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Table 1 Overview of included studies

From: Mental health and psychological wellbeing of maritime personnel: a systematic review

References Country Participants: ‘n’ and job role Participant demographics Relevant measures Quality (%)
Akamangwa [66] UK 41
Staff at a UK-based global shipping company and aboard two of its ships—34 ship crew, 7 managers
Not reported Semi-structured interviews about experiences complying with health, safety and wellbeing requirements on board 70
Andrei et al. [67] Australia Unclear; study states n = 199 but also reports that 25 were members of command team and the other 125 were members of crew
Seafarers working for marine operations of a large global mining company
99% male
Mean age 36.65
3 items from Questionnaire on the Experience and Assessment of Work; 4 items adapted from existing research on monotony and attention capacity literature; 3 items from Work Design Questionnaire relating to decision-making authority; 4 items adapted from existing scale on perceived availability of instrumental support from colleagues and direct supervisor; 10 items developed for previous study to measure different types of fatigue; 4 items adapted from previous literature on common sleep problems 65
Andruskiene et al. [34] Lithuania 393
Students at Lithuanian Maritime Academy studying either Marine Navigation, Marine Engineering, or Port and Shipping Management/Finances of Port and Shipping Companies/Maritime Transport Logistics Technologies
78.9% male
Mean age 20.71
Pittsburgh Sleep Quality Index; Hospital Anxiety and Depression Scale 60
Arcury-Quandt et al. [25] USA 598
Active-duty ship-assigned military personnel—US Navy and Marine Corps
71.2% male
Mean age 26.3
CES-D; CAGE questionnaire and abbreviated AUDIT-C; modified Holmes-Rahe Stress Scale 70
Barbarewicz et al. [70] Germany 60
Maritime pilots; 12 on a 1-week rotation system and 48 on 4-month rotation system
Gender not reported
Mean age 48.7
RESTQ-work 27; Berlin Questionnaire; validated short version of the 'evening morning protocols'—a sleep diary; Resilience Scale RS-13 80
Bergheim et al. [31] Norway 486 in Study 1; 594 in Study 2
Maritime workers from 3 shipping companies
Study 1: 100% male
Mean age 40.8
Study 2: 99% male
Mean age 40
Study 1: Norwegian offshore risk and safety climate inventory; Psychological Capital Questionnaire
Study 2: As above, plus three items from Job Satisfaction Scale—short version
Bergheim Valdersnes et al. [43] Norway 397
Seafarers from a Norwegian company in the offshore oil and gas industry
Gender not reported
32.9% aged between 30–39; mean not reported
Subscale of Swedish Occupational Fatigue Inventory; questionnaire based on hazard categories used in official reports from Norwegian Maritime Directorate; Psychological Capital Questionnaire; Safety Climate Questionnaire 65
Bobdey et al. [76] India 568
Personnel posted on a capital ship of the Indian Navy
Not reported Interpersonal Support Evaluation List 65
Brasher et al. [46] UK 144 submariners within the Royal Navy v 144 general service controls Not reported Work and Wellbeing Questionnaire; GHQ-12 70
Carotenuto et al. [48] Authors in Italy; participants were from Argentina, Bulgaria, India, Italy and Romania 162
Seafarers on board merchant ships for at least two weeks—7 tankers belonging to the same shipping company
100% male
Mean age 34.9
Psychological General Well-being Index 60
Chambers and Main [82] Australia and New Zealand 50
Maritime pilots employed across ports in Australia and New Zealand
98% male
Mean age 51.42
9-item Vitality Scale from the short form Health Survey; 10-item symptoms of fatigue checklist; 10-item coping strategies checklist 60
Chowdhury et al. [78] India, Madagascar, Philippines, Ukraine, and 'cross-regional' 615
International Transport Workers' Federation—seafarer affiliates
100% male India; 80% male Madagascar; 98.4% male Philippines; 99% male Ukraine; 88% male cross-regional
Age not reported
Study-specific questionnaire establishing knowledge, attitudes and behaviour regarding HIV/AIDS, health and wellness, health-seeking or risk-taking behaviour and the role of the workplace and union in promoting health 45
Chung et al. [29] South Korea 160
Seafarers on shipping vessels belonging to a Korean shipping company, docked at Busan Port
99.35% male
Mean age 35.77
Copenhagen Burnout Inventory; Siegrist's ERI Scale; Epworth Sleepiness Scale; Emotion Regulation Questionnaire 70
Devereux and Wadsworth [77] Authors in UK; participants were British, Polish, Romanian, Norwegian, Russian Swedish, Dutch and Filipino 37
Seafarers berthed in UK ports on 4 vessels—one offshore vessel and three chemical/product tankers
97.3% male
Mean age 39
Semi-structured interviews covering seafarers’ experiences of the arrangements made to manage risks to their health and safety 80
Dohrmann et al. [49] Denmark 193
Employees of Danish ferry shipping industry; most slept at home or in onshore watch-rooms
89% male
Mean age 47.6
Swedish Occupational Fatigue Inventory; two subscales of Copenhagen Psychosocial Questionnaire (work-family conflict and supervisor support) 70
Dohrmann et al. [61] Denmark As above As above Swedish Occupational Fatigue Inventory; two subscales of Copenhagen Psychosocial Questionnaire (job demands and control) 65
Doyle et al. [27] Authors in Ireland, participants international 387
Seafarers of tanker vessels in an international gas and crude oil shipping company who had been on board between 0–24 weeks; 1% catering, 28% rating/crew, 65% officer/engineer
98% male
21% aged 18–29, 37% between 30–39, 41%between 40–64, and 1% 65; mean not reported
2 questions each asking number of weeks participants had been on board since last shore leave and how long they have worked as a seafarer; Dispositional Resilience Scale-15; 4-item version of Perceived Stress Scale; The Employees Survey—an annual survey of work attitudes and experiences completed anonymously by employees 70
Hystad and Eid [42] Authors in Norway, participants international 742
Seafarers working in the offshore re-supply industry (402) and seafarers working on board combined passenger and cargo ships (340)
Gender not reported
Offshore supply: 12.2% aged 24 or under, 16.9% aged 25–29, 32.3% aged 30–39, 27.6% aged 40–54, 9.7% aged 55 or over
Seafarers on freight and passenger ferries: Mean age 37.02
Psychological Capital Questionnaire; Swedish Occupational Fatigue Inventory; Pittsburgh Sleep Quality Index; asked to judge the extent to which they felt disturbed by different environmental factors such as noise and motion; asked how long they had been on board since last shore leave and length of seafaring career 65
Hystad et al. [30] Authors in Norway, vessels operating in North Sea and Southeastern Asia 402
Seafarers working in offshore oil and gas re-supply industry
Gender not reported
12.2% aged 24 or under, 16.9% aged 25–29, 32.3% aged 30–39, 27.6% aged 40–54, 9.7% aged 55 or over
Swedish Occupational Fatigue Inventory; Zohar and Luria's scale of safety climate; questions on psychological demands and job control from General Nordic Questionnaire for psychological and social factors at work 65
Jegaden et al. [50] France 80 seafarers (40 officers, 40 crew) vs 63 office staff from the same shipping company 100% male
Mean age 40.3 for officers, 42.3 for crew members, 43.6 for office staff
Farmer and Sundberg Boredom Proneness Scale; Hospital Anxiety and Depression Scale; Job Content Questionnaire 45
Jezewska et al. [41] Poland 300
Seafarers employed in the Polish fleet and foreign flag vessels
100% male
Mean age 44
WHOWOL-BREF; Survey for people working at sea; NEO-FFI Questionnaire; PTS Temperament Questionnaire 60
Jo and Koh [33] South Korea 146 officers on Navy ships, 98 officers on submarines Ship officers: 97.5% male, mean age 30.7
Submarine officers: 100% male, mean age 29.61
Items from Korea National Health and Nutrition Examination Survey; Job-Related Affective Well-Being Scale 75
Kalvaitiene and Sencila [69] Lithuania 45
Marine navigation, marine engineering and electrical engineering students at the Lithuanian Maritime Academy, all with seagoing practice experience
Not reported Semi-structured interview with questions about difficulties on board; communication with ship's crew members; and measures taken to make it easier to adapt on board 30
Kelley et al. [75] USA 108
US Navy personnel assigned to a homeported Arleigh Burke-class destroyer anticipating deployment within 2 months
70.4% male
Mean age 28.15
AUDIT; Command Stress Assessment; CES-D-10; Friendship Scale Assessment; Relationship Assessment Scale 75
Kelley et al. [81] USA 101
US Navy personnel assigned to an Arleigh Burke-class destroyer who experienced an 8-month deployment
71.3% male
Mean age 28.34
Command Stress Assessment; Pittsburgh Sleep Quality Index; AUDIT; CESD-10 75
Kim and Jang [28] South Korea 149
Marine officers working at a harbor (people in command of a commercial vessel and the crew)
100% male
Mean age not reported, but half were in their 20 s and 30 s
SCL-90-R; survey on job stress modified and customised for seafarers; modified tool based on Job Descriptive Index 75
Kim and Jang [44] South Korea 280
Seafarers of a shipping firm, living and working on a ship for more than 6 months
Gender not reported
80.4% in 20 s-30 s, 19.6% aged 40 + 
Modified version of organisational culture tool; tool based on tool for emotional and instrumental support; Cho et al.'s self-efficacy measurement; short form of Park et al.'s perceived fatigue tool; modified version of Psychological General Well-Being Index (PGWBI-S) 70
Kingdom and Smith [83] UK 282
76% male
Mean age not reported, but 64% aged between 41–60
Questionnaire measuring exposure to physical agents and noise; job demands-control-support; effort-reward imbalance; organisational culture; management of change; leader-member exchange; team-member exchange; bullying; role conflict and ambiguity; training; how stressful work is; number of sick days in past year; work-related illness; Hospital Anxiety and Depression Scale; Epworth Sleepiness Scale; symptoms and medication; insomnia; accidents and injuries; memory; risk-taking; smoking and drinking; weight and exercise; time to relax; time spent on hobbies; impact of family on job; impact of job on family; negative affectivity; coping 60
Kum and Ertas [73] Turkey 50
Shipping company personnel
78% male
Mean age not reported, but 40% under 30, 40% between 30–40, 20% over 40
Questionnaire derived from Work Harassment Scale 60
Lefkowitz et al. [23] Authors in USA, data international Examined 278 mental illness claims between 2007–2015 from marine insurance provider for seafarers on Gard vessels N/A N/A 77.8
Lefkowitz et al. [45] USA 233
Domestic shipping vessel masters (captains) and pilots at two vessel piloting training centres
Gender not reported
Mean age 46
PHQ-9; GAD-7; Sleep Condition Indicator 65
Matsangas and Shattuck [56] USA 892
Sailors on US Navy surface ships
78.8% male
Median age 25 (mean not reported)
Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Insomnia Severity Index; Profile of Mood States 65
McVeigh and MacLachlan [60] Philippines 32
Merchant seafarers on board liquefied natural gas carriers, product oil tankers and crude oil tankers
100% male
Age not reported
Focus groups to discuss perceptions and experiences of stress, resilience and wellbeing 80
McVeigh et al. [35] Not reported; authors based in Ireland, South Africa, Czechia, and the UK 512 at Time0, 276 at Time1 (approximately 10 months later)
Merchant seafarers within a large shipping organisation (officers and ratings/crew)
Time0: 98.2% male, 41% aged 40–64
Time1: 98.2% male, 39.9% aged 40–64
The organisation's Employees Survey; Dispositional Resilience Scale-15; Perceived Stress Scale-4 65
McVeigh et al. [68] Not reported; authors based in Ireland, South Africa, and Czechia 24
Superintendents (office-based, n = 5), and officers and crew (n = 19) of a large shipping company
Not reported 11 interviews and 1 focus group with 13 participants
The first six interviews assessed perceptions of the pilot resilience programme and perceptions and experiences of resilience
Remaining interviews and focus group covered perceptions and experiences of wellbeing, resilience and stress
Nielsen et al. [63] Norway 541
Seafarers from 2 large Norwegian shipping companies
99% male
Mean age 40
3 items about intentions to leave; three items from Job Satisfaction Scale—short version; Brief Norwegian offshore risk and safety climate inventory (Brief-NORSCI); 5 items from Multifactor Leadership Questionnaire; Authentic Leadership Questionnaire' 3 items on job demands; Negative Acts Questionnaire Revised; 4 items from Platoon Cohesion Index adapted for maritime context 75
Oldenburg et al. [32] Germany 251
Seafarers in merchant marine service
92.8% male
Mean age 41.9
Study-specific scale of shipboard stressors; emotional exhaustion scale of the Maslach Burnout Inventory; one question each; Epworth Sleepiness Scale 75
Oldenburg et al. [58] Germany 104
Sailors on board container ships (19 nautical officers, 51 deck ratings and 34 engine room employees)
100% male
Mean age 35.4
Questionnaire used in the authors’ previous maritime studies, provided in form of a standardised interview, asking participants to rate whether they experienced various physical environmental influences and a free-text response on physical influences during their stay on board 75
Oldenburg and Jensen [38] Germany 323
Seafarers on board container ships (nautical officers, deck ratings, engine room personnel)
100% male
Mean age 38.3
Study-specific questionnaire about communication of crews with their home 70
Oldenburg and Jensen [51] Authors in Germany, participants European and Southeast Asian 323
Sailors on container ships
100% male
Mean age 38.3
Participants recorded working time, leisure time, lying/sleeping time and sport time; SenseWear armband monitor and Polar watch worn continuously to give an objective measure of strain (watch measures heart rate and heart rate variability; armband monitors physical activity and calorie expenditure); asked about subjectively experienced stress due to job-related physical or mental impacts, working hours, and sleep deficit 75
Oldenburg and Jensen [57] Germany 323
Seafarers on board container ships (nautical officers, deck ratings, engine room personnel)
100% male
Mean age 38.2
Study-specific questions on mental and physical strain as a result of activities carried out in the respective voyage episodes and various seafaring stressors, derived from their own previously published study 75
Oldenburg and Jensen [79] Germany 323
Seafarers on board container ships (nautical officers, deck ratings, engine room personnel)
100% male
Mean age not reported, median 37
Study-specific questionnaire asking about use of and needs for recreational facilities on board and strategies for coping with stress; daily log of leisure activities and sleeping time 70
Osterman et al. [22] Sweden 1980 (survey); 29 (interviews)
Survey: Service crew on passenger ships
Interviews: 5 HR department, 4 hotel, restaurant and cruise managers, and 20 ratings service department including safety delegates and union representatives, and seafarers working in bars, restaurants, housekeeping, shops, warehouses and spas on board
Survey: Mostly men but exact statistics not reported; largest age group 20–30
Interviews: 51.7% male; age not reported
Survey based on questionnaires from the International Social Survey Program, Work Orientations III relating to organisational and occupational commitment, job satisfaction and work experiences
Unclear what the semi-structured interview questions were
Othman et al. [52] Malaysia 60
Seafarers—20 senior deck cadets, 20 senior deck officers, 20 junior deck officers
Not reported ‘Technique for Order Performance by Similarity to the Ideal Solution’ method used to rank the root causes of distractions causing accidents at work 25
Peplinska et al. [39] Poland 210
Mariners working on deep-sea ships
Gender not reported
Age range 25–60, mean not reported
Purpose In Life Test; State-Trait Anxiety Inventory; Perceived Stress Questionnaire; Questionnaire of Suitable Marriage 45
Peplinska et al. [40] Poland 210
Mariners working on deep-sea ships
Gender not reported
Age range 25–60, mean not reported
State-Trait Anxiety Inventory; Levestein's Stress Level Questionnaire; Well-Matched Marriage Questionnaire 50
Pesel et al. [64] Authors in Spain, Italy and Denmark; participants international—54% from Asian countries, 17% from European countries, 28% from Russian and former USSR countries, 1.3% other 72
Seafarers on container ships
100% male
Mean age 39
GHQ12 with three extra questions about COVID precautions on board 65
Rapoliene et al. [84] Lithuania Baseline: 180 (65 balneotherapy intervention v 50 music intervention v 65 controls)
Completed intervention: 55 v 35 v 50 respectively
Seamen who had been working at sea for more than 5 years
100% male
Mean age 47.5 for balneotherapy group, 47.6 for music group, 46.2 for controls
Overall reported health, medication use, pain, mood, changes in feelings assessed in GP evaluation; General Symptoms Distress Scale; Multidimensional Fatigue Inventory; Cognitive Failures Questionnaire 75
Saitzyk and Vorm [24] USA Retrospective database analysis of 425 cases of self-directed violence found in records
Military personnel on board US Navy aircraft carriers
61.4% male
Mean age not reported, majority under 25
N/A 77.8
Schmied et al. [59] USA 22
Active duty service members from naval commands, assigned to sea duty
77.8% male
16.7% aged 18–24, 38.9% aged 25–29, 44.4% aged 30 + 
Semi-structured interviews assessing experiences of sleeping in shipboard environments 80
Seyle et al. [26] India, Philippines and Ukraine 101 seafarers who had been held hostage by pirates in the past 10 years vs. 363 not exposed to piracy Not exposed to piracy: India—100% male, mean age 29.46 (n = 103), Philippines – 99% male, mean age 40.34 (n = 144), Ukraine—87% male, mean age 34.85 (n = 127)
(Note: it is unclear why 374 participants are described when ‘n’ is reported to be 363)
Exposed to piracy: India – 100% male, mean age 37.41 (n = 44), Philippines – 100% male, mean age 40.34, Ukraine – 96% male, mean age 42.88 (n = 26)
Previous trauma exposure; 2 items about training and how helpful it was; PCL-C; CES-D; Duke Health Profile; three study-specific items about the impact of piracy on work decisions 65
Shevchenko et al. [53] Ukraine 80
Cadets specialising in sea and river transport—students from two Maritime Academies on their first or second course (n = 40) or third/fourth (n = 40), who had undergone long-term floating practice lasting over 3 months
Not reported Coping-Strategy Indicator; Well-being-Activity-Mood questionnaire 40
Sliskovic [65] Author in Croatia; participants international – 57 countries represented 752
Seafarers employed in the global shipping sector
89.23% male
Mean age 37.34
Questionnaire with questions on sociodemographic and work characteristics and one open question about personal experiences relating to the COVID-19 pandemic 70
Sliskovic and Penezic [55] Croatia 530
Seafarers on cargo ships
Gender not reported
Mean age 37.7
Job satisfaction scale; 10 questions on specific aspects of job; 2 open questions about sources of satisfaction and dissatisfaction 60
Sliskovic and Penezic [71] Croatia 298
Officers on cargo ships
Gender not reported
Mean age 39.16
3 questions on contract (number of months contracted to be on board, number of months at home, compliance with contract regarding changes to ship and home periods); 1 question on free and unlimited access to the internet on board; Overall Job Satisfaction scale; Satisfaction with Life Scale; 5-item version of Mental Health Inventory 75
Sliskovic and Penezic [47] Croatia 530
Seafarers employed in international shipping
Gender not reported
Mean age 37.7
Study-specific scale assessing smoking, alcohol, sleeping, exercise and diet; newly-developed instrument for stress on board; Mental Health Inventory-5 70
Tedesco et al. [36] Authors in Italy, participants international 801
Seafarers of Italian shipping companies
94.5% male
Mean age 36.4
Study-specific survey on health status and smoking/drinking/drug habits; Karasek Demand-Control-Support Questionnaire 90
Turkistanli and Sevgili [54] Turkey 266
Undergraduate maritime students (marine transportation engineering or marine engineering)
89% male
Mean age 21.43
Survey created for a previous study, on awareness of health risks, general perception of danger and discomfort in the workplace and risks of contracting diseases 55
Xia et al. [80] China 71
Crew members of a hospital ship for approximately 3 months
100% female
Mean age 32.1
SCL-90 60
Xiao et al. [62] China 917
Crew members from Nantong Entry-Exit Inspection and Quarantine Bureau
100% male
Mean age 33.5
Social Support Rating Scale; Zung Self-Rating Depression Scale; Occupational Stress Questionnaire; World Health Organization Quality of Life-BREF 65
Xue and Tang [74] China 55
Crew members and shore management of two shipping companies
Not reported Semi-structured interviews about experiences of implementing the International Safety Management code and the outcomes and impacts of management’s safety inspections on ships 80
Yuen et al. [72] Singapore 202
Deck officers, engine officers and ratings from containers, dry bulk, liquid bulk, and specialised carriers
Not reported Multifactor Leadership Questionnaire; Multidimensional Scale of Perceived Social Support; scale based on literature review assessing physical environment, task-related factor, technology-related factor, organisational factor and individual factor; PsyCap Questionnaire; burnout scale from Maslach Burnout Inventory; safety behaviour scale obtained from Lu et al 60
Zhao et al. [37] China and two European countries (not specified) 880 questionnaires and 60 interviews
Questionnaires: Seafarers from two Chinese and two European shipping companies
Interviews: Seafarers and managers from two Chinese and two European shipping companies
Questionnaires: 99.1% male, mean age 36.1
Interviews: gender and age not reported
Questionnaires: Shortened version of questionnaire from Cardiff Seafarers' Fatigue Research Programme—sections focusing on job/vessel, hours of work and rest, fatigue at sea, work, sleep patterns and health-related behaviours, and travel to/from vessel
Interviews covered work shift schedule, work hours, workload, sleep, on-leave, fatigue and company supports