This paper investigates whether deficiencies detected during port state control (PSC) inspections have predictive power for future accident risk, in addition to other vessel-specific risk factors like ship type, age, size, flag, and owner. The empirical analysis links accidents to past inspection outcomes and is based on data from all around the globe of PSC regimes using harmonized deficiency codes. These codes are aggregated into eight groups related to human factor aspects like crew qualifications, working and living conditions, and fatigue and safety management. This information is integrated by principal components into a single overall deficiency index, which is related to future accident risk by means of logit models. The factor by which accident risk increases for vessels with above average compared to below average deficiency scores is about 6 for total loss, 2 for very serious, 1.5 for serious, and 1.3 for less-serious accidents. Relations between deficiency scores and accident risk are presented in graphical format. The results may be of interest to PSC authorities for targeting inspection areas, to maritime administrations for improving asset allocation based on prediction scenarios connected with vessel traffic data, and to maritime insurers for refining their premium strategies.