoea and chlamydia;
￭ Some STDs become chronic and have a less favourable
prognosis (HIV, Hepatitis B). Others that can be cured but are
very contagious and can have complications, can cause
inflammation, neurological syndromes, infertility and even
cancer;
￭ Among preventable illness, sexually transmitted infections HRO –Health & Occupational Medicine
are the main cause of infertility.

Sexually Transmitted Diseases
Prevention
￭ The first form of prevention is to avoid risky sexual
behaviour;
￭ The most effective way to prevent Hepatitis B is the
vaccine;
￭ Latex condoms are the most effective way to prevent
STDs if worn before sexual intercourse begins. This
includes vaginal, anal and oral sex;
Early Diagnosis
￭ Travellers that have indulged in risky sexual behaviour
must see a doctor when they return. This is in their own
best interest as well as in the best interest of current
and future partners.
Anyone who commits criminal acts against minors
while abroad (sexual abuse, exploitation,
prostitution), in addition to being subject to severe,
local law, will be persecuted according to current law
upon returning to their country of origin.
A Reminder For Those Who Choose To Get
Tattoos or Piercings
The procedures that require the use of needles and sharp instruments carry
the risk of transmitting bloodborne pathogens as well as serious skin
infections, if prevention and hygiene precautions are not scrupulously
applied:
 Did you know that getting a tattoo means introducing various types of ink directly into
your skin?
 Did you know that it is permanent and that to have it removed requires plastic surgery?
Did you seek advice from someone older than you?
 Did you know that tattoos or piercings can potentially transmit Hepatitis or AIDS?
 Did you know that the risk of infectious disease is greatly reduced or eliminated if the
operator applies fundamental hygiene, disinfection and sterilisation rules?
 Do you have a skin condition? If so, see your doctor before getting a tattoo or piercing
 Did you know that it is possible to be or become allergic to ink or metals?
 Have you fully understood the risks that you are exposing yourself to?
49 mercoledì 4 gennaio 2017 49

Local Culture
Travelling in the different countries where the company is active and present is a
big opportunity for professional interrelations, both in terms of human and social
relations and in terms of cultural comparisons and exchanges. Lifestyles, ethical
choices, customs and traditions: from food to hygiene habits, adapting to
different climates and environments. In any case, we recommend to always
respect different cultural and religious expression and the different social
systems related to the context where you are currently working.
50 mercoledì 4 gennaio 2017 50

Driving Safely
Road accidents are a public health issue that is still too often neglected. These represent
the ninth cause of death in the world among adults, the first among young people aged
between 15 and 19. It is also estimated that, without adequate countermeasures, within
2020 they will become the third global cause of death and disabilities in the world (source WHO).
The main causes of RTA-s (ROAD TRAFFIC ACCIDENTS REPORTED), are:
 Travelling over the speed limit at speeds not suitable to the road surface;
 Disregard / lack of knowledge of local traffic laws;
 Distracted driving, fatigue;
 Vehicle in bad condition (brake system malfunction, worn tyres,
poor maintenance...);
 Using cell phones while driving;
 Meteorological conditions;
 Errors committed by other drivers.
THEREFORE...
 Drive only when absolutely necessary;
 Do not speed and do not allow others to do so;
 Do not drink and drive and do not allow others to do so;
 Do not smoke while driving and do not allow others to do so;
 Use hands free devices to make telephone calls;
 Always wear a seatbelt, both in the front and back seats.
offshore Security
Due to the delicate political and social situation in some countries, Saipem
advises its workers to scrupulously observe rigorous Security procedures during
transfers from the airport to the offshore site, which include behavioural rules,
necessary limitations and, in some cases, the use of protected means of
transportation and/or armed escorts.

Chapter 7
Psychosocial
Risks

Psychosocial Risks
Your roots
Expatriation can be a very enriching experience which must be carefully

prepared for in order to avoid some pitfalls that could be very harmful.
Take care of your roots, do not let them perish
What are your Roots?

 your family,
 your friends,
 your hobbies.
How do you care for them?

COMMUNICATE!!!
 by phone,
 by writing,
 by letting people know what you are doing and keeping in touch with your
network and not losing touch with your daily routine.
DO NOT LET YOUR ROOTS PERISH THEY ARE YOUR LIFE FORCE
Psychosocial Risks
The Stress
Stress is a little bit like Cholesterol. There is « GOOD » and « BAD » stress.
GOOD stress stimulates while BAD stress destroys.
GOOD stress comes from within. When a person wants to challenge themselves
to reach their objectives by improving their performance.
BAD stress is imposed by others. When a person who knows their limits, is forced
to exceed them to reach objectives that are, in their opinion, unachievable.
The way we think alters the way in which a particular type of stress affects us.
What is stressful to one individual may not be to another. What is stressful to an
individual today may not be tomorrow.
Distress is related to the perception of loss of control that results from a
perceived imbalance between the pressures being exerted and the resources of
the individual.
CHAPTER 8
Climatic
Risk

If the weather is different than your country of origin,
remember that the body needs time to adjust, depending on
health conditions and age. Wear clothing suited to the local
weather conditions. Once on board you will be provided with all
the equipment you need to work safely. Be careful when leaving
air conditioned or very warm environments, due to the drastic
temperature changes.

Chapter 9
Air
travel

Any trip and stay abroad and What to do if ...
related vaccines (and
antimalarial chemoprophylaxis)
must take pregnancy into
consideration and be approved
by your gynaecologist.
Air travel is not recommended
after the 8th month (airlines
will not allow women to fly in
their last month of pregnancy).
The ideal period is between the
16th and 28th weeks.
Air travel
Dry cabin air causes dehydration.

To combat this it is necessary to drink a lot of liquids and to avoid alcohol.
If you are subject to "air sickness" do not drink tea or coffee (they irritate your
stomach) or carbonated beverages (including beer). Carbonated beverages should
be avoided because, due to the way gases react to atmospheric pressure, dilating
more under lower pressure. This means that the bubbles in the drinks at ground
level will dilate in flight, adapting to cabin pressure, causing bloating and
meteorism.
Changes in pressure during landing can cause earache
which, in some cases can result in inflammation.
It can be particularly bad if you have a cold. In
most cases you can find relief by swallowing,
Chewing or yawning. If the problem persists
you can try forceful exhalation against a
closed airway, usually done by closing
one's mouth, pinching one's nose shut
(Valsalva manoeuvre).

Air travel
Swelling: Remaining seated without moving for long periods of time, as happens
on an aeroplane, reduces blood flow to the heart that normally occurs with
movement. This may cause water retention, especially in the lower limbs. Move
as much as possible. Walking up and down the aisle, standing for short periods
and doing some light stretches while in your seat will help to reduce swelling in
your legs and feet. Wear comfortable shoes that are not tight around your ankles,
avoid crossing your legs during the flight, get up often and stretch your legs in the
aisle, doing the recommended exercises as much as you can. Those that are in
high risk categories (obesity, diabetes, etc.,) should wear compression socks.

In Flight Problems
Motion sickness: Never fly on an empty stomach. Contrary to what you may
think, it makes air sickness worse. Travellers that are affected by air sickness may
also be subject to headache, nausea, excessive perspiration and dizziness. To
reduce these ailments, ask to be seated on the aisle close to the wings. The seats
over wings feel the least amount of motion during flight. Before flying and during
the flight we recommend that you eat light snacks like fruit and vegetables. Avoid
coffee, tea, alcohol, nicotine and fatty or spicy foods. You can use medication such
as specific chewing-gums or pills, that reduce motion sickness.

Effects of jet lag
Moving quickly to a location with a different time zone will cause a change
in your body's daily rhythm.
Not only does it disrupt the normal sleep-wake
cycle, but it also interferes with the smooth
running of many other functions that are set to
24-hour cycles. To combat the effects of jet
lag, it is advisable to sleep well the night
before the flight and, if your stay at the
destination does not exceed two days, keep
your physiological clock set to home time. For
longer stays, however, it is advisable to adhere
to a healthy lifestyle to adapt to the local time
as quickly as possible taking into account that
you will typically recover from jet lag faster if
you travel westward.
Once on board the aircraft adjust your watch to the time of destination: this
will help you to adapt mentally to different daily rhythm that awaits you. Avoid
taking sleeping pills because it would only confuse the body even more and induce
an unnatural "stillness" and slowdown the bloodstream.
Saipem «Si Viaggiare» app
All the information found in this

country presentation, and any further
details on the topics covered, are
available in the Saipem Health Manual
for International Travellers with the
«Si Viaggiare» app from the company
Travel Medicine service, which can be
downloaded on your devices
(smartphone, PC and tablet),
Apple, Android and Windows.
http://www.saipem.com/sites/SAIPEM_en_IT/minisiti/saipem-app-en.shtml

Source
References and Updates
This country presentation was prepared using the guidelines

expressed, to the best of their responsibilities, by the following
institutional bodies, healthcare organizations and industries.
The health information contained therein is updated in real time
thanks to Health Surveillance services through email alerts and RSS.
If you should have any questions or require further information please contact the
Saipem Health and Occupational Medicine Unit at travelmedicine@saipem.com
or the site doctor upon arrival.
Visit Saipem Health Portal at:

http://hsesite.saipemnet.saipem.intranet/Health/Pages/default.aspx
Legal disclaimer
This information, published by Saipem, is based on reputable sources of medical evidence. It has been prepared and
updated by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every
presentation of a condition. The information contained on these pages and in any third party websites referred to on this
page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical
diagnosis or treatment.

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Health Offshore V2

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Saipem health training

Health and Occupational

mercoledì 4 gennaio 2017

mercoledì 4 gennaio 2017 2

Pre-travel counselling activities and all the information

Before Drugs and Vaccinations

General Animal and Sexually

Psychosocial The journey

S10000 Scarabeo 8 Castorone mercoledì 4 gennaio 2017 5 S7000

There is always a doctor on board all Saipem offshore vessels.

mercoledì 4 gennaio 2017 6

mercoledì 4 gennaio 2017 7

compliance with International and ILO Organization

guidelines, at the time of employment

 We recommend a full dental examination with your

 Make note of the emergency numbers in the

 Bring a supply of prescription medication that you

mercoledì 4 gennaio 2017 9

In case of health problems abroad and

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In the event of an illness or injury that requires medical repatriation, Saipem

mercoledì 4 gennaio 2017 11

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The problem appears of be of extreme importance at work, both due to the

In compliance with the Saipem Corporate documents and

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Mental and physical Professional

mercoledì 4 gennaio 2017 15

mercoledì 4 gennaio 2017 16

mercoledì 4 gennaio 2017 17

This Certificate, issued after vaccination against Yellow Fever, must be

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Hepatitis A: is an acute infectious disease that affects the liver. It is found

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Meningococcal meningitis: human to human transmission through food and saliva.

any age, that will be going to

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Since April 2012, the Arabic

Source of the virus: The source of MERS-CoV is a

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All food and water on board offshore facilities are “safe”.

Packaged milk Beverages Home-made ice-cream

Beverages in cups Wild game

Canned foods Peeled

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Offshore animal-borne hazards are remote.

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Upon arrival ON BOARD, go to our Medical Service.

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￭ Every year there are over 340 million new cases of

are the main cause of infertility.