This report provides an analysis of marine incidents reported in the 2022 calendar year with trends from 2019-2022 for Domestic Commercial Vessels (DCVs) and from 2018-2022 for foreign-flagged vessels and Regulated Australian Vessels (RAVs).
This report provides an analysis of marine incidents reported in the 2022 calendar year with trends from 2019-20221 for Domestic Commercial Vessels (DCVs)2 and from 2018-2022 for foreign-flagged vessels and Regulated Australian Vessels (RAVs).
Marine incident data from this report in combination with other safety data including inspections and investigations data and further supporting research is used to identify safety issues. AMSA considers all this safety data in the development of the National Compliance Plan, where targeted activities to address identified safety issues for the 2023-2024 financial year are set out.
This report is not intended as a complete overview and/or comprehensive technical analysis.
Apart from marine incident reports AMSA also receives notifications relating to marine safety concerns which are processed and recorded in the same way as marine incidents. However, unlike marine incidents which are required to be reported by the master, owner/operator of a vessel, Vessel Traffic Services and Pilotage providers, marine safety concerns can be reported by anyone who observes an incident that may endanger, or if not corrected could endanger, the safety of a commercial vessel or persons on board a commercial vessel to AMSA.
Classification of marine incident reports and follow up investigations
AMSA classifies all reported marine incidents into one or more occurrence types4 to consistently describe what happened and help identify patterns and areas for further analyses.
The focus of this report is on consequence, technical and operational occurrence-types and their sub-types as these comprise the majority of reports received by AMSA.
In addition to classifying types of incidents based on what happened, AMSA reviews and classifies domestic commercial vessels (DCV) investigation reports to describe how and why the incident occurred using a safety framework. Marine incidents are a result of many factors and underlying safety issues that often are not directly linked to the incident – such as organisational issues. To capture underlying safety factors, AMSA developed and maintains a maritime safety framework based on research and data to classify investigation findings.
A list of acronyms and definitions as well as extra information on the classification used in marine incidents is available on the AMSA website.
Footnotes
1. DCVs operating under the Marine Safety (Domestic Commercial Vessel) National Law Act 2012 (the National Law) commenced marine incident reporting to AMSA in July 2018.
2. AMSA also publishes monthly updates of very serious and serious incidents for DCVs and monthly safety lessons briefs based on marine investigation reports which are intended to target owners, operators and crew.
4. Note that multiple occurrence types can apply to the same incident. For example, an incident may include more than one consequence (i.e. collision and injuries).
In 2022, AMSA received a total of 5159 marine incident reports and 404 marine safety concerns from foreign-flagged vessels, Regulated Australian Vessels (RAVs) and Domestic Commercial Vessels (DCVs).
Marine incident reporting has increased in the last few years. In 2022 there was a 10.1% increase in reports received from 2021.
Figure 1 shows the total marine incidents reported by commercial vessels operating within Australia’s maritime jurisdiction, or in preparation to enter Australia’s maritime jurisdiction,5 between 2018 and 20226.
Footnotes
5. Whilst foreign-flagged vessels are required to report marine incidents to AMSA when they occur within Australian waters, AMSA often receives reports from foreign flagged vessels in all stages of their journey to or from Australian ports. Unless otherwise noted, incidents reported by foreign flagged vessels are not limited to Australian waters.
6. Note that DCVs are excluded from 2018 in Figure 1 as per footnote 1.
In 2022 AMSA received a total of 1054 reports of marine incidents involving DCVs which is an increase of 11.5% from 2021 and represents a 41.5% increase in the annual number of incident reports from DCV’s since 2019 (Figure 2).
In 2022
there was an increase of 129 (4.9%) less serious incidents reported from 2021
there was a decrease of 22 (5.1%) serious incidents reported from 2021
very serious incidents remained low but did increase from 6 in 2021 to 8 in 2022.
When considering incident reports by vessel class (Figure 3, Tables 1 and A1) results show:
In 2022, passenger vessels continue to demonstrate a good reporting culture in relation to all other classes of vessels. Passenger vessels which account for a relatively small proportion (9.1%) of the DCV fleet reported almost half (47.5%) of all DCV incidents in 2022. This represented an increase of 27.3% from 2021 in incidents reported from passenger vessels.
In 2022, fishing vessels and hire & drive continue to be under-represented in marine incident reporting. Fishing vessels which account for 28.3% of the fleet reported 10.8% of all incidents in 2022. This outcome is consistent with 2021 data where fishing vessels reported 11.2% of all incidents. In 2022 fishing vessels reported 46.5% of serious incidents. This rate is 22.8% higher than the average rate of serious incidents reported across all vessel classes. Additionally hire & drive vessels which account for 13.8% of the DCV fleet reported 7% of all incidents in 2022.
Table 1 DCV marine incident reports by vessel class (2019-2022)
Vessel type
2019
2020
2021
2022
Passenger
333
264
393
500
Non-passenger
217
313
371
366
Fishing
116
115
106
114
Hire & drive
78
66
75
74
The rate of incident reporting by State varied greatly across Australia (Figure 4, Table A2). Figure 4 shows the proportion of incidents reported by State with information added on the proportion of the fleet in each state. The highest rates of incident reporting were from QLD, NT and WA.
In 2022 there were no operational-related fatalities associated with DCV vessel operations.
Between 2018 and 2022, there were 11 operational-related fatalities on DCVs (9 crew and 2 passengers) associated with 11 marine incidents. Seven (63.6%) of these occurred on fishing vessels (Table 2).
Table 2 DCV fatalities by year, state and vessel class, (2018-2022)
NSW
Vessel class
2018
2019
2020
2021
2022
Passenger
0
0
0
0
0
Non-passenger
0
1 (passenger)
0
1 (crew)
0
NT
Vessel class
2018
2019
2020
2021
2022
Non-passenger
0
0
0
0
0
Fishing
1 (crew)
0
1 (crew)
0
0
QLD
Vessel class
2018
2019
2020
2021
2022
Non-passenger
0
0
1 (crew)
0
0
Fishing
0
2 (crew)
0
0
0
TAS
Vessel class
2018
2019
2020
2021
2022
Fishing
0
0
1 (crew)
1 (crew)
0
WA
Vessel class
2018
2019
2020
2021
2022
Passenger
0
0
0
1 (passenger)
0
In 2022, the fatality rate (the number of fatalities per 100,000 crew employed on DCVs) was 1.8. This remains lower than the five-year average annual fatality rate of 2.7 per 100,000 crew7 and lower than the fatality rate for Agriculture, forestry & fishing and Transport postal & warehousing reported in 2021 (Table 3).
Table 3 Fatality rate per 100,000 crew employed on DCVs compared to similar industries8
Year of incident
Number of operational-related crew fatalities on DCV fatalities
Domestic commercial vessels fatality rate per 100,000 crew9
Agriculture, forestry & fishing fatality rate per 100,000 workers
Transport, postal & warehousing fatality rate per 100,000 workers
2018
1
1.5
11.2
5.9
2019
2
3.0
9.4
9.0
2020
4
6.1
13.1
7.8
2021
2
3
10.4
7.9
2022
0
0
*
*
Five-year average
(2017-2021)
3.4
5.2
12.1
7.8
Five-year average
(2018-2022)
1.8
2.7
*
*
Injuries
In 2022, 18.3% (196) of incidents on DCV’s included reports of an injury to a crew member or passenger.10
Table 4 Incidents on DCVs with reported injuries to a crew member or passenger, total and as a proportion of all incidents (2019-2022)11
Consequence
2019
2020
2021
2022
Total
% DCV incidents
Total
% DCV incidents
Total
% DCV incidents
Total
% DCV incidents
Injury to crew
84
11.3%
78
10.3%
108
11.4%
114
10.8%
Injury to passengers
65
8.7%
52
6.9%
72
7.6%
82
7.8%
Injury (total)
148
19.9%
131
17.3%
179
18.9%
193
18.3%
In 2022 the total number of injuries reported to AMSA increased by 32.0% from 2021. This is largely due to reports of injuries to passengers (Figure 5).
In 2022 the total passenger injuries reported increased by 68.1% from 2021. This is mainly due to a single incident involving a high-speed thrill ride in which a high number of passenger injuries, including serious injuries were sustained. This single incident also accounted for a 100% increase in serious injuries to passengers in 2022 from 2021. The number of serious injuries to crew has increased from 39 in 2021 to 44 in 2022 but generally has remained more or less steady across the last 4 years.
More than half (54.5%) of the serious crew injuries in 2022 were reported by non-passenger vessels, followed by fishing (27.3%) and passenger (18.2%) vessels.
In 2022, most crew injuries were associated with shortfalls in the control and navigation of the vessel (36.9%) followed by operational access (25.2%) and cargo handling and stores (17.5%) (Figure 6). Examples of injuries associated with the control and navigation included head injuries requiring medevac when a vessel ran aground on a reef at speed, the vessel was navigating using an old route in plotter that hadn’t been reviewed prior to sailing. In another instance a sole operator was thrown overboard and sustained serious foot and chest injuries when their attention was diverted from navigating the vessel after they dropped their phone. Whilst looking at deck to retrieve phone, the vessel made heavy contact with a navigation marker.
Examples of injuries associated with operational access were broken fingers and hand when an unsecured hatch closed on a crew member’s hand with the hatch strap flicking onto hand and breaking fingers. There were several instances of crew members slipping on fenders or gunwales when transferring between vessels and landing in water or heavily on deck, slipping and falling heavily on engine room ladders due to oil residue on boot or on ladder.
This pattern was similar across all classes of vessels except for fishing, where most injuries were associated with Cargo handling and stores (44.4%) followed by Dangerous fauna (22.2%) and Vessel control and navigation (Table A3).
Persons overboard
In 2022 AMSA received 87 reports of incidents involving person overboard (POB) from DCVs representing a 19.2% increase from 2021. Passenger vessels reported the majority (50.7%) of all POB incidents.
In 2022, 17 POB incidents were classified as ‘intentional’ and 70 were classified as ‘unintentional’.12
Of the 70 ‘unintentional’ POB incidents (Figure 7, Table A4):
39 involved crew members overboard
21 involved persons overboard not wearing a lifejacket and 22 where unknown if wearing a lifejacket
19 involved crew members who were wearing a lifejacket
6 involved passengers who were wearing a lifejacket
46 involved vessels between 7.5m and 35m in length, with vessels in this group making up 39.9% of DCV’s (Figure 8)
6 incidents involved crew and 12 involved passengers overboard where it was reported that more than one person entered the water
Footnotes
7.The actual number of fatalities must be considered when interpreting the fatality rates for this data due to the difference the size of the respective workforces. As noted in Work-related traumatic injury fatalities Australia 2021 by SafeWork Australia, fatality rates are sensitive to the number of people employed in the industry. In smaller industries that employ fewer employees (such as in the DCV fleet), a small variation in the number of fatalities produces an apparent larger variation in the fatality rate. Compared to the estimated 66,000 crew engaged in the DCV fleet, agriculture/forestry and fishing fatality rates are calculated from nearly five times the number of workers (approximately 317,300) and transport/postal and warehousing rates from nearly ten times (approximately 658,200).
9. Based on a calculated approximation of 66,000 crew engaged on domestic commercial vessels.
10. All incidents reporting serious operational injuries to crew or passengers are classified as serious.
11. Incidents may report injuries to crew and passengers. In both 2019 and 2020 AMSA received one report of an injury to a stevedore in relation to the operation of a DCV.
12. AMSA classifies a POB as unintentional when the persons going overboard was associated with of the operation of the vessel.
Over half (55.1%) of marine incidents in 2022 included a vessel consequence outcome. The three most frequently occurring consequences on DCVs in 2022 were collisions, groundings and contacts (with something other than a vessel) (Figure 9, Table A5).
In 2022:
Collisions, groundings and/or contacts accounted for 54.3% (75) of the total very serious and serious (138) incidents involving consequences to a vessel. This represents a 4.3% decrease from the proportion in 2021 (58.6%) (Figure 10).
Grounding incident reports increased by 52.1% from 2021(Figure 9) and comprised the majority of serious vessel consequences (Figure 10).
The most frequently reported consequence across all severity levels for each vessel class in 2022 were (Table A5):
Passenger: Contact (26.0%)
Non-passenger: Contact (25.2%)
Fishing: Foundering/sinking/loss (20.5%)
Hire and drive: Collision (42.3%)
Figure 10 shows the vessel consequence type for very serious and serious incidents by vessel class.
Consistent with crew injury incidents, shortfalls in the control and navigation of a vessel were reported in 46.3% (285) of vessel consequence incidents, followed by 19.6 % (124) for weather/water conditions and 12.7% (74) for power, propulsion and steering failures.
There were 8 very serious DCV incidents in 2022 all involving very serious consequences to the vessel resulting in a total loss or being lost at sea (Table 5).
Table 5 Very serious incident vessel consequence and circumstance (2022)
Since 2020, 9.5% of all marine incidents reported shortfalls in the operation of the vessel.
Since 2020, vessel control and navigation issues accounted for 28.3% (306) of all Operational related incidents. This is followed by cargo handling issues resulting in 26.1% (283) and maintenance resulting in 19.5% (211) of Operational related incidents (Figure 30).
In 2022, cargo handling and stores (80) for the first time surpassed vessel control and navigational (78) issues.
Figure 31 shows the most frequent issues associated with the operational occurrences for 2022. 42.5% (34) of the cargo handling incidents occurred during loading and unloading. 44.9% (35) of vessel control and navigation incidents occurred during berthing and unberthing and mooring operations and 58.9% (33) of operational access incidents occurred while climbing or descending ladders or stairs.
Between 2019 and 2022, 84.0% (12,363) of marine incidents included a Technical occurrence type. There was a steady increase in technical occurrences from 2019 to 2022, with 2022 resulting in a total of 3702 technical occurrences with 4.5% (126) of technical occurrence categorised as very serious or serious incidents (Figure 26, Table A9).
In 2022, vessel system failures comprised the majority of technical occurrence types having increased steadily from 263 in 2019 to 653 in 2022 (Figure 26). This increase is attributed to a significant increase in the reporting of ballast system failures from 57 in 2019, to 343 in 2022 (Figure 27).
In 2022, 17.3 % (639) of technical occurrences involved power, propulsion and/ steering system failures. Main engine and gearing failures were the most frequently reported technical failures and were amongst the top 3 technical occurrences for all vessel types except passenger vessels (Figure 27, Table A-10).
Figure 27 shows the top 10 failures in equipment associated with propulsion, power/steering; engineering systems, cargo and stores, and vessel access in 2022. These included:
356 reported failures related to main engine and gearing, 14.3% (51) of these were categorised as serious incidents.
343 reports of issues with ballast systems. 82.2% (282) of these issues occurred on bulk carriers.
211 reported failures of mooring and anchoring systems. 69.2% (146) of these failures were reported on bulk carriers.
198 reported failures of pilot/combination ladder.
Figure 28 includes the top 10 failures in equipment associated with navigation and communication for 2022.
235 Radar and 110 Voyage Data Recorder failures accounted for 53.3% of the 647 navigation monitoring equipment failures reported in 2022.
198 reports were of issues with a vessel GMDSS.
Figure 29 includes the more frequently occurring failures in equipment associated with firefighting and lifesaving.
72 reports were of a failure of a lifeboat. One of these was a serious incident where a lifeboat capsized when being launched resulting in two crew overboard.
59 reports of issues with fire detection equipment. This category included reports of faults with alarm panels and detectors.
59 reports of issues with rescue boats. Many of these were reports of faulty davit gears and motors or hydraulics requiring repairs.
This section presents the findings from the safety framework coding of completed DCV investigation reports. The findings provide an understanding of safety issues and identifies if, and where, greater compliance focus needs to be applied.
Between 2020 and 2022, 178 DCV marine incident investigation reports were coded using the safety framework.14
From the 178 investigations coded, the majority of consequences resulted in crew injuries (19.7%) followed by contacts (13.6%), collisions (12.9%), and groundings 12.9% (Figure 16).
A total of 804 safety factors were identified from the 178 investigation reports analysed.
Aspects related to people (27.0%), and internal organisational issues (30.2%) continue to form the majority of safety factors (Figure 17).
The analyses presented will focus on the three primary safety factors of concern, people, onboard condition, and organisational influences (internal) for the 178 coded investigation reports.
People
People actions refer to observable behaviours such as decisions, actions and/or inaction by the crew that increased risk.
Of the people actions identified, the 38.7% (84) were Navigation actions, followed by 36.4% (79) of Deck operation actions and14.3% (31) of Maintenance actions (Figure 18).
Navigation actions comprised shortfalls in assessing and planning (25.0% (21)), monitoring/checking/documenting (25.0% (21)), using equipment (21.4% (18)), communicating and coordinating (13.1% (11)) and other navigation actions (15.5% (8)).
Assessing and planning issues included no passage planning, incorrect assessment of the safety risk when taking certain course of action and making inappropriate plans to rectify the situation. Problems with monitoring/checking/documenting included poor monitoring of the status of the voyage, poor lookout and lack of monitoring of environmental conditions.
Onboard conditions
Onboard conditions include onboard conditions that impact safety such as knowledge skills and experience to perform tasks onboard, internal and external factors influencing personal performance and wellbeing and the social environment.
Safety factors related to onboard conditions are evenly distributed with 31 (34.4%) associated with knowledge, skills, experience, 31 (34.4%) with personal factors which includes fatigue and 27 (30.0%) with task demands (Figure 19).
Knowledge skills and experience issues identified in investigation reports included lack of knowledge in the operation of key machinery and safety systems onboard the vessel and in performing key tasks such as anchoring or responding to emergencies.
Shortage of skilled and competent crew are associated with factors including pressure to complete tasks, high workload and fatigue.
Internal organisational influences
A significant portion of the risks to safety of vessels and crews reside at the organisational level.
Safety management processes comprise most of the internal organisational issues, forming 65.8% (160) of the total internal organisational issues. Investigation reports identified shortfalls associated with the processes an organisation uses to establish, maintain, and otherwise ensure the effectiveness of its risk controls as factors affecting onboard safety. Poor, lack of or ineffective risk assessments continue to be major areas of concern in DCV fleet incidents and operations. 38.1% (61) were associated with shortfalls in risk assessment and 35.6% (57) related to Safety Procedures (35.6%) and both continue to represent the majority of safety management system issues (Figure 20).
Footnotes
14.Note that subsequent to the publication of the 2021 annual report, a further 39 investigations into incidents which occurred in 2020 and 2021 were coded using the safety framework.
In 2022 AMSA received a total of 4105 reports of marine incidents from Regulated Australian Vessels (RAV) and Foreign Flagged (FF) vessels. 268 of the reported marine incidents were from RAVs.15 5.6% (231) of all incidents reported were classified as very serious or serious.
There continues to be an increasing annual trend in the reporting of marine incidents since 2018 with 2022 showing an increase of 9.8% from 2021. This is a positive trend particularly as in 2022, there was a decrease of 2.2% in the proportion of very serious and serious incidents reported from 2021 (Figure 21).
Consistent with port arrivals data16 most marine incident reports from foreign flagged vessels in 2022 were from bulk carriers. Bulk carriers which account for 54.0% of the foreign flag arrivals reported 65.2% (2502) of incidents in 2022, but only 48.4% (92) of very serious and serious incidents.17 Container vessels which account for 14.6% of the foreign flag arrivals reported 11.9% (458) of incidents in 2022, and 17.9% (34) of very serious and serious incidents. Similarly, general cargo/multi-purpose vessels accounted for 4.4% of arrivals, 4.2% (161) of incidents and 7.4% (14) of very serious and serious incidents (Figure 22, Table A7).
Footnotes
15. The low number of incident reports compared to foreign-flagged vessels means that RAV data lacks the statistical power to support meaningful trend analysis; hence we have not included further analysis of RAVs.
17. It is not uncommon for bulk carriers to submit multiple reports of minor equipment and/or machinery defects or failures at the same time and such reports would often be captured as separate less serious incidents.
In 2022 there were two operational related seafarer fatalities on foreign flagged vessels. There were no passenger fatalities reported in 2022.
Detailed reporting on vessel crew fatalities is contained in the Maritime Labour Convention Annual Report 2022.18
Injuries
In 2022, a total of 170 injuries of crew and passengers were reported from RAVs (38) and foreign flag (132) vessels (Table 6). Of these, 56 were categorised as serious injuries.
Table 6 Incidents that include a reported injury to a crew member or passenger, total and as a proportion of all incidents 2019-2022
Consequence
2019
2020
2021
2022
Total
% incidents
Total
% incidents
Total
% incidents
Total
% incidents
RAV
Injury to crew
36
14.7%
60
18.1%
38
19.5%
37
13.8%
Injury to passengers
2
0.8%
1
0.3%
3
1.5%
1
0.4%
Foreign flag
Injury to crew
177
5.7%
126
4.0%
158
4.5%
114
3.0%
Injury to passengers
102
3.3%
24
0.8%
1
0.0%
18
0.5%
The proportion of serious crew injury incidents on foreign flag vessels was 36.8% (42) in 2022, which represents a reduction from the 37.3% (59) in 2021.
In 2022, most injuries were reported from bulk carriers with 43.6% (68) of incidents involving crew injuries of which 46.4% (24) were serious injuries.
Most injuries were associated with operational access followed by maintenance. Although maintenance was more frequently associated with incidents resulting in serious injuries (Figure 23, Table A8).
Persons overboard
In 2022, 10 persons overboard (POB) incidents were reported with 3 of these associated with the operation of the vessel which occurred during a vessel-to-vessel transfer. These involved:
A surveyor attending a foreign flag vessel at anchor fell when transferring between vessel combination ladder to a small vessel.
Two RAV incidents both of which involved crew falling into the water when transferring between a tug and another vessel.
Footnotes
18. The MLC Annual 2022 report contains a detailed breakdown of seafarer fatalities on international commercial vessels in Australian waters including person overboard incidents.
In 2022, 4.9% (187) of incidents involved a vessel consequence. 63 of these incidents resulted in very serious or serious vessel consequences.
Figure 24 shows the most frequently occurring vessel consequences between 2020 to 2022.
In 2022 the most frequently occurring consequences included contact (17.1% (32)) and hull damage (9.6% (18)). Fire was the third most frequently reported vessel consequence incidents in 2022 accounting for 9.1% (17).
Incidents reporting total power failure decreased from 10.2% (21) in 2021 to 8.6% (16) in 2022. Similarly, incidents reporting vessels being disabled20 also decreased from 16.0% (33) in 2021 to 7.0% (13) in 2022 (Figure 24).
In 2022, 24.1% (45) of vessel consequences were associated with failures in power, propulsion and/or steering with 32.3% (20) categorised as very serious and serious (Figure 25). This presents a serious concern with planned maintenance shortfalls continuing to be a focus of AMSA’s education and inspection compliance activities.
This is followed by operational shortcomings in the control or navigation of the vessel which were associated with 21.9% (41) of vessel consequences of which 25.8% (16) were categorised as very serious and serious. One very serious vessel consequence involved a vessel colliding with two tugs berthed alongside causing the loss of both tugs.21
Footnotes
20. Vessel Disabled incidents reflect incidents where a vessel was unable to make way due to loss of propulsion machinery or because of a d total loss of vessel’s power. Total power failure incidents reflect occurrences where vessels experienced a blackout either for a short period of time before power or emergency power was restored, or for an extended period, however due to circumstances the vessel was not ‘disabled’ (e.g., was at anchor, alongside).
Between 2019-2022, 29.3% (957) of DCV marine incidents included a technical equipment failure with power propulsion and steering comprising 50.0% (519) of technical occurrence types (Figure 14).
The majority of power propulsion and steering technical occurrence types (green in Figure 14) in 2022 were main engine and/or gearing failures (50.3%).
In 2022, 81.6% of vessel system technical occurrence types (yellow) were mooring and anchoring equipment failures.
The majority of engineering systems occurrence types (light blue) included fuel (28.3%), electrical faults (19.6%) and hydraulic system failures (15.2%). Electrical failures pose a significant concern noting the fire risks associated with faulty electrical systems (Figure 15, Table A6).
Half of DCV marine incidents between 2019-2022 reported shortfalls in the operation of the vessel.
In 2022 one third of incidents were due to shortfalls in vessel control and navigation (Figure 12). This is consistent with the 2019-2022 data which shows that 4 of the 5 top operational issues for every vessel class involved control and navigation operational failure (Table A6). This was followed by shortfalls in operational access (61) and communication (34).
Figure 13 shows a breakdown of vessel control and navigation and other operational occurrence types.
In 2022, of the 347 occurrence types related to vessel control and navigation, 131 (37.8%) were associated with shortfalls in lookout/collision avoidance, 82 (23.6%) with vessel handling/loss of control and 40 (11.5%) with berthing/unberthing (Figure 13).