Still sleepless at sea: worrying health research findings from SIRC

The latest data in a longitudinal maritime health study by SIRC at Cardiff University indicates that seafarer fatigue has reached crisis levels – particularly in the cruise sector. Meanwhile, provision of decent food and access to healthcare remain inadequate. Andrew Draper reports

Seafarers have never been more exhausted, according to new research into crew health by the Seafarers International Research Centre (SIRC) at Cardiff University.

SIRC researchers – Professor Helen Sampson, Iris Acejo, Neil Ellis and Dr Nelson Turgo – have been carrying out a longitudinal study across 14 years, and found in their 2024 research that fatigue had worsened since similar data was collected in 2016 and 2011. This latest instalment of the study involved interviews with 1,240 cargo ship workers and 1,202 cruise sector workers – many of which were carried out in person during port calls.

Prof Sampson said: 'We asked the seafarers why they weren't getting enough sleep. They reported problems with working hours, work shifts, and anxiety about work, which is particularly an issue in ports.

'I was surprised that problems in the cruise sector are even worse than on cargo ships. However, it isn't the engineers and watch-keeping officers who struggle most, but the hotel, catering and entertainment staff working long hours and split shifts whilst sharing cabins.'

Tinkering around the edges

'I've been at SIRC for 25 years, and even when I first joined, there were fatigue studies in the cargo sector. It's a concern which hasn't been addressed properly,' Prof Sampson continues. There have been many efforts 'tinkering around the edges' to introduce more oversight of work and rest hours, she notes, but this has not made a real difference.

'If there aren't enough people onboard the ship to do the work in a way that allows people to rest properly, then all that happens, as several studies have shown, is that seafarers are forced to falsify their records,' she stresses.

Under UK regulations for shore-based workers, employees are deemed to need 11 hours of rest between work shifts, she points out. 'How much, then, do seafarers need when they're living and working in an environment that moves, where they might be feeling seasick and where there's noise? It would be rational for the rest hours to be greater for seafarers, not less.'

Prof Sampson proposes that the Maritime Labour Convention should be amended to enable all seafarers to obtain an unbroken eight-hour period of sleep in any 24-hour period.

Missing out on medical care

Worryingly, the latest report found that, in almost one in five cases, cargo seafarers who had experienced a serious injury or illness at sea had received no medical attention.

Current regulations mean that, if there are more than 100 people onboard a ship, there needs to be a doctor. Cruise ships, for example, have a doctor onboard for the benefit of passengers.

Many ocean-going cargo ships, however, have just 20-25 seafarers onboard. 'So they're not going to reach that threshold and they don't have medically trained personnel on their vessels,' Prof Sampson said.

SIRC is calling for medical personnel onboard cargo vessels. 'It's a relatively marginal cost. Some shipping companies are making large profits, so you could reduce the profit margin slightly without it being catastrophic,' Prof Sampson said.

Cargo ships are required to have medical chests onboard and an officer in charge with some first aid training. However, the professor argues that are often 'totally inadequate for actually dealing with any real trauma, injuries and medical emergencies.'

'Crew have no diagnostic skills. Of course, they are supported by telemedical services, but these are hampered by the fact that you usually have to have a seafarer acting as an intermediary, either with email communication and then going face-to-face with the seafarer concerned, or perhaps with telephone calls and then going off to talk to the seafarer and coming back to the telephone and so on.'

The researchers call for improvements in the protection of seafarers' health onboard by eliminating job-related problems such as vibration white finger and arc eye from welding. They also advocate for enhanced protections against environmental hazards such as sun exposure when working on deck.

Steps should also be taken to address the high levels of stress experienced by senior officers in the cargo sector and senior managers in the cruise sector.

Onboard culture concerns

The researchers found that the traditional onboard hierarchy, the mix of nationalities and languages, and job insecurity from temporary contracts all combined to create barriers to seafarers reporting medical concerns. 'There's a whole issue of seafarers not wanting to make a fuss and risk losing their job,' Prof Sampson points out.

'We did hear a lot of horror stories that we didn't really look for, but they came. We heard of cases of seafarers who had been misdiagnosed and misunderstood onboard. There was one case where a seafarer was thought to have quite common gastrointestinal problems. He clearly had something much more serious. And when he didn't turn up for his watch, they found him dead in his cabin. The seafarers onboard were really traumatised and shocked because they'd all thought that he had something minor wrong with him.'

Diet squeeze

A low daily food allowance of US$6-US$8 per seafarer on cargo vessels – and even less for cruise ships – make it difficult for catering staff to produce interesting and varied menus, the study found. Seafarers reported that food budgets had fallen at a time when food prices had increased, hampering the efforts of catering staff to provide good nutritious food.

Some cargo vessels run out of provisions during long voyages or when facing delays, the researchers learned. Crew members are then served endless amounts of congee, a rice-based gruel.

The study found that cruise ship seafarers had to endure poor quality food that did not meet preferences or needs. Many ate more fried food than at home and some even disliked the provided food so much they brought along their own, like instant noodles. They did get fruit and vegetables, but these were often spoiled and over-ripe leftovers from the passengers.

Cargo seafarers had less access to fresh fruit and vegetables than their cruise counterparts.

A ray of hope

One of the few encouraging findings of the SIRC research is that the personal health habits of seafarers in the cargo sector have improved from the 2011 study to the 2016 study to today. Alcohol consumption fell in terms of frequency and amount, and smoking eased. Fried food consumption is also down.

'There's room for improvement. But I think in terms of their own behaviours and their own health awareness, taking multivitamins and things like that, seafarers are really onboard with keeping healthy,' Prof Sampson says. Given all the pressures they face, seafarers are 'remarkably upbeat about their own health'.

• Read the SIRC research at bit.ly/fatigue_study_SIRC