The short version
- The ILO’s first global register counted 449 seafarer deaths in 2024, reported by 66 countries[1].
- Illness, not accidents, led: 245 health-related deaths, against 86 occupational accidents[1].
- Insurance data is starker. Britannia P&I found 81% of crew fatalities were illness-related, and cardiovascular conditions caused 58% of those[3].
- Persons overboard and suicide each kill seafarers every year: 36 and 26 cases in 2024[1].
- US commercial fishing ran at 86.0 deaths per 100,000 workers in 2016, 23 times the rate for all US workers[7].
Illness kills more seafarers than accidents do
Ask a crew what kills people at sea and the answer is usually weather, machinery or a fall. The first global data from the ILO says otherwise. Of 449 deaths reported to the ILO for 2024, 245 were health-related, close to 55%, and occupational accidents accounted for 86[1].
The register exists because the 2022 amendments to the Maritime Labour Convention, in force from the end of 2024, require every seafarer death on board to be investigated, recorded and reported annually[2]. It is young data with gaps, and it is still the best count anyone has.
| Cause, ILO 2024 register | Deaths | Share of 449 |
|---|---|---|
| Health-related | 245[1] | 54.6% |
| Occupational accidents | 86[1] | 19.2% |
| Persons overboard | 36[1] | 8.0% |
| Suicide | 26[1] | 5.8% |
| Under investigation | 14[1] | 3.1% |
| Other causes | 13[1] | 2.9% |
Shares are our calculation from the ILO counts. The published categories total 420, so 29 deaths in the 2024 total are not assigned a cause in the published breakdown[1].
Why one source says 55% and another says 81%
Search this question and the AI answer quotes a range of 54.5% to 83% without saying why. The range is real, and it comes from counting different populations.
The ILO counts deaths that flag states report. Britannia P&I counts deaths that became claims across nearly 3,000 crew claims in the 2023-24 and 2024-25 policy years[3]. The German mortality study counts deaths aboard German-flag ships from 1998 to 2008, where a cause was documented in 45 of 68 cases[4].
| Dataset | What it counts | Illness share |
|---|---|---|
| ILO register, 2023 | 403 deaths, 51 countries[2] | 139 illness deaths, the leading cause[2] |
| ILO register, 2024 | 449 deaths, 66 countries[1] | 245 health-related, about 55%[1] |
| Britannia P&I, 2023 to 2025 | Crew fatalities within about 3,000 claims[3] | 81%, with 58% of those cardiovascular[3] |
| German flag, 1998 to 2008 | 68 deaths aboard[4] | 19 natural deaths, mostly ischaemic heart disease[4] |
The point for an operator is the direction, not the decimal. Every dataset puts illness at or near the top, which means the medical plan matters as much as the safety management system.
The heart is the single biggest killer aboard
Britannia’s figure is the sharpest one published: cardiovascular conditions caused 58% of illness-related crew deaths[3]. A 2024 scoping review of 55 studies reached the same direction, finding seafarers at higher cardiovascular risk than reference populations, while warning that about half the studies carried a risk of bias[6].
Rank changes the picture. In the German study, cardiac mortality ran at 38 per 100,000 seafarer-years among engine officers, 24 among deck officers and 7 among crew[4]. Telemedical data from the Italian centre CIRM shows the diagnosis shifting too: officers were most often diagnosed with hypertensive disease (46%), non-officers with ischaemic heart disease (41%)[5].
What this means for the chest
A cardiac event far from port is decided in the first hour, by the drugs and equipment aboard and by whoever can reach a physician. That is why chest contents are scaled to flag state and voyage, why the medevac decision needs a written threshold, and why medical oxygen is not optional equipment on many vessels.
Defibrillation is the one intervention that is both time-critical and trainable. In a German study of 130 ship officers, 81.7% of untrained officers delivered an effective shock with an AED, and after 7 hours of training all 130 did[13]. Germany became the first flag state to require AEDs on seagoing merchant ships, by September 2012[13].
Overboard and on deck: the deaths a procedure can prevent
Persons overboard caused 91 deaths in the 2023 register and 36 in 2024[2][1]. Britannia puts man-overboard at more than one third of its injury-related fatalities[3].
CDC fishing data shows how these deaths happen. Between 2000 and 2016, 204 US commercial fishermen died after falling overboard. 121 of those falls, 59.3%, were not witnessed, and 108 of those victims were never found[7]. Of the 83 witnessed falls, rescuers recovered 22 people who could not be resuscitated[7].
| US commercial fishing, 2000 to 2016 | Figure | What it points to |
|---|---|---|
| Fatality rate, 2016 | 86.0 per 100,000 FTE, against 3.6 for all US workers[7] | About 23 times the national rate[7] |
| Fatal falls overboard | 204 deaths[7] | Second-largest cause after vessel sinkings[7] |
| Falls not witnessed | 121, or 59.3%[7] | Man-overboard alarms and tethers[7] |
| Recovered but not revived | 22 of 83 witnessed falls[7] | Recovery devices and rescue training[7] |
For the medical side of the fishing fleet, see commercial fishing vessel medical requirements and the Alaska fleet guide.
Suicide: 26 deaths a year, and the likely undercount
The register recorded 26 suicides in 2023, 6.5% of that year’s total, and 26 again in 2024[2][1]. Our reading, labelled as inference: the true figure is probably higher, because the ILO notes that only 59% of reporting countries supplied suicide data, against 83% for occupational accidents[1].
Longer case series point the same way. A study of UK and Bermuda passenger ships from 1976 to 2018 found 38 suicides and disappearances at sea among 140 crew fatalities, with no significant decline over 43 years while accident deaths fell[8]. A review of the wider evidence found depression and suicide research among seafarers scarce and inconsistent[9].
What a US operator must do when a crew member dies
Three federal records are triggered by one death aboard, and they are not interchangeable.
- Coast Guard casualty notice. Loss of life is a reportable marine casualty under 46 CFR 4.05-1[10]. The procedure is in death on board a US vessel.
- CDC report. A death aboard a vessel bound for a US port must be reported before arrival under 42 CFR 71.21[11]. See reporting a death or illness to CDC.
- Official logbook entry. Where the vessel keeps one, 46 U.S.C. 11301 requires an entry for each death on board with the cause[12]. The entry rules are in official logbook medical entries.
The US has not ratified the MLC, so the ILO register duty sits with ratifying flag states rather than with a US-flag operator directly. The US records above are the ones a US investigator will ask for.
Five changes the data supports
| Cause | Evidence | First change to make |
|---|---|---|
| Cardiac events | 58% of illness deaths in P&I data[3] | AED aboard plus trained officers[13] |
| Illness far from care | 245 health-related deaths in 2024[1] | Chest scaled to voyage, stocked step by step |
| Evacuation delay | Most deaths at sea, not in port[1] | A written remote medical plan |
| Overboard | 59.3% of fishing falls unwitnessed[7] | Alarms, tethers, recovery drills |
| Suicide | 26 recorded deaths a year[1] | Named physician access for crew concerns |
Discovery Health MD builds the medical half of that list. The chest sits in our ship medical chest management service, scheduled drugs in controlled substances management, and the plan itself in maritime medical consulting. Start with a compliance audit or speak to a physician.
Common questions
What is the leading cause of death for seafarers?
Illness. The ILO register recorded 245 health-related deaths among 449 seafarer deaths in 2024, ahead of 86 occupational accidents[1]. Among illnesses, cardiovascular conditions dominate: Britannia P&I found they caused 58% of illness-related crew deaths[3].
How many seafarers die each year?
The ILO register counted 403 deaths reported by 51 countries for 2023 and 449 reported by 66 countries for 2024[2][1]. Both are counts of reported deaths from the countries that responded, so the true global number is higher.
What percentage of seafarer deaths are caused by illness?
About 55% in the ILO’s 2024 data, 245 of 449[1]. Britannia P&I’s claims data puts it at 81% of crew fatalities[3]. The gap reflects different populations: flag-state reports on one side, insured crew claims on the other.
How many seafarers die from falling overboard?
The ILO register recorded 91 persons overboard in 2023 and 36 in 2024[2][1]. In US commercial fishing, 204 fishermen died after falling overboard between 2000 and 2016, and 59.3% of those falls were not witnessed[7].
Is suicide common among seafarers?
The register recorded 26 suicides in each of 2023 and 2024, 6.5% of deaths in 2023[2][1]. Only 59% of reporting countries supplied suicide data, so the figure is likely an undercount[1].
Is commercial fishing more dangerous than merchant shipping?
For US workers, the fishing figures are extreme: 86.0 deaths per 100,000 full-time workers in 2016, 23 times the all-worker rate of 3.6[7]. Vessel sinkings cause the most fishing deaths and falls overboard are the second most[7].
What must a US vessel do when a crew member dies?
Notify the Coast Guard of the casualty under 46 CFR 4.05-1[10], report the death to CDC before arriving at a US port under 42 CFR 71.21[11], and record the death and its cause in the official logbook where 46 U.S.C. 11301 applies[12]. Our death-on-board guide sets out the order.
