Human Factors in Aviation Maintenance - Research Paper Example

Human Factors in Aviation Maintenance Abstract The study looks to provide to the practices of human factors in aviation maintenance. The study revolves around the important role played by human factors in case of aviation maintenance and security. Relation between the aviation industry and human factors is a complex and vast topic. However, the study looks to present the complex relationship in a simple and concise format; so that even a lay man can able make out the importance of the relationship. Introduction The term human factor can be explained as the application of knowledge by individuals or human beings. The knowledge could be from diverse fields of interests such as psychology, physiology, anthropology, medical science, engineering, construction, maintenance, management, etc. The main objective of the application of human factors is to reduce the chances error and build safer and better products and systems. Maintenance is an important part of aviation safety. Despite of such importance, lack of proper maintenance causes a significant amount of aviation accidents. This is mainly due to the fact that a certain percentage of the maintenance tasks are carried out in correctly or even het omitted; mainly due to human negligence. Some of the examples of such human error include machine parts installation in correct fashion, negligence in required checking, missing parts, etc. Studies have revealed that majority of the aviation accidents occur due to errors in maintenance; even though, there is no such precise statistics stating that. However, one thing is for sure that the chances of detection of human errors are quite low. Such errors may not affect the aircraft immediately, but in the long run it can lead to severe consequences. The main objective of the study is to provide a layman’s explanation to the application and importance of human factors in aviation maintenance, accidents occurring due to human negligence and propose certain models so that the accidents occurring due to human negligence can be reduced. Critical human issues in aviation maintenance Maintenance professionals in the aviation industry often get confronted with some critical, yet unique human actors. Maintenance professionals work in a lot more hazardous environment as compared to any other job requiring labor power. The maintained work might be carried out in a cramped up space, at heights, in cold conditions and also in extreme heat. The work is extremely physically demanding and yet it may require great degree of concentration. Detailing and documentation is a key aspect of the maintenance work. Therefore a maintenance professional uses a pen probably as many times holding a screw driver. The work requires great degree of communication. Yet, communication it is extremely difficult due to the high level of noise. Most of the time, the problem solving is carried out by professionals under severe time constraints leading to high degree of stress. However, that is not all. The maintenance professionals are well aware of the risks associated with their mistakes. That is the reason many times work carried out by the professionals is related to the ob of the doctors. A doctor knows that his actions may be lead to the life or death of a patient. Same goes for maintenance professional. A slight bit of mistake can lead to an aircraft damage claiming lots and lots of lives. Such emotional angle increases the amount of mental stress on the professionals. There is also the factor of anxiety. Most of the times, the maintenance worker prepare for something that may or may not occur. Just like the medicines provided by Doctor Maintenance work can be both preventatives as well responsive. Typically the work can be divided in to two segement: Scheduled and unscheduled maintenance work. Scheduled works are mostly preventive. Such tasks are usually performed on regular basis. Unscheduled work is more corrective or responsive in nature. Such tasks are performed to respond to unplanned situations such as competent failure or aircraft damage, etc. Examples of Accidents related to Maintenance Japan Airlines, Boeing disaster, 1985 In the year 1985 one of the worst aircraft accidents ever claimed the lives of 520 passengers as the Beoing-747 lost control and crashed. The plane took off from Tokyo on the way to Osaka. As the plane reached an altitude of 24, 00 feet, the cabin suffered a decompression. It mainly happened due to failure of the rear bulk head. The hydraulic lines were also breached. Eastern Airlines L-1011, 1983 The Lockheed L-1011 took off with 162 passengers and 10 crewmembers for Miami. Suddenly due to the low oil pressure light on the center engine turned on. The engines were turned off and the flight captain decided to return to base. The aircraft was then cleared to climb at altitude of 20, 00 ft. However, on way to Miami the low pressure oils of the two engines again turned. 15 minutes after the center engine was turned off the right engine was on flames. After a while the left and right engine was on flame. The flight asked the passengers to get the life jackets on and prepare for emergency landing. Somehow, at an altitude of 40,000 ft, the crew was able to restart the center engine. On one engine the crew decided to come back to Miami. Luckily, there were no more casualties. Later on, the investigators found out that magnetic cheap detectors were installed on each of the engines without o- rings. Some other examples: Aloha Airlines Boeing, 1988, British Airways BAC, 1990 and many more. The PEAR Model The term PEAR has been used for more than a decade. The main purpose of the PEAR model is to pin point the human factors related to aviation industry. PEAR model consists of four key elements such as: People, Environment, Actions and Resources. People are the one who create jobs. People carry out the jobs in the environment. The jobs executed as referred to as actions. Resources are used by the people to conduct the job. In each of the three factors, the people factor is connected immensely. Aircraft electronics association treats PEAR as an excellent model to identify the human factors and the considerations. People Aviation maintenance should focus on the people factor the most. The people are the one that carry out the work. The people are the one that can deal with physical, psychological and physiological factors. The system should focus on the individual capabilities and factors affecting them, add to it the cognitive ability and the mental state should also be taken in to consideration. Environmental factors: Two main environmental factors must be considered in case of aviation maintenance. The most obvious is the physical environment. Add to that, there is an organizational environment also within the company. The most obvious physical environment includes noise issues, different temperature, layout, design, lighting, humidity, work place cleanliness, etc. The second factor to be considered is however tangible. The important organizational factors are mostly related to the coordination, cooperation, communication, values, corporate culture, mutual respect, etc. An organizational environment should always promote objectives, leadership and communications related to the profitability and safety factors. Actions An organization should consider all the successful human factors and analyze all the actions or tasks to be performed to ensure efficiency and safety. Resources The last letter in PEAR is the ‘R’. ‘R” stands for resources. To be really honest it is sometimes literally impossible to separate other elements from the resources. The people, actions and the environment usually control the use of resources (Edwards, 1988, p. 78). ACCIDENT CAUSATION: SWISS CHEESE MODEL The error committed by the maintenance professional could be the most seen aspect of the human factors related to the maintenance. But, to understand why and how the maintenance errors take place, one needs to understand the logical sequence in which the errors occur. Mr. James Reason developed a model to explain the logical sequence of occurrence of errors. This model is famously known as ‘Swiss Cheese’ model. This model helps the professional to find out the logical occurrence of the errors. This comes real handy to find out the root cause leading too such errors. This is mainly known as the root cause analysis. Individual actions Human errors are a great threat to most of the advanced technological systems. AS per studies human errors are involved in over 60 percent of the aircraft accidents. Therefore, it is not a surprise that human errors are a significant threat to airline maintenance issues. However, the use of the term human error may not imply to the problem related to the people. In quite a few cases maintenance errors can be a reflection the underlying hidden problems. Errors most defiantly are unwanted events; but the errors provide an opportunity for improvements also. Individuals actions leading to error can usually be described through two main approaches: psychological description and physical description. Physical descriptions One of the simplest ways to categorize human errors is to explain the errors as a set of observable actions. Errors can be divided in to timing, omission, precisions and omission. An omission can be describes as a failure to perform a required action. Say, leaving oil caps in an unsecured fashion. Commissions on the other hand are set of execution of set tasks that should have been avoided. Say, cross connection among cables. Precision and time are a set of work carried out at a wrong time in wrong order. Say, use of wrong settings on torque wrenches. Psychological descriptions Psychological errors can be categorized according to the intentions of a person at the time of the task performed. Say, rather than concluding that someone did not secure a connection, one can try to understand the mindset of the person at the time of the error. This can be achieved by asking certain specific questions like: Did they forget to do to so? Did they leave it loose intentionally? Did they expect someone else to do it? Some may argue that it literally impossible to know the mindset of a person. But, this may give certain indications leading to the root cause of the problem. There is however one certain advantage of psychological description. This approach enables someone to place the error in the organizational context. Say, if one concludes that the wok was not performed because the person probably forgot to execute it. Therefore required actions could be taken to prompt the memory, such as documentation. Local Conditions Individual actions leading to maintenance problems reflect conditions in which the work is to be executed or is being executed. Accurate identification of an error and the local condition leading towards the error is likely to be critical step in indentifying the way the system could be improved preventing errors. Some of the most local conditions leading to maintenance errors are being discussed in this section. Time pressure Delays to the aircraft due to maintenance errors may impose certain amount costs on the operators. Most of the maintenance work is carried out under time constraints. Time pressure is most certainly can’t be avoided incase of aircraft operations. But sometime a maintenance professional may find it hard to deal with the pressure cause by the aircraft departure time leading to errors. Most common errors are memory via lotions in procedure or lapse in memory due to the time factor (Dekker, 2002, p. 29). Maintenance procedures and documentation Aircraft maintenance has always been heavily dependent documented procedures. According research any aircraft maintenance professional usually spends 30 to 40 percent of the time dealing with documentation related to maintenance. However it has also been seen that poor documentation is one of the main reasons for maintenance related problems. Poor maintenance may lead to a range of diverse errors like technical understanding, violations in rules, etc. According to a survey conducted by the US maintenance technicians showed that the majority of the respondents overcame the problems related to following of procedures via discussion with the peers. In appropriate procedures are the most common reasons for procedural valuations. Hence it can be summed up that three is most certainly a way to narrow the gap between the people who write technical procedures and those who actually carry it out. Teamwork Maintenance workers usually work alone. However, from time to time they also need to communicate and co-ordinate with personnel from other departments also. Problems related to communication and co-ordination such as incorrect assumptions, misunderstandings, etc. leads to problems. According to a survey, most of the maintenance engineers treated communication skills as the most important for success at work. The figure below shows a relatively simple model of communication. The diagram mainly explains the purpose only. This process gets a lot more complex in case of maintenance works as the workers have to communicate under noisy conditions. It may lead to a situation message was sent, was not received by ‘A’ or something else. Shift handover Most of the maintenance task, especially the ones needing heavy maintenance usually cannot be completed in a single shift. Maintenance workers often need to accept the concept of work in progress from the peers and pass on incomplete works to other shifts. Sometimes such handover of shifts happen without any face to face communication. This is why shift handover is treated as a critical aspect of maintenance work. Shift handover errors can be fatal as discussed before. There are mainly four types of shift hand overs (Dekker, 2005, p. 305). Type 1 handover: This is believed to be the ideal handover. The task is progressing normally before it is being handed over to another shift. After the handover, the work continues to proceed in a normally fashion. Type 2 handover: In this type of handover the work has gone off track in the first shift. But there is opportunity to get it back on track in the second shift. . Type -3 handover: In this case the task was performed in the correct fashion the first shift. But things started to go wrong in the second shift. Type 4 handover: This is probably the worst case scenario. In this case the error was made in the first shift. The error was also continued in the second shift. Risk controls The risk control was originally referred as ‘defenses’ by Mr. Reason. Risk control is all about countering and managing hazards related to the maintenance work. The risk control factor can be categorized into two categories: recovery risk control and preventive risk control. Preventive control is done to minimize the chances of unwanted factors such as human error. Classic examples of preventive risk control could be components designed to protect incorrect installation. Training or other procedures like the use of boards can also be a form of preventive risk control. Recovery risk controls are mainly derived to identify and recuperate e from potentially dangerous situation. Organisational influences on maintenance error It has already been discussed that maintenance error mainly occurs due to human errors made by the maintenance professionals. However, the experts also identify training, allocation of resources as well as the organizational culture and systems as organizational levels factors. For example maintenance violence may happen due to unavailability of correct tools that in turn may show the equipment buying policies and the financial restrictions. One of the main reasons for maintenance violation happens to be the time pressure. Time pressure may be a reflection of organizational planning, staff levels and job scheduling. Sometimes organizations try to minimize maintenance errors by reducing shift blame among workers. Also increase in profitability, customer satisfaction also act as an indication of reduced maintenance errors. Although human factors often lead to errors in maintenance, sometimes organizational diagnosis helps in reducing the overall maintenance errors (Bond, Rigney and Warren, 1989, p. 105). Error management systems There is an increasing amount on error management system within the airlines maintenance. It is treated as an important part of the overall safety management system of an organization. Safety management system is a cohesive approach that goes beyond organizational regulatory compliance. As per International civil aviation organization or ICAO, effective SMS needs strong commitment on the part of the management. SMS should be made an integral part of the corporate culture to ensure success. This really helps the management to encourage the professionals to communicate the errors to the authorities. Despite of all the detailed documentation the maintenance professionals may be not able to communicate with the management on daily basis. Hence the work done by the maintenance professionals could be less visible to the management as compared that of a pilot. The job done the pilots and their performance is under constant scrutiny. On the contrary if a maintenance professionals faces a problem while in a remote hangar the problem may not be known to the management, if it is not communicated by the professional itself. It may sound a bit strange, but there have been instances when an error becomes visible to the management after few years. Despite of such problems the overall culture revolving around maintenance is to discourage the professional to report the error to the management. There is still a lack of proper reporting because such error may have lead to strict disciplinary actions. In many companies, errors such as leaving the oil filled caps open may result in working for a month without pay. According survey 60 percent of the maintenance engineers said that the errors made by them were actually corrected by another engineer. But there is no official documentation, neither about the error nor about the repair. It was also said that the main reason to do so was to avoid the potential punitive actions. Some have proposed a blame free culture in the aviation industry to encourage reporting of the errors. However, that would mean that ‘no will be held for their actions’. Off late some airlines round the globe are promoting the ‘just’ culture. Here, some extreme procedural violations would be penalized only. However, in reality most of them won’t be (Bartsch, 2004, p. 67). Conclusion It is pretty needless to say that the aviation industry just cannot survive and function without the efforts of the maintenance professionals. However, maintenance errors continue to be a major threat to the aviation safety. Maintenance errors in the past were treated as nothing more than failures by individuals that were assigned to do the job. The organization used to rend in the form of some punitive actions. However, things have changed now the maintenance errors reflect that there are factors come in to play leading to errors. Such factors are interpersonal skills of the individual as well as other organizational factors. Therefore the organizational response to the maintenance errors has two probable directions. At first, maintenance error can be reduced by identifying and diagnosing the organizational factors leading to the errors. Second is the understanding fact that errors can be reduced, but not eliminated totally. The airlines companies should adopt the same action plan used to deal with hazards to minimize errors in maintenance. Reference Bartsch, I.C. (2004). Aviation Law in Australia (Second Edition). Australia: Thompson Law book Company. Bond, N.A., Bryan, G.L., Rigney, J.W., & Warren, N.D. (1989). Aviation Psychology. US: University of Southern California. Dekker, S.W.A. (2002). The Field Guide to Human Error Investigations. UK: Ashgate. Dekker, S.W.A. (2005). Ten Questions about Human Error: A New View of Human Factors and System Safety. US: Lawrence Erlbaum. Edwards, E. (1988). Introductory Overview: Human Factors in Aviation. US : Academic Press. Bibliography ATSB. (2006). Human Factors Course for Transport Safety Investigators. Canberra: Australian Transport Safety Bureau. Hawkins, F.H. (1987). Human Factors in Flight (Second Edition). London: Ashgate Publishing. Hopkins, A. (2005). Safety, Culture and Risk: The Organisational Causes of Disasters. Australia: CCG. Kirwin. B., (1994). A Guide to Practical Human Reliability Assessment. London: Taylor and Francis. Maurino, D.E., Reason, J., Johnston, N. & Lee, R.B. (1995). Beyond Aviation Human Factors. UK: Avebury Aviation. Read More