title: Fatal accidents and injuries among merchant seafarers worldwide.
abstract: BACKGROUND
  The British merchant fleet has expanded in recent years but it is not known whether this expansion has led to proportionate changes in mortality.
  
  
  OBJECTIVE
  To investigate mortality from accidents and injuries in British merchant shipping, to determine whether this has increased in recent years, to compare fatal accident rates across British industries and to review fatal accident rates in merchant shipping worldwide over the last 70 years.
  
  
  METHODS
  Examinations of marine accident investigation files, death registers and death inquiry files, national mortality statistics, worldwide surveys and review methodology. The main outcome measure was the fatal accident rate per 100 000 worker-years.
  
  
  RESULTS
  Of 66 deaths in British shipping from 2003 to 2012, 49 were caused by accidents, which largely affected deck ratings. The fatal accident rate in British shipping increased by 4.7% per annum from 2003, although this was not significant (95% confidence interval: -5.1 to 15.6%). During 2003-12, the fatal accident rate in shipping (14.5 per 100 000) was 21 times that in the general British workforce, 4.7 times that in the construction industry and 13 times that in manufacturing. Of 20 merchant fleets worldwide with population-based fatal accident rates, most have shown large reductions over time.
  
  
  CONCLUSIONS
  The expansion of the British merchant fleet in recent years does not appear to have had a major impact on fatal accidents. Further preventive measures should target fatalities during mooring and towing operations. Internationally, most shipping fleets have over time experienced large decreases in fatal accident rates.
authors.affiliation: College of Medicine, Swansea University, Swansea, UK, stephen.e.roberts@swansea.ac.uk.
authors.forename: S E
authors.initials: SE
authors.lastname: Roberts
authors.affiliation: Messrs. Weselmann Asia Ltd, Tsuen Wan, Hong Kong SAR, China.
authors.forename: D
authors.initials: D
authors.lastname: Nielsen
authors.affiliation: Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Kotłowski
authors.affiliation: Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk, Poland.
authors.forename: B
authors.initials: B
authors.lastname: Jaremin
mesh_terms: D000062:Accidents, Occupational / Q000401:mortality*; D000328:Adult; D000368:Aged; D002423:Cause of Death; D003132:Commerce; D006801:Humans; D008875:Middle Aged; D009326:Naval Medicine; D060051:Occupational Injuries / Q000401:mortality*; D009790:Occupations; D012767:Ships; D006113:United Kingdom; D055815:Young Adult
keywords: Fatal accidents and injuries; merchant shipping; seafarers.