There are a few different ways to get hurt on a boat. Any of these could kill you under the right circumstances, so take them seriously. The risks are easily minimized if proper caution is used.
Fall overboard
Don’t think that knowing how to swim eliminates this risk. The distances to shore is usually much greater than it seems. I a large swell, even treading water is difficult. Without a flotation device, the only realistic way to survive is to get back to the boat. Below a water temperature of 70 degrees, hypothermia is a concern:
Mitigations
Wear a PFD in any heavy weather and/or “exposed” conditions, i.e. going forward on the bow. Learn Man Overboard Procedures.
Get Hit in the Head with the Boom
On a large boat in heavy weather, this risk is high. If you fall overboard as a result, your chances of surviving are even less because you will likely be unconscious or dazed.
Mitigations
Be aware of this danger and stay below the Boom swing zone. Be cognizant of the Main Sheet and do not ever allow it to run free. Follow proper procedures during Tacking and Gybing. Always use an accidental gybe Preventer when sailing downwind. When at the helm do not allow the boat to steer or drift onto a heading that would cause the Boom to swing, and if/when you do, alert the crew.
Get Hurt by Machinery or Electronics
Follow proper procedures when using the Windlass. Do not fiddle with anything you don’t fully understand. Electronics are generally safe if they are 12 Volts, unless there is flammable gas (propane, diesel fumes) nearby and a spark is caused. Don’t mess with the engine if you don’t know what you’re doing. In general, ask the Skipper before playing with any of this stuff.
Get Caught in a Rope Under Load
Mitigations
Know how to handle lines. Stay clear of the Jib sheets while Tacking and Gybing. Stay clear of the Anchor Rode.
Safety Note: Alcohol and Drugs
When skipper or crew is under the influence, the likelihood and severity of all of these safety risks increases. For example, falling overboard is both more likely and more difficult to recover from when either Crew or Skipper is under the influence.
Generally, alcohol is to be avoided except when the boat is docked or on a mooring. When at anchor, alcohol is to be limited to one or two drinks with dinner. There is always a real risk that the anchor will drag and the Crew will need to pull it and re-anchor. This can be dangerous since it usually occurs at night, with already sleepy Crew, limited visibly, high seas, and most “good” anchoring spots taken by other boats. If the Crew is also drunk, the danger is multiplied. The same is true for a mooring, but the likelihood of dragging or slipping the mooring is much lower.