MEDICATION AND WORK OFFSHORE

Dr Stuart Scott, Medical Director, International SOS

Medication that may be appropriate for use onshore is not necessarily acceptable for use offshore. Many GPs are unfamiliar with the offshore environment – particularly those based outwith Aberdeen or Aberdeenshire – and may not realise the safetycritical nature of work offshore. In some parts of the UK, a GP may have only one patient with an offshore role. And the same may apply to some Occupational Health physicians – we did receive one request that the person in question should be given the seat closest to the toilet on the helicopter!

In our Operating Procedures Offshore, our medics have a detailed list of commonly declared medications of concern and the actions they should take in each instance. The medic will review the medication and discuss with Topside and the Medical Advisor for the operator – disembarking somebody because of their medication would be a last resort.

In most cases, when there is an issue with medication offshore, it is because the medication has side effects which are incompatible with the safetycritical offshore environment. In some cases, these side effects may be temporary – there are some antidepressants, for example, that have a very low risk of causing agitation or an increased risk of suicide within the first 14 – 21 days of taking them. Although the risk may be very low, waiting until the 14 – 21 days has passed, and the patient is stabilised on the medication removes that risk completely – and the patient would then be fit to return offshore.

In the case of medication that is not permitted offshore – for example, some painkillers would not be suitable for work offshore – medication can be discussed in advance and your occupational health clinician can advise if an alternative would be appropriate.

If somebody is disembarked after declaring medication, it may not be the medication that is the issue, but rather that they have a new diagnosis that has not previously been declared and the individual would require an appropriate risk assessment before deploying or returning offshore. It is the diagnosis that is the issue, rather than the medication.

For example, this might be because somebody has a new diagnosis of diabetes. People with diabetes can work offshore, but assessments are required to ensure the offshore environment is safe for them - it would be important to ensure their control is good and they are not at risk of having either too low or too high levels of blood sugar. Or possibly somebody may deploy offshore with an EpiPen for a severe allergy, without declaring the diagnosis in advance. We would want to make sure that an appropriate risk assessment had been conducted and that, for example, the medic and the camp boss are made aware in advance and could take any allergies into account to avoid any risk to the individual – particularly in the case of a severe nut allergy. Cardiac medication is usually safe for use offshore, but some cardiac conditions require a risk assessment prior to allowing people to deploy offshore. If someone were to have a new diagnosis of angina, a risk assessment would be required to ensure it is safe for that individual to be offshore.

The main point to remember is that any new medication or any new diagnosis should be declared at your medical assessment or, if prescribed or diagnosed between assessments, notified as soon as possible to your HR Department, who will ensure the appropriate checks and risk assessments are carried out in time to allow you to return offshore for your next trip.

Further details on restrictions on medication offshore and on the procedures to follow are available in our Medication and Work Offshore leaflet, which is available to download from our website: https://my.internationalsos.com/ medicalassessments