We are pleased to publish the first marine incident annual report for regulated Australian and foreign flagged commercial vessels in Australian waters. 

The 2019 annual report presents an analysis of marine incidents including fatalities reported to AMSA. It provides an insight into reported marine incident data between 2016 and 2019 in Australian waters. The report aims to provide an overview of current trends over the last 4 years in maritime safety.

Marine incident reporting helps inform proactive and reactive approaches to managing safety. The information from these marine incident reports is used reactively by implementing control measures on a case-by-case basis, and proactively by analysing trends and implementing more systemic measures.

Introduction

Marine incident reporting is an important source of information that informs both regulation and approaches to managing safety. Additionally, findings from analyses of marine incident reports allows AMSA to use this information to shape our annual compliance plans. 

AMSA has been working to improve the collection and use of marine incident data so that it can be used to better inform education and compliance activities. This report provides a historical trend of data between 2016 to 2019, with a particular focus on 2019 data.

While marine incident reporting is mandatory, it is also important from a safety perspective as reporting informs the ongoing safety of operations, people and vessels.

AMSA’s incident report allow those making a report to identify shortfalls in the risk assessment and subsequently review and update the vessel’s safety management system. This information assures AMSA as the regulator that the owner, operator and master have an understanding of the safety issues that contributed to the marine incident and have implemented effective control measures to learn from incidents and prevent recurrence.

AMSA also has in place a mechanism for reporting marine safety concerns. This is available for anyone to report. A marine safety concern provides the opportunity to report any incidents observed that endangers, or if not corrected could endanger, the safety of vessels or persons. AMSA deals with marine safety concerns in the same way as it deals with incident reports.

Reporting assists AMSA in responding quickly and efficiently to a marine incident when it occurs. This is done with the intention of ensuring that appropriate control measures are implemented to prevent a re-occurrence.

Further information is available on our incident reporting page.

In 2019, there were 28,584 port arrivals by 5981 foreign-flagged vessels in Australian ports. While this is a decrease in port arrivals by 1.8% from 2018, there was an increase in the number of unique ships by 1.4%.

Bulk carriers accounted for the majority (50.4%) of foreign flag port arrivals in 2019, with container vessels being the next most common (15.2%).²

The proportion of port arrivals by vessel type remained relatively consistent across the years (Figure 3), with bulk carriers dominating.

^{Footnote: 2 ‘Other’ vessel types includes tugs, offshore service vessels and other vessel types.}

Reported marine incidents

Between 2016 and 2019, AMSA received a total of 12,349 marine incident reports.

There was an increasing number of reports received each successive year.

The increase in reporting trends specifically of less serious incidents across each year is viewed as a positive trend with more awareness on the importance of reporting marine incidents (Figure 4).

In 2019, there was a total of 3371 marine incidents reported to AMSA.

Marine incidents are classified by AMSA into one of three severity levels, as described below:

AMSA also classifies injuries into one of two categories as below:

On average, 96.4% of incidents reported each year are less serious incidents. The number of very serious incidents has been stable over the last four years with a total of seven very serious incidents reported between the 2016 to 2019 period. One occurred in 2016 and two annually from 2017 through 2019. 

In 2019, 0.06% of reported incidents were very serious (2), 4.2% serious (141) and 95.8% less serious (3228).

Reported incidents by vessel type 

Between 2016 and 2019, 4909 unique vessels were associated with the 12,349 marine incident reports. This represents an average of 2.5 incidents reported per vessel over the four year period. Annually, the average of 1.7 incidents reported per vessel has remained consistent. 

In 2019, 2004 unique vessels were involved in the 3371 marine incidents reported.

In 2019, the majority (54.5%) of incident reports came from bulk carriers followed by container vessels. This is consistent with previous years’ data.

Figure 8 represents the annual percentage of reported incidents in relation to the percentage of port arrivals from 2016 to 2019. Although the results show consistency across the years in the proportion of reported incidents as related to the proportion of port arrivals, there are some minor differences. For example, between 2018 and 2019 the increase in the bulk carrier sector did not result in an increase in reporting. 

In 2019, bulk carriers represented 55.4% of reported marine incidents and 50.4% of port arrivals. Although passenger vessels only represented 3.9% of port arrivals, they represented 7.1% of reported incidents. Similarly, special purpose vessels represented 1.4% of 2019 port arrivals but 4.3% of reported incidents.

The proportion of very serious and serious incidents in relation to less serious incidents varies by the type of vessel. Although bulk carriers have the highest number of reported incidents, the rate of very serious and serious incidents is proportionally lower (3.2%) when compared to other vessel types. The ‘other’ vessel types (which include tugs, offshore service vessels and other) represent the highest proportion (9.9%) of very serious and serious incidents. This is followed by 7.9% for passenger vessels and 7.7 % for special purpose vessels.

Reported incidents by location

Most incidents in 2019 occurred while the vessel was within port limits (44.2%) with a similar percentage (42.8%) occurring outside of coastal waters3 but within the limits of the exclusive economic zone (EEZ).

Reported incidents by age of vessel

In 2019, vessels more than 15 years old represented approximately 8% of port arrivals and 24% of reported incidents.

^{Footnote 3: Coastal waters incidents occur within 3 nautical miles offshore.}

Incidents are usually the result of a complex set of circumstances, often involving a chain of events. To gain a better understanding of what incident reports are telling us, AMSA categorises all incident reports into one or more ‘occurrence types’, to consistently describe what happened in each incident. Classifying incidents in this way helps to understand patterns of what has taken place and identify potential areas for safety improvement. 

The categorisation of incidents does not explain why a marine incident happened—it describes what occurred. 

Incident categories 

The coding of all incident reports into occurrence types consists of a three-level hierarchy. The first level of the hierarchy is categorised into the following occurrence type groupings:

The table below provides a descriptor of each of the level 1 occurrence types.

Each of the level 1 occurrence types are sub-divided into a number of related level 2 occurrence types. In turn, level 2 occurrence types are further sub-divided into level 3 occurrence types. The hierarchical nature of the occurrence types is of fundamental importance, as it helps in the identification of trends. For example, a series of incidents may be seen to be unrelated as they reflect collisions with other vessels, collisions with wharves, and grounding. However, the underlying issue in all these incidents may be engine failure. 

Figure 12 provides a visual representation of part of this framework with the level 1 occurrence type ‘Technical’, expanded into its level 2 and level 3 occurrence types.

Figure 12. An example of the level 1 ‘Technical’ occurrence type expanded into its level 2 and level 3 occurrence types.

Figure 13 shows a breakdown of the 3371 marine incidents reported in 2019 into their level 1 occurrence types by severity ⁴. Overall, the most common level 1 occurrence type associated with reported incidents is Technical (78.4% of incidents) followed by Personal Consequence (14.7% of incidents).

Occurrence types – Level 1

Technical occurrences are the most common level 1 occurrence type with the data showing an increasing trend in technical related incident reports between 2016 and 2019. The relative distribution of the other occurrence types has been consistent across the years from 2016 to 2019.

^{Footnote 4: Note that one incident may be coded into multiple categories.}

Some marine incidents result in consequences to passengers or crew on-board. These consequences can include injury, person over-board or fatalities. Figure 15 shows the incidents involving personal consequence by severity across each year (2016 to 2019).

Figure 16 details the non-fatal personal consequences by crew and passengers. The majority of injuries, illnesses and persons overboard involved crew members.

From 2016 to 2019, a total of 1180 incidents were reported to AMSA which involved a non-fatal injury to a passenger or crew member. Of these, 60% (710 incidents) involved crew. 

In 2019, there were 215 reported crew injuries and 104 reported passenger injuries.

Most injuries occurred during incidents classified as less serious. In 2019, 12.9% of injuries occurred as a result of serious incidents. This represents an increase from the previous years.

In 2019, 236 incidents resulted in a vessel consequence. 

Figure 21 provides an overview of the vessel consequence as a result of a marine incident for 2019. The most common vessel consequence occurring in 2019 were contact (24.2%) followed by pollution (23.3%), disablement (15.7%) and close quarters (13.1%).

Although “Other” vessels (including tugs, offshore service vessels and other) only represent 4.8% of reported incidents, they had the highest frequency of incidents in 2019 involving contact (18), and the second highest number of incidents involving pollution (12). 

The incidents involving pollution in 2019 are further broken down as shown in Figure 23. The number of reports of pollution have been consistent over previous years.

AMSA collects and records data on operational related fatalities⁵ on regulated Australian and foreign flagged vessels. Between 2016 and 2019, there were seven fatalities associated with seven incidents (Figure 19). All occurred on foreign-flagged vessels. Six involved crew members and one (in 2016) was a passenger fatality.

Of the six crew fatalities, two involved elevator maintenance, one was a result of an electrical shock and three of the crew fatalities involved falls. 

In response to these incidents, AMSA has published safety bulletins and marine notices on these topics, including: 

• Electrical Safety (2016/03) – This safety bulletin explores electrical safety and aims to provide further awareness and recommended actions that will promote an effective electrical safety culture on board ships.
• Working over the side (2016/04) – This safety bulletin focuses on working over the side and safety issues associated with such tasks. 
• Fatal accidents caused by moving elevators on ships (2020/01) – This marine notice highlights shipowners, operators, masters and crews obligation to ensure safe working arrangements are in place for any work involving a ship’s elevator.

Figure 20 provides a breakdown of the fatality data for the period 2016 to 2019 by vessel type with most fatalities occurring on bulk carriers.

^{Footnote: 5 These include fatalities associated with the operation of the vessel and are captured as a fatality occurring during a marine incident.}

Incidents that involved a failed, missing or defective structure, equipment or system are categorised as Technical occurrence types. The most frequently reported category of technical failures in 2019 were power propulsion and steering (26%), followed by navigational monitoring equipment (17.6%). Of the 56 serious incidents in 2019 involving a technical failure, 41 were related to power propulsion and steering (73%).

Figure 25 presents the top 10 most frequently occurring level 3 equipment and/or system faults that resulted in the above level 2 technical failures for 2019. Under Power propulsion and steering, the following level 3 technical failures include main engine/gearing (406), auxiliary engines/ alternators (130) and steering gear/rudder (70). Equipment related to the navigational monitoring equipment failures were radar (175), voice data recorder (VDR) (85) and electronic chart display and information system (ECDIS) (76).

Figure 26 shows that the number of power propulsion and steering failures are proportionally higher compared to other technical failures for vessels aged 20 years and over.

Operational marine incidents are related to shortfalls in the operation of the vessel. For example, of the incidents reported in 2019, 3.7% had an operational related event.

Bulk carriers accounted for 52% of operational related incidents in 2019. The three operational incidents categorised as serious occurred on tankers (2) and general cargo (1) vessels.

Cargo handling was the most common operational incident (43), followed by communication (40).

Figure 30 breaks down cargo handling into its level 3 components. Loading / Unloading and Containers account for more than half of these incidents.

This annual report will support a data-driven approach which is essential for improving safety in an increasingly complex maritime context. 

The data suggests that reporting of maritime incidents has improved, with a significant increase in the reporting of less serious incidents. The vast majority of these reports are of a technical nature (78.4%), with personal consequences representing 14.7% of incident reports. The increased reporting rate is a positive sign in terms of industry commitment to safety, and suggests that industry engagement initiatives are yielding results. However, the upward trend in serious incidents between 2018 and 2019 indicates that a concerted effort on improving safety, and safety culture should remain a priority for the maritime sector. 

There were seven incidents that resulted in fatalities between 2016 and 2019. Six of these incidents involved crew members and were associated with elevator maintenance (2), electrical shock (1) and falls from height (3). These present immediate focus areas for improving safety. As a result of these fatalities, AMSA has issued marine notices and safety awareness bulletins focusing specifically on the safety issues that contributed to these fatalities. 

The majority of technical failures reported involved power, propulsion and steering, followed by navigation monitoring equipment and engineering systems. Again, these leading sources of failure provide valuable focus for safety initiatives. Additionally, the higher percentage of serious incidents
on vessels greater than 20 years old highlights the need for a focus on effective maintenance to improve reliability and safety in ageing vessels. 

The second highest consequence of maritime incidents for 2019 was pollution, at 23.3%. This highlights the impact maritime incidents can have on our fragile marine environment. 

Analysis of the data summarised in this report provides insights that have, and will continue to guide AMSA’s education and engagement initiatives. 

AMSA recognises the strategic importance of collaborating with our stakeholders, and this includes educating our maritime community. As such, AMSA has leveraged incident data and the latest maritime safety and human factors research to produce a range of publications that target the safety priorities identified in this report. These publications include Safety Awareness Bulletins and Marine Notices.

Safety publications

Safety Awareness Bulletins are published biannually, with topics prioritised on safety data. In particular, the following safety awareness bulletins were published in response to maritime incident trends, as summarised in this report: 

1. Working at heights (February 2015)
2. Electrical safety (March 2016)
3. Working over the side (September 2016)
4. Risk assessment (September 2016)
5. Marine incident reporting (September 2017)
6. Maintenance (March 2018)
7. Safe vessel access (September 2018)

Additionally, AMSA issued a number of marine notices in response to safety incidents, including Marine Notice 2020/01 Fatal accidents caused by moving elevators on ships.

Glossary – vessel type classifications

Bulk: bulk carriers

Tanker: oil tanker, gas carrier, chemical tanker, NLS tanker

General cargo / multi-purpose: vehicle carrier, general cargo/multi-purpose ship, wood-chip carrier, heavy load carrier, ro-ro cargo ship, refrigerated cargo vessel, combination carrier

Container: container ship

Passenger: passenger ship, commercial yacht

Special purpose: special purpose ship, livestock carrier, mobile offshore drilling unit or floating production storage and offloading unit

Other: other types of ship, tug, offshore service vessel