Abstract
Introduction: This study reports the global occurrence of passenger and crew mortality on cruise ships. To date, no comprehensive study of passenger and crew mortality has been published. Methods: All data on passenger and crew mortality between 2000 and 2019 were obtained from 78 ocean and river cruise lines registered globally and analyzed by their age, gender, nationality, cruise line, and recorded cause of death. Results: There were 623 reported deaths. Out of all deaths, 89% were passenger deaths and 11% were crew deaths. United States residents accounted for 61% of passenger deaths and crew from India (18%) and the Philippines (17%) recorded the highest crew deaths. Falls overboard or onto lower decks (23%), suicide, murder, and a terror attack (19%), unspecified natural causes (18%), and cardiac incidents (16%) were the primary causes of passenger deaths. Suicide and murder (29%) and falls overboard or from height (24%) were the primary cause of crew member deaths. The most passenger deaths occurred on Carnival Cruise Lines (29%), Royal Caribbean Cruises (12%), and Norwegian Cruise Line (10%). The highest crew member deaths occurred on Carnival Cruise Line (19%) and Royal Caribbean Cruises (19%). Conclusion: Falls overboard or onto lower decks, cardiac incidents, and suicides are the leading cause of passenger deaths. Suicide and murder and falls are the leading cause of death for crew members. Travel health advisories targeting US citizen passengers and crew members from India and the Philippines are warranted. The addition of mental health care to ship infirmaries is also suggested.
Highlights
This study reports the global occurrence of passenger and crew mortality on cruise ships
The existing research literature has done well to identify traveler’s diarrhea and respiratory infections as frequent illnesses incurred on cruise ships and cardiovascular incidents as a frequent issue leading to the death of elderly passengers.[9,11,12,13,14,15,16]
In order to address the limited knowledge about cruise ship mortality, this study aims to examine the global incidence and patterns of passenger and crew mortality
Summary
This study reports the global occurrence of passenger and crew mortality on cruise ships. No comprehensive study of passenger and crew mortality has been published. Travelling by sea is one of the earliest known forms of transportation.[1,2] From ancient times to the present, people have traveled by sea for reasons such as trade, conquest, and leisure.[2,3] Over the past few decades, travel by sea for the purpose of cruise tourism has become exceptionally popular.[4] For example, from 2009-2018 the annual number of individuals boarding cruise ships increased from 17.8 million to 28.2 million passengers.[5] Since the cruise ship industry has been recognized as the fastest-growing segment of the global travel and tourism industry.[6,7]. As the industry continues to expand it is likely more passengers and crew will be exposed to life-threatening injury and illness.[9,10] The existing research literature has done well to identify traveler’s diarrhea and respiratory infections as frequent illnesses incurred on cruise ships and cardiovascular incidents as a frequent issue leading to the death of elderly passengers.[9,11,12,13,14,15,16] Additional studies have raised concern about the occurrence of varicella and hepatitis E outbreaks on cruise ships.[17,18] while these studies have provided valuable data to the Vessel Sanitation
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