TAIC blames fatigue and skipped checks for boiler blast that burned 2 crew at Bluff

Tired officers, an under-staffed night shift and a boiler that had never been checked as safe to clean combined to seriously burn two seafarers on a bulk carrier berthed at South Port in Bluff, the Transport Accident Investigation Commission has found.

The commission released its final report into the 24 May 2025 blowback on the Malta-flagged Olivia on Friday. Three crew were hurt and taken to Southland Hospital. Two of them suffered serious facial and arm burns; the third was bruised.

The 32-day stay that preceded the accident was never meant to happen. The ship had berthed at Bluff on 23 April 2025 intending to stay about five days, but problems with its main engine and generators kept it tied up while repairs dragged on, with Maritime New Zealand requiring the work to be completed before the vessel could sail.

On 23 May the ship's boiler flamed out and crew tried repeatedly to relight it. The commission found the failure was likely caused by a malfunctioning air-intake flap, a faulty ignition transformer and a build-up of soot. In the early hours of the next morning a night-shift crew went into the furnace with an air lance to clear the soot. As the lance was withdrawn, disturbed hot soot most likely ignited leftover fuel and caused the blowback.

Louise Cook, the commission's Chief Investigator of Accidents, said nobody should clean inside a furnace until it had been isolated and confirmed cool. Blowing compressed air into a hot furnace that still held unburned fuel was, in her words, "a recipe for a blowback", according to the report and RNZ's account of it.

The crew regarded boiler cleaning as routine, but the report says they normally did it at sea, days after the boiler had been shut down. On this occasion the boiler had been reignited several times and had already suffered an earlier blowback while hot. No one took an objective reading to confirm the furnace temperature was safe, and no documented risk assessment was done.

The commission found it was "very likely" the ship's senior engineering officers were fatigued after concentrating on the daytime generator repairs, which affected their decision to approve the overnight job. No senior engineer was on duty overnight, so the smaller night shift had nobody with the authority to plan or supervise work that had become riskier than expected. When the third engineer on the night shift phoned the chief engineer, the conversation did not make clear what work was being done or what controls were needed.

Injuries would very likely have been less severe if the crew had worn face protection, the report says; their decision not to use face or eye protection showed they did not grasp the hazard.

The commission identified two safety issues: the vessel's safety management system was not properly implemented on board, and the operator, Fleet Management Limited, had no guidance for managing crew through long periods of intensive work.

It made no new recommendations because Fleet Management had already acted. The company issued a fleet-wide safety memorandum, reviewed its risk assessment and fatigue procedures, upgraded its protective equipment requirements, produced a boiler safety poster and added the case to training for seafarers joining its ships.

Ms Cook said rest, supervision and workloads all needed watching throughout a long repair programme, and that stopping to get the right support should be a simple decision when a job is beyond the people on hand.

The full report is published on the commission's website under inquiry MO-2025-204.