The short version
- In 793 work-related injuries treated by radio on Italian-flagged ships from 2010 to 2022, one in three (33.3%) hit the hand or wrist[1].
- The leading causes were slips and falls (32%), burns and explosions (16.6%) and overexertion lifting or carrying (14.8%)[1].
- A P&I club sees the same shape: hand injuries are almost 25% of its injury claims, and slips and trips rank second[2].
- Each department has its own injury: falls on deck, machinery in the engine room, burns in the galley[1]. The first aid kit should follow the same map.
The two datasets, side by side
Two independent sources describe the same pattern. Sagaro and Amenta analyzed every work-related injury in the CIRM radio medical database for Italian-flagged ships over 13 years[1]. Britannia P&I reported its crew claims for two policy years[2].
| Measure | CIRM, 2010 to 2022[1] | Britannia P&I claims[2] |
|---|---|---|
| Sample | 793 injured seafarers | Crew claims, 2022/23 and 2023/24 |
| Hand injuries | Hand/wrist 33.3% of injuries | Almost 25% of injury claims |
| Top cause | Slips/falls 32% | Slips and trips second most common |
| Most affected ranks | Deck ratings 27.9%, engine officers 20% | Engineers first, then able seamen, for hand injuries |
The injured were working-age crew: average age 39.15 years, with 39.2% aged 30 to 40[1]. Women made up only 3.9% of reported injuries, too few for the authors to compare by sex[1].
Where on the body, and what kind of injury
| Body region[1] | Share of injuries |
|---|---|
| Hand/wrist | 33.3% |
| Knee/lower leg | 21% |
| Head/eye | 19% |
By type, open wounds led at 38%, followed by burns and abrasions at 14%[1]. Those two together describe most of what a ship’s medical locker is used for after an accident: closing wounds, preventing infection and dressing burns.
Each department has its own injury
| Department[1] | Leading cause | Leading injury types |
|---|---|---|
| Deck | Slips/falls 35%; overexertion lifting or carrying 19% | Open wounds 40%, sprains/strains/dislocations 15%, fractures 13% |
| Engine room | Caught in machinery or equipment 19% | Cuts/lacerations most common in engine ratings; amputations 7% in engine officers |
| Catering | Burns/explosions 32.5% | Burns/abrasions 27.5%, cuts/lacerations 13.8%, bruises 10% |
Nearly 35% of all injuries happened on deck[1]. The authors call for non-slip surfaces, regular safety drills and wider use of protective equipment[1]. Britannia flags falls from height, being struck by moving objects and eye injuries as the other categories to watch[2].
Match the first aid kit to the injury map
If a third of injuries are to hands and open wounds lead by type[1], wound care is the core of the kit, not an extra. A practical stocking order follows from the data:
- Wound closure and dressings sized for hand and lower-leg wounds, the two biggest regions[1].
- Burn dressings where the galley is: burns/explosions cause 32.5% of catering injuries[1].
- Eye irrigation and eye kit: head and eye injuries are 19% of the total[1], and Britannia lists eye injuries separately[2].
- Splints and immobilization for deck crews, where sprains and fractures follow open wounds[1].
- Pain relief that is lawful to hold, including controlled options where a physician has set them up.
US fishing vessels must carry a medicine chest suitable for the number aboard, plus crew certified in first aid and CPR[5]; see the 46 CFR 28.210 guide and first aid kit requirements by vessel class.
Prevention the data points to
The study’s own recommendations follow the causes: non-slip surfaces and regular safety drills against slips and falls, and wider use of protective equipment against the rest[1]. Britannia’s hand injury finding, engineers first and able seamen second[2], tells a fleet where gloves, guarding and tool training pay back first.
| Cause[1] | Share | Control that matches it |
|---|---|---|
| Slips/falls | 32% | Non-slip surfaces, housekeeping, footwear, drills[1] |
| Burns/explosions | 16.6% | Galley procedures, burn first aid within reach |
| Overexertion lifting or carrying | 14.8% | Team lifts and handling aids on deck |
| Caught in machinery | 19% of engine room injuries | Guarding, lockout, gloves rules for engineers[2] |
When an injury becomes a Coast Guard report
For US vessels, the injury itself can trigger federal duties. 46 CFR 4.05-1 lists the marine casualties that must be reported to the Coast Guard[3]. A reportable casualty that causes an injury needing professional treatment beyond first aid, and that leaves a crew member unfit for routine duties, is a serious marine incident[4], which brings drug and alcohol testing.
The threshold questions are covered in injury beyond first aid and marine casualty reporting and the testing clock in serious marine incident testing. A hand laceration that needs sutures ashore is a typical example of a routine injury that can cross that line.
What this data cannot tell you
The CIRM series counts injuries where the ship called for radio medical advice[1], so minor injuries treated aboard without a call are not in it. The Britannia figures are claims[2], which skew toward costly cases. Both point the same way, but neither is an injury rate per crew member.
Discovery Health MD builds the medical side of an injury program from this data: a kit weighted to hands, wounds, burns and eyes through ship medical chest management, lawful pain relief through controlled substances management, and a physician-written injury and reporting protocol through maritime medical consulting. Send us your last year of injury logs and we will map them against this pattern.
Common questions
What are the most common injuries on ships?
Hand and wrist injuries: 33.3% of radio-treated work injuries on Italian-flagged ships[1] and almost 25% of one P&I club’s injury claims[2]. Open wounds are the most common type[1].
What causes most injuries at sea?
Slips and falls (32%), burns and explosions (16.6%) and overexertion lifting or carrying (14.8%) led the CIRM data[1].
Which crew members get injured most?
Deck ratings accounted for 27.9% of injured seafarers and engine officers for 20%[1]. For hand injuries, Britannia sees engineers first, then able seamen[2].
What injuries happen in the engine room?
The leading cause there was being caught in machinery or equipment, 19% of engine room injuries[1]. Cuts were most common in engine ratings and amputations reached 7% among engine officers[1].
What injuries happen in the galley?
Burns and explosions caused 32.5% of catering department injuries, with burns and abrasions the leading type[1].
Does a crew injury have to be reported to the Coast Guard?
Reportable marine casualties are set out in 46 CFR 4.05-1[3]. An injury beyond first aid that leaves a crew member unfit for duty, from a reportable casualty, is a serious marine incident[4]. See death on board: the US procedure for the most serious case.
How should a first aid kit reflect these injuries?
Weight it to wound care, hand injuries, burns, and eye injuries, the patterns that lead the data[1][2]. US fishing vessels must size their chest to the number aboard[5].