Cruising: Hidden dangers, from fatal falls to widespread sickness
MDlinx Aug 20, 2024
Cruise ship travel brings to mind ideas of glamorous dinners overlooking the sea and bustling port cities bursting with culture. Even though cruising is becoming one of the fastest-growing sectors in tourism (with 31.5 million passengers sailing in 2023), cruise ships can pose serious risks to tourists both on and off the boat.
Cruise Lines International Association. State of the Cruise Industry: 2023. May 2023
A look at recent cruise ship accidents and injuries
Earlier this year, a Bulgarian ship cruising down the Danube River in Austria crashed into a concrete wall. Of the ship’s 160 passengers, 17 people were injured, 11 of whom were taken to the hospital. In 2023, a cruise ship hit a small boat on the same river, killing 25 tourists and two crew members. The captain was sentenced to five years in prison for his role in the incident.
Mishra S. At least 17 passengers hurt as cruise ship crashes into wall in River Danube. The Independent. March 30, 2024.
Numerous tragic incidents caused by passengers have also occurred on cruise ships. In 2019, an 18-month-old died after falling from her grandfather’s arms and through an open cruise ship window. The parents’ attorneys say the cruise ship company, Royal Caribbean, failed to “utilize fall prevention devices recommended by the American Society for Testing and Materials despite estimates showing more than 5,000 children are injured in window falls in the United States annually.”
Goggin K. Parents of toddler killed on cruise ship argue for new chance to sue Royal Caribbean. Courthouse News Service. March 23, 2023.
Some of these cruise ship tragedies have resulted in huge payouts—like the $21.5 million—which included $5 million for past and future pain, suffering, and emotional distress—recently awarded to a man who suffered a minor brain injury after a sliding-glass door hit him on the head on a Holland America ship. The passenger experienced memory loss, vertigo, and seizures as a result of the injury. According to The Seattle Times, other passengers have been injured by sliding-glass doors on Holland America ships.
Carter M. $21.5M verdict follows repeat injuries from Holland America ship’s doors. The Seattle Times. November 10, 2015.
Even though cruise liners are responsible for keeping their passengers safe, research shows that passengers actually behave differently while on board. According to a study published in the Health Promotion Journal of Australia, cruise travel can lead passengers to “abandon cautious behaviours.”
Werder O, Holland K, Kiaos T, et al. Between the sea and the sky: A social practice investigation into health behaviours during cruise travel. Health Promotion Journal of Australia. 2022;33(Suppl 1):367–378.
The authors aimed to “understand travel health perceptions and behaviours in the context of the meanings, competences and materials associated with cruise travel.”
They found that most passengers only considered sea/motion sickness, sunburns, and dehydration as possible “serious health scenarios.” In fact, 80% of interviewees put all their trust into the cruise ship crew, taking less accountability for themselves and their own health.
Cruise ships are also breeding grounds for illness
As James H. Tabibian, MD, PhD, a gastroenterologist at Adventist Health in Glendale, CA, tells MDLinx, living in close quarters above a cruise ship—in addition to potentially widespread food contamination—are both variables that can lead to passenger illness.
Earlier this year, for example, over 150 people reportedly experienced gastrointestinal illness, including diarrhea and vomiting, while on board the Cunard Queen Victoria cruise ship.
Diaz J. C.D.C. Investigating Gastrointestinal Illness on Luxury Cruise Ship. The New York Times. February 8, 2024.
Lin H. Chen, MD, FACP, FASTMH, FISTM, Director of the Travel Medicine Center at Mount Auburn Hospital in Cambridge, MA, tells MDLinx that other risks on cruise ships could include contracting malaria or yellow fever—depending on itinerary—or respiratory infections due to being in confined spaces.
Dr. Chen says that cruise travel—even considering the COVID-19 pandemic—is alive and well. “Cruise travel has rebounded, and by 2023 has surpassed pre-pandemic levels,” she says.
A lot of these passengers, she notes, are older adults who may have underlying health conditions that need to be managed well.
Dr. Chen says there are a few things passengers can do to stay safe, starting with preparing for the trip in advance. “Travelers with chronic conditions should make sure they are stable and, if appropriate, have ways to monitor the conditions during the cruise. Consulting with your own doctors who are familiar with [your] health is a good start. If there are any questions about health risks with the journey, consult a travel medicine specialist,” she says. Preventive strategies could include getting vaccinations, educating oneself on self-management strategies, and refilling prescriptions.
The key to staying safe—from sickness or other injury—is to maintain excellent hygiene, embrace quarantining if necessary, and avoid excessive drinking, Dr. Chen adds.
What does this mean for you?
According to David M. Cutler, MD, a board-certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, cruise ship passengers should be encouraged to pack a first aid kit that includes basic items like Band-Aids, antiseptic wipes, and pain relievers, as well as any prescription medications. Passengers should also know the locations of medical facilities on board the ship. Beyond packing a first-aid kit and knowing where medical help can be found, passengers should be aware of all possible risks—and play a key role in keeping themselves safe.
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