# Can people with diabetes work on board cruise ships?



## falcon69 (14 Apr 2007)

can people with diabetes work on cruise ships?


----------



## RainyDay (14 Apr 2007)

*Re: Pre-employment medical - what to expect*



falcon69 said:


> can people with diabetes work on cruise ships?


Interesting case - I don't think there is any absolute law one way or other. The kind of issues involved would be;

- Is the employer an Irish company? If not, it might be difficult to enforce Irish employment rights.
- Does the diabetes impact on the person's ability to carry out the job in question?
- Does the presence of the diabetes impose any additional risk on the employer, e.g. risk of having to respond to an emergency?

I have a vague recollection of a case taken against the Asgard sail training ship who rejected an application from a person with diabetes. I think the diabetic person won the case, but I'm not 100% sure (and the search facility on  doesn't seem to be working.


----------



## ajapale (14 Apr 2007)

The people at  are very helpful.

[broken link removed] is case study of someone with type1 who works on board a cruise ship.


----------



## falcon69 (14 Apr 2007)

i've seen some articles that say 
*Occupations with a blanket ban on recruiting people with insulin treated diabetes:-
*Armed forces
Airline pilot
Jobs requiring a Large Goods Vehicle (LGV), Passenger Carrying Vehicle (PCV) licence or a minibus (D1) licence. If a person drives a C1 class vehicle for a living, and develops Type 1 diabetes or starts insulin treatment, they will have to be medically assessed on their fitness to drive. Further information www.diabetes.org.uk
Police service
Working offshore, eg on oilrigs or aboard cruise liners, regardless of the type of job the person is doing.
Train driver
There was a blanket ban on employing fire fighters with Type 1 diabetes. However, several individuals challenged the ruling and were allowed to continue active service, if they were already employed as fire fighters. This took a lot of hard work but proves change is possible. The ban on recruiting new fire fighters with Type 1 diabetes is also being challenged.


----------



## jhegarty (14 Apr 2007)

falcon69 said:


> can people with diabetes work on cruise ships?




we all presume its Type 1, you might want the clarify...


----------



## ajapale (14 Apr 2007)

Hi Falcon and welcome to AAM,

You point out the regulatory situation as it pertains in the UK. Im assuming in the [broken link removed] above that it is an American since she measures her blood sugar in using the us units.

Im not sure what juristiction's employment law extends to the operators of cruise ships. I dont imagine they recruit in Ireland so its hardly Irish law. It might not even be UK law.

I dont know what the regulations are in other EU countries such as Poland and Latvia.

aj

thanks for the http://www.diabetes.org.uk/ link its also a very good resource


----------



## falcon69 (15 Apr 2007)

well I'm just doing some research for a friend who is from England, and she has been offered a job for a cruise company that is based in the Carribbean, she has type 1 has only been diagnosed with it for about 6 weeks, got sick with her diabetes  in mid march as she refuses to use insulin thinking she can balance it with her diet , and she also had her appenix removed at the end of march. So I have my doubts whether she'll pass the medical, and i just really hope she doesnt lie about any of this just to get the job, or do you think the medical exam which, she has to take will uncover all of this anyway. I just dont want to see her getting really sick.


----------



## ajapale (15 Apr 2007)

If your friend is a newly diagnosed t1 diabetic then it is important that she gets the condition under control and builds up a good relationship with her GP and Diabetic Team. I imagine it will take her up 12 months to get to grips with the condition as there are many variables ( diet, insulin, exercize etc) to manage. The diabetes.co.uk site that you mentioned earlier is a good starting point where she can get more information. From the [broken link removed] page of diabetes.co.uk:


----------



## falcon69 (15 Apr 2007)

yes i would have thought it would take sometime to get to grips with the conditon too, but she's ready to take this job any day now.


----------



## Satanta (15 Apr 2007)

falcon69 said:


> she has type 1 has only been diagnosed with it for about 6 weeks, got sick with her diabetes  in mid march as she refuses to use insulin thinking she can balance it with her diet


If you're worried about her getting really sick then this is the real issue, the job being a far second.

Without taking insulin she is in serious trouble. The glucose in her blood can't be absorbed without the enzyme, so keeping it at whatever level she likes (even if it stayed at a constant 6.1mmol/l - which wouldn't/won't happen without the medication) isn't going to keep her healthy. 

I've no idea what advice she has been given so far, but this really strikes me as a very dangerous situation. Type two diabetes can be controlled with a mixture of diet and tablets to help suplement the insulin production and in some cases with diet alone, but if she has type 1 then she is producing no insulin, so diet alone simply can't solve the situation. It's not simply about keeping blood sugar levels between 5.0 and 7.0 mmol/l, it's also about providing the body with the energy it needs.


> Insulin acts like a key. It opens doors in the muscle cell walls, enabling sugar from your blood to get into the cell to produce energy.



Speaking as a Type 1 diabetic (for approx 14 years now) it really isn't a major problem (I don't view it as a problem at all, it's just something I live with. I can't say it's ever had a negative impact on any aspect of my life). Keeping close control of it is the key, but if she refuses to accept the medication she may run into some very severe problems down the line.


----------



## falcon69 (15 Apr 2007)

well yeah i am worried about her getting sick, but its kinda hard to ruin someones dream of working on the carribbean for 6 months, so I was hoping that if she was a risk, that the medical exam would fail her cause of it, cause I'd rather a health profesional  who conducts the exam tell her why she shouldnt go rather than me which could ruin our friendship if you know what I mean, but if they do pass her as medically fit I'm sure there would be no worries then right?


----------



## Satanta (15 Apr 2007)

falcon69 said:


> but if they do pass her as medically fit I'm sure there would be no worries then right?


Well, as I said above, the fact that she isn't taking the medication means that whether she's working on the ship or just sitting on the couch at home... she is in danger of being quite sick! 

It is possible that a type 1 diabetic can/could control blood sugar levels over a short period with diet alone, but her body needs the insulin to allow absorbtion. So while she may keep the blood sugar level at guidline values (which I don't believe she would be able to achieve over a longer term - not sure she'd even manage over a short term to be honest, I wouldn't fancy trying it to see), her body isn't actually receiving the necessary energy from this and will suffer, badly.


----------



## Satanta (15 Apr 2007)

falcon69 said:


> so I was hoping that if she was a risk, that the medical exam would fail her cause of it, cause I'd rather a health profesional  who conducts the exam tell her why she shouldnt go


Personally, I don't see any major risks for a diabetic working on a cruise ship.

Usually the bans are in place where the possibility of a diabetic experiencing a hypo would put others at risk (e.g. pilot). If cruise ships are included then the medical should pick up on this and exclude her from applying for the position. 

The problem is that the medical may not include any blood tests, so may not pick up the condition. It should have a tick the box question section (guessing here, never completed a medical so no knowledge what they do/don't contain). She'd really need to discuss the situation with the employer and be completely honest about the situation. 

If I were considering it I'd have question marks over being able to obtain the medication in the potential coutries I'd be visiting. Her Irish LTI (Long Term Illness) number probably wouldn't cover her (I've never been outside Ireland for more than a month at a time so never had to investigate this) to pick up Insulin/Glucagens (emergency injections to treat a diabetic coma)/monitoring equipment etc. abroad, so not sure how she'd manage this element of it. 

Six months of supplies would be fairly tough to obtain and storage for six months may cause some of the stuff to be comprimised. She'd really need to discuss this with the employer to see how she can/could obtain the medication while abroad and also organise storage for the insulin on board (must be stored in a fridge - possible she may have a personal fridge??). She'd also need to provide the employer with a few of the glucagens in case the worst did happen (my employer has some placed with all first aiders as we have a couple of diabetics in the company, all of which are replaced frequently - the only one ever used so far was to treat a visiting client, luckily wearing a Medic Alert identity bracelet), so a big mistake if she tries to hide it from them.


----------



## pat127 (15 Apr 2007)

Frankly, I think it is verging on the irresponsible to even think about taking the job without discussing the medical condition with the employer. Having been in the Merchant Navy I can say that there are issues such as the problems caused in terms of delay (and costs more importantly), if there is a medical emergency which is beyond the capacity of the liner's medical personnel. Knowing the West Indies well, I can add that the onshore medical facilities are not guaranteed to be the best in certain areas. These liners frequently cross the Atlantic at the beginning and end of WI cruises, adding another complicating factor.


----------



## falcon69 (15 Apr 2007)

pat127 said:


> Frankly, I think it is verging on the irresponsible to even think about taking the job without discussing the medical condition with the employer. Having been in the Merchant Navy I can say that there are issues such as the problems caused in terms of delay (and costs more importantly), if there is a medical emergency which is beyond the capacity of the liner's medical personnel. Knowing the West Indies well, I can add that the onshore medical facilities are not guaranteed to be the best in certain areas. These liners frequently cross the Atlantic at the beginning and end of WI cruises, adding another complicating factor.


 


Yes this is what I thought, and I have seen some cruise ship sites that say that people with such medical conditions like asthma/epilepsy/diabetes etc are auomatically denied a job if they have any of those conditions. So if she decides to hide it from them, I dont think it will take long for her to get sick a few times as she doesnt use insulin, and they would probably re assess her or something and if they find out she has diabetes or shes hid it from them I think she'll be automatically dismissed.


----------



## ajapale (15 Apr 2007)

Hi falcon,

I have to step in here as a mod and point out posting guidline no 20.



> 20. Please don't discuss medical issues
> 
> We do not provide medical advice on Askaboutmoney other than to provide links to support groups and medical forums. Posts offering medical advice will be deleted. This does not apply to availability and pricing of medical services, health insurance, tax relief for medical expenses. There are many other sites which are better equipped to deal with such issues.



Your friend has a *serious life threatening condition*: t1 diabetes. As a priority she needs to engage *immediately* with her diabetes management team and her GP. If she does not take her insulin she will develop ketoacidosis leading ultimately to death. As a friend 100% of your efforts should be to get her to get to grips with her diagnosis.

We can continue to discuss "the employment rights of people with t1 diabetes" here but Im afraid discussion of the medical treatment of the condition is not an issue that can be dealth with here on AAM.


----------



## falcon69 (15 Apr 2007)

sorry if my post started heading towards treatment of diabetes, my main aim was to try and find out if anyone knew that being diabetic would stop you from working on a cruise ship. I was also hoping for someone to know for a fact because they had tried and got knocked back. I understand your rules, but I never set out to break them.
Apologies


----------



## Satanta (15 Apr 2007)

falcon69 said:


> sorry if my post started heading towards treatment of diabetes, my main aim was to try and find out if anyone knew that being diabetic would stop you from working on a cruise ship. I was also hoping for someone to know for a fact because they had tried and got knocked back. I understand your rules, but I never set out to break them.
> Apologies


Technically it was me who pulled the discussion off track onto the discussion of medical treatment, so my need to apologise Falcon not yours. Apologies.  

As you've stated, T1 IDD should rule her out. Even if she doesn't point it out to the company, the medical *should* pick it up (especially if it's not being dealt with correctly), but it isn't guaranteed (a lot depends on the type of medical of which I have no knowledge).

Best of luck to your friend both on the employment front and on the treatment of her IDD.


----------



## munstergirl (16 Apr 2007)

Your friend should ask the HR manager who hired her.... then she will know. Be Honest!!!!

I have worked on plenty of cruise ships and personally don't know anyone with diabetics but there are between 500-1500 crew on each ship. Hundreds of ships that would be a lot of people to be in "perfect health" so I would guess yes.... 

Also there are syring bins onboard the ship for needles.

I do know you have to be in PHYSICAL Health due to safety.....

The medical for cruise ships is very thorough, with blood tests, urine tests, x-ray, drug test. Questionaires and it does say *Falsification is grounds for immediate termination* etc..... They will find out and it could cost her a lot of money.... having to fly home at her own expense from ship/medical centre...

When you join a ship you are advised to bring enough prescription medicines for your contract (6 months).

You said your friend plans to control it with food, you can't just pop to the shop when you feel like it. The cruise line supplies the food,depending on the line can vary from awful to ok.... gets very boring....(That was the worst thing to me about working at sea) UGH the food! 

I hope your friend gets this job, if not there are plenty of cruise lines and jobs keep coming up as people don't stay on ships forever...


----------

