The High-Risk Reality of Seafarer Overwork and the Crisis of Offshore Medical Access

In a world where over 80% of global trade relies on maritime shipping, deep-sea seafarers have become the backbone of international logistics. However, under the pressures of dense shipping routes, excessive working hours, and downsized crews, seafarers now face growing structural threats—chronic overwork and limited access to medical care at sea.

In August last year, a senior crew member aboard a Taiwan-flagged bulk carrier suddenly collapsed on deck after working at sea for approximately 290 days. At the time, the vessel had just departed from a port in Australia. Despite the medical emergency, the captain chose not to turn back. Instead, the ship continued its planned course and returned to Taiwan after ten days at sea. The crew member was eventually evacuated by helicopter upon arrival. He was diagnosed with intracerebral hemorrhage and ischemia on the right side, resulting in paralysis of his right limbs. He remains under ongoing treatment.

This is not an isolated incident. Rather, it represents just the tip of the iceberg in the widespread overwork and health risks confronting Taiwan’s deep-sea seafarers.

Multiple Causes of Seafarer Overwork

1.Excessive Workload and Severely Inadequate Rest Time

According to relevant studies, nearly half of crew members working on cargo and bulk carriers report actual working hours exceeding 85 hours per week. Respondents indicated that despite the introduction of more regulations prohibiting excessive working hours in recent years, their working hours have actually become longer compared to a decade ago.

In a 2024 survey conducted by the Taiwan Occupational Safety and Health Link (職安連線) involving 596 seafarers, the findings were equally concerning:

• 66% reported working overtime for extended periods without sufficient rest,

• 59% pointed to understaffing on board,

• 53% stated that they had worked for multiple consecutive days without a proper rest day.

These figures reflect how chronic fatigue has become the norm for many seafarers.

Take, for instance, the aforementioned crew member who fell ill. He had to continuously adjust to sailing schedules and work demands, with a regular daily workload of about 10 hours. During intensive operations such as setting sail, unloading, or tank cleaning, his work hours often extended to 20 hours per day, and at times he was on call for up to 24 hours. In the two days prior to his collapse, he was still working on deck during the early morning hours and had less than four hours of rest before returning to duty.

2.High Responsibility and Chronic Mental Strain

Seafaring work involves not only physical labor but also significant responsibility for accident prevention, equipment maintenance, emergency standby duties, and responding to various unforeseen situations—such as extreme weather, rough sea conditions, or sailing through high-risk areas prone to piracy. These factors place seafarers under continuous mental strain, with little opportunity for relaxation.

The previously mentioned overworked crew member also reported that due to prolonged stress, imbalanced work hours, and difficulty sleeping, he had to constantly sacrifice personal rest to cope with an overwhelming workload. Moreover, because of manpower shortages, he often had to take on additional duties beyond his own role, further increasing his workload. When crew numbers are insufficient, the remaining seafarers are forced to assume greater responsibility, resulting in extended working hours and compounded stress.

3.Time Zone Shifts Disrupt Biological Rhythms

In addition to long working hours, the constant crossing of time zones during long-distance voyages presents a lesser-known but serious risk. Because international routes often span multiple time zones, the onboard operational time may not align with the actual geographic time. The combination of shift work and time zone adjustments disrupts the body’s circadian rhythms and reduces sleep quality, making it harder for seafarers to recover from fatigue. Over time, this significantly elevates health risks.

Limited Access to Medical Care at Sea Increases the Risks of Overwork and Health Deterioration

The vast majority of commercial vessels do not have professional medical personnel onboard. When seafarers experience cardiovascular emergencies or other acute medical conditions at sea, they can only rely on limited medications, basic equipment, and remote medical consultations. In situations where the vessel cannot turn back or reach a nearby port quickly, the seafarer’s condition may worsen, missing the critical window for treatment.

In some cases, shipowners may prioritize cost-saving and choose not to divert the vessel or seek the nearest port for medical assistance. In the case mentioned earlier, the seafarer went ten days from the onset of symptoms to receiving medical care－a delay that not only cost valuable treatment time but also highlighted how emergency medical decisions at sea are heavily dependent on the company’s judgment, in the absence of binding legal requirements or systemic safeguards.

Barriers to Occupational Disease Recognition

For seafarers to apply for recognition of an occupational injury or illness, they must provide substantial evidence after the fact, including records of working hours, working conditions, and job duties. However, timekeeping systems on board are often merely procedural and fail to accurately reflect actual working hours. In addition, operational records are often opaque. As a result, workers face immense difficulty when seeking occupational injury compensation.

In the case described, the seafarer returned to Taiwan, remained hospitalized, and continues to undergo rehabilitation. Yet nearly a year later, the incident still has not been officially recognized as a compensable occupational illness. Several factors contribute to this: onboard work hour records did not accurately reflect actual conditions; the widespread use of so-called “responsibility systems” or “task-based systems,” which blur the line between work and rest, making it difficult to prove overwork.

Furthermore, whether the delay in treatment was due to poor judgment on the part of the company remains unaddressed, as there is no clear mechanism for accountability. As a result, seafarers may be left bearing significant medical and living expenses without receiving compensation—a manifestation of systemic injustice.

Overwork Is Not Just a Land-Based Problem

In Taiwan, public concern over overwork often centers around healthcare workers, engineers, and logistics drivers. Yet deep-sea seafarers—these “invisible laborers”—remain largely overlooked. Once aboard, they may stay at sea for six months to a year, working over ten hours a day, constantly facing harsh weather, turbulent seas, time zone shifts, and chronic understaffing. Despite these conditions, they have little access to timely medical care and limited external oversight.

Although international frameworks such as the International Maritime Organization (IMO) and the Maritime Labour Convention, 2006 (MLC) mandate reasonable working hours and rest periods, there remains a significant gap between policy and practice.

The government must confront the realities of maritime labor, promoting transparent work-hour recording systems, strengthening emergency medical response protocols at sea, and clarifying the chain of responsibility in urgent situations. Only then can seafarers—isolated on their “floating islands”—face the elements with adequate support and protection.

Ensuring that the physical and mental health, as well as the lives of seafarers, are placed at the heart of operational systems is essential. Without this, Taiwan’s maritime industry cannot truly move toward sustainable development.