Abstract
Fishing communities globally continue to face poor health and safety outcomes, driving the expansion of fisheries occupational health and safety (OHS) interventions. However, narrowly focused OHS interventions that neglect the social and structural determinants of health may have unintended consequences. We illustrate this problem through a case study from the UK where a recent OHS intervention, the introduction of compulsory medical certificates to all commercial fishers, led to unforeseen negative impacts. Through analysis of data from interviews, focus groups and a participatory workshop in Cornwall, UK, we highlight three key findings. First, while seeking to improve safety at sea, the regulatory change actually had negative consequences for fishers' health, their access to healthcare and potentially even their safety. Second, a mismatch between the requirements of the regulation and fishers' lived experience undermined the efforts of health promotion and outreach activities. Third, a failure to account for the implications for different sectors of the fleet has contributed to mistrust that may have ramifications for future fisheries governance activity. Our research brings to the fore important implications for the design of OHS regimes in fisheries. These include the broadening of OHS approaches to consider fishers' wider health and well‐being; engagement of fishers in the development and implementation of OHS interventions to account for their lived experiences of health and safety at sea and better integrate their knowledge; support for bottom‐up fisher‐led initiatives aimed at managing health and safety at sea; and improved coordination between agencies responsible for different areas of fisheries governance.