Fatigue, anxiety and no access to medical care: The experiences of cargo ship workers around the world

Work-related fatigue among cargo seafarers has increased, despite efforts to monitor work and rest regulations on ships, a study from Cardiff University shows.

The analysis, from the Seafarers International Research Centre, derives from anonymous questionnaires and interviews with 1,240 cargo ship workers and 1,202 cruise sector workers.

The series of reports offer recommendations for how the health and wellbeing of seafarers could be improved.

These reports come out within days of a cargo ship running aground in Norway, narrowly missing a house. The watch officer has told police that he had fallen asleep on the bridge prior to the incident. Authorities are investigating whether rules regarding rest hours were adhered to on board the vessel.

Sleep 

This new study shows more than a third of cargo workers who were on board a ship when they completed the questionnaire had not had enough sleep in the past 48 hours.

Seafarers stated that they did not get enough sleep because of the number of hours they worked, the patterns of work they observed, their port duties, vessel movement and noise. These issues had increased since similar data was collected in 2016 and 2011.

A higher number of cargo workers also described insufficient sleep due to work-related anxiety, general anxiety and homesickness than in previous surveys. Insufficient sleep as a result of work-related anxiety was a particularly acute problem among senior officers.

Other findings show that in almost one in five cases, cargo seafarers who had experienced a serious injury or illness had not had medical attention when they needed it. There was normally no access to a qualified medic on board, with patchy telemedical assistance being provided until they arrived at port.

Challenges

At any one time, there are more than 1.5 million people working at sea around the world, often in difficult and demanding conditions. It is believed there is widespread underreporting of the challenges on board, with people working precarious contracts nervous of jeopardising their employment.

Professor Helen Sampson, director of Cardiff University’s Seafarers’ International Research Centre, said: “Despite better monitoring of staff work/rest hours, fatigue remains an intractable problem for seafarers.

“It emerged most recently, when the second officer on the NCL Salten fell asleep on watch and the ship grounded beside a domestic home in Trondheim, Norway. The NCL Salten had called at three ports in the previous 24 hours increasing the likelihood of fatigue among crew members.

“Evidence shows there are many instances of work/rest hours records being falsified to conceal overwork – but even when the Maritime Labour Convention is followed, seafarers can still be left without enough rest. An overhaul of work/rest hours regulations is long overdue. The regulations need to be changed to provide for an uninterrupted rest-period for all seafarers which is aligned with the recommended levels of sleep for adults.

“It is also clear that access to medical care on board cargo ships is woefully inadequate, with no medically qualified person on board in the event of an emergency. Having a trained medic on board would ensure workers are not left suffering for long periods if they are injured or ill when far from land.”

Cruise ships

The reports also focus on the experiences of cruise ship workers, with just under half of the 950 participants who were at sea when surveyed feeling they had not had sufficient sleep in the previous 48 hours. Work hours and work patterns were the main reasons for insufficient sleep.

Almost one in 10 cruise workers described a medical condition which they attributed directly to their work, although most had access to a qualified doctor on board.

Unlike cargo ship workers, the majority of cruise workers were denied private sleeping arrangements as a result of a desire to prioritise revenue earning spaces over crew accommodation.

Almost all seafarers reported a lack of access to the benefits of bathtubs and described a preference for greater access to these as well as to saunas.

Professor Sampson added: “There are many areas where improvements can be made to protect the health and wellbeing of seafarers in the cruise and cargo sectors. The provision of facilities which seafarers can use for therapeutic purposes such as baths and saunas, increased access to shore leave and the provision of good quality food would all be important inclusions in aholistic effort to protect and promote seafarers’ health and wellbeing.”

This research was funded by the Stiftelsen Sveriges Sjömanshus and received some additional support from the Sjöbefälsföreningen.

The reports are available here:

Helen Sampson, Iris Acejo, Neil Ellis, Nelson Turgo (2025) The health and wellbeing of seafarers working on cargo ships in 2023-2024.

Helen Sampson, Iris Acejo, Neil Ellis, Nelson Turgo (2025) The health of seafarers working on cruise and cargo vessels 2023-2024.

Helen Sampson, Iris Acejo, Neil Ellis, Nelson Turgo (2025) Seafarers’ access to health care while working on cruise and cargo vessels.

Helen Sampson, Iris Acejo, Neil Ellis, Nelson Turgo (2025) Seafarers’ health and access to healthcare in the cruise and cargo sectors in 2024: An overview.