November 2023: Net roller / Cod end serious injury on commercial fishing vessel

This safety update highlights the importance of good communication on commercial fishing vessels and safe work practices.

This safety update is for

  • New Zealand commercial fishing vessels



On the morning of 23 July 2022, a crew member working on a commercial fishing vessel suffered a severely broken leg after being hit by the cod end of a mid-water trawl net.

During fleeting, a process where lengths of fishing net are brought sequentially onboard by use of port and starboard Gilson winches (Bull wires), the Gilson hook used to hook into the hauling strops got caught on the midwater cod end that was stowed on the midship net roller. Instead of the net being spread evenly across the net roller, the net had bunched up on one side. The deckhand went to remove the Gilson hook from the bunched net.

The first mate who was on watch in the bridge saw that the hook had caught on the net, so rotated the net roller remotely so the Gilson hook could be freed by the deckhand. However, the midship net roller would not normally rotate during this part of the operation.

The first mate did not communicate their intention to rotate the net roller to the deckhand or to the crew on the deck. Subsequently, the rotation of the net roller caused the cod end of the net to swing around at speed striking the deckhand. The sudden and violent impact broke his lower leg bone.

The deckhand was airlifted off the vessel and required surgery on his leg.

Gilson hook

Gilson Hook


Gilson winch (Bull wire)

Gilson Winch



Maritime New Zealand was advised of the incident.

The resulting investigation revealed the mid-water trawl net at times had a tendency to wind onto the midship roller unevenly, causing the net to bunch when it was stored. When this occurred, the Gilson hook could then get caught on the exposed net that was not in use while being stowed on the midship net roller.

When the crew were completing a fleet, the tension on the port side Gilson winch was taken up allowing the opposite side Gilson hook to drop down over the midship net roller becoming caught on the stowed mid-water cod end. The crew had developed a work around to deal with this issue by remotely rotating the net roller from the bridge to allow a deckhand to access the caught Gilson hook in preparation for the next fleet.

When interviewed, the fishing company stated they were not aware of the ongoing issues with the Gilson hook catching on the midship roller. Consequently it had not been added to their hazard register by the ship’s master and they were accordingly unaware of the risks the crew were taking with the alternative method of operation.

The company confirmed they had regular health and safety meetings with their crews when they returned from each trip but it had never been made aware of this issue.

Issues identified during the investigation were:

  • The use of a workaround to deal with a safety issue rather than raising it as a health and safety hazard
  • Lack of awareness by the Person Conducting a Business or Undertaking (PCBU) of the crew using a workaround when the Gilson hook became caught on an exposed net
  • Midship net not evenly spread or covered
  • Lack of communication between crew about the unexpected operation of the midship net roller
  • Limited visibility for the first mate operating from the bridge
  • Deckhand received insufficient training and supervision to undertake their duties safely
  • The then current onboard safe operating procedures did not capture hazards associated with working close to the midship net roller

Actions taken to address the incident:

  • The PCBU, in this case the commercial fishing company, was not told of the ongoing issue with the Gilson hook catching on the net by the crew
  • A new procedure was introduced to store the midship roller with the net evenly spread and covered with a tarpaulin to mitigate the risk of the Gilson hook catching
  • CCTV cameras have been installed to provide fuller visibility of the area of operations for the officer operating from the bridge, which has eliminated blind spots caused by the midship net roller.
  • Safe Operating Procedures were reviewed and hazards associated with working close to net rollers identified and mitigated against.


Safety reminder

PCBUs must so far as is reasonably practical:

  • Provide all workers with appropriate information, training, instruction, or supervision to help protect them from risks to their health and safety resulting from their work
  • Make sure there are clear communication processes for all workers when plant and equipment is operating outside normal operations
  • Hold regular health and safety debriefs with workers to record and monitor hazards at work that could put workers’ health and safety at risk
  • Maintain a detailed hazard register and report any safety issues to management rather than finding a work around
  • Ensure plant and equipment, such as nets, are stored and operated following safe systems of work


More information

Refer to the ‘Health and Safety: A guide for mariners’ on the Maritime New Zealand website.


Contact us for more help

If you have any questions about this safety update, please contact our Wellington office.


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