Environmental and Occupational Injuries Aboard Ship

Environmental and Occupational Injuries Aboard Ship

Seafarers face a unique mix of environmental hazards — extreme temperatures, chemical exposure, electrical equipment, and the ever-present risk of falling overboard. Recognizing these injuries quickly and acting correctly before a physician can be reached can mean the difference between life and death. This lesson covers six injury types you must know for watchkeeping duty and for your STCW Basic Training certification.

Hypothermia and Cold-Water Immersion

Hypothermia occurs when the body's core temperature drops below 95 °F (35 °C). Water conducts heat away from the body far faster than air, so cold-water immersion can produce hypothermia within minutes in very cold seas.

Stages and signs:

• Mild: shivering, confusion, clumsiness
• Moderate: shivering stops (a dangerous sign), muscle stiffness, drowsiness
• Severe: unconsciousness, very slow or absent pulse, dilated pupils

First aid — rewarming sequence:

1. Remove the casualty from the cold environment carefully — rough handling can trigger cardiac arrest.

2. Remove wet clothing if possible; handle the person gently.

3. Insulate with blankets; apply heat packs wrapped in cloth to the armpits, neck, and groin (never directly on skin).

4. Keep the person horizontal; do not allow them to walk.

5. If conscious, give warm, sweet drinks — never alcohol.

6. Seek urgent medical evacuation for moderate or severe cases.

Immersion foot (trench foot) results from prolonged exposure to cold, wet conditions above freezing. Signs are numbness, pale or mottled skin, and swelling. Rewarm gently, keep dry, and do not rub the affected area.

Heat Exhaustion vs. Heat Stroke

Engine rooms and weather decks in tropical waters create serious heat illness risk.

| Feature | Heat Exhaustion | Heat Stroke |

|---|---|---|

| Skin | Pale, cool, sweaty | Hot, red, may be dry |

| Mental state | Alert or mildly confused | Confused, combative, or unconscious |

| Core temperature | Below 104 °F (40 °C) | 104 °F (40 °C) or above |

Heat exhaustion: Move to a cool area, loosen clothing, give cool water if conscious, apply cool wet cloths. Most patients recover with these measures.

Heat stroke is a life-threatening emergency. Cool the casualty rapidly by any available means — cool water spray with fanning, ice packs to neck, armpits, and groin, or immersion if resources allow. Do not give fluids to an altered or unconscious person. Arrange urgent medical evacuation.

Chemical Splash — Eye and Skin Exposure

Shipboard chemicals include cleaning agents, battery acid, refrigerants, and cargo residues. The Safety Data Sheet (SDS) for each chemical must be kept accessible aboard and lists the correct first aid response.

General rule: Flush immediately and continuously with clean water. For the eye, hold the eyelid open and irrigate from the inner corner outward. The SDS specifies minimum irrigation duration — commonly at least 15 minutes, but some corrosive chemicals require longer. Follow the SDS exactly.

Key points:

• Do not neutralize an acid with a base or vice versa on the skin — this can cause additional chemical reactions and injury.
• Remove contaminated clothing while flushing.
• After irrigation, cover the eye loosely with a clean dressing and seek medical advice.
• Wear chemical splash goggles and appropriate PPE when handling hazardous chemicals — prevention is the first line of defense.

Electrical Shock

Scene safety is your first priority. Never touch a person who may still be in contact with a live electrical source — you will become a second casualty.

Steps:

1. De-energize the circuit using the correct lockout/tagout procedure or the breaker before approaching.

2. Only when confirmed safe, approach the casualty.

3. Check responsiveness, breathing, and pulse; begin CPR if indicated.

4. Treat burns at the entry and exit points as thermal burns.

5. Even if the person appears fine, arrange medical evaluation — internal injuries and delayed cardiac arrhythmias can occur.

Decompression Illness

Relevant for divers working on underwater hull inspections or salvage operations. Decompression illness (DCI) results from nitrogen bubbles forming in tissues when a diver ascends too quickly.

Signs: joint pain, skin mottling, weakness or paralysis, shortness of breath, altered mental status.

First aid:

1. Lay the casualty flat (do not elevate the legs).

2. Administer 100% oxygen continuously — this is the single most important pre-hospital treatment; it promotes nitrogen elimination.

3. Keep the person warm and give oral fluids if conscious and able to swallow.

4. Arrange urgent medical evacuation to a recompression chamber. Do not delay.

Using the Ship Captain's Medical Guide

The Ship Captain's Medical Guide is the standard shipboard medical reference for vessels without a physician aboard. It provides step-by-step guidance for diagnosing and treating injuries at sea. Always cross-reference your assessment with this guide and follow company and flag-state medical radio advice when available.

Summary

For any environmental or occupational injury: ensure scene safety first, protect yourself with appropriate PPE, assess the casualty using a systematic approach, apply correct first aid, consult the Ship Captain's Medical Guide and SDS as needed, and arrange medical evacuation whenever the injury exceeds your capability to manage aboard.