Download the EU SHIPSAN ACT JA - Newsletter: Issue 6 in .pdf format

Editorial

Dr Mauro Dionisio, Ministry of Health, Italy

Dear Readers,

The considerable longer life expectancy in Europe and the possibility of reaching an advanced age in good health are increasing the number of elderly people interested in spending their holidays on board of a cruise ship. These travelers may have mobility or health concerns, so, when cruising, they worry about medical care and accessible ships. They may also have other health issues, ranging from restrictions on their diets to regular treatment for chronic conditions. The cruise stakeholders who want to be ready to face a challenge like this, put more attention on tourist with disabilities problems. Telemedicine (the use of telecommunication and information technologies in order to provide clinical health care at a distance) is another task to be developed by those companies who have not done it yet.

I would like to draw your attention to the new directory of authorised ports to issue Ship Sanitation Certificates under IHR(2005) developed by the SHIPSAN partnership where contact details of the authorised ports can be viewed. Please read the “What’s new in the website” section below for further details.

Dear friends, this is my last editorial. As it was decided in the first meeting of the SHIPSAN ACT coordination team, at the end of the first year the editor's duties will be taken over by our well-known colleague Dr. Carmen Varela Martinez. I would like to express my personal thanks to all the colleagues who helped us in the editing of the Newsletter as well as the secretariat for its help and comprehension. Last but not least a special thanks goes to the very perceptive leadership of the project, that has encouraged the interest towards ship sanitation all over Europe.

News from the leadership

Prof. Christos Hadjichristodoulou, SHIPSAN ACT Joint Action Coordinator
Dr Barbara Mouchtouri, SHIPSAN ACT Joint Action Manager

Firstly we would like to wish you all a Happy New Year! May the 2014 be a productive and successful year for all the partnership.
The 2014 is expected to be an important year for the SHIPSAN ACT Joint Action implementation. Our objectives for the following year at a strategic level include the following:

• The SHIPSAN ACT general assembly will be formed. The general assembly members will have the role to decide on recommendations derived from the sustainability working group, the advisory board and the coordination team.
• Present the SHIPSAN ACT Joint Action activities in the forthcoming Greek Presidency Chief Medical Officers’ Meeting where a session will be organized titled “Sustainability of the EU SHIPSAN ACT Joint Action – Focus on the essential components to be supported: hygiene and health inspections, training of port health authorities and communication platform”. 
• Produce a draft Memorandum of Understanding on Health and Hygiene Inspections of Ships and Infectious Diseases Prevention based on the sustainability working group and advisory board decisions.
• Deliver an exit/sustainability plan (draft in June 2014, final in March 2015) outlining an exit/sustainability strategy focusing on models/scenarios, outlining what should happen to the Joint Action outputs and exploring how they can be sustained. 
• The draft Memorandum of Understanding between the EU SHIPSAN ACT and European Agency for Safety and Health at Work (EU-OSHA) has been produced and will be signed. This Memorandum of Understanding provides the basis for the cooperation between EU-OSHA and the EU SHIPSAN ACT Joint Action for developing a risk assessment tool for occupational health risks per cargo ship type using the OiRA tool (an inter¬active risk assessment – web application).

Summary of the Annual Work Plan:

At the implementation level, the SHIPSAN ACT annual work plan includes meetings and events that you can read in detail in the “News and forthcoming date” section below. Moreover, the following planned activities for three out of the nine work packages of the SHIPSAN ACT Joint Action will be completed.

• The interim technical, financial and evaluation reports will be produced describing in detail the activities of the SHIPSAN ACT Joint Action completed from February 2013 until August 2014.
• The State of the Art will be completed in the forthcoming months delivering the following which will be available in the SHIPSAN ACT website: 
  • Part A: Literature review on infectious diseases on all types of ships\
  • Part B: Bibliographic review and survey on chemical and radiological incidents in maritime transport
  • Part C: Survey on hygiene inspection practices regarding fishing vessels in European Union
  • Part D: Survey on training needs related to core capacities at the points of entry-ports in European Union

• The 2nd year pilot announced inspections accompanied by a SHIPSAN trainer will be planned and conducted from May 2014 until October 2014.
• The activities that will be completed in the forthcoming year in relation to the chemical and radiological incidents on ships include:
  • Guidelines for dealing with chemical and radiological incidents on ships
  • Procedures for arrangements for notification and alerting for chemical events
  • Training material on chemical and radiological incidents

• The SHIPSAN ACT training activities for 2014 include:
  • Update of the e-learning platform 
  • One training course for port health officers and professional seafarers on inspection of hygiene & health standards on passenger ships 
  • Advanced, focused training courses for water safety

• The SHIPSAN ACT Information System will be updated and a table top and operational exercise will be completed.
• Work on preparing the first draft of the risk assessment tool for occupational health on ships and a report including public health risks of international concern according to the type of cargo ships will be completed within this year.

People from the project

Audrone Lavruvianec
I completed a study at the Faculty of Medicine of Vilnius University and became a doctor in epidemiology and hygiene. First I worked at the chemical research laboratory at Klaipeda city sanitary and epidemiological station as a specialist, later as a head of the laboratory. In 1989 I started working at the department of communicable diseases prevention and control at Klaipeda Public Health Centre as a chief specialist. From 2009 I am a head of medical quarantine station of this department. I am responsible for inspecting ships and issuing the Ship Sanitation Certificates according to IHR (2005), providing medical quarantine control on ships calling at the port of Klaipeda. Also I conduct inspections of medical supplies of vessels’ flying the flag of the Republic of Lithuania.

From 2004 to 2006 I attended at EpiTrain I, EpiTrain II, EpiTrain III and EpiTrain IV courses in advanced infectious diseases epidemiology (EpiNorth Project). From 2009 to 2011 I participated in the SHIPSAN TRAINET project as a consultant, from February of 2013 until now I am participating as a researcher in the SHIPSAN ACT Joint Action.

Besides, in 2011 I graduated from Mykolas Romeris University with a Master’s degree in Law after writing a thesis on legal regulation of public health centres activities.

 

Thematic Sections

Environmental health and hygiene on ships - The Galley
Martin Walker, Port Health Officer, Suffolk Coastal Port Health Authority, Felixstowe, England

Key Message: Vero cytotoxin-producing Escherichia coli (VTEC) – a serious food poisoning bacteria that can affect crew and passengers on all vessels

When it comes to vessel inspection, a major area that is covered is the Food Safety side. The catering operation on ships will vary tremendously in terms of scale, processes employed, types of food handling employed for example and thus the risks posed to crew (and passengers where relevant) will vary considerably. One matter that will be common to all types of vessels will be the hazards that can arise where due care and attention are not paid.

Food poisoning is a longstanding issue and a number of micro-organisms can be a source. Most recently, the VTEC group of bacteria have come to prominence with a number of high profile cases, which sadly, have led to a number of deaths. The most important strains to cause illness (particularly serious) is E. coli O157 and E. coli O104. O157 is the strain that was linked to the death of 5 year old in South Wales 1 and 21 deaths in Scotland from contaminated meat 2, while O104 was associated with the 2011 outbreak focused in Northern Germany and linked to contaminated bean sprouts3. The latter outbreak led to EU legislation banning imports of bean sprouts from Egypt (now repealed).

E. coli are coliform bacteria that live in the intestines of humans and animals and whilst most are harmless, E. coli O157 can cause severe diarrhoea and kidney damage. Complications can arise (especially in children under 5) such as Hemolytic Uraemic Syndrome that can cause kidney failure and death. At the time of the outbreak in Northern Germany, Hamburg Port Health Center issued advice to seafarers, which can be found here detailing symptoms and actions that seafarers could take.

The risk from E. coli in food preparation is closely linked to cross contamination between raw food (such as unwashed fruit and vegetables, and raw meat) and food that would be classed as ready to eat such as cooked meats and washed fruit and vegetables). In the UK, the Food Standards Agency has issued advice to Food Businesses (that would apply equally to vessels operating in the UK) as to how to control the risk of E. coli O157. This can be found at http://www.food.gov.uk/multimedia/pdfs/publication/ecolifactsheet0211.pdf. The key control points are:

1. Always separate – separate raw and ready to eat foods, paying attention to work areas, storage facilities, equipment, protective clothing, utensils etc.
2. Clean effectively – this is not just visual cleanliness but sanitising through the use of appropriate disinfection.
3. Heat cleaning – specifically for cleaning of utensils and cloths – the use of dishwashers and washing machines at the correct temperature and contact time.
4. Handwashing – a key component of basic hygiene but stressing suitable techniques and facilities.
5. Handling food – use of tongs/other utensils, disposable gloves between tasks.

For those involved in food preparation on board vessel and inspectors, attention to the risks and control measures posed is vital as the simple failings could lead to serious consequences to human health. Relevant control measures/corrective actions for all types of this can be found in the WHO Technical Handbook4 Area 2 Galley Pantry and Service Area and Area 3 Stores and for standards and requirements for passenger ships in the EU SHIPSAN TRAINET Manual5, Area 3 Food Safety (pages 41-72) .

Next issue, I will feature another relevant food safety issue in the Galley. If you have any good examples of cases that you would like to share with SHIPSAN ACT readers, please email details to me at martin.walker@suffolkcoastal.gov.uk

References:
World Health Organization, International Health Regulations 2005, available through http://whqlibdoc.who.int/publications/2008/9789241580410_eng.pdf

1 http://www.reading.ac.uk/foodlaw/pdf/uk-09005-ecoli-report-summary.pdf
2 http://news.bbc.co.uk/1/hi/health/154107.stm
3 http://www.euro.who.int/en/health-topics/emergencies/international-health-regulations/outbreaks-of-e.-coli-o104h4-infection
4 World Health Organization, 2011 Handbook for Inspection of Ships and Issuance of Ship Sanitation Certificates available through http://www.who.int/ihr/publications/handbook_ships_inspection/en/
5 European Manual for Hygiene Standards and Communicable Diseases Surveillance on Passenger Ships (EU Ship Sanitation Training Network)

 

Chemical and radiological issues on ships
Mark Griffiths, Public Health Scientist at the Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Didcot, Oxfordshire.

Key Message: The Centre for Radiation Chemical and Environmental Hazards (CRCE) of Public Health England (PHE) has the responsibility to develop best practice guidance for competent authorities to support risk assessment and response for managing chemical and radiological incidents on ships, where passengers or cargo may be affected and where there is a need to protect public health. This article considers the role of the laboratory in port health checks and lessons learned from the EU FP7 project SLAM

Port health authorities have a responsibility to protect the public, environment and animal health from imports that do not meet safety and hygiene standards. Port health officers carry out a range of health controls, including checks on imported food, inspecting ships for food safety and infectious disease control as well as general public and environmental health checks.

To ensure imported products safe to eat and that it is the same product as certified, samples may also be taken for laboratory assessment. Sample analysis of goods brought into ports are carried out by accredited reference laboratories that conform to accredited European standards such as EN ISO/IEC 17025, who are employed by the local authority or port health authority according to EU legislation (EC) No 882/2004.
Through the work of an EU funded project entitled the Standardisation of Laboratory Analytical Methods (SLAM) the work of the laboratory in sampling, sample analysis and transport of Chemical, Biological, Radiological and Nuclear (CBRN) agents has been examined (www.cbrnecenter.eu/project/slam/). Two international stakeholder workshops have been held as part of the SLAM project to evaluate member states approaches for sampling, monitoring, analysis and transport of potential CBRN agents following a large scale incident with cross border impacts, which is relevant to the work of SHIPSAN ACT.

Whilst standardisation of laboratory procedures and equipment might be considered the ‘gold standard’ to achieving consistent and accurate laboratory results, this is not realistically achievable (nor perhaps even desirable) across Europe. Rather, a set of harmonised procedures which focus on minimum required performance criteria, and which are in regular use will ensure consistent results are achieved by staff that are competent and confident in the methods which have been validated in their own laboratories.

Part of the SLAM project recommendations included harmonised transport documentation to ensure that package certification issued by one Member State is accepted by all other EU countries; common methodology to achieve simultaneous certification of packaging and development of a mechanism to achieve rapid validation in the other Member States of the approval issued by the competent authority sending the samples.

To foster a cross-border collaborative framework, laboratory networks need to be established. A model such as that provided by the United States Environmental Protection Agency’s Environmental Response Laboratory Network (ERLN; http://www.epa.gov/oemerln1/) could be adopted in Europe and applied to reference and accredited laboratories. Such a network could organise comparative tests between the official national laboratories and ensure an appropriate follow-up of such comparative testing. Such proficiency testing would provide means to establish laboratory networks and make analysis and reporting more consistent and harmonised. This would make it more feasible for neighbouring member states to provide laboratory assistance when another country’s laboratory capability or capacity is exhausted.

A final SLAM workshop will be held in Brussels in February 2014 with the aim to deliver a road-map for necessary actions to be taken to achieve an acceptable level of harmonisation and standardisation of EU CBRN laboratory capability. The outputs of this work will be of relevance to all accredited and reference laboratories. For further information about this workshop, send an email to SLAM@phe.gov.uk.

The Voice of the Industry
Christos Hadjipetris, HOPS Senior Manager, Louis Cruises

Revenue, Innovations, Quality, Service, Health and Hygiene etc.
How to fit them all in?

The demands for results are growing: It makes no difference what company we are talking about. The demands have become a monster and this monster is the same for everybody. All companies face competition and dealing with competition calls for innovations, improvements and product differentiation. Quality and Service standards need a constant battle to be maintained but at the same time revenue needs to be increasing. On top of that and it goes without saying, everybody’s priority is to have a safe and hygiene environment for guests and crew. What do we do first and how do we fit everything together? What do we teach our crew? How do we set up priorities?

Here at Louis Cruises, we also need to consider another parameter. Our East Mediterranean ships sailing out of Piraeus are multi cultural, multi lingual melting pots. Sailing with guests from all over the world, means that our crew members need to speak a number of languages in order to communicate with our multi-national clientele.

Finding the answer to these challenges is not an easy task and it takes a lot of effort to make it happen. Over the years we have managed to make Health and Safety a priority by introducing Standard Operating Procedures in our practices. In other words we teach our crew to aim for quality, service and increasing revenue, however to do it through a Safe and Hygiene way. The aim is to work towards the company’s goals but work safely following SHIPSAN standards. To achieve this there is only one way: training, development and active, supportive supervision. People need to be explained why and how; just giving directions does not work. Directions are effective only if paired with explanations therefore training and development is imperative.

At Louis Cruises we have developed an elaborate Training & Development program through which we set the priorities for our crew and teach them how to work correctly. The trainings are divided into categories and are specific according to rank. Job related trainings are dynamic and designed to breakdown the greater concepts of quality, service and revenue into specific tasks filtered through health, hygiene and safety practices.

All crew will undergo Health and Hygiene training by internal and external trainers and will be examined and certified by the Chartered Institute of Environmental Health in the UK. Louis Cruises is a training center of CIEH since 2005. All crew is certified at Level II, management at Level III and finally Senior Management at Level IV. Moreover, Louis Cruises closely follows all European Sanitation initiatives and as an active collaborator of SHIPSAN participates in all training sessions.
Our onboard management will undergo managerial trainings including 4th generation time management. The purpose is to ensure that our supervisors are given the tools to be able to supervise and manage their teams in achieving the company goals through safe and hygiene practices.

Therefore Health and Hygiene need to become part of the core practices. Need to be embedded in the way things are done. We find this is the only way to be safe and at the same time be able to keep up with the industry requirements and competition.


Recent Publications

Legionella spp. survival after different disinfection procedures: Comparison between conventional culture, qPCR and EMA–qPCR
A. Mansi, I. Amori, I. Marchesi, A.M. Marcelloni, A.R. Proietto, G. Ferranti, V. Magini, F. Valeriani, P. Borella
Microchemical Journal Volume 112, January 2014, Pages 65–69

Abstract
The development of rapid and sensitive methods for the detection and quantification of Legionella viable cells is essential for monitoring water quality and preventing legionellosis. The aim of this study was to verify the applicability of a quantitative PCR (qPCR) method used in combination with ethidium monoazide (EMA) to the quantification of Legionella spp. in samples collected from swimming pools, water recirculation systems and hot water systems in two fitness clubs. This molecular technique (EMA–qPCR) allows the amplification of target DNA from culturable and viable cells, but prevents the amplification of DNA from non-viable cells. The effectiveness of this new method able to detect alive legionellae was also compared with conventional qPCR and culture method. Our results confirm that EMA–qPCR allows to discriminate the non-viable cells from those viable and that it is particularly indicated for monitoring the effectiveness of thermal treatments for the Legionella contamination control in water environments, also providing information about the presence of Viable But Non-Culturable (VBNC) cells. Other Gram-negative bacteria typically associated with biofilm were identified in samples taken from swimming pools and balance tanks, suggesting that also the presence of biofilm should be monitored for a more general view of water contamination.


Antimicrobial nanomaterials as water disinfectant: applications, limitations and future perspectives.
Hossain F, Perales-Perez OJ, Hwang S, Román F.
Science of the Total Environment. 2014 Jan 1;466-467:1047-59.

Abstract
Nanotechnology and its application is one of the rapidly developing sciences. As demand of fresh drinking water is increasing, nanotechnology can contribute noticeable development and improvement to water treatment process. Disinfection process is the last and most important step in water and wastewater treatment process. Some nanomaterials can be used as disinfectants due to their antimicrobial properties and reduce the possibility of harmful disinfection by-products (DBPs) formation during traditional disinfection process. A significant number of research efforts is done or going on to understand the mechanisms and enhance the efficiency of nanomaterials as antimicrobial agents, although it will take more time to understand the full potential of nanomaterials in this field. This review paper focuses on inactivation pathways of benign nanomaterials, their possible and probable application and limitations as disinfectants and future opportunities for their application in water cleaning processes.

 

News and forthcoming dates

Preliminary plan for EU SHIPSAN ACT Joint Action meetings and training courses in 2014

Month	Meeting/Event	Status
March (4-7)	1.      European introductory training courses for the SHIPSAN Manual for port health officers and seafarers 2.      Sustainability working group meeting	Confirmed date
June	3.      Advanced, focused training course for water safety	Provisional date
October	4.      Interim collaborative group meeting 5.      Advisory board meeting 6.      General assembly meeting 7.      Sustainability working group meeting 8.      Meeting of working group for Manual revision 9.      Advanced, focused training course for water safety	Provisional date

 

What’s new on the website www.shipsan.eu  

 

• European directory of authorised ports to issue Ship Sanitation Certificates under IHR 2005 
  
  The contact details of the authorised ports of EU countries for issuing Ship Sanitation Certificates under IHR (2005) are now available via the EU SHIPSAN ACT Joint Action website.
  The aim is to create the first contact list for authorised ports of EU countries responsible for issuing Ship Sanitation Certificates under IHR (2005) that will:
   - facilitate port to port communication,
   - strengthen the network of port health officers in Europe and
   - further facilitate communication of the ship directly with the appropriate port health authorities when desiring to ask for a Ship Sanitation Certificates renewal.
  By using the different fields either individually or in combination in the link provided below you can search for the contact details of authorised ports of EU countries for issuing Ship Sanitation Certificates under IHR (2005): http://www.shipsan.eu/Inspections/AuthorisedportstoissueSSC.aspx
  The contact details were provided by the SHIPSAN ACT partners and are published after receiving written consent.



• Advice to international travellers for a healthy voyage

            The EU SHIPSAN ACT Joint Action has published a leaflet containing advice to international travellers for a healthy voyage.



During a cruise or ferry voyage, travellers may be exposed to potential health risks although it is rare illness will occur. The type of travel and destination can influence the health risks to which travellers may be exposed. Following simple guidelines can help travellers enjoy their voyage and help maintain a healthy environment for both themselves and other passengers.


Travellers are responsible for their health and for preventing the transmission of communicable diseases to other passengers. Effective prevention of infection requires strict adherence to the health advice provided on board ships. To safeguard the health of passengers, ship operators implement health and hygiene policies and the ships are inspected regularly by port authorities to ensure that public health risks are effectively managed.


Click here to download the leaflet containing advice to international travelers for a healthy voyage.

 

 

 

 

 

Quiz

By Audrone Lavruvianec, Chief specialist at the Department of Communicable diseases prevention and control, Klaipeda Public Health Center

About the term “Quarantine”: According to the International Health Regulations (2005) the term “quarantine” means the restriction of activities and/or separation from others of suspect persons who are not ill or of suspect baggage, containers, conveyances or goods in such a manner as to prevent the possible spread of infection or contamination.

Question: What is the origin of the term "quarantine"?

Please send your answers to: info@shipsan.eu

Answer to Issue 5 quiz:
The ship was the first ever built cruise ship launched on June 29, 1900 and christened Prinzessin Victoria Luise. The cruise ship idea came from Albert Balli.

Source: http://cruiselinehistory.com/the-prinzessin-victoria-luise-worlds-first-cruise-ship/

Congratulations to:

• Tom Sugrue, Port Health Officer for Rosslare Europort, Environmental Health Officer, Environmental Health Service, Health Service Executive, Wexford, Ireland
• Mario Cassar, Senior Principal Environmental Health Officer (Reg. No. 047), Units & Legislation, Environmental Health Directorate, Health Inspectorate Services, Malta
• Audrone Lavruvianec, Chief specialist at the Department of Communicable diseases prevention and control, Klaipeda Public Health Center 
• R K Rowlands, Principal EHO,. Anglesey County Council, Wales, UK (responsible for Port Health Duties at the port of Holyhead).
• Vjekoslav Srdoc MD, Senior state sanitary inspector, Department of border sanitary inspection, Ministry of Health of Republic of Croatia

 

Port in focus
Port of Bratislava – Slovak Republic

Martina Pilková, Ministry of Transport, Construction and Regional Development of the Slovak Republic, Department of the Chief Public Health Officer


The port of Bratislava is located almost in the middle of the water connection between the North Sea and Black Sea. The territorial district of the port includes port basins and both banks of the Danube river between river kilometres 1871,35 and 1862,00. The port of Bratislava is situated at the left bank of the river Danube close to the city centre and consists of passenger port and cargo port.

The passenger port is located between the city’s Old Bridge and New Bridge close to the old historic centre of Bratislava. The operator, Shipping and ports – Passenger shipping JSC, provides sightseeing, ferry and charter services. The company also provides river cruises between Bratislava and Vienna.

In recent years, taking a cruise on the Danube River through Central and Eastern Europe has been a growing leisure interest among tourists. In 2012, about 15,000 passengers travelled to the Danube on a cruise. According to the Danube Tourist Commission, one of the most popular routes for cruises in 2009 is the Passau-Budapest-Bratislava-Vienna-Passau voyage.
The cargo port is located to the east of the passenger port and consists of two parts. The older part which was constructed in the 19th and 20th century is located at the west site of the cargo port and consists of two basins: the North Basin and the South Basin. Both Basins used to be winter ports, but nowadays only the South Basin (1) is used for protective measures only so no cargo handling activities take place there. The North Basin (2) can be operated as a commercial port and used for the transhipment of bulk and general cargo.

The following map shows the location of the Basins and the major service providers within the port areas.

The second part of the cargo port is newly developed port which was developed since the early 80’s. This part is located east of the older cargo port and consists of 1 basin, named the Palenisko Basin (3) and contains several warehouses and terminals. On the north quay of Palenisko Basin container terminal (4) and public customs warehouse (5) are situated. The container terminal is tri-modal including three railway tracks, has five containers handlers and two KBS cranes. This terminal has a theoretical potential of 50,000 TEU/year. Most containers handled in the port of Bratislava are transported by land modes. The share of inland waterway transport is much smaller than the share of rail and road. In 2010 inland water transport transported around 3% of all containers handled at the terminal.

On the south bank a mineral oil terminal (6) is located. Products handled at the terminal are gasoline, crude oil, light and heavy fuel oils and other heavy oil derivates. The refinery Slovnaft a.s. exports 700,000 tonnes of the light and heavy fuel produced by barge way with main destinations in Austria and Germany.

On the east bank of the Palenisko Basin an oversized load transhipment facility (8) and RoRo ramp (7) are located. The oversized load transhipment facility has two cranes available with an individual capacity up to 280 tons. The RoRo ramp is able to handle 400 or more cars per loading or unloading activity.

To the east of the Palenisko Basin a shipyard Basin (9) is located. The shipyard offers building of new vessels, reconstruction and repair services, renovation of vessel equipment and winter parking of ships and yachts. Main types of vessels built are tank barges, passenger vessels and patrol boats.

The Danube is more important for Slovak exports than for imports in Slovakia. In 2011 the Slovakian ports exported almost 2.4 million tons on cargo1. Most of the exports via the Danube are heading upstream for Austria (83,1%) and Germany (11,1%), while a small part also moves downstream towards Romania (2,6%), Bulgaria (1,2%) and Ukraine (1,1%). Chemicals and chemical products are the most important goods transported to Germany, as well as some refined petroleum products and agricultural goods. The largest export products towards Austria and Romania are metal ores and quarrying products, followed by coke and refined petroleum products.

The port of Bratislava could potentially be a logistics hub for Europe. It has a favourable geographical location at the core of Central Europe and at the crossroads of West and East, as well as North and South Europe, along with well-established rail and road connections to the Slovak industrial and economical areas and to other countries.

Source:

1 Eurostat, Inland water transport country flows