Better data collection for better health

Concerns about seafarers' physical and mental health are nothing new, but it's been hard to make successful interventions without the right information. A research project at Solent University aims to fill that data gap with a new 'toolbox' that crew can use onboard ship. Dr Helen Devereux reports

According to the International Labour Organization (ILO), the leading cause of work-related death among seafarers in 2023 was illness and disease, accounting for 139 premature deaths. Most commonly, these resulted from cardiovascular events and other non-communicable diseases – all conditions often aggravated by the physically demanding nature of the job, prolonged working hours, chronic stress, and limited access to timely medical care while at sea.

Furthermore, there were 26 reported suicides, highlighting the mental health strain faced by many seafarers. 

In recent decades there has been considerable focus on the safety of those who work at sea, with various drives such as slips, trips and falls campaigns, but there has been far less consideration of the physical and mental health of seafarers.

This is despite clear evidence across all industries that the incidence of work-related ill-health far exceeds that of injuries. We need to better understand the reason for this, which is why Solent University recently undertook a project to develop a 'toolbox' to collect more comprehensive and consistent data about suspected work-related adverse health events.

Challenges to collecting health information

One major issue our researchers faced was the absence of an accepted clear definition of work-related ill-health. There can be a confusing overlap between ill-health arising from work and that from other causes that may affect work, or to which work may contribute.

Although there are a number of well-defined occupational diseases (such as occupational asthma), our understanding of current major causes of work-related ill-health, such as, mental ill-health and musculoskeletal disease, is more limited, reflecting the complexity both of their aetiology and their association with work.

For example, arguably there are factors related to how seafarers are employed and how their work and workplaces are organised that are beyond the traditional horizon of those who collect and analyse work-related ill-health data in the industry.

In addition to conventional exposure data, relevant variables might include details such as whether the seafarer is employed on a permanent or voyage contract, the time spent on a particular task, the extent of their autonomy and so on.

There is therefore a need to equip individuals charged with supporting a healthy as well as safe workforce with the necessary tools to investigate health as well as safety. In the longer-term, detailed analysis of such data will shed more light on the determinants of work-related ill-health among seafarers and so may ultimately lead to positive change in the industry.

Developing the toolbox

To design the toolbox, we first conducted workshops to understand the experiences of individuals within the UK seafaring industry, including those involved in the collection health data, such as QHSE superintendents, other relevant stakeholders such as MCA policy leads, and seafarers themselves.

Using this information, we then devised a survey to explore which variables workshop participants felt should (and could) be recorded when ill-health is reported. Our toolbox, therefore, has been produced with direct input from those who will use it.

Research findings

One of the key findings that emerged from the data collection was the indication that, in general, variables related to psychosocial health risks are not currently being recorded. In addition, many of the participants raised the issue of fatigue, suggesting that at the moment recording of work/rest hours is insufficient for identifying the role fatigue may play in ill-health.

They wanted to see data including, for example, number of hours worked in the previous three days, length of time onboard, working pattern, and duration of previous work shift.

Similarly, our participants felt that employment type data should be collected, as those with fixed periods of work and leave might be more likely to have sufficient leave time at home to rest.

A second key finding was the indication from participants that it is common for seafarers to withhold health information in order to avoid being declared permanently unfit or restricted on their ENG1. They suggested that this was particularly the case with regard to mental ill-health, and extended to those who do not need an ENG1 to work onboard (e.g. some workers on domestic ferries).

Fear of withdrawal of an ENG1 and/or losing employment onboard, and how this might prevent seafarers from seeking support for mental ill-health, is especially concerning, particularly given that a number of our participants knew of colleagues who had completed suicide in recent years.

Releasing the toolbox for industry use

The toolbox will be released later this year, along with an animation designed to help those in the industry think about the data collected in their organisation when a seafarer reports ill-health. Alongside data relating to physical risk, such as exposure to hazardous materials, the animation highlights data that may be missing, incomplete or inconsistent, including that related to psychosocial risks, and the organisation of work and employment.

Whilst the toolbox does not purport to solve all the issues regarding seafarer ill-health, we hope the resource can be a starting point for some much needed developments in the industry around data collection, the understanding and prevention of occupational ill-health, and the design and maintenance of safe and healthy workplaces for seafarers.

• The Toolbox for recording analysing work-related adverse health outcomes was developed by Helen Devereux, Eva Makri and David Walters of Warsash Maritime School at Southampton Solent University. Their work was funded by the UK Institution of Occupational Safety and Health. To keep up to date as the project develops and access the outputs, including the toolbox, visit here