The confined environment of a ship promotes the transmission of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) due to close contact among the population on board. The study aims to provide an overview of outbreaks of SARS-CoV-2 on board of cruise, navy or cargo ships, to identify relevant outbreak management techniques, related problems and to derive recommendations for prevention. Four databases were searched. The study selection included reports about seroprevalences or clinically/laboratory confirmed infections of SARS-CoV-2 on board ships between the first of January, 2020 and the end of July, 2020. A total of 37 studies were included of whom 33 reported outbreaks of SARS-CoV-2 on cruise ships (27 studies referred to the Diamond Princess). Two studies considered outbreaks on the Grand Princess, three studies informed about Nile River cruises and one study about the MS Westerdam (mention of multiple outbreaks possible in one study). Additionally, three studies reported outbreaks of SARS-CoV-2 on navy vessels and one study referred to a cargo ship. Problems in handling outbreaks resulted from a high number of asymptomatic infections, transportation issues, challenges in communication or limited access to health care. Responsible operators need to implement infection control measures which should be described in outbreak management plans for ships to prevent transmission risks, including, e.g., education, testing strategies, communication lines, social distancing and hygiene regulations.

Introduction: The German Social Accident Insurance (DGUV) has introduced lung cancer screening (LCS) by means of annual low-dose CT. Eligibility criteria for the main cohort are age ≥55 years, smoking history of ≥ 30 pack years and occupational asbestos exposure (OAE) of ≥ 10 years with onset before 1985. Medical counselling prior to CT scan is mandatory and supports shared decision-making. After being launched in pilot regions, LCS has been rolled out nationwide since 2017. As guidelines recommend a systematic evaluation for LCS, the research project EVALUNG has been implemented since 2022. Methods: EVALUNG was designed to evaluate process and outcome of LCS combining quantitative and qualitative elements. The quantitative part is based exclusively on routine administrative and medical data. So far, anonymised data with selected items were used to assess availability of data and potential quality indicators, and to perform initial descriptive analyses in terms of participation rates, suspicious findings and detected lung cancer in first round screening. Results: By end of 2021, 22,794 eligible persons were offered participation in LCS at least once. Based on first round screening, 12,808 pre-screening medical consultations were carried out and resulted in 9,277 initial CT scans, corresponding to a participation rate of 40.7 % of invited persons, and 72.4 % after medical consultation, respectively. Overall, 931 CT findings (10.0%) required control scans within a shortened interval. A total of 103 persons (1.1 %) were diagnosed with lung cancer, of which almost half (n = 54) were legally recognised as occupational disease. Conclusions: EVALUNG shows feasibility of a screening evaluation of an occupational cohort based on routine data. However, not all quality indicators for LCS can be covered yet and outcome parameters need to be investigated in more detail in this cohort. Linkage with cancer registry data is an option to enhance data and will be explored further in the project. Key messages: • Routine administrative data can be used to assess basic outcomes from LCS in an occupational cohort from Germany. Linkage with registry data is desirable to investigate detailed LCS indicators. • Detection rate in first round LCS in an occupational cohort from Germany was 1.1% and half of detected cases were legally recognised as occupational disease.

Within the framework of the interdisciplinary research project ARMIHN (Adaptive Resilience Management in the Port) a two-day large-scale exercise took place in the Port of Hamburg in October 2021. Due to the COVID-19 pandemic, the exercise could not be realized as a full-scale exercise with a large number of participants and actors as originally planned. Therefore, a hybrid exercise concept with virtual and live parts was developed. The project ARMIHN has shown that the planning, organization, and implementation of a hybrid large-scale exercise is demanding, resource- and time-intensive. On the other hand, the project showed the possibility for exercises to be conducted even when underlying conditions like the COVID-19 pandemic do not support a full-scale exercise in presence.

The COVID-19 pandemic burdened the working and living conditions of seafaring personnel with particular challenges. The present study investigated the health and occupational burden of 301 multinational seafarers from merchant ships using self-administered questionnaires. The survey was carried out between September and November 2021 on the occasion of SARS-CoV-2 vaccinations at the Port of Hamburg, Germany. Participants generally reported good physical and mental health status while general burden perception increased compared to pre-pandemic levels. Three-quarters of seafarers reported experiencing shore-leave denial at least once throughout the pandemic. In summary, the study reveals the substantial impact of the COVID-19 pandemic on the perceived occupational burden of seafaring personnel.

On Merchant vessels, there is usually no physician on board. Health management there is a great challenge for the responsible nautical officers. To simplify health administration on board diverse electronic health modules including a medical logbook and pharmacy module were developed in cooperation with an IT company. These modules are integrated in an existing fleet management system. The medical logbook and pharmacy modules were designed to offer more functions than just classic documentation and allow quick access to patient information. The included functions can support the nautical officer in his healthcare duties on the vessel.

Introduction: The ongoing COVID-19 pandemic has demonstrated the importance in strengthening cooperation and coordinated action of Member States (MS) to improve preparedness and response capacities at points of entry (PoE). This emphasizes the need for perpetuating the work of EU HEALTHY GATEWAYS (EU HG) and the availability of this cross-European network to transfer lessons learned for future public health threats. Methods: An interdisciplinary sustainability working group identified options for continuity of activities at EU level and provided a template national sustainability plan to be adapted by MS based on national needs and priorities. Results: Since the beginning of the pandemic EU HG provided 37 consultations to MS, developed 15 advice documents, delivered training courses, produced a study on preparedness and response at PoE and developed the EU digital Passenger Locator Form (EUdPLF) system. A European web-based network for PoE was developed including discussion forums, e-learning platform, searchable network of professionals' at PoE registry, bibliographies, web-based training resources and best practice catalogues. Overall, the 533 inspectors in the EU SHIPSAN INFORMATION SYSTEM (EU SIS) recorded 29268 IHR (International Health Regulations) certificates, followed up 69 public health events via the communication network for EU ports, and recorded >4600 hygienic deficiencies. Conclusions: EU HG has a holistic approach, supporting operations on local, regional, national and European level and by taking into account all transport sectors. The web-based systems and capacity building activities support EU Decision 1082/2013/EU for serious cross-border health threats and the EUdPLF supports implementing Decision (EU) 2017/253 for the contact tracing of passengers identified through PLFs. Adoption of components of EU SIS will support implementation of Regulation (EU) 2019/1239 which includes the provision of a common ship sanitation database.