Fatality in the Cargo Hold (Enclosed Space)
The MAIB report on three stevedore deaths aboard a bulk carrier highlights the dangers of enclosed spaces and failures in supervision and safety protocols. Key issues included toxic, oxygen-deficient atmospheres, lack of training, unsecured access, and non-compliance with safety procedures.
Loss Prevention
Published: April 23, 2025
The UK Marine Accident Investigation Branch (MAIB) has released report no. 5/2025 investigating the deaths of three stevedores in a cargo hold access space on board a bulk carrier. The investigation highlights not only the dangers and hazards of enclosed spaces but also the importance of ensuring proper supervision of shore personnel working onboard ships.
According to the MAIB report, the vessel was loading bulk coal and during a rain delay, all cargo hold hatches were closed. Once the rain stopped, a stevedore attempted to access a bulldozer located in cargo hold No.7 but mistakenly entered the access hatch for hold No.8, where he was overcome by the atmosphere inside. The collapsed stevedore was located and the alarm raised, it was whilst the rescue equipment was being assembled that two other stevedores collapsed after entering hold No.8 access hatch to try and rescue him. The three casualties were recovered from the access space but, despite medical attention being administered, they failed to regain consciousness, and were declared deceased.
The MAIB investigation concluded that contributory safety issues were:
- Entry into an enclosed space that had a noxious atmosphere, deficient in oxygen and high in hydrogen sulphide, that could not sustain life.
- Inadequate supervision.
- Lack of routine atmosphere testing.
- Unsecured access points to enclosed spaces.
- Stevedores having little or no understanding of safety warning signs and being unaware of the inherent risks of enclosed spaces.
- Permit to Work was not used for cargo hold access when loading cargo.
- The Ship-Shore Safety Checklist applied only at the start of cargo operations, and the agreed requirements were neither followed nor promoted safe cargo work.
- The port authority and terminal failed to follow international guidelines, compromising stevedore safety.
The maritime industry continues to see enclosed space fatalities and Members are reminded that the Club has published a number of Risk Alerts, and other pertinent material, on the dangers of entry into enclosed spaces. Details can be found on the Club website under Loss Prevention, with specific links listed in the Resources section below, including to the ongoing China Maritime Safety Administration (China MSA) “Special Campaign against Illegal Entry into Enclosed Spaces onboard Ships” entering Chinese ports.
In addition, available through the MME Donate & Train Scheme, there are two programmes “Enclosed Spaces are Dangerous Places” and “Entry To Enclosed Spaces”. The programmes look at how the oxygen levels in such enclosed spaces can be depleted, and the procedures that should be followed to minimise the possibility of injury to personnel.
Supportive Information
For further information on this or other Loss Prevention topics please contact the Loss Prevention Department, Steamship Insurance Management Services Ltd.
Tel: +44 20 7247 5490 Email: [email protected]
Resources
Special Campaign against Illegal Entry into Enclosed Spaces onboard Ships (China MSA)
Safety Bulletin 7
