The maritime energy transition from traditional fuels and marine gas to cleaner fuels, such as ammonia, biofuels, e-fuels, hydrogen, liquefied natural gas (LNG) and methanol, is raising concern at the emergence of new risks for seafarers and offshore workers.

Marine Medical Solutions (MMS) – a member of OneCare Group – CEO Dr Jens Tülsner comments that this energy transition and its associated risks require enhanced medical services and solutions to ensure that seafarers have easy access to medical solutions should an issue arise when handling alternative fuels.

“As ships shift from conventional heavy fuel oil and/or marine gas oil to the alternatives, the exposure picture changes. Some traditional hazards may decrease, but new acute toxicity, cryogenic and low-flashpoint risks become more prominent,” says Tülsner.

He notes that each alternative fuel type is accompanied by various short- and long-term risks for seafarers, which can be contracted through several exposure pathways, including inhalation, skin and/or eye contact, and secondary exposure from contaminated spaces and off-gassing.

For example, ammonia is accompanied by the hazards of corrosivity and toxicity, which can lead to short-term risks, such as burning and tearing eyes, airway swelling and lung injury, as well as chemical burns on the skin. The long-term effects include potential chronic airway symptoms.

Methanol is also known to cause systemic toxicity. This means that it could have short- term effects such as metabolic acidosis, nausea and headaches. The long-term effects of methanol inhalation, include severe headaches and eye irritation.

LNG, methane and cryogenic gases, meanwhile, could cause cold-related injuries and/or asphyxiation. Short-term risks include oxygen displacement in poorly ventilated spaces and cryogenic burns from cold surfaces or splashes. The long-term effects include lung problems.

Further, hydrogen is extremely flammable, and has risks associated with asphyxiation, while biofuels tend to cause eye irritation but can also cause dermatitis and inhalation irritation depending on the composition of the biofuel blend. The long-term risks include chronic dermatitis, adds Tülsner.

He states that medical support and training initiatives from MMS have proven to be highly beneficial for protecting seafarers – especially with ammonia and hydrogen, as the severity of those risks increase exponentially, the longer it takes to mitigate or address the incident. Those events are a “minutes matter” scenario, he adds.

For instance, he highlights that MMS can provide standardised treatment pathways for various chemical and/or fuel scenarios; “train-the-trainer” programmes for extending skills to many, instead of one expert; simulation support for tabletop exercises and periodic high-fidelity drills during high-risk routes; and feedback loops after the occurrence of incidents. The latter entails the updating of protocols, equipment lists and training content.

“Early actions – to remove risk of exposure, decontaminate, provide oxygen and airway support, and facilitate rapid evacuation decisions – can be the difference between full recovery and permanent injury,” he stresses.

Additional medical support and training programmes that could be offered to seafarers include fuel-specific first aid modules, personal protective equipment proficiency training, scenario-based drills, the use of detection equipment, and telemedical rehearsal for dealing with incidents remotely.

He adds that MMS can offer programmes to eliminate deficiencies caused by stress by equipping seafarers with short drills to enhance confidence and competence; create clear go and/or no-go regulations; facilitate medical readiness to match hazards; and safeguard psychological safety through non-blame reporting and fatigue management.

Going forward, he says that shipowners ought to establish several new protocols and regulations to ensure that workers are healthy and protected from alternative fuel incidents and risks. This can be achieved by expanding and/or enhancing competency and training requirements, improving medical preparedness and onboard exposure control standards, upgrading incident reporting, and continuously improving the International Code of Safety for Ships Using Gases or Other Low-Flashpoint Fuels, known as the IGF Code.