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Incident and Accident Investigation in Aviation Report

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Updated: Apr 22nd, 2022

Abstract

Accidents and incidents in aviation can be fatal. They may result to loss of life and cause damages to the aircraft as well as the ground. This report is an analysis of incidents and accidents in aviation. The aim of investigating is to establish the causes and to give appropriate recommendations. Since every incident and accident must be investigated, reports have been written and have given information on the nature of these accidents. It was discovered that many accidents are related to human factors, for example: fatigue, stress, medical conditions, workload and thinking ability, which affect the ability to perform. Mistakes in procedure, giving instruction and decision making can also cause accidents. Failure to service and adhere to maintenance of the aircraft as well as neglect of problems may lead to incidents or accidents. Communication facilities should be working efficiently and the workforce must be trained and be in good mental condition to undertake their tasks. Consequently, accidents can be prevented in most cases. To avoid occurrence of accidents and incidents, planning must be done and correct changes be made within the prescribed time. The aircraft must be in good condition and all the facilities must be in good shape. Human factors must also be addressed and training be given. Professionalism must be encouraged and workforce be given tasks within their capability.

Introduction

An accident occurs when the aircraft and the people inside are fatally injured or sustain any form of injury and the structure of the aircraft damaged. Sometimes, the aircraft cannot be traced and is declared missing. An incident happens when an occurrence that is not associated with an accident affects the operation, causing danger or risk in the aircraft safety. Aviation incidents and accidents occur mainly due to operational problems or human related mistakes. Accidents are fatal most of the times and may lead to the loss of life and destruction of the aircraft. Incidents and accidents investigations assist in giving findings and recommendations on the prevention of another accident. Investigations state the causes and lead to changes that are necessary for the safety of the aircraft. Investigation reveals the nature of the accident. This report will analyze incidents and accidents. It will examine the workforce, the aircraft, the causes, human factors, manufacturers, and the legal framework and give recommendations.

Methodology

The report has been based on literature review. Documentation on the accidents and incidents that have happened provide details on the possible causes and preventive measures of the accidents. Accidents and incidents are fatal and most of the time, an analysis is conducted and recorded, which makes it possible to gain knowledge on accidents and incidents. Intensive and extensive details of accidents are available from investigating organizations.

Analysis

The workforce

According to Ford et al (2007, p. 343), the pilot controlling and the pilot receiving instruction must be qualified and certified. Moreover, they must get medical examination to ascertain that are in good health. The number of flying hours that determine their working experience should be considered. Professional tests are important because they assess the proficiency of the pilot. Those who have stayed for long before practicing are required to take test for proficiency.

Air traffic controllers must be available to offer assistance. They are supposed give instruction of the movement and clearance. They send messages and give information on the weather and other operations. Their task is to ensure a traffic separation that is organized. The traffic controllers must undergo proficiency test and have a medical record that states that they are healthy (Senders and Moray 2001, p. 69).

In their discussion, Ford et al (2007, p. 343) noted that, although experience is highly recommended, the individual working may have difficulties coping with the workload. Human beings are capable of performing tasks up to a certain measure and then rest. Fatigue may hinder an experienced pilot or controller to perform efficiently.

Investigations on an accident must consider the working hours and time of rest of the workforce. They must be in good health and psychologically fit when they come to work. Medical record must indicate that they have a good eye sight. A clean medical record gives confidence that the pilot and the controller can safely control an aircraft (Ford et al 2007, p. 343).

The aircraft

The aircraft must adhere to the weight limit it is assigned. Senders and Moray (2001, p. 39) mentions that, exceeding the limits of the weight may have an impact. The flight must be with fuel before take off for the prescribed flight. The aircraft must get regular service. Additionally, the aircraft must receive maintenance to rule out any defects. Then the aircraft can be issued with the certificate showing that it is serviced and has gone for maintenance.

Ford et al (2007, p. 343) indicate that metrological information is important to determine the visibility and the safety of the aircraft. The risk of an accident increases if there is no visibility. The aircraft is unsafe if there are thunderstorms. Navigation aid is also important and reduces the risk of an accident.

Senders and Moray (2001, p. 39) indicate that; communication is very important and makes it possible for the controllers and the pilots to exchange information. The facilities for communication must be in good condition all the time. Whenever an incident or accident happens, the information that is exchanged prior to the accident helps determine the cause of accident. If the facilities of communication are in good condition, the accident can be avoided. Ford et al (2007, p. 343) states that recorded tapes also help in the study of the possible problems that may have occurred. Data on the particular aircraft should be available on clearance, communication, restrictions actions of the pilots and the details on the plan of the flight. Flight recording facilities assist in giving information that assists in the investigation of an accident.

Wreckage after an accident may be useful and provide information that may clarify the possible causes of the accident. The area with the wreckage must be secured for investigation. The distribution and the pattern of the wreckage should also be observed. The impact on the ground must be noted since it might be related to the accident. If it is a collision, the impact can be determined by observing the distribution of the wreckage. The angle at which the collision happens can also be studied from the wreckage. The speed too can be determined leading to a better understanding of the circumstances (Geller et al 2000, p. 32).

The impact of the collision and the impact on the ground may result in fire. In such instances, the wreckage may be burnt. Obtaining information on the possible causes may become complicated. Aircraft accidents are fatal and in most cases the survival is minimal.

Ford et al (2007, p. 343) reveal that recording of the actual aircraft accident may be available on video or photography if there was surveillance. The pictures may be helpful in the investigation. Computer graphics can also be generated to gain more understanding on the impacts and the prevailing circumstances of the accident.

Causes

According to Geller et al (2000, p. 30), inaccurate information from the control tower may cause an accident. With increased frequency and the schedules being tight, instructions must be given at the appropriate time. The work load may affect the ability of the controllers, where they may end up giving inaccurate information. Increased frequency implies that changes must be done and time to work increased.

The process of determining changes can be challenging. A process with an error may cause an accident. Timing and the availability of space may actually be a major challenge. However, it is essential that accurate process be used (Senders and Moray 2001, p. 39).

Ford et al (2007, p. 343) mention that system failure may cause an incident and accident. Aircraft that is old may be risky to use. If maintenance is not done as required, the system may fail and the accident may occur. International Civil Aviation Organization (2007, p. 7) points out that an old aircraft can be replaced with a new one. Lack of enough funds may be a hindrance to purchasing new ones. However, safety standards must be maintained and regular inspection be done.

An incident and accident may emanate from poor decision making. The decision may be inadequate for the problem. The controller or pilot may make a mistake in the procedure, misinterpret the available information or fail to notice a signal. They may also fail to use the available information or misuse useful information. The workforce failure to communicate at the appropriate time may result to the occurrence of an accident as discussed by Reason (1990, p. 11). Failure to use the resources available or lack of supervision may pose danger to the aircraft. Moreover, reluctance in making changes in areas that have demonstrated problems may eventually lead to accidents (Wiegmann and Shappel 2001, p. 6).

Human factors

Human factors are a major contributor of accidents. In line with Rasmussen (2002, p. 312), it is important to understand the situation of the pilot. Information on their ability to control must be assessed to determine that the task was within their capabilities. Moreover, it should be considered that psychological factors can affect the pilot and cause them to be unable to perform well.

The frequency of flights may be increased and the work load increase. Geller et al (2000, p. 29) says that changes in the frequency may cause additional effort and rapid decision making. The crew may be required to have additional devotion, besides being called to adjust to changes that come along with the busy schedules. The work load may have an impact of the crew as well as the controller.

The controller may become overwhelmed by the situation if it is beyond their capabilities. The situation may also seem manageable from the point of view of the controller. The case may be different if they underestimate the problem.

Reason (1990, p. 33) states that emotional stress and lack of rest may have an impact on the controller. Fatigue may cause them be unable to perform well and become prone to an accident. Personal issues, if unresolved, may also hinder their ability to perform. Some of the major personal issues include marital problems and financial problems.

Training is significant in enhancing the controller’s skills and experience. However, training and skills alone do not guarantee absolute safety. A problem that the controller needs to analyze and engage in reasoning may occur. The challenge is the nature of the problem may require an urgent solution within a time frame that the controller is unable to give a solution. Moreover, the workload will increase and may impact on his performance (Reason 1990)

Human beings ability to process information is limited. The pilot and the controller must be aware of the nature of human beings in decision making. A human being can only perform a single task in the brain, thus they must accept that they cannot be equivalent to machines. Their capability is limited by their ability to think. Depending on their ability to think, they can make the right decisions.

Controllers and pilots who have work overload tend to process information inaccurately. They also unconsciously fail to perform their designated duties and even fail to note signals. They take too long to respond and do so after being alerted when it is too late. The response may be lacking and inappropriate. When the problem continues, there is a tendency by the pilot or controller to unconsciously adopt an over learnt habit. The worst comes if they retire and withdraw by abandoning any attempts to solve the problem.

Rasmussen (2002, p. 312) notes that the voice and the tone of instructions can be analyzed. Whenever a mistake is realized instructions given are usually frequent and repetitive. Sometimes the tone may be raised. Whenever the pilot is aware of a forthcoming coming danger, their voice is characterized by a raised pitch. Workload may interfere with the period that the pilot of controller takes before they respond. The pilot may become anxious especially if they are unable to tolerate the workload

Manufacturers of the aircraft

The manufacturers of the aircraft have a major impact in the development of aircraft safety. When purchasing an aircraft, safety is considered one of the major factors. If a certain product has been found to be prone to accidents due to manufacturing faults, such an aircraft is not supposed to have been produced. Aircrafts with an exit system in case of an emergency are preferred. The aircrafts have been equipped with a computer system, alert systems and recovery system. The manufacturers have improved the turbine engines to that it lasts long (International Civil Aviation Organization 2007, p. 3).

The engines have been improved so that they can be contained in case of failure. Another major improvement by the manufacturing is the lowering of the landing gears. The gear can be lowered even in a situation where there is insufficient power (Geller et al 2000, p. 30).

Legal framework

Different countries have diverse approaches towards safety in the aviation. All of them have a common goal of minimizing accidents and the incidents. The parliament has been involved in issuing directives to enhance safety. Internationally, the 1994 Convention held in Chicago on the international Civil Aviation recommends and states the standards on aircraft investigations. The standards aim at preventing accidents and incidents.

According to the European Aviation Safety Agency (2011, p. 1), every incident and accident must be analyzed and a detailed report be documented. International Civil Aviation Organization (2007, p. 2) adds that the reports will enable the study of accidents and incidents. Considering the recommendations given in the report, future accidents can be avoided. Every accident must be reported and analyzed by experts. Details of the type of aircraft and situation are important and help in pointing out a common problem. The information becomes relevant and applicable to train the aircraft workforce.

In some states there is a body that is appointed to perform investigations on incidents and accidents in aviation. Their tasks include following up on all accidents and incidents to obtain a report. They also involve the expertise and give recommendations that they follow up on. They are involved in giving relevant information and directing significant measures (European Aviation Safety Agency 2011, p. 1).

Conclusion

This report concludes that a large number of accidents are preventable. The pilots and controllers receive training relevant to their task. Their duties are well shared with the emphasis of being available and following instructions accurately. They also get medical certificates of good health before they are assigned their duties. Normally, the aircraft receives services and regular maintenance before it is allowed to go ahead with the flight. The analysis should also consider the human factors that affect the operation. Human beings have a limitation and can only take a specific measure of instruction at a given time. They may be affected by psychological issues and personal problems and may be ineffective at work. Fatigue and stress may have an impact on an individual and affect one’s ability to receive instructions and to act. Accidents can be caused by poor decision making, inappropriate translation of messages, wrong procedures, following wrong instructions and loss of communication. Problems with the mechanical parts of the aircraft and operational difficulties can cause accident. An investigation on the wreckage gives information on the possible conditions that the aircraft experienced before the accident. Computer graphics can be generated where photos or video coverage is not available. Accidents may sometimes involve fire which may burn the wreckage and cause the investigation to have challenges. The manufacturer of the aircraft is a factor to consider since the aircraft comes with instructions. Some aircrafts have improved engine and computerized system that increase the safety. Civil Aviation Organization have legal framework that collect data and conduct investigation. They provide recommendation and give relevant information on aviation safety.

Safety recommendations

International Civil Aviation Organization (2007, p. 2) suggests that planning must be done whenever there is increased frequency. Using the updated information, the situation can be assessed. Revision must be made to include the chosen best options. The revised frequencies must be communicated to all the affected routes within the appropriate time. The controller making the changes must be involved in the monitoring so that they ensure instructions are adhered to.

Wiegmann and Shappel (2001, p. 7) say that, old aircrafts should be replaced with new ones and should not exceed the period of time it is designed to operate. Safety should be a priority and thus the inspection of the aircraft must be done regularly. European Aviation Safety Agency (2011, p. 1) insists that supervision, service and regular maintenance should not be compromised. The aircraft must be in good condition. Problems that are detected can be addressed immediately. Defects in models must be addressed and corrected by the manufacturers.

Every aircraft must be certified to be air worthy before the designated flight. It must have adequate fuel and every part of the aircraft must be functional. It is important to ensure that the communication facilities are in good shape. Communication should be done often and within the right time. The pilot and the controllers must always be alert and remain focused on their duty. The workforce must be ready to work and have a medical report (Rasmussen 2002, p. 312).

Human factor is a major contributor of accidents and must be addressed. Wiegmann and Shappel (2001, p. 2) argue that funding the research on human factor investigations is relevant. Data on the recorded accidents can also be retrieved and studied to obtain the patterns and to gain understanding.

The workforce must be mentally prepared to control and receive instructions. They must be adequately trained so that they can work under minimal supervision. The workforce must be able to manage their tasks appropriately and professionally. They must have enough rest and should not assume that they are capable of handling a challenge, even without resting enough (Wiegmann and Shappel 2001, p. 6).

Reference List

European Aviation Safety Agency., 2011. Accident and incident investigation: the legal framework. Web.

Ford, C., Jack, T., Crisp, V. & Sandusky, R., 2007. ‘Aviation accident causal analysis’. Advances in Aviation Safety Conference Proceedings, 4, 31-133

Geller, E., 2000. ‘Behavioral safety analysis: A necessary precursor to corrective action’. Professional Safety, 29-33.

International Civil Aviation Organization., 2007. Comprehensive Regional Implementation Plan for Aviation Safety. Web.

Rasmussen, J., 2002. ‘Human errors: A taxonomy for describing human malfunction in industrial in- stallations’. Journal of Occupational Accidents, 4, 311-333

Reason, J., 1990. Human error. New York: Cambridge University Press.

Senders, J. & Moray, N., 2001. Human error: Cause, prediction and reduction. Hillsdale, NJ: Earlbaum.

Wiegmann, D. A. & Shappel, S. A., 2001. ‘A Human Error Analysis of Commercial Aviation Accidents Using the Human Factors Analysis and Classification System’. Journal of Occupational Accidents. Web.

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