Britannia P&I Club released a case study focusing on a tragic incident unfolded on board a bulk carrier, claiming the life of a cadet who had spent three months on board.
What happened
On 12 November 2022, aboard a bulk carrier off the western coast of Africa, a sequence of events unfolded that tragically led to the death of the deck cadet (DC). At the time of the incident, the ship was carrying approximately 46,000 MT of Nickel Ore, with the no. 5 cargo hold loaded to an estimated 47%. The ship had several Heavy Fuel Oil (HFO) tanks, including the no. 2 HFO tank (port), which emitted vapours from vents with approximately 170 MT low Sulphur fuel (0.49% of Sulphur content). The ship’s chief officer (CO) tasked the fitter with conducting repairs in the no. 5 cargo hold, and both began preparations around 0800 hours. They noticed a strong smell of fumes emanating from a vent associated with the no. 2 HFO tank port.
The fitter assured the DC that the repair wouldn’t take long, and the work began once the bosun opened the hatch cover, taking approximately 15 to 20 minutes. The DC assisted the fitter by passing equipment into the cargo hold while standing near the HFO tank vent on the main deck. Both exited the cargo hold around 1115 hours, with the DC expressing discomfort. The following day, the DC reported feeling unwell to the CO, mentioning a headache and attributing it to inhaling fumes from the HFO tank vent the previous day. The CO advised rest and informed the ship’s master. The DC’s condition gradually
worsened over the next few days, marked by reduced food consumption and diarrhoea.
Efforts were made to provide medical advice through communication with the crewing manager and a medical professional. The advice was to place the DC on a light diet. On 20 November, while the ship was sailing near the Cape of Good Hope, the master advised the DC to remain in his cabin due to choppy seas.
On 24 November 2022, citing that the DC had been experiencing dizziness, vomiting and diarrhoea, the master contacted the crewing manager to discuss the possibility of signing off the DC at Mauritius (ETA – 28 November 2022). It was decided that the second officer should accompany the DC’s sign-off, while the company-initiated plans for the DC to seek medical attention in Mauritius. Attempts were made to encourage the DC to consume food and receive medical advice, but his condition continued to deteriorate.
On 25 November, the DC’s condition deteriorated significantly, and he was found unresponsive by another deck cadet (DC 2) tasked with monitoring his condition every two hours. CPR was initiated, but the DC did not show any vital signs, and he was declared deceased.
According to Britannia Club, this tragic incident highlights the need for effective safety measures, crew training and awareness of potential health hazards on board ships. it also serves as a reminder of the importance of timely medical intervention and communication with medical professionals in the event of crew member’s health issues at sea.
Experience of the crew member
The DC had been on board for three months, and this was his first time on a ship. He had received familiarisation training as per the Safety Management System (SMS). However, there was no specific familiarisation training on the risks associated with shipboard operations for cadets or trainees who were on their first ship. Due to his lack of experience and inadequate supervision while performing his duties, the DC was not aware of the risks associated with inhaling fumes rom HFO. Although he found it uncomfortable to breathe the fumes, his inexperience left him unsure of what steps to take, such as seeking an alternative method to complete the task.
Nature of work
The fitter was tasked by the chief officer to carry out some repair work inside no.5 cargo hold and the fitter prepared the items needed for the repair with the DC. When the bosun opened the hatch cover, both the fitter and the DC were waiting near no. 2 HFO tank port and noticed a strong smell of fumes from the vent of HFO tank. The DC lowered equipment required for repair into the hold standing on the raised steps aft of the HFO tank vent.
It is unclear from the casualty investigation report whether a permit-to-work system was followed and if a permit was issued for the Hot Work conducted in the cargo hold. Typically, such a job requires a risk assessment to identify associated risks, necessary safeguards, the appointment of a responsible officer not involved in the Hot Work, a work plan meeting to identify personnel, equipment, PPE, a detailed operation plan, a toolbox meeting at the work site, and a cease-task system to halt work if it becomes unsafe.
If the above procedures had been followed, they would have identified the DC’s lack of experience as a risk. The DC should have accompanied another crew member with suitable experience. A responsible officer monitoring safety at the work site would have noticed the proximity of where equipment was lowered into the cargo hold to the bunker vent, which was venting fumes. A cease-task system or a similar mechanism could have allowed the fitter and DC to abort the task when they both sensed strong fumes and select an alternative access point to lower equipment into the hold. A typical SMS may prohibit deck cadets and trainees from performing such tasks as part of Hot Work, without guidance and supervision from experienced crew members.
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