” This professionalism is determined by attitudes and performance, very often shaped by the culture of the shipping company [15]. The IMO also stresses the importance of safety management systems in shipping. And, in accordance with Cooper’s safety culture model, IMO recognizes the bi-directional link between safety culture and safety management. The IMO’s International Safety Management (ISM)

Code provides a standard for the safe management and operation of ships and for pollution prevention. The ISM Code is mandatory and establishes safety management objectives. It requires that a safety management FDA approved Drug Library system be established by whoever is responsible for the operation of the ship. The philosophy underlying the application of the ISM Code supports and encourages the development of a safety culture in the shipping industry. The Code constitutes a system of self-regulation of safe ship operation as well as occupational safety and health on board. The Code requires procedures to ensure safe operation, the management IGF-1R inhibitor of risk, procedures for reporting and analyzing accidents and conformities, and procedures for internal audits and reviews [16]. The efficacy of the ISM

Code has been investigated in several studies but no definitive indication has been provided. Tzannatos and Kokotos [17] found that the Code had a positive outcome in Greek shipping. After examining accidents involving Greek-flagged ships between 1993 and 2006 (i.e., before and after the implementation of the ISM Code), the implementation of the ISM Code led to an overall reduction of human-induced accidents (from 64% to 52%), although Greek-flagged ships still maintained their dominance in shipping accidents. In the pre-ISM period, tankers and Ropax vessels were also deeply linked to human-induced accidents, but implementation of the ISM Code managed to remove this link [17]. However, the ISM Code has been criticized because of the increased amount of

paperwork and bureaucracy. Moreover, the standardization of the management of safety and the demand for written procedures are perceived by many seafarers as going against common sense, experience, and the professional knowledge of seamanship [18]. For effective self-regulation of safety and occupational safety and health to be achieved, the implementation of safety CYTH4 management systems must go hand in hand with employer’s safety commitment and employee’s participation in safety management decision-making [19]. These factors are very much associated with the safety culture in an organization. Employee participation in decision-making will enhance their commitment to take action and implement changes when needed [20]. Good communication and listening skills across organizational levels, groups and individuals strengthens a shared situational awareness of risk and safety [21]. Effective communication and employee participation are also factors that drive organizational change [20] and [22].