E238 Lesson 1 To 6 Combined

OFFICIAL (CLOSED) \ NON-SENSITIVE
Incorporating CAAS SAR Part 66:

Module 9 – Aviation Human Factor
Lesson 01
The need to take human
factors into account
Aviation Legislation and Human Factors (E238)
For Training Purpose Only Issue No: 0

Rev No: 0
Learning Outcomes
• Describe the 4 basic tasks relating to human factors
at workplace
• Explain the importance of human factors to be
applied in the workplace
• Examine the incidents attributable to human
factors/human error
• Elaborate Murphy’s law applicable to aviation human
factors
• Describe visual acuity, parts, and function of human
ears, and the effects on human performance
• Explain the impact of noise on hearing affecting
human performance
2
‘Aviation Human Factors’

An introduction
Let’s watch the video below
Crossed Wires
https://www.youtube.com/watch?v=566P25kin2g
3
Interactive Session
Discuss in team and share with the class:
List down the key human factors' issues.
How Perfect Twins Maintenance have

manage better?
4
The need to take human factors into account
Why do we need to maintain an equipment?

• Reliability
• By not maintaining the equipment, we run the risk of equipment
reliability that threaten;
• Efficiency
• Safety
• However maintenance is also a major cause of
system failure. In aviation there is evidence that
maintenance is contributing to an increasing
proportion of accidents.
• Understanding the human factors in maintenance, we
can improve;
• Safety
• Reliability
5
The cost of maintenance error

Maintenance errors not only pose a threat to flight safety, but can
also impose significant financial costs through;
• Delays,
• Cancellations,
• Diversions, and
• Other schedule disruptions.
For example, in the case of a large aircraft such as a Boeing 747-

400,
• A flight cancellation can cost the airline around 140,000 Euros,
• Delay at the gate can cost an average of 17,000 Euros per
hour.
In this context it can be seen that even simple errors such as gear
pins left in place, requiring a return to gate, can involve significant
costs. Even a small reduction in the frequency of maintenance
induced schedule disruptions can result in major savings.
6
‘Human Factors’ defined

• FAA Order 9550.8 Human Factors Policy:
• A multidisciplinary effort to generate and compile information
about human capabilities and limitations and apply that
information to equipment, systems, facilities, procedures, jobs,
environments, training, staffing and personnel management for
safe, comfortable, effective human performance.
• United Kingdom Health and Safety Executive:
• Human Factors refer to environmental, organizational and job
factors, and human and individual characteristics which
influence behaviour at work in a way which can affect health
and safety.
• Human Factors is about
• people in their living and working situations;
• their relationships with machines, with procedures, with the
environment around them and with other people.
7
What is ‘human factors’?

‘Human factors’ refers to the study of human capabilities and
limitations in the workplace. Human factors researchers study
system performance. That is, they study the interaction of
maintenance personnel, the equipment they use, the written and
verbal procedures and rules they follow, and the environmental
conditions of any system. The aim of human factors is to optimise
the relationship between maintenance personnel and systems
with a view to improving safety, efficiency and well-being.
Thus, human factors include such attributes as:

• human physiology
• psychology (including perception, cognition, memory, social
interaction, error)
• work place design;
• environmental conditions
• human-machine interface
• anthropometrics (the scientific study of measurements of the
human body).
8
Why Aviation Human Factors?
Efficiency
Safety
Well-being of
crew members
9
Unique human factors issues in aviation maint.
• Maintenance technicians work can be;

• Hazardous (heights, in confined spaces, in numbing cold or
sweltering heat).
• Physically strenuous.
• Required time to plan task.
• Environmentally noisy and required good communication and
coordination thus require to don hearing protection.
• Of time constraint and pressures
• Stressful.
• Error made by maintenance during their shift will have either had
an immediate impact or no impact at all.
10
Unique human factors issues in aviation maint.

• Maintenance can be divided into two categories.
• Scheduled and,
• Unscheduled maintenance.
Schedule Maintenance
• Preventive and performed regularly
• Likelihood of “absent minded” mistakes
• No lack of knowledge or skills
Unscheduled Maintenance
• Corrective in nature
• require extensive system knowledge, problem
solving and specialised skills 11
Incidents and accidents attributable to human

factors/human error
Causes/major contributory factors % of accidents in which this
was a factor;
• Pilot deviated from basic operational procedures 33
• Inadequate cross-check by second crew member 26
• Design faults 13
• Maintenance and inspection deficiencies 12
• Absence of approach guidance 10
• Captain ignored crew inputs 10
• Air traffic control failures or errors 9
• Improper crew response during abnormal conditions 9
• Insufficient or incorrect weather information 8
• Runways hazards 7
• Air traffic control/crew communication deficiencies 6
• Improper decision to land 6
12
factors/human error
It is clear from such studies that

human factors problems in aircraft
maintenance engineering are a
significant issue, warranting serious
consideration. 13
factors/human error
• Japan Airlines, Boeing 747, 1985
After the repair, the aircraft flew over 12,000 flights and underwent
six C checks before the accident occurred. The accident highlighted
the potential for maintenance errors to remain dormant for long
periods before having their effect.
• Eastern Airlines, L-1011, 1983

As the US National Transport Safety Board (NTSB) reported: ‘In
every incident ... management investigated the circumstances and
concluded that the problem was with the mechanics [engineers] and
not with the maintenance procedure.’ Rather than addressing the
wider system problems such as poor procedures and undocumented
norms, the incidents resulted in individual disciplinary action and
training.
14
factors/human error
The accident highlighted the potential for preventative maintenance
to introduce risk, and how a single error could be carried across
multiple systems.
• Aloha Airlines, Boeing 737, 1988

The NTSB concluded that the accident was caused by the failure of
Aloha Airlines to detect the presence of significant disbonding and
fatigue damage that ultimately led to the failure of the lap joint and
the separation of part of the fuselage. As a result of the accident,
the human factors of inspection became a major issue of concern,
particularly in the United States.
15

factors/human error
• British Airways, BAC 1-11, 1990
There were several human factors issues contributing to this
incident, including perceptual errors made by the SMM when
identifying the replacement bolts, poor lighting in the stores area,
failure to wear spectacles, circadian effects, working practices, and
possible organizational and design factors.
• Air Midwest, Beech 1900D, 2003

The NTSB noted that the US Federal Aviation Administration (FAA)
did not have a general requirement for complete functional checks
to be performed after maintenance on critical flight systems or
components.
16
factors/human error
• Excalibur Airways, Airbus A230, 1993
The misunderstanding was due, in part, to familiarity of the
engineers with other aircraft (mainly 757) and contributed to a
lack of adequate briefing on the status of the spoilers during the
shift handover.
• British Midland, Boeing 737-400, 1995

The incidents were characterized by the following:
• There were staff shortages;
• Time pressures existed;
• All the errors occurred at night;
• Shift or task handovers were involved;
• They all involved supervisors doing long hands-on tasks;
17
Interactive Session
Discuss in team and share with the class:
List the common issues and errors.
18
factors/human error
• There was an element of a ‘can-do’ attitude;
• Interruptions occurred;
• There was some failure to use approved data or company
procedures;
• Manuals were confusing;
• There was inadequate pre-planning, equipment or spares.
19
The Error Chain

Above accidents or incidents involved a series of human factors
problems which formed an Error Chain. Some of the factors that
can contributed to the above accident or incidents;
• Lack of inquisitiveness among team members to a particular
action.
• Failed to recognize or react to signs of potential hazards.
• Allowed themselves to be diverted from giving their attention to
the task in hand, leaving themselves open to the likelihood of
committing an error.
Can be prevented by;

• Strengthening the chain by building in measures to prevent a
problem at various stages.
20
Murphy’s Law
21
Murphy’s Law
• A rule that states, “If something can go wrong, it will.” An addition to
this law reads, “and usually at the worst time.” The identity of “Murphy”
is unknown, but the saying was first used during the 1940s and may
have originated with members of the armed forces in World War 2.
References:
http://www.dictionary.com/browse/murphy-s-law
http://www.murphys-laws.com/murphy/murphy-true.html
22
Murphy’s Law
• There is a tendency among human
beings towards complacency.
• The belief that an accident will

never happen to “Me” or to “My
Company” can be a major
problem.
• When attempting to convince individuals or organisations of the

need to look at human factors issues, recognise risks and to
implement improvements, rather than merely to pay ‘lip-service’ to
human factors.
23
factors/human error
Interactive session
• You have 10 minutes to watch the video or read through the
references.
Watch the video on British Airways Flight 5390 incident.

https://www.youtube.com/watch?v=9vbpdPo8c7k
• Reference:
https://en.wikipedia.org/wiki/British_Airways_Flight_5
390
24
Tasks
Tasks
26
Tasks
Physical work
Planning
Before commencing a task, an individual engineer, engineering team or
planner should ask themselves a number of questions.
These may include:
• Do I/we know exactly what is the task that has to be done?
• Are the resources available to do it effectively (safely, accurately and
within the time permitted)?
Where resources include:
• personnel;
• equipment/spares;
• documentation, information and guidance;
• facilities such as hangar space, lighting, etc.
• Do I/we have the skills and proficiency necessary to complete the task?
Job cards or task sheets
• Detail about information of task
• Scope of task (e.g. checks or inspection, repair, replacement, overhaul)
• details to aid the engineer (such as maintenance manual references,
part numbers, etc.)
27
Tasks
Physical tasks
• It is important that maintenance tasks on aircraft are within the

physical limitations of aircraft maintenance engineers.
• Physical work over a period of time will result in fatigue thus
adequate rest and recovery time between work periods are
required
28
Tasks
Repetitive tasks
Repetitive tasks can be tedious and reduce arousal (i.e. be boring).
29
Tasks
Danger of repetitive tasks;
• Engineer may cease to consult the maintenance manual, or to use
job cards
• The engineer may not be aware of the change if something in the
task is changed.
• Can results in complacency whereby an engineer may skip steps or
fail to give due attention to steps in a procedure, especially if it is to
check something which is rarely found to be wrong, damaged or
out of tolerance.
It is always advisable to be wary of changes to procedures or parts,

remembering that ‘familiarity breeds contempt’.
30
Tasks
Visual inspection
• Tools for Visual inspection;

• Magnifiers
• Borescope
• Good eyesight
• Often the principal method used to identify degradation or defect in

systems or components of aircraft.
• For a good reliable inspection, training, experience and common
sense are essential quality an engineer should process.
31
Tasks
There are various steps that an engineer can take to help him
carry out a reliable visual inspection. The engineer should:
• Ensure that he understands the area, component or system he
has been asked to inspect (e.g. as specified on the work card);
• Locate the corresponding area, component or system on the
aircraft itself;
• Make sure the environment is conducive to the visual inspection
task (considering factors described in subsection 9.5, physical
environment, such as lighting, access, etc.);
32
Tasks
• Conduct a systematic visual search, moving his eyes carefully in a
set pattern so that all parts are inspected;
• Examine thoroughly any potential degradation or defect that is seen
and decide whether it constitutes a problem;
• Record any problem that is found and continue the search a few
steps prior to where he left off.
Downside of visual inspection;

• It requires considerable amount of concentration which leads to low
arousal
• Low arousal can contribute to a failure to spot a potential problem
or a failure in recognising a defect during visual inspection.
Overcoming low arousal;

• take short breaks between visual inspection tasks.
• Non-destructive inspection (NDI) includes an element of visual
inspection, but usually permits detection of defects below visual
thresholds.
33
Tasks
Complex systems
With a complex system, it should still be clear to an aircraft

maintenance engineer what the system’s purpose is.
34
Tasks
Maintenance of complex system
• Attend system-specific training which would have furnished the
engineers with an understanding of how it works (and how it can
fail) and what it is made up of (and how components can fail);
• Engineer understands enough about the overall functioning of a
large, complex aircraft, but not so much that he is overwhelmed
by its complexity;
• Must have written procedures and reference material as an
important source of guidance.
35
Tasks
36
Human Performance and

Limitations #1
( Visual & Noise)
‘Human Performance and

Limitations’
“What the Experts say: Human Performance and its

limitations”
https://www.youtube.com/watch?v=_SSGJGHtMuY
38
Human Performance and Limitations
Performance Limitations
• Physical and Mental Human performance characteristic

• Vision
• Hearing
• Information processing
• Attention and Perception
• Memory
• Judgement and decision making
39
Vision
Anatomy of the eye:
Cornea
• Clear ‘window’ at the very front of the eye.
• Acts as a fixed focusing device.
• Responsible for 70% to 80% of light total focusing ability
Iris and pupil

• Coloured part of the eye
• Controls the amount of light that is allowed to enter the eye
The Lens
• Shape is changed by the muscles (cillary muscles) surrounding it
• Final focusing adjustment to place a sharp image onto the retina
• The change of shape of the lens is called accommodation
• Can be affected by factors such as fatigue or the ageing process
40
Vision
The Retina
• Made up of a complex layer of nerve cells connected to the

optic nerve
• Central area of the retina is known as the fovea
• Contain 2 types of sensitive cells
• Rod
 Located in periphery of the retina
 cannot detect colour
 poor at distinguishing fine detail
 sensitive at lower light levels
• Cones
 capable of detecting fine detail and are colour sensitive
 Function in good light
 Located at the Fovea
41
Vision
The sense of vision is the most important
• The cones in the retina of the eye require good light to
resolve fine detail.
• Colour vision requires adequate light to stimulate the cones.
Figure 1. The human eye 42

Vision
43
Vision
Common eye defects:
Short sight (near-sight) - known as myopia

• Eyeball is longer than normal
• image to be formed in front of the retina
• Distance object are blurred
• A concave lens overcomes short sightedness by bending light
outwards before it reaches the cornea
Long sight (far sight) - known as hypermetropia, or hyperopia

• Eyeball is shorter than normal
• image is formed behind the retina
• Blurred vision will result when looking at close objects
• A convex lens overcomes long sightedness by bending light
inwards before it reaches the cornea.
44
Vision
45
Vision
Blind spot
• Occurs at the point where the optic nerve enters the retina
(between the rods and cones).
• Hold the picture away and focus on the circle with your right eye.
Move the page slowly towards your face and at some point the
triangle will disappear - the blind spot.
46
Vision
Visual acuity
• Is the ability of the eye to discriminate sharp detail at varying
distances
Various factors can affect and limit the visual acuity of the eye:
• Physical factors
• influence of ingested foreign substances
• Environmental factors
• Factors associated with object being viewed
• Other visual problems
47
Vision
Colour vision
Good colour vision for maintenance engineers is important for:
• recognizing components;
• distinguishing between wires;
• using various diagnostic tools;
• recognizing various lights on the airfield (e.g. warning lights).
Colour loss at night

The reason for night myopia lies in the differing frequency of colours
that prevail by night, and the varying ability of the eyes lens to focus
them.
48
Hearing
Ears perform two function;
• Detect sounds by receiving vibrations in the air
• responsible for balance and sensing acceleration
Components of the ear
• Outer ear
 The outer part of the ear directs sounds down the auditory
canal, and on to the eardrum.
• Middle ear
 transmits vibrations from the eardrum by way of three small
bones known as the ossicles,
 protect the ear from sounds above 80 dB by means of the
acoustic or aural reflex, reducing the noise level by up to
20 dB.
49
Hearing
• Inner ear
 This contains a fine membrane (the basilar membrane)
covered in hair-like cells transmits vibration to the brain
via the auditory nerve
50
Hearing
Performance and Limitation of ears
The audible frequency range that a young person can hear is

typically between 20 and 20,000 cycles per second (or Hertz),
with greatest sensitivity at about 3000 Hz.
Impact of noise on performance
Noise can have various negative effects in the workplace. It

can:
• be annoying (e.g. sudden sounds, constant loud sound, etc.);
• interfere with verbal communication between individuals in
the workplace;
• cause accidents by masking warning signals or messages;
• be fatiguing and affect concentration, decision making, etc.;
• damage workers’ hearing (either temporarily or permanently).
51
Hearing
Hearing Impairment
• Depends on intensity of the noise
• Hearing loss can be temporary or permanent
• Volume (or intensity) of sound is measured in decibels (dB).
• Such damage is known as noise induced hearing loss
(NIHL)
Temporary loss
• caused by relatively short exposure to very loud sound
• Can last from a few seconds to a few days
• Additional exposure may lead to permanent hearing loss
Permanent loss
• Regular exposure to high levels of noise over a long period
52
Hearing
UK ‘Noise at Work’ regulations stipulate
three levels of noise at which an
employer must act:
85 decibels:
• assess the risk to employees’ hearing
• tell the employees about the risks and
what precautions are proposed;
• Provide ear protection and explain their
use
90 decibels:
• Reduce expose to noise
• Mark zone where noise reach 2nd level
and provide sign to restrict entry
140 decibels (noise causes pain).
53
Hearing
• The combination of duration and intensity of noise can be
described as noise dose.
• Exposure to any sound over 80 dB constitutes a noise dose,
and can be measured over the day as an eight-hour time-
weighted average sound level (TWA).
• recommended maximum TWA is 90 decibels. Permanent
hearing loss may occur if the TWA is above the recommended
maximum.
It is normally accepted that a TWA noise level exceeding 85 dB

for 8 hours is hazardous and potentially damaging to the inner
ear. Exposure to noise in excess of 115 decibels without ear
protection, even for a short duration, is not recommended.
54
Hearing
High and low tone deafness
• Normal human hearing range is 20

Hz to 20000Hz
• This is very important when
measuring noise since two sounds
of equal intensity, but of different
frequency, may appear subjectively
to be of different loudness.
• Deterioration of the sensory hairs
occurs with over exposure to
high levels of noise
• Long hair sensory; which detect
low frequencies, and
• Short hair sensory; which
detect high frequencies.
55
Hearing
Hearing protection
Noise levels can be reduced (attenuated) by up to 20 decibels

using ear plugs and 40 decibels using ear muffs. However, using
ear protection will tend to adversely interfere with verbal
communication. Despite this, it must be used consistently and as
instructed to be effective.
• It is good practice to reduce noise levels at source, or move noise

away from workers.
• Hearing protection should always be used for noise, of any
duration, above 115 dB
Presbycusis
• When one grows old, hearing deteriorates and it affects the ability
to hear high pitch sound first. When this natural decline is
exacerbated by noise induced hearing loss, it can obviously occur
rather sooner.
56
Interactive Session
Vision: Photoreceptors (Rods vs Cones)

https://youtu.be/_ElAuQyw4uA
Auditory Structure
https://youtu.be/6GB_kcdVMQo
Discuss in team: How do these two sensory affect

your learning in class. Each group is to present one
effect to class and no similar is to be presented ?
End of Week 1 57

Lesson 2
Limitations
For Training Purpose Only

Issue No: 0
Rev No: 0
Learning Outcomes
• Explain the Human information process affecting
Attention and Perception
• Evaluate Situation Awareness (SA) affecting decision
making
• Explain individual and group responsibility in the
aerospace MRO environment;
• Describe the impact of motivation and de-motivation
in driving the performance of an individual ;
• Explain the Team Working, Peer Pressure, and
Cultural Challenges that build the Safety Culture in
the aerospace MRO environment.
2

Limitations #2
(Attention & Perception and
Situation Awareness)
Information processing
Introduction to
“Information processing model”
https://www.youtube.com/watch?v=pMMRE4Q2FGk
4
This section examines the
way the information
gathered by the senses is
processed by the brain.
An information
processing model
• Captures the main

elements of the process,
from receipt of
information via the
senses, to outputs such
as decision making and
actions.
5
Sensory receptors
Physical stimuli are received via the sensory receptors (eyes, ears,
etc.)
Sensory Stores (Sensory memory)

• It is the shortest-term element of memory
• Echoic memory
 auditory sensory memory
 retained for up to two seconds.
• Iconic memory
 visual sensory memory,
 retained only for about 0.5 second.
• Haptic memory
 Touch sensory memory
 retained only for about 10 second
6
Cognition
• The standard information processing model has 3 major
components:
 sensory memory,
 working memory (i.e., short-term memory), and
 long-term memory.
Sensory Working Explicit

Memory Memory LTM
Iconic,
Subsystem Auditory, Semantic,
Echoic
s Haptic
Visual-spatial Episodic
Iconic – 0.5s
Duration Echoic – 2.0s 10 – 30s Lifetime
Haptic – 10s
Capacity limited 7 ± 2 chunks Unlimited

7
• Information is passed from
the sensory memory into
short-term memory via the
process of attention
• Attention is a cognitive
process that allows us to
focus on particular
environmental stimuli.
• Perception is the process of
recognizing different stimuli.
8
Attention and perception
• Attention is influenced by arousal level and stress.

• Types of attention
• Selective - attention cannot be focused on more than one thing
at a time. It has a limited capacity.
• Divided - is concentration on more than one thing
(for example, listening to two people speaking at once).
• Focused - Focused attention is the state of concentrating on one
stimulus to the exclusion of all others.
• Sustained - "the ability to direct and focus cognitive activity on
specific stimuli." In order to complete any cognitively planned activity,
any sequenced action, or any thought one must use sustained
attention.
9
Perception
• transforming data into information

• requires existing knowledge and experience to know what data to keep and
what to discard, and how to associate the data in a meaningful manner.
Decision making
Is the generation of alternative courses of action based on available

information, knowledge, prior experience, expectation, context, goals,
etc. and selecting one preferred option. It is also described as thinking,
problem solving and judgment.
Confirmation bias
Once we have formed a mental model of a situation, we often seek information
which will confirm this model and, not consciously, reject information which
suggests that this model is incorrect.
10
Perception illusions
Importance of context
Visual illusions
11
Interactive session
Are you attentive?

1) https://www.youtube.com/watch?v=IGQmdoK_ZfY
Lecturer will play the 1st 40 seconds of the clip & pause to allow
students share their responses.
Lecturer will then proceed to play the entire video.
2) https://www.youtube.com/watch?v=ubNF9QNEQLA
Lecturer will play the 1st 51 seconds of the clip & pause to allow
students share their responses.
Lecturer will then proceed to play the entire video.
How observant were you? Are you really detailed ?

12
Attention and perception shortcomings
• Can impinge on decision making

• Depending on Human memory to make decision is fallible as
information;
• may not be stored;
• may be stored incorrectly;
• may be difficult to retrieve
• Forgetting is when information is not available (not stored in the

first place) or inaccessible (cannot be retrieved).
• To avoid forgetting;
• Use manual
• Use temporary aide-memoires
13
14
Memory
• Memory can be considered to be the storage and retention

of information, experiences and knowledge, as well as the
ability to retrieve this information.
• Memory depends on three processes:

• registration - the input of information into memory;
• storage - the retention of information;
• retrieval - the recovery of stored information.
• It is possible to distinguish between three forms of memory:

• Ultra-short-term memory (or sensory memory);
• Short-term memory (often referred to as working
memory);
• Long-term memory.
15
Memory
16
Memory
Ultra Short Term memory
• Sensory information storage
• Duration up to 2 sec
Short Term memory

• Duration 10 to 20 sec
• Store information in five to nine (often referred to as 7 ±2) items of
information
• Duration of short term memory can be extended through;
• Rehearsal
• Encoding the information in some meaningful manner
• Short-term memory is particularly susceptible to interference
Long Term memory

• Capacity unlimited
• Divided into 2 types; Semantic memory & Episodic memory
• Motor programs; ingrained routines that have been established
through practice
17
Memory
18
Interactive session
Let’s play a memory quiz game
Watch the video

In your team identify as many as possible the correct
logos of world-famous companies and brands,
https://www.youtube.com/watch?v=l5wNel08clA
How many logos did you get it right because you actually
pay attention to their details?
Do you always remember what your teacher says and
revise in class?
In your team suggest 2 ways how you can improve your

memory ?
19
Situation Awareness
Situation awareness is the synthesis of an accurate and up-to-date
‘mental model’ of one’s environment and state, and the
ability to use this to make predictions of possible future states.
In Maintenance engineering context, it refers to:

• the perception of important elements, e.g. seeing loose
bolts or missing parts, hearing information passed verbally;
• the comprehension of their meaning, e.g. why is it like this?
Is this how it should be?
• the projection of their status into the future, e.g. future
effects on safety, schedule, airworthiness.
To improve situational awareness;

• feedback - informing us of the accuracy of our mental models
and their predictive power
• project system status backward - determine what events may
have led to an observed system state, as it allows effective fault
finding and diagnostic behaviour.
20
Situation Awareness
Situation awareness for the aircraft maintenance engineer can
be summarized as:
• the status of the system the engineer is working on;
• the relationship between the reported defect and the intended
rectification;
• the possible effect on this work on other systems;
• the effect of this work on that being done by others and the
effect of their work on this work.
21
Situation Awareness
22
Claustrophobia, physical access and other phobias
Physical access and claustrophobia
Claustrophobia can be defined as abnormal fear of being in an

enclosed space.
• Work in team to assist one another making allowances for the

fact that people come in all shapes and sizes and that it may be
easier for one person to access a space, than another.
• Aware of fellow colleagues if they may difficulty in working in
enclosed space
Fear of heights
• it is very important that appropriate use is made of harnesses and
safety ropes.
• Avoid such task if it can affect safety
END 23
Social Psychology
(Responsibilities, Individual
Performance, and Safety
Culture)
Interactive session
‘Social Psychology’
Overview of the topic this week
“What the Experts say: Teamwork”
https://www.youtube.com/watch?v=iCs1-HTZJxk
Discussion about teamwork:

What are the characteristics of a good team member?
25
Social Psychology
• This section draws together issues relating to the social context
in which the aircraft maintenance engineer works. This includes
the organisation in which he works and how responsibilities
may be delegated, motivation, and aspects of team working,
supervision and leadership.
• The various factors within a system in which Aircraft
Maintenance Engineer works can range from:
• knowledge, skills and abilities
• environment in which he works
• culture of the organisation for which he works
Organisational culture – It is the company own set of philosophy,

policies, procedures, selection and training criteria, and quality
assurance methods.
26
Social Psychology
27
Social Psychology
Responsibility: individual and group
• If someone is considered responsible, they are liable to be
called to account as being in charge or control of, or
answerable for something.
• responsibility should be spread across all those who play a part
in the activity.
Individual responsibility
Advantage:
• Will mostly do well for a given task
Disadvantage:
• overlook the importance of working together as a cohesive
team or group to achieve goals.
28
Social Psychology
Group or team responsibility
Advantage:
• Ownership as a group. May involve cross checking others work
Disadvantage:
• Diffusion of responsibility. A notion of “someone else will do it”.
• May act against safety.
Phenomena to be aware of when working in group or team;
Intergroup conflict:
• rivalries may arise between this team and others.
• implications in terms of responsibility, with teams failing to share
responsibility between them.
Group polarisation
• tendency for groups to make decisions that are more extreme than the
individual members’ initial positions. This is known as risky shift
29
Social Psychology
Social loafing
• tendency for some individuals to work less hard on a task when
they believe others are working on it.
In summary, Responsibility in Aircraft Maintenance Engineering

ought to be addressed by;
• licensing, regulations and procedures
• education and training
• Incorporate culture of shared responsibility
30
Social Psychology
Motivation and de-motivation
Motivation can be thought of as a basic human drive that arouses,
directs and sustains all human behaviour. Generally, we say a
person is motivated if he is taking action to achieve something.
Can be affected by:

• Financial bonus
• Weather condition
Two type of motivation;

• External: system rewards & punishments. Less effective
compare to internal
• Internal: do it because we want to.
• What people want from work:
o To feel valued and competent
o To feel in control (to a degree)
31
Social Psychology
Reward and Punishment
32
Social Psychology
Maslow’s hierarchy of needs
humans are driven by two different sets of motivational forces:
• those that ensure survival by satisfying basic physical and psychological
needs;
• those that help us to realize our full potential in life known as self-
actualization needs (fulfilling ambitions, etc.).
33
Social Psychology
Highly motivated people tend to show the following

characteristics:
• high performance and results being consistently achieved;
• the energy, enthusiasm and determination to succeed;
• unstinting co-operation in overcoming problems;
• willingness to accept responsibility;
• willingness to accommodate change.
De-motivated people tend to demonstrate the following

characteristics:
• apathy and indifference to the job, including reduced regard
for safety whilst working;
• a poor record of time keeping and high absenteeism;
• an exaggeration of the effects/difficulties encountered in
problems, disputes and grievances;
• a lack of co-operation in dealing with problems or difficulties;
• unjustified resistance to change.
34
Social Psychology
Extrinsic vs. Intrinsic Motivation: Which Is Best?
The over-justification effect;

offering excessive external rewards for an already internally
rewarding behaviour can lead to a reduction in intrinsic motivation.
Three primary conclusions with regards to extrinsic rewards and

their influence on intrinsic motivation:
• Unexpected external rewards typically do not decrease intrinsic
motivation.
• Praise can help increase internal motivation.
• Intrinsic motivation will decrease, however, when external
rewards are given for completing a particular task or only doing
minimal work.
35
Social Psychology
36
Social Psychology
Peer pressure
• Peer pressure is the actual or perceived pressure which an individual may feel,
to conform to what he believes that his peers or colleagues expect.
• Peer pressure thus falls within the area of conformity. Conformity is the tendency
to allow one’s opinions, attitudes, actions and even perceptions to be affected by
prevailing opinions, attitudes, actions and perceptions.
Susceptibility
View of individual can be affected by conformity or peer pressure which include:
• Culture
• Gender (men tend to conform less than women);
• self-esteem (a person with low self-esteem is likely to conform more);
• familiarity of the individual with the subject matter
• the expertise of the group members
• the relationship between the individual and group members
Countering peer pressure and conformity

• Air individual view publicly from the outset
• Inculcate safety culture among team members so that peer pressure and
conformity perpetuates this.
37
Social Psychology
Culture issues
The culture of an organisation can be described as ‘the way we do
things here’. It is a group or company norm.
It is possible to have cultures difference which affect individual

organisation;
• Sites
• between shifts within the same organisation
• industry as a whole
38
Social Psychology
39
Social Psychology
Safety culture
• can best be judged by what is done rather than by what is said.

• policies are preached at the top are actually put into practise at the lower levels.
• It may be difficult to determine the safety culture of an organisation by auditing
the procedures and paperwork; a better method is to find out what the majority of
the staff actually believe and do in practice.
• Engineer a just culture - an atmosphere of trust, where people are encouraged,
even rewarded, for providing essential safety related information.
Social culture
Individual’s background or heritage can be important in determining how an

individual integrates into an organisational culture.
Can be affected by;

• different nationalities,
• different political views,
• different religious beliefs
40
Social Psychology
Culture: a workable definition
Shared values (what is important) and beliefs (how things work)
that interact with an organisation’s structure and control systems to
produce behavioural norms (the way we do things around here).
Significant of Cultures:
• Defences, barriers and safeguards take many different form
• organisational culture has far reaching effects on defences (for
good or ills).
Culture: two aspects

• Something an organisation is: shared values and beliefs.
• Something an organisation has: structures, practices, systems.
• Changing practices is much easier than changing values and
beliefs.
41
Social Psychology
Engineering a safety culture
Safety culture = informed culture
• An informed culture means not forgetting to be afraid in the
absence of bad accidents.
• An informed culture means collecting data about incidents
and near misses.
• An informed culture is one in which those who manage the
system know where the ‘edge’ is without falling over it.
“Trust lies at the heart of developing a reporting culture”
42
Social Psychology
The blame cycle
Answer lies in two parts:
• fundamental attribution error – attributes to person’s character or
ability
• illusion of free will – People are assumed to be the least constrained
factor causing an accident.
Avoiding the blame cycle

• Recognise that human actions are almost always affected by factors
outside a person’s control.
• Recognise that people cannot easily avoid those actions they did not
intend in the first place.
• Recognise that errors are consequences rather than causes. The
beginning of search rather than end.
• Recognise that in a well-trained and well-motivated workforce,
situations are easier to fix than people.
The main focus of error management must lie: in changing the

conditions that provoke errors rather than trying to change
humankind. 43
Social Psychology
44
Social Psychology
Engineering a just culture
Line should be drawn between acceptable and unacceptable actions,
between blameworthy and blameless behaviour.
• A ‘no blame’ culture is neither feasible nor desirable.
• Some unsafe acts deserve sanctions.
• A ‘just’ culture depends on:
− the trust of the workforce
− knowing the difference between acceptable and unacceptable
behaviour.
The law
The law identifies two kinds of actions: those that are merely negligent and
those that are reckless. The latter clearly deserve some kind of sanction,
even dismissal.
• Negligence: involves bringing about a bad consequence that a
‘reasonable and prudent person’ would have foreseen and avoided.
Actions do not need to be intended. Mainly an issue for civil law.
• Recklessness: involves taking a deliberate and unjustifiable risk. Mainly
an issue for criminal law. 45
Social Psychology
The substitution test
After an unsafe act has been committed, the perpetrator’s peers are asked
whether or not it could have happened to them. We all recognise human
fallibility. We all know that we have made mistakes in the past. If the peers
say it could have happened to them, then the act is probably blameless.
46
Social Psychology
Personality types
The five factors model;

• Openness - appreciation for art, emotion, adventure, unusual ideas,
curiosity, and variety of experience.
• Conscientiousness - a tendency to show self-discipline, act dutifully,
and aim for achievement; planned rather than spontaneous behaviour.
• Extraversion - energy, positive emotions, surgency, and the tendency to
seek stimulation and the company of others.
• Agreeableness - a tendency to be compassionate and cooperative
rather than suspicious and antagonistic towards others.
• Neuroticism - a tendency to experience unpleasant emotions easily,
such as anger, anxiety, depression, or vulnerability; sometimes called
emotional instability.
When scored for individual feedback, these traits are frequently
presented as percentile scores
Accident prone
Accident proneness is associated with unstable extroverts.
47
Social Psychology
48
Social Psychology
Team working
The concept of a team

• Teams are associated with interdependence and working together in
some way to achieve one or more goals.
• Teams may comprise a number of individuals working together towards
one shared goal
• Have a recognized leader and one or more follower(s).
Advantage of Team working

• individuals can share resources (knowledge, tools, etc.);
• they can discuss problems and arrive at shared solutions;
• they can check each-others’ work (either ‘officially’ or ‘unofficially’).
• Having a team identity encourage pride in the product of a team.
• A share ownership of task
• Awareness of team members weakness and strength
Disadvantage of Team working

• May cause problem if not handled correctly when work is to be handed
to next team
49
Social Psychology
Important elements of team working
For team to function cohesively and productively, they must have;

• Communication
• exchanging work-related information within the team
• important to listen to what others say.
• Co-operation
• Fairness and openness within the team encourage
cohesiveness and mutual respect.
• Co-ordination
• delegation of tasks so that all the resources within the team
are utilised and supervised and monitored as required.
• Mutual support
• heart of the team’s identity
50
Social Psychology
Management, supervision and leadership
Management, supervision and leadership are all skills that a team leader
requires
Characteristics of a leader
A leader in a given situation is a person whose ideas and actions influence
the thought and the behaviour of others.
A good leader in the maintenance engineering environment needs to

possess a number of qualities:
• Motivating his team;
• goals or targets of the work need to be clearly communicated and
manageable
• honest and open, highlighting any potential problems and where
appropriate encouraging team solutions.
• Reinforcing good attitudes and behaviour;
• Give recognition for good work
• bad habits are eliminated and inappropriate actions are
constructively criticized.
51
Social Psychology
• Demonstrating by example;
• personal understanding of the activities and goals of the team
• establishes a good safety culture within a team through his attitude
and actions
• Maintaining the group;
• Encourage ‘team spirit’ where the team members support each
other and feel responsible for the work
• recognize and resolve disputes
• Fulfilling a management role.
• responsible for coordinating the activities of the team on a day-to-
day basis, which includes allocation of tasks and delegation of
duties.
End of Lesson 02 52
Interactive session
Watch the video “Just Culture at skyguide

2017?”
https://www.youtube.com/watch?v=nGcbivj3wqg
Team Activities:
Group discussion on how “Just Culture” is applied and

each team member to come out with ONE word to best
describe “Just Culture“
53

Lesson 3
Social Psychology (Dirty
Dozen)

Issue No: 0
Rev No: 0
Learning Outcomes
• Apply ‘The Dirty Dozen Principles” in the case study

to determine the root cause of aviation incidents and
accidents in accordance with UK CAA CAP715
2
The Dirty Dozen

Twelve most common causes of maintenance errors:
(Often a combination of a few causes)
• Lack of Teamwork • Pressure

• Lack of Resources • Distraction
• Lack of Awareness • Fatigue
• Lack of Communication • Stress
• Lack of Knowledge • Complacency
• Lack of Assertiveness • Norms
The Dirty Dozen of Aircraft Maintenance - FAA/EASA "MAG" Compliant

Human Factors Training
https://www.youtube.com/watch?v=AS0qrIvtECo
Recap from Lesson 1.
Introduction to Case Study

“Eastern Air Lines Flight 855, L1011 aircraft, May 5th 1983”
How can the DIRTY DOZEN be applicable to this ?
4
The Dirty Dozen Factors in Aviation
LACK OF COMMUNICATION
This is simply the failure to exchange information. The training
should focus on not only how this comes to happen, but also what
safety net will prevent it. Very simply, in good communication, “the
mental pictures must match.”
• Safety Nets
• Use logbooks to communicate, to remove doubt.
• Discuss work to be done and what has been completed to
the one taking over from you.
• Never assume anything, always check.
5

COMPLACENCY
This is where we become so self-satisfied that we lose awareness
of dangers. It is sometimes called overconfidence and creeps in as
we become more proficient at what we do. Awareness of this
insidious contributing factor is one of the safety nets that can help to
reduce it.
Safety Nets
• Train yourself to expect to find a fault and to consistently

look out for these faults or hazards.
• Never sign for anything you didn’t do.
• Never assume anything, always check.
6
LACK OF KNOWLEDGE
With constantly changing technology, this contributor to an error is
more common than we think. Add to that the fact that the average
human only retains about 20 percent of what they learn, unless
they use it often. Training is one of the best safety nets we have to
help avoid human error.
Safety Nets
• Don’t rely on memory and consult the relevant up to date

manuals.
• Always ask if you are in doubt. Get training on type.
7

DISTRACTION
This is anything that takes your mind off the job at hand even
for an instant. Our mind works much quicker than our hands,
and thus we are always thinking ahead. Any distraction can
cause us to think we are further ahead than we actually are.
This contributing factor is known to be responsible for at least
15% of all aviation accidents.
Safety Nets
• Always finish the job or unfasten the connection.

• Document and handover the uncompleted work. When
you return to the job, reinspect by another or always go
back three steps by yourself.
• Use a detailed check sheet.
8

LACK OF TEAMWORK
The larger an organization becomes, the more common this
contributing factor is. Because teamwork is constantly evolving and
changing, it must be constantly worked on to prevent accidents from
occurring. It is hard to gain and very easy to lose.
Safety Nets
• Discuss what, who and how a job is to be done.

• Be sure that everyone understands and agrees through
good communications and co-ordination with team
members.
• Look out for one another.
9

FATIGUE
This is considered the number one contributor to human error. It is
insidious, and the person fails to realize just how much his/her
judgment is impaired until it’s too late. Fatigue seldom works alone
but is a contributor to one or more of the other dirty dozen.
Safety Nets
• Be aware of the symptoms and look for them in yourself and

others.
• Plan to avoid complex tasks when you are physically
exhausted.
• Sleep and exercise regularly. Ask others to check your work.
If you are fatigued, take a break.
10

LACK OF RESOURCES
Lack of resources to safely carry a task has caused many fatal
accidents. For example, an aircraft is dispatched without a
functioning system that normally would not be a problem suddenly
encounters circumstances where it does become a major problem.
Safety Nets
• Check suspect areas at the beginning of the inspection.

• Order and stock anticipated parts before they are required.
• Know all available parts sources and arrange for pooling or
loaning.
• Maintain a standard and if in doubt ground the aircraft.
• Preserve all equipment through proper maintenance.
11

PRESSURE
Pressure to be on time is ever-present in the aviation industry. We
are very time-sensitive and many decisions center on that fact. Over
64 percent of pressure-caused errors are caused by self-pressure.
One has to learn how to recognize and deal with pressure.
Safety Nets
• Be sure the pressure isn’t self-induced.
• Communicate your concerns.
• Request for assistance.
• Just say No.
12

LACK OF ASSERTIVENESS
Lack of confidence in failing to speak up when things don’t seem
right has resulted in many fatal accidents. However, assertiveness
also calls for listening to the views of others before making a
decision. Assertiveness is that middle ground between being
passive and aggressive.
Safety Nets
• Be assertive and provide clear feedback when danger is perceived.

• If it’s not critical, record it in the journey log book and only sign for what
is serviceable.
• Refuse to compromise your standards.
• Allow team members to give their opinions and accept criticisms
positively
13

STRESS
Stress is the subconscious response to the demands placed upon a
person. We all have some stress in our lives, and it is not all bad
until it becomes excessive and we have distress. We must learn
how to manage stress, or it will manage us with a high probability
that human error will occur.
Safety Nets
• Be wary of the effects of stress on your performance.

• Stop and look rationally at the problem.
• Determine a rational course of action and follow it.
• Take time off or at least have a short break.
• Discuss it with someone.
• Ask fellow workers to monitor your work.
• Exercise your body.
• Ensure sufficient rest at all times.

LACK OF AWARENESS
Lack of awareness occurs when there is a lack of alertness and
vigilance in observing. This usually occurs with very experienced
personnel who fail to reason out possible consequences to what
may normally be a good practice. One of the safety nets for lack of
awareness is to ask more “what ifs” if there is conflicting
information or things don’t quite seem right.
Safety Nets
• Think of what may occur in the event of an accident.

• Check to see if your work will conflict with an existing
modification or repair.
• Ask others if they can see any problem with the work done by
checking periodically to ensure correct work procedures.
15

NORMS
This is the last (twelfth) factor in ‘The Dirty Dozen’. Norms is short
for “normal,” or the way things actually are done around an
organization. Norms are unwritten rules followed or tolerated by the
majority of a group. Negative norms are those that detract from an
established safety standard.
Safety Nets
• Always comply with defined work procedures.

• Be aware that “norms” don’t make it right.
16

Lesson 04
Factors Affecting
Performance

Issue No: 0
Rev No: 0
Learning Outcomes
By end of the lesson, the students should be able to :
• Describe the effects on individuals from different physical
working environments
• Explain the effects of drugs, alcohol, caffeine, and medication on
individual performance
• Evaluate the impact of the seven (7) performance factors that
affect individuals performing the MRO activities
2
Interactive Session
‘Factors Affecting Performance’

Overview of the topic this week
"Grounded" - A story of Fatigue
https://www.youtube.com/watch?v=FNsXpG4J8AQ
A brief discussion on “Symptoms” and “Causes” and

Consequences of “Fatigue”
3
Fitness and health

Regulatory requirements
Presently there are no defined requirements for physical or mental

fitness for engineers or maintenance staff. However;
ICAO Annex 11 states;

An applicant shall, before being issued with any licence or
rating [for personnel other than flight crew members], meet
such requirements in respect of age, knowledge, experience
and, where appropriate, medical fitness and skill, as specified
for that licence or rating.”
Article 36 of the Air Navigation Order (ANO) states;

“The holder of an aircraft maintenance engineer’s licence
granted under paragraph (1) or of an aircraft maintenance
licence granted under Part 66 must not exercise the
privileges of such a licence if the holder knows or suspects
that their physical or mental condition renders them unfit to
exercise such privileges.”
4
Fitness and health

Two aspects to fitness and health: the disposition of the engineer
prior to taking on employment and the day-to-day wellbeing of the
engineer
Pre-employment disposition
• Medical examination to ascertain fitness for employment

• an airworthiness authority, when considering issuing a licence,
will consider these factors and may judge the condition to be of
such significance that a licence could not be issued
Day-to-day fitness and health

• can be reduced through illness (physical or mental) or injury
• it is important that the engineer is aware that his performance,
and consequently the safety of aircraft he works on, might be
affected adversely by illness or lack of fitness.
5
Fitness and health

Take positive steps to remain healthy.
6
Stress: domestic and work related

Stress
• Stress can be defined as any force, that when applied to a system, causes some
significant modification of its form, where forces can be physical, psychological or
due to social pressures.
• From a human viewpoint, stress results from the imposition of any demand or set
of demands which require us to react, adapt or behave in a particular manner in
order to cope with or satisfy them.
• From these we can get acute stress (typically intense but of short duration) and
chronic stress (frequent recurrence or of long duration) respectively.
• A stress problem can manifest itself by signs of;
• irritability,
• forgetfulness,
• sickness
• absence,
• mistakes, or
• alcohol or drug abuse
UK CAA’s CAP 562 Leaflet H-60 states that:

“Everyone is subject to various stresses in their life and work. Stress can often be
stimulating and beneficial but prolonged exposure to chronic stress (high levels or
differing stress factors) can produce strain and cause performance to suffer
allowing mistakes to occur. 7

Types of stressors
• Physical: heat, noise, vibration, etc.

• Social: anxiety, incentives, group pressures.
• Drugs: alcohol, nicotine, medication, etc.
• Work: boredom, fatigue, sleep deprivation too much to do in too little time.
• Body clock: shift changes, jet lag.
• Personal: domestic worries, aches and pains, feeling under the weather,
etc.
In brief, the possible signs of stress can include:

• physiological symptoms – such as sweating, dryness of the mouth, etc.;
• health effects – such as nausea, headaches, sleep problems, diarrhoea,
ulcers, etc.;
• behavioural symptoms – such as restlessness, shaking, nervous laughter,
taking longer over tasks, changes to appetite, excessive drinking, etc.;
• cognitive effects – such as poor concentration, indecision, forgetfulness,
etc.;
• subjective effects – such as anxiety, irritability, depression, moodiness,
aggression, etc. 8
9

Domestic stress
• results from major life changes at home
Work related stress

• task or job they are undertaking at that moment. Can be increased by
lack of guidance in this situation, or time pressures to complete the task
or job.
• general organisational environment.
Stress management
• Respond to stress;
• Defence
• Coping
• Coping is the process whereby the individual either adjusts to the

perceived demands of the situation or changes the situation itself.
• Defence strategies involve alleviation of the symptoms (taking
medication, alcohol, etc.) or reducing the anxiety (e.g. denying to
yourself that there is a problem (denial), or blaming someone else).
10

Coping/defusing techniques include:
• Exercise/sports
• Fresh air
• Diversions/hobbies.
• Relaxation therapy and meditation
• Sex
11
Time pressure and

deadlines
12
Time pressure and deadlines

• One of the potential stressors in maintenance is time pressure.
• Time pressure may be of two types;
• External source (Management, Supervisor)
• Self imposed (LAE to complete task to get aircraft out on
time)
• Aircraft maintenance engineers have two driving forces:
• the deadlines handed down to them; and
• their responsibilities to carry out a safe job.
The potential conflict between these two driving pressures can
cause problems.
The effects of time pressure and deadlines

Due care and attention when carrying out tasks diminishes and
more errors will be made.
13
Managing time pressure and deadlines

• Prioritise task
• Consider actual time to complete task
• Personnel available throughout the whole job
• Appropriate utilisation of staff
• Availability of parts and spares.
14

Workload – overload and underload
• Level of arousal has an important influence upon
performance.
• The best performance is associated with an intermediate
level of arousal. This is sometimes called the inverted U-
curve; reflecting how performance varies with arousal level.
• Arousal is the body’s reaction to stresses, drives and
motivation.
• Sleep (low arousal) − panic (high arousal)
• Too little or too much arousal causes poor performance.
• Low arousal: focus on task-irrelevant cues.
• High arousal: neglect task relevant cues.
 At low levels of arousal, our attention mechanisms will not
be particularly active and our performance capability will be
low (complacency and boredom can result).
 High level of arousal, performance deteriorates as we are
forced to shed tasks and focus on key information only
(called narrowing of attention) 15
16

Factors determining workload
• Workload is subjective (i.e. experienced differently by different people).

• It is affected by the nature of the task and the person and its state.
Nature of task can depends on; The person and states depends on;
• Physical demands • Skills
• Mental demands • Experience
• Standard of performance required • Current health and fitness
• Time available to complete task • Emotional state
• Perceived control of the task
• Environmental factors
17

Overload
• High level of arousal
• Performance deteriorates
• Error rate increase
Coping with overload

• Ignore selected inputs.
• Trade-off accuracy for speed.
• Postpone things until quieter times.
• Reduce level of discrimination
• Redistribute the work if possible
• Abandon the task altogether
Underload
• Under aroused
• Deterioration in
performance
• Increase in errors
18

Workload Management
Not possible to make large amendment to;
• Maintenance schedule
• Eliminate time pressure
However to manage workload in aviation maintenance;

• Staff should have the skills, proficiency and experience;
• Tools and spares needed to do the task;
• Allocating tasks that are accomplishable and in time available
• Providing Human Factors training to planning staff
• Recognise overload situation is building up
Relief overload situation;

• Seeking simpler methods of doing work that is just effective and
legitimate;
• delegating certain activities to others;
• Securing further time to complete task;
• postponing, delaying tasks/deadlines and refusing additional work. 19
Sleep, fatigue and

shift work
20
Sleep, fatigue and shift work

What is Sleep?
5 stages of sleep;
• 1st stage: Transitional phase between sleeping and waking. Easy to
wake someone up
• 2nd stage: Deeper level of sleep. Fairly easy to wake someone up.
• 3rd stage: Sleep is even deeper and the sleeper is now quite
unresponsive to external stimuli and so is difficult to wake
• 4th stage: deepest stage of sleep and it is very difficult to wake
someone up
• Rapid eye movement or REM sleep: even more difficult to awaken
than stage 4. It is therefore also known as paradoxical sleep.
21
22

Circadian rhythms
• Circadian rhythms are physiological and behavioural functions and

processes in the body that have a regular cycle of approximately a day
(about 25 hours in man).
• Related to length of the day and controlled by the brain, they are
influenced and synchronised by external (environmental) factors such as
light.
• The lowest point in the circadian rhythms that affect the body’s alertness
is between 4 a.m. and 6 a.m. This is due to the body temperature which
is at the lowest.
• The drop in body temperature appears to be linked to a drop in alertness
and performance in man.
23
24

Fatigue
• loss of alertness and a feeling of tiredness
• low circadian levels are associated with decreased performance and
alertness
Can cause by;

• Lack of sleep
• Working overtime
• Working on shift
• Fitting in too many things in a 24-hours period
Other factors that influence fatigue;

• stress,
• drugs,
• medications,
• illness,
• large temperature variations,
• noise,
• boredom,
• vibration, and dehydration.
25

Effect on performance
• Most common effects due to fatigue are;
• feeling lethargic,
• becoming withdrawn,
• having difficulty concentrating,
• a reduced attention span,
• short-term memory loss (what was I working on?);
• complacency (it doesn’t matter);
• lack of awareness affected by hearing and
eyesight;
• loss of coordination;
• lack of good judgment and decision making;
• lengthened reaction time.
26

Solution
• Be aware of your performance Level
• Take a break (Take a short walk, have a glass of water or snack)
• Talk to co-worker.
• Lifestyle
• Try and get adequate sleep
• Exercise regularly,
• eat a balanced diet,
• drink at least eight glasses of water a day
• eat a balanced diet
• Work conditions and practices
• Support a culture that supports safety
• conducts human factors training
• adequate staff to handle tasks (Right experience levels and
manpower)
• additional inspections,
• rotating shifts, and
• longer rest periods following night shifts
• critical tasks should be allocated for day shifts
• Procedures should be documented so that there is a record of
27
what has been done.

“Abu Dhabi Aviation, Bombardier DHC8-300 (A6-ADB) on 9
September 2013”
28

Shiftwork
• Work that takes place on a schedule outside the
traditional 9 am – 5 pm day. It can involve evening or
night shifts, early morning shifts, and rotating shifts.
• Required for industries where operations are conducted
outside the standard working hours, especially those that
operate 24/7
• A shift is defined as a single continuous work period
• Type of shifts
• Morning, afternoon, night
• Shift systems
• Fixed
• Rotating or rotational
• Changes from shift to shift or cycle to cycle 29

Advantages of shiftwork
• More days off
• More time with family if they are available at the
same time
• Avoid peak traffic times when travelling to work
• Reduced travelling time to work
• Opportunities for second/part-time job
• Higher pay
30

Disadvantages of shift work
• Work-life schedule is out of the norm
• Difficult to spend time with family and friends with standard
work hours
• May result in low morale, depression, divorce, alcohol and
drug abuse, etc.
• Working when human performance is poorer
• May cause more errors at work, traffic accidents while
commuting to and from work
• Desynchronization of the body’s rhythms
• Poor sleep quality, sleep deprivation, chronic fatigue
syndrome
• May result in gastrointestinal and cardiovascular disorders
31

Effects on Circadian Rhythms
• Working at night is the most common cause of wake-sleep cycle
disruption .
• When trying to sleep during the day after a night shift, sleep
quality is often poor.
• It is possible for a person to become acclimatized to working at
night, if he can establish a new wake-sleep cycle. However, this
is difficult.
• For instance, when a person drives home after a night shift
the bright morning sunlight resets the internal clock and they
start to feel more alert and not ready for sleep.
• Trying to sleep in daylight is more difficult as the light is
sensed even through closed eyes. This is the reason why
cabin crew dim the lights of an aircraft and issue blindfolds
when they wish the passengers to go to sleep.
32
Effects of caffeine
• Caffeine is a stimulant. It can be considered as the
world’s most widely used psychoactive drug.
• Found in coffee, tea, cola drinks, chocolate, energy drinks
such as Red Bull.
• People often perceive the stimulating effects of
caffeine as beneficial for boosting energy and
alertness
• Some experience unpleasant side effects.
• Caffeinism refers to an overindulgence in caffeine
• Five or more cups of coffee (at least 500 milligrams) each day
• Mood changes, anxiety, and sleep disruption, insomnia,
irritability, headaches, ringing ears, dry mouth, increased
blood pressure, and digestive problems
33
Improve alertness during night shift

• Have adequate quality sleep with a combination of proper diet,
and exercise.
• Satisfy basic physiological and psychological needs.
• Brightly lit workplace using painting and lighting can help to

increase alertness, improve mood, better visibility, etc.
• Block out noise when sleeping in the day

• Turn off the phone.
• Disconnect the doorbell.
• Talk to your family about your need to get the right amount of
sleep and ask for help keeping noises down.
• Wear earplugs.
34
Improve alertness during night shift

Block out light when sleeping in the day
• Light triggers our brain to think it is
daytime making sleep more difficult.
• Use black out curtains.
Caffeine
• Coffee, tea and some soft drinks contain
caffeine and are widely used in our
society.
• When taken in moderation, it may help us
to be alert.
Nap
• Taking short naps during break time helps
to improve level of alertness and reduce
fatigue.
Figure 2. Effects of coffee

35

Planning shift work sleep
Two options:
• Sleep early and set to wake up early so that by

afternoon time the body should be ready to sleep due
to sleep deficit.
• Go to bed late, sleep late and relax in the afternoon

and still have a good sleep credit for the night duty.
36
Interactive Session
Watch the video
“What the Experts say: Stress, Workload and Time

Pressure”
https://www.youtube.com/watch?v=KzBMKQFYB3k
37

Jet Lag
• Jet lag is a physiological condition that is caused by the
interruption of the individual’s circadian rhythm.
• The term is generally used when individuals travel by air across
different time zones and their bodies are unable to immediately
adjust to the new daylight and darkness hours.
• Some negative health effects due to jetlag include
• Fatigue, insomnia, anxiety, constipation, diarrhea, confusion,
dehydration, headache, irritability, nausea, sweating,
coordination problems, and even memory loss.
38

Medication
• Depressants are psychoactive drugs that slow down mental and
physical activity.
• Stimulants are psychoactive drugs that increase the central
nervous system’s activity.
• Prolonged usage of drugs will cause
• Tolerance
• Physical dependence
• Psychological dependence
• Medication may have side effects
• The duration of the effect is variable from person to person
and may be unduly prolonged.
• Individuals should have expert medical advice before using
them, especially if they are operating heavy machineries.
39

• It is also wise with any medication to take the first dose at least 24
hours before any duty to ensure that it does
not have any adverse effects.
40

Effects of alcohol
• Alcohol adversely affects performance:
• Impairs discrimination
• Impairs visual and auditory perception
• Disrupts short-term and long-term memory
• Impairs thinking and decision making
• Impairs coordinated hand-eye movements
• Slows reaction time
• Lowers inhibitions and increases recklessness
• Risk taking increases
• Errors in judgment can pass unnoticed
41

Effects of alcohol
• A person with 0.09% blood alcohol concentration level will have
a similar work performance (0.94) to a person who has not slept
for 22hours.
• 1 standard drink : A 355ml can of beer OR half a glass (150ml)
of wine OR a shot (44ml) of spirit.
• Limit : Men (2 standard drinks) Women (1 standard drink)
Figure 1. Alcohol concentration vs performance 42

Physical
Environment
43
Physical Environment
Both physical environments have their own specific features or

factors that may impinge on human performance.
Noise
• Noise can be thought of as any unwanted sound, especially if it is
loud, unpleasant and annoying.
• It is very important that aircraft maintenance engineers remain
aware of the extent of the noise around them. It is likely that some
form of hearing protection should be carried with them at all times
and, as a rule of thumb, used when remaining in an area where
normal speech cannot be heard clearly at two metres.
• It is important that noise does not impair their ability to
communicate, as this could obviously have a bearing on the
successful completion of the task (i.e. safety).
44
Fumes
• Fumes can cause problems for engineers mainly as a result of
inhalation, but they can also cause other problems, such as eye
irritation.
• May be exacerbated in aircraft maintenance engineering by the
confined spaces.
45
Illumination
• For work safety and efficiency, proper lighting is essential for the
eye to resolve fine detail.
• Poor lighting leads to mistakes in work tasks or can increase the
time required to do the work.
• Avoid direct or reflected glare as both glare are a distraction from
the task and may cause mistakes.
46
Climate and temperature

• Temperatures should be maintained such that
personnel can carry out required tasks without undue
discomfort.
• Environmental conditions can affect physical
performance.
• Extreme environmental conditions may also be
fatiguing, both physically and mentally.
• For example, cold conditions make numb fingers,
reducing the engineer’s ability to carry out fiddly
repairs, and working in strong winds can be
distracting, especially if having to work at height (e.g.
on staging).
47
48
Motion and vibration
• Any sensation of unsteadiness may distract an engineer, as he may
concentrate more on keeping his balance than the task.
• it is vitally important that engineers use mobile access platforms properly
in order to avoid serious injury.
• Vibration in aircraft maintenance engineering is usually associated with
the use of rotating or percussive tools and ancillary equipment, such as
generators.
• The range between 50 to 150 Hz is most troublesome for the hand and
is associated with vibratory-induced white finger syndrome (VWF).
49
Aircraft maintenance
engineers often make use of
staging and mobile access
platforms to reach various
parts of an aircraft. As these
get higher, they tend to
become less stable.
For example, when working at

height on a scissors platform
or ‘cherry picker’, applying
force to a bolt being fixed to
the aircraft may cause the
platform to move away from
the aircraft..
50
Confined spaces
• Engineers should ideally work with a colleague who would assist
their ingress into and egress out of the confined space.
• Good illumination and ventilation within the confined space will
reduce any feelings of discomfort.
Working environment
It comprises the;
• Physical environment,
• Social environment;
• Tasks that need to be carried.
Each of these three components of the working environment
interact, for example:
• engineers are trained to perform various tasks;
• successful task execution requires a suitable physical
environment;
• an unsuitable or unpleasant physical environment is likely to be
de-motivating.
51
Physical environment include:
• workplace layout and the cleanliness and general
tidiness of the workplace (e.g. storage facilities for
tools, manuals and information, a means of checking
that all tools have been retrieved from the aircraft,
etc.);
• the proper provision and use of safety equipment and
signage (such as non-slip surfaces, safety harnesses,
etc.);
• the storage and use of toxic chemical and fluids (as
distinct from fumes) (e.g. avoiding confusion between
similar looking canisters and containers by clear
labelling or storage in different locations, etc.).
52
53

Lesson 05
Communication &
Hazards in the Workplace
E238 Aviation Legislation and Human Factors
For Training Purpose Only Issue No: 0

Rev No: 0
Learning Outcomes
By end of the lesson, the students should be able to:

• Identify the 3 types of behaviours that can lead to human error
• Describe the differences between Error and Violation in the aerospace
industry
• Differentiate the 2 types of communications used in aerospace industries
• Explain the communication processes and information flow used by
aerospace engineers
• Evaluate the barriers to effective communication in the workplace
• Evaluate the hazards that are present in the MRO workplace
2
Communications
(Processes & Information,
Types, and Effective
Communications)
Communications
Opening Activity
Activity 1
Verbal communication exercise
• All students in class is to get a sheet of letter size/A4 paper.
• Lecturer will select an object drawing for a student to describe to class.
• Each student will draw the object onto the A4 paper in 3 mins
• All Students are not allowed to ask questions.
• After 3 mins students will show their drawing and compare the drawing and see
how it looks like.
Activity 2
Non-Verbal communication
https://www.youtube.com/watch?v=0cIo0PkBs2c
• What drink was Eddie Murphy trying to order?

4
Communications
Opening Activity
Activity 1
Reflection:
• Does the drawing looks different from the one drawn on the
whiteboard? What does this mean?
• Would the result could have been better if questions were allowed?
Activity 2
Reflection:
• How did he end up walking away with so much items?
• What could have caused this to happen?
5
Communication
Within and between teams
Aircraft Maintenance Engineer often communicate

• Information
• Ideas
• Feelings
• Attitude and Believes
 Normally involve two person; Sender and Recipient. A response is always expected
and it constitutes a feedback.
 A response can be a simple acknowledgement or a detailed reply. 6
Communication
Form of Communication
• Verbal/spoken; e.g. a single word, a phrase or sentence, a grunt.
• Written/textual; e.g. printed words and/or numbers on paper or on a screen, hand
written notes.
• Non-verbal;
• Graphic; e.g. pictures, diagrams, hand drawn sketches, indications on a cockpit
instrument.
• Symbolic; e.g. ‘thumbs up’, wave of the hand, nod of the head.
• Body language; e.g. facial expressions, touch such as a pat on the back, posture.
Transactional analysis (TA)
Based on two concepts;
• 3 Parts or Ego states to our personality – Parents, Adults and Child.
• Communication(Transaction).
Child;
• Natural
Parents;
• Curious and Exploring, Little professor
• Nurturing
• Adaptive
• Controlling
Adults;
• A grown up rational person. 7
Communication
Communication(Transaction)
• When two people communicate, each exchange is a transaction.
• Problem come when the transaction are unsuccessful.
Conflict
• When people are thinking in the same level, communication is easy.
• Problem arises when there is a cross transaction where people think
at a different level.
https://www.youtube.com/watch?v=3_dAkDsBQyk
8
Communication
9
Communication
The Freudian approach
• Understanding personality and communication.
Three levels of awareness

• Conscious mind – current awareness.
• Pre-conscious mind - things of which we are aware, but where we are not paying
attention.
• Subconscious mind - the process and content are out of direct reach of the
conscious mind. It thinks and acts independently. Much behaviour is driven directly
from the subconscious mind.
Three components of personality
• An individual’s feelings, thoughts, and behaviours are the result of the interaction
of the id, the superego, and the ego. This creates conflict, which creates anxiety,
which leads to defence mechanisms.
Id, Ego, Superego - Understanding An Old School Psychology Concept

https://youtu.be/GC7KNAyDt4I
10
Communication
Id
• Has no perception of reality.
• Seek to satisfy its needs through primary
process e.g. Baby crying when hungry.
Ego
• Aware of reality and hence operates via
the reality principle. It recognises
behaviour has its consequences.
• Uses secondary processes (perception,
recognition, judgment and memory) that
are developed during childhood.
• Controls higher mental processes such as
reasoning and problem-solving.
Superego
• Contains our values and social morals.
• Is a counterbalance to the id. 11
Communication
12
Communication
Communication channels
In Maintenance communication can be in a form of oral-speech; written documentation;
non-verbal (wordless) cues; and physical cues.
• Speech;
• Those conveying the message need to make sure the message has been understood, and
those receiving it must listen, confirm that they have received the message, and ask
questions if they have any doubts.
• Documentation;
• Communication via written material i.e. maintenance manuals and parts catalogues.
• Few opportunities to clarify or query the message once it is ‘sent’.
• Non verbal cues;
• Use where speech cannot be used, such as in noisy environments, or where people are
wearing hearing protection.
• Includes facial expression, tone of voice and body language.
• Physical cues;
• Placement of tools and parts and the location of ground servicing equipment, tags or lockout
devices, signing off a logbook entry, or referring to a maintenance manual.
• Can be an informal cues i.e. An open cowl, or the position of a work stand.
13
Communication
Verbal and written communication
For a spoken or written message to be understood, the sender has to make sure that the
receiver:
• Is using the same channel of communication;
• Recognises and understands his language;
• Is able to make sense of the message’s meaning.
• For spoken communication, this might be face-to-face, or via the telephone.

• Written messages might be notes, memos, documents or e-mails.
• Vital that message coding use by sender are able to decode by the recipients. This
means that engineers must have a similar knowledge of technical language, jargon and
acronyms.
14
Communication
What can we understand from these pictures?
15
Communication
To extract meaning to message, the engineer has to;
• Understand the content of the message.
• This means that it has to be clear and unambiguous.
• The message must also be appropriate to the context of the workplace
and preferably be compatible with the receiver’s expectations.
• Where any ambiguity exists, the engineer must seek clarification.
Non-verbal communication
• Smiling during face to face communication.
• Sketches, nodding of the head; use in noisy environment.
Synchronous communication
• Both the sender and the receiver are present at the same time.
• Does not necessarily require the sender and the recipient to be face to
face, or in the same room, at the same time. A two-way telephone
conversation, or even and online chat, can be synchronous. 16
Communication
Asynchronous communication
• Sender transmits the information to be communicated, but the recipient does not receive the
information immediately.
• E.g. written information (e.g. manual), email.
Synchronous vs. Asynchronous Communication

https://youtu.be/ONGtUTGc9sE
Explicit communication
• Refers to the things we say or write, often messages intended to influence the behaviour of
others. “Do this” and “Don’t do that” count as examples of explicit communication.
• They leave as little room as possible for interpretation or ambiguity.
• Explicit communication is intentional.
Implicit communication
• Refers to the things we do, individually or collectively, usually without regard to the messages
others receive.
• Such communication is often given off, much depends on the recipient or observer of the
message.
• Implicit communication may or may not be intentional.
17
Communication
Applying this idea: We always need to be
concerned about the consistency between our
words and our actions. Remember that
actions do speak as loudly as words, as the
old axiom tells us.
18
Communication
• The diagram shows the message sent by

the sender (A) and the message from the
point of view of the receiver (C). The
overlapping area (B) represents effective
communication.
• Size of Area B depends on noise, unclear

speech, time pressure or distraction.
19
Communication
Communication Errors
Errors by sender
• Partial message not sent - sender has a hidden agenda, and keeps partial
information to themselves.
• Incomplete or ambiguous message sent - sender uses inappropriate method
(message left on phone, face-to-face communication not used for
important/sensitive messages).
• Inconsistency between oral and non-verbal cues - sender’s attitude/body language
does not reinforce an urgent, safety-critical message.
Errors by sender and receiver
• Failure to reach clear understanding-shared meaning.
• Wrong mode used (e.g. oral message when documentation required, or email sent
assuming it would be read).
Errors by receiver
• Message not received.
• Message understood incorrectly.
• Message not clarified when necessary.
20
Communication
Why does communication fail in aviation maintenance?
• Lack of assertiveness
 It is direct and open, without being either aggressive or excessively polite.
• Passive listening
 A receiver who does not repeat, (or paraphrase) the message cannot be sure that
they have completely understood it. E.g. Pizza Hut sales person reading back your
order.
• Expectancy errors
 Our expectations set the context for communication and influence the messages we
receive. E.g. If you expect you are about to be told about an oil leak, but are told about
a fuel leak instead, you may unconsciously continue to think about an oil leak.
• Inappropriate non-verbal cues

 If a colleague told you that there is a fire but told you in a relaxed manner, you might
assume that you had misheard them.
 We sometimes pay more attention to the non-verbal part of the message. 21
Interactive Session
Watch the Video:
“What the Experts say: Communication”
https://www.youtube.com/watch?v=18AMnxnk8HQ
Team Activity:
Discuss in your teams and choose either:
1) Make a class presentation on the 3 different ways to improve communication in aviation
maintenance providing examples
or
2) Perform a 3 to 5 mins skit on 1 of the way to improve communication in aviation
maintenance
22
Case Study
“Continental Flight 2574, EMB-120 Brasilia, September 11th 1991”
https://en.wikipedia.org/wiki/Continental_Express_Flight_2574
Youtube: https://www.youtube.com/watch?v=4f5TKSu9BZo
23
Communication
Communication within teams
Individual aircraft maintenance engineers need to communicate:
• Before starting a task – to find out what to do;
• During a task – to discuss work in progress, ask colleagues questions, confirm actions
or intentions, or to ensure that others are informed of the maintenance state at any
particular time;
• At the end of a task – to report its completion and highlight any problems.
Spoken communication makes up a large proportion of day-to-day communication within
teams in aircraft maintenance. It relies both on clear transmission of the message (i.e.
not mumbled or obscured by background noise) and the ability of the recipient of the
message to hear it (i.e. active listening followed by accurate interpretation of the
message). Good communication within a team helps to maintain group cohesion.
24
Communication
Communication between teams
It is the means by which one team passes on tasks to another team. This
usually occurs at shift handover. The information conveyed will include:
• Tasks that have been completed;
• Tasks in progress, their status, any problems encountered, etc.;
• Tasks to be carried out;
• General company and technical information.
Usually involved;
• Written report of task passed from one shift supervisor to another. E.g. (maintenance
cards, procedures, work orders, logs, etc.) and warning flags/placards provide a record
of work completed and work yet to be completed – in other words, they provide
traceability.
• Spoken details passed between supervisors and, where appropriate, individual
engineers. Preferably outgoing engineers brief incoming engineers.
• Information communicated at shift handover ensures good continuity.
25
Communication
Shift handover
Concepts
Effective shift handover depends on three basic elements:
• The outgoing person’s ability to understand and communicate the important elements of the job or
task being passed over to the incoming person.
• The incoming person’s ability to understand and assimilate the information being provided by the
outgoing person.
• A formalised process for exchanging information between outgoing and incoming people and a
place for such exchanges to take place.
Aids to effective communication at shift handover

• The introduction of redundancy, by using more than one way of communicating i.e. written,
verbal or non-verbal, greatly reduces this risk.
• Information should be repeated via more than one medium. For example, verbal and one other
method such as written or diagrams etc.
• The ability for two-way communication to take place is therefore important at shift handover.
• To facilitate the formulation of a shared mental model of the maintenance system, aircraft
configuration, tasks in work etc. I.e. Misunderstandings are most likely to occur when people do
not have this same mental ‘picture’ of the state of things.
• Good design of handover log.
• The availability of feedback, to allow testing of comprehension. 26
Communication
Barriers to effective communication at shift handover
• Key information can be lost if the message also contains irrelevant, unwanted
information
• The language we use in everyday life is inherently ambiguous.
Reduce ambiguity by:
• Carefully specifying the information to be communicated e.g. by specifying the
actual component, tooling or document;
• Facilitating two-way communication which permits clarification of any ambiguity
(e.g. do you mean the inboard or outboard wing flap?).
• Misunderstandings are a natural and inevitable feature of human communication.
Communication therefore has to be two-way to achieve full and accurate information
thus reducing misunderstanding.
• People and organisations frequently refer to communication as unproblematic,
implying that successful communication is easy and requires little effort. This leads to
over-confidence and complacency. Organisations need to expend effort to address
complacency by:
• emphasising the potential for miscommunication and its possible consequences;
• developing the communication skills of people who are involved in shift
handovers. 27
Communication
Guidelines
Apply for operations that are manned on multiple shifts to allow for continuous 24-hour
maintenance.
• Shift handover meetings
• An important aspect related to individual shift handover is when it actually begins.
• Throughout their shift people should be thinking about, and recording, what
information should be included in their handover to the next person or shift.
• Walkthroughs
• The most effective way to communicate this information is for the affected incoming
and outgoing personnel to go over the task issues while examining the actual jobs
on the hangar floor or at the workplace.
• Task handover
• Handing over a task directly to another person – Face to face using verbal and
written communication.
• Handing over a task for somebody to complete at a later stage - Face-to-face
communication is not possible therefore total reliance has to be placed on written
communication, a single medium with no redundancy and opportunity to question
and test a true understanding by the person expected to finish the job.
28
Communication
Scheduled tasks
• The paperwork normally associated with scheduled tasks are the task cards.
• Additional written information must be used to clearly identify the point of exit from the
task and what is required to complete the job and restore serviceability when there is a
deviation from task cards.
29
Communication
Non-scheduled tasks
• Complex or lengthy non-scheduled tasks should always be broken down in to a
number of discrete steps using stage or process sheets.
• It is vital that time is taken by the person leaving the job to comprehensively record
what activities have taken place and what is required to complete the job.
Non-routine task and process sheets

• The primary purpose of a job card is to identify the task to be performed but then act as
a job aid to help the engineer plan, complete the task fully, and in the correct sequence.
• However certain tasks have no pre-printed task cards or process sheets which break
down the job in to stages and so help the engineers i.e. engine change. Effective shift
handovers should be:
• Conducted face-to-face;
• Two-way, with both participants taking responsibility for accurate communication;
• Via verbal and written means;
• Based on analysis of information needs of incoming staff;
• Given as much time as is necessary for accurate communication.
30
Communication
Work logging and recording
Even if engineers think that

they are going to complete a
job, it is always necessary to
keep the record of work up-
to-date just in case the job
has to be handed over.
31
Communication
Keeping up-to-date, currency
Responsibility for maintaining currency lies with both the individual engineer
and the maintenance organisation for which he works.
To maintain his currency, he must keep abreast of pertinent information

relating to:
• New aircraft types or variants;
• New technologies and new aircraft systems;
• New tools and maintenance practices;
• Modifications to current aircraft and systems he works on;
• Revised maintenance procedures and practices.
Engineers are likely to keep up-to-date by:

• Undertaking update courses;
• Reading briefing material, memos and bulletins;
• Studying maintenance manual amendments.
32
Communication
Dissemination of information
• Good dissemination of information within an organisation forms part of
its safety culture.
• Part of engineers work planning should include checking that all
information relating to the task has been gathered and understood.
This includes checking to see if there is any information highlighting a
change associated with the task (e.g. the way something should be
done, the tools to be used, the components or parts involved).
• Communication is an active process whereby both the organisation
and engineer have to play their part.
33


Recognising and avoiding hazards
Potential hazards in aircraft maintenance engineering

Physical hazards may include:
• Very bright lights (e.g. from welding);
• Very loud sounds (sudden or continuous);
• Confined or enclosed areas;
• Working at significant heights;
• Noxious substances (liquids, fumes, etc.);
• Excessive temperature (i.e. too cold or too hot);
• Moving equipment, moving vehicles and vibration.
35

Name some of the hazards
36

Relevant legislation and the maintenance organisation’s responsibilities
• The Health and Safety at Work Act 1974 places a responsibility on employers to
produce a written statement of general policy with respect to the Health and Safety
at Work of its employees.
The health and safety policy might include statements applicable to the organisation
such as the need to:
• Carry out assessments of work including inspections to determine Health and Safety
risks;
• Provide safe working practices and procedures for plant, machinery, work equipment,
materials and substances;
• Inform employees and other persons including temporary workers of any risk;
• Provide suitable training and/or instruction to meet any health and safety risks;
• Develop and introduce practices and procedures to reduce risks to health and safety
including the provision of special protective devices and personal protective equipment;
• Provide for the welfare of employees;
• Discuss with and consult employee representatives on health and safety matters.
37
If hazards cannot be removed from the workplace, employees should be

made aware that they exist and how to avoid them. This can be effected
through training and warning signs. To be effective, warnings signs must:
• Clearly identify the hazard(s);
• Describe the danger (i.e. electric shock, radiation, etc.);
• Inform employees what to do or not to do.
38

Sign must;
• Attract an engineer’s attention;
• It must be visible;
• It must be understandable to the people it is aimed at;
• It must be durable enough to remain effective, often for years, in areas where dust
and the elements can be present.
• Positive recommendations are more effective than negative ones. For example,
the statement ‘Stay behind yellow line on floor” is better than ‘Do not come near
this equipment”.
Warning signs;
• Should contain a single word;
• DANGER denotes that the hazard is immediate and could cause grave, irreversible
damage or injury.
• CAUTION indicates a hazard of lesser magnitude.
The sign should also detail how to avoid or manage the risk;
• CAUTION signs are generally yellow and black.
• DANGER signs use red, black and white. 39
40

Engineer’s individual responsibilities
In an aircraft maintenance organisation, the health and safety policy might include statements
applicable to engineers such as the need to:
• Take reasonable care of the health and safety of themselves and others who may be affected by
their acts or omissions at work;
• Co-operate with the maintenance organisation to ensure that statutory requirements concerning
health and safety at work are met;
• Work in accordance with any safety instruction and/or training received;
• Inform their supervisor or management of work situations that represent an immediate or potential
danger to health and safety at work and any shortcomings in protection arrangements;
• Not interfere intentionally or recklessly with, nor misuse, anything provided in the interests of health
and safety.
Individuals who display an anti authority attitude, are impulsive, or reckless are a danger in aircraft
maintenance.
41

Aircraft safety in hangars
Propellers
Always avoid walking within the arc of an aircraft propeller.
The hangar floor

Keeping the aircraft hangar floor clear of hoses and cords reduces tripping hazards.
Overhead hazards
Leading and trailing edges on the wing, protruding antennas, wing struts, temperature probes and
lowered flaps are just a few of the items which can cause a nasty bump on the head or worse.
Working around aircraft

• When working on an engine or inside a cowl area, remove jewellery, pens and small tools in your
shirt pockets.
42

Switches and controls
Great care should be used when activating cockpit switches when the plane is in the hangar.
Medical and fire equipment

A first aid kit and fire extinguisher should be kept within easy reach in the hangar, and you
should know how to use this equipment.
What is risk assessment?

It is simply a careful examination of what, in your work, could cause harm to people, so that you can
weigh up whether you have taken enough precautions or should do more to prevent harm.
43

How to assess the risks in your workplace
• Identify the hazards;
• Decide who might be harmed and how;
• Evaluate the risks and decide on precaution;
• Record your findings and implement them;
• Review your assessment and update if necessary.
Difference between a Hazard and Risk:

• A hazard is anything that may cause harm, such as chemicals, electricity, working from
ladders, an open drawer, etc.;
• The risk is the chance, high or low, that somebody could be harmed by these and other
hazards, together with an indication of how serious the harm could be.
44
45

Dealing with emergencies
Emergencies may include:
• An injury to oneself or to a colleague;
• A situation that is inherently dangerous, which has the potential to cause
injury (such as the escape of a noxious substance, or a fire).
Maintenance Organisation should provide;

• Appropriate guidance and training;
• Procedures and facilities for dealing with emergency situations;
• Adequately communicated to all personnel;
• Appoint and train one or more first aiders.
46
Emergency drills are of great

value in potentially dangerous
environments. Aircraft
maintenance engineers should
take part in these wherever
possible. Knowledge of what to
do in an emergency can save
lives.
47
Interactive Session
Team Activity
Video: https://www.youtube.com/watch?v=slq1nAhZuqE
Watch the video above on Hazard Identification, Risk Assessment, and Risk
Control (HIRARC) also known as HIRA.
Based on the video, the lesson today, or further reading as required, in your
team you are to do as follows:
1) Select one activity that you will perform in the Classroom.
2) Perform HIRA on this activity and present it in Learning Phase 3.
48
Human Error
(Types of Behaviours and
Errors & Violations)
Interactive Session
‘Human Error’
Let’s watch the 2 videos below
“Managing Human Error”

http://youtu.be/5jk0uAVdBC4
and
“Error - FAA Human Factors”

https://www.youtube.com/watch?v=D1TPWGYtfTY&t=21s
50
Human Error
Introduction
The following quotation illustrates how aircraft
maintenance engineers play a key role in keeping
modern aircraft reliable: “Because civil aircraft are
designed to fly safely for unlimited time provided
defects are detected and repaired, safety becomes
a matter of detection and repair rather than one of
aircraft structure failure. In an ideal system, all
defects which could affect flight safety will have
been predicted in advance, located positively
before they become dangerous, and eliminated by
effective repair. In one sense, then, we have
changed the safety system from one of physical
defects in
aircraft to one of errors in complex human-centred
systems”.
51
Human Error
Error models and theories
• Design- versus operator-induced errors
• A flaw in its original design may lead to operational safety being compromised.
• Flawed procedures put in place by airline, maintenance organisation or air traffic
control management may also lead to operational problems.
• Variable versus constant errors

• Variables errors are random in nature and cannot be predicted and are much harder
to deal with.
• Constant errors follow some kind of consistent, systematic (yet erroneous) pattern
thus it may be predicted and therefore controlled.
Professor Reason - Error types

https://youtu.be/iHaQjoxQlLs
52
Human Error
• Reversible versus irreversible errors
• Reversible errors can be recovered e.g. if a pilot miscalculates the fuel he should carry, he
may have to divert to a closer airfield.
• Irreversible errors cannot be recovered e.g. if a pilot if he accidentally dumps his fuel, he may
not have many options open to him.
• A well designed system or procedure like duplicate inspection should be done after critical
system on aircraft has been disturbed.
• Active and latent errors

• Active error – an action that has an immediate effect.
• Latent error – an action that has a delayed effect. Because of the time delay between error
and consequence, latent errors and their causes are much more difficult to trace than are
active errors.
• Slips, lapses and mistakes

• Slips – action not carried out as intended or planned.
• Lapses - missed actions and omissions.
• Mistakes - brought about by a faulty plan/intention. i.e. somebody did something believing it to
be correct when it was, in fact, wrong.
53
Human Error
Slips typically occur at the task execution stage, lapses at the storage (memory)
stage and mistakes at the planning stage.
54
Human Error
Skill-rule and knowledge-based behaviours
• Skill-based behaviours
• Rely on stored routines or motor programmes that have been learned with practice
and may be executed without conscious thought.
• Skill-based errors
• Action slips - same as slips, i.e. an action not carried out as intended.
• Environmental capture. E.g. an engineer used to carrying out a certain
maintenance adjustment on an Airbus A300, may inadvertently carry out this
adjustment on the next A300 he works on, even if it is not required.
• Reversion - occur once a certain pattern of behaviour has been established,
primarily because it can be very difficult to abandon or unlearn it when it is no
longer appropriate.
• Rule-based behaviours
• Are those for which a routine or procedure has been learned. The components of a
rule based behaviour may comprise a set of discrete skills.
• Fairly robust and this is why the use of procedures and rules is emphasised in
aircraft maintenance. 55
Human Error
• Rule based errors can arise from:
• Misapplication of good rules;
• Application of bad rules;
• Non-application of good rules (violations).
• Knowledge-based behaviours
• Are those for which no procedure has been established. These
require the [aircraft maintenance engineer] to evaluate information,
and then use his knowledge and experience to formulate a plan for
dealing with the situation.
• Knowledge-based mistakes
• Are more varied.
• They arise when people have to improvise in a novel situation.
56
Human Error
57
Human Error
Recognition failures
• The misidentification of objects, messages, signals, etc.

• Some reasons for misidentifications include:
• Similarity: (in appearance, location, function, etc.) between right and wrong
objects.
• Indistinctness: poor illumination and signal-to-noise ratios.
• Expectation: we tend to see what we want to see (confirmation bias or
mindset).
• Perception is derived from two types of information: the evidence of our senses
and knowledge structures stored in long-term memory. The weaker or more
ambiguous the sensory evidence, the more likely it is that our perceptions will be
dominated by expectation, or the stored knowledge structures.
• Habit: in well-practised and familiar tasks, perceptions become less precise.
• The non-detection of problem states (inspection or monitoring failures).

58
Human Error
Memory failures (forgetting)
There are three basic memory processes:
• Encoding – taking information into memory.
• Storage – keeping it there.
• Retrieval – calling information to mind when it is needed.
Failures in each of these processes can be a cause of “forgetting”.
Input failures
1st kind of input failures - forgetting names. Due to failure of attention.
2nd kind of input failures – forgetting previous actions. Due to failure of
attention.
Consequences of this kind of forgetting;

• Losing our place in a series of actions.
• The time-gap experience. 59
Human Error
Storage failures
Memory for intentions is called prospective memory, and it is particularly prone to
forgetting or side-tracking, so that the action is not carried out as intended.
Such scenarios include:

• Forgetting the plan; a vague feeling that you should be doing something, but
can’t recall what;
• ‘What-am-I-doing-here?’ experience; find yourself in front of open drawer or
cupboard, but can’t recall what you came to get;
• Forgetting items in a plan; necessary steps omitted.
60
Human Error
Retrieval failures
• Fail to recall something you know you know - often a name, a word or a fact;
• Frequently, the memory search is blocked by some other word or name that you know to
be wrong, but which keeps coming to mind;
• ‘Tip-of-the-tongue’ states ended by further search, pop-ups (just comes to mind later) or
external prompts.
Attentional failures
• Attention is a limited resource.
• Direct it to one thing and it is withdrawn
from another (attentional capture).
• The attentional investment is necessary
to direct actions along their currently
intended pathways.
• Too much attention given to these
automatic runs of action can be highly
disruptive.
61
Human Error
Attentional Failures
Omissions following interruptions

• The failure to make the proper attentional check on progress is caused by
distraction.
• For example, you intend to collect manual, but on removing it from shelf other
books fall down. You replace books but depart without the manual.
Premature exits
• Slips of this kind feature very commonly among aircraft engineering lapses.
• For example, nuts left finger tight and not torqued.
General factors promoting wrong actions

• The performance of a routine, habitual task in familiar surroundings;
• Attentional capture by preoccupation or distraction;
• Change, either in the plan of action or in the surroundings.
Nimrod panel incident

https://youtu.be/HBqi6usw8S8
62
Human Error
Violations
Four types of violations
• Routine violations;
• Normal way of doing something’ within the person’s work group.
• They can become routine for a number of reasons: engineers may believe that
procedures may be over prescriptive and violate them to simplify a task (cutting
corners), to save time and effort.
• Situational violations;
• Due to the particular factors that exist at the time. Factors such as time pressure,
high workload, unworkable procedures, inadequate tooling, poor working
conditions.
• Optimising violations;
• Breaking the rules for ‘kicks’.
• The person just uses the opportunity to satisfy a personal need.
• Exceptional violations;
• Typified by particular tasks or operating circumstances that make violations
inevitable, no matter how well intentioned the engineer might be. 63
Human Error
Violations
• Violations are deliberate acts.
• People weigh up the perceived risks against the perceived benefits.
• When the benefits exceed the possible costs they are likely to violate.
Why people violate good rules

These are some of the beliefs that lead
people to violate:
• “I can handle it.”
• “I can get away with it.”
• “I can’t help it.”
• “Everyone does it.”
• “It’s what they want.”
• “They’ll turn a blind eye.”
A number of them relate to the widely held

attitude that violating is the prerogative of the
skilled person. Their skill shows them how to
bend the rules and get away with it. 64
Human Error
65
Human Error
Reasons for not following procedures
These are some the reasons given why workers for not following
procedures. These are universal reasons for not following procedures
and manuals. Any attempt at improving compliance must address
these problems;
• If followed to the letter, job wouldn’t get done;
• People are not aware that procedure exists;
• People prefer to rely on own skills and experience;
• People assume they know what is in the procedure.
Violation types
This is a breakdown of violation types:
• Corner-cutting violations (Routine violation);
• Thrill-seeking violations (Optimising violation);
• Violations to get job done (Situational violation).
66
Human Error
Applying bad rules
Bad rules can become established as part of our normal behaviour for a number of
reasons:
• No one corrects us at the time;
• Applying the bad rule seems to get the job done;
• And most of the time, there are no bad consequences.
How violations differ from errors
Errors are unintended. Violations are deliberate(the act not the occasional bad
consequences).
The distinction between errors and violations depends upon the following factors:
• Intentionality:
• Error is unintentional while violations are. However they may not result occasionally in bad
consequences.
• Only saboteurs intend both the act and its bad consequences.
• Information versus motivation:
• Errors arise from informational problems and are generally corrected by improving the
information, either in the person’s head or in the workplace.
• Violations arise largely from motivational factors, from beliefs, attitudes, norms and from the
67
organisational culture at large.
Human Error
Demographics:
• Men violate more than women and the young violate more than the old.
• The same does not apply to errors.
Errors due to individual practices and habits
• Often, a ‘good’ rule or principle is one that has been used successfully in
the past.
• Problems occur when the rule or principle is wrongly applied.
 E.g. This may have been a factor in an A320 locked spoiler incident,
where subtle differences between the operation of the spoilers on the
A320 and those of the B767 (with which the engineers were more
familiar) meant that actions which would have been appropriate on
the B767 were inappropriate in the case of the A320.
• Engineers may pick up some ‘bad rules’, leading to bad habits during
their working life.
68
Human Error
69
Human Error
Errors associated with visual inspection
Two particular types of error :
• Type 1
• Error occurs when a good item is incorrectly identified as faulty.
• Not a safety concern per se except that it means that resources are
not being used most effectively.
• Time being wasted on further investigation of items which are not
genuine faults.
• Type 2
• Error occurs when a faulty item is missed.
• Safety concern if the fault (such as a crack) remains undetected, it
can have serious consequences.
70
Q&A
71

Lesson 06
Human Error (Swiss Cheese & SHEL)
E238 Aviation Legislation and Human Factors

Learning Outcomes
By end of the lesson, the students should be able to
• Evaluate the causes of aviation accidents and incidents using two(2)

types of Human Factors models used in the aerospace industry.
2

Flybe Bombardier DHC8-400 (G-PRPC) 14th Dec 2016
3
Swiss Cheese Model
Watch Video below on the Swiss Cheese model:
How It's Made Swiss Cheese

https://www.youtube.com/watch?v=LX_IqDf81Xo
The Swiss Cheese Model of Accident Causation

https://www.youtube.com/watch?v=JRCMxfBULB4
(7)
4
Swiss Cheese Model

Swiss Cheese (Reason’s) Model of Accident Causation
• James Reason, Professor of Psychology at Manchester University. Books
such as Human Error (1990) and Managing the Risks of Organizational
Accidents (1997). Received Flight Safety Foundation/Airbus Industrie
Human Factors in Aviation Safety Award in 2001.
• Defences and safeguards protect potential victims and assets from local
hazards in the system approach. Defences are more like slices of Swiss
cheese with many holes, but they are continually opening, shutting, and
shifting.
• The presence of holes in any one “slice” does not normally cause a bad
outcome.
A bad outcome usually happens only
when the holes in many layers
momentarily line up to permit
a trajectory of accident opportunity.
Figure 3. Swiss cheese model 5

Swiss Cheese Model

Swiss Cheese Model (continued…)
Active Failures
• The unsafe acts committed by front line people in the system e.g. Aircraft Maintenance
Engineers.
• Direct and short-lived impact on the integrity of the defenses.
• The more holes in a system’s defences, the more likely it is that errors result in incidents or
accidents.
Latent Conditions
• May lie dormant within the system for many years before they combine with active failures and
local triggers to create an accident opportunity.
• Can be identified and remedied before an adverse event occurs.
• May be introduced at the time an aircraft was designed or may be associated with a
management decision.
Prof James Reason's Swiss Cheese Model

https://youtu.be/twsA3z3xFVE
6
Swiss Cheese Model
7
Interactive Session
Team activity:
Apply the model to the following the road accident scenario.
https://www.youtube.com/watch?v=Dlr_Jpk-8mQ
https://www.youtube.com/watch?v=lKbcsULIEO0
Present to the class using the Swiss Cheese model on how it could have been prevented.
8
Human Error
Types of error in maintenance tasks
As aircraft maintenance engineers are human, errors in the
industry are inevitable.
9
Human Error
Implications of errors (i.e., accidents)
In the worst cases, human errors in aviation maintenance can and do cause aircraft
accidents. However, as portrayed in Figure 27, accidents are the observable
manifestations of error. Like an iceberg which has most of its mass beneath the water line,
most errors do not result in actual accidents.
Errors that do not cause accidents but still cause problem are known as incidents.
10
Human Error
• The engineer may detect his own error, or it may be picked up by colleagues, supervisors
or quality control. In these cases, the engineer involved should (it is hoped) learn from his
error and therefore (it is hoped) be less likely to make the same error again.
Blame does not necessarily act as a positive force in aircraft maintenance;

• It can discourage engineers from ‘coming clean’ about their errors. They may cover up a
mistake or not report an incident.
• It may also be unfair to blame the engineer if the error results from a failure or weakness
inherent in the system which the engineer has accidentally discovered.
11
Human Error
Avoiding and managing errors
Error management seeks to:
• Prevent errors from occurring.
• Eliminate or mitigate the bad effects of errors.
Two components of error management as:

• Error containment.
• Error reduction.
To prevent errors from occurring;

• Within a maintenance organisation, data on errors, incidents and accidents should be captured
with a safety management system (SMS), which should provide mechanisms for identifying
potential weak spots and error-prone activities or situations.
• Output from this should guide local training, company procedures, the introduction of new
defences, or the modification of existing defences.
12
Human Error
Error management: What do you aim for?
Most organizations go for the person which should be avoided;

• Blame and train:
• ‘Carpet’ the error-maker, or discipline him, or tell him to be more careful, and then, if
necessary, send him for retraining.
• Write another procedure:
• All industries tend to write procedures to prohibit actions that have been implicated in
some event or incident. The result is that the range of permitted actions is often less
than the range of actions necessary to get the job done.
• Search for the ‘missing piece’:
• When these measures fail (and they usually do), managers start looking for
psychological ways of finding the piece that will remove violations and errors.
Somewhere out there, they think, is a psychologist who can come up with the ‘magic
bullet’ solution.
13
Human Error
Comprehensive error management, however, prefers to focus most of its efforts on:
• Identifying and correcting error-prone tasks;
• Improving error-producing work situations;
• Identifying and correcting latent organisational conditions.
Summary: managing the manageable

• Fallibility is part of the human condition.
• We are not going to change the human condition.
• But we can change the conditions under which people work.
“Changing situations is more effective than trying to change human nature.”
14
Human Error
15
Human Error
Changing the future means…
• Learning the right lessons from past incidents:
• Not ‘who’s to blame?’ but what were the task, workplace and organisational
factors that contributed to the incident?
• Identifying task, workplace and organisational problems that could combine to
cause some future incident or accident?
• Being proactive as well as reactive.
Professor James Reason - Error Models

https://youtu.be/4qnoc5EkFCE
16
MAINTENANCE ERROR DECISION AID (MEDA)

MEDA was developed to assist investigators to look for the factors that contributed to
the error, rather than concentrate upon the employee who made the error.
The MEDA philosophy is based on these principles.
• Positive employee intent (maintenance technicians want to do the best job
possible and do not make errors intentionally).
• Contribution of multiple factors (a series of factors contributes to an error).
• Manageability of errors (most of the factors that contribute to an error can be
managed).
• The maintenance error decision aid (MEDA) process offered by Boeing continues to
help operators of airplanes identify what causes maintenance errors and how to prevent
similar errors in the future. Because MEDA is a tool for investigating the factors that
contribute to an error, maintenance organizations can discover exactly what led to an
error and remedy those factors.
• By using MEDA, operators can avoid the rework, lost revenue, and potential safety
problems related to events caused by maintenance errors.
17
MEDA
18
The SHEL model

• The SHEL Model is simply defined as “the relationship of human factors and the aviation
environment”.
• The SHEL model is named after the initial letters of its components [Software, Hardware,
Environment, Liveware (human)].
• The SHEL model is a conceptual model of human factors that clarifies the scope of aviation
human factors and assists in understanding the human factor relationships between aviation
system resources/environment (the flying subsystem) and the human component in the aviation
system (the human subsystem).
• Since liveware is at the centre of the model, all other aspects (software, hardware and
environment) must be designed or adapted to assist his performance and respect his
limitations.
• The SHEL model was first developed by Edwards in 1972 and later modified into a 'building block'
structure by Hawkins in 1984.
19
The SHEL model

Hardware
A mismatch at any
of the four interfaces
can be a source of
human errors
L-H
L-S L-E
Software L-L Environment
Liveware 20
The SHEL model

Liveware-Software (L-S)
Software
• Non-physical items.
• Requires mental interactions.
Examples of software
• e.g. maintenance procedures, maintenance manuals,
checklist layout, etc.
Examples of mismatch
• Insufficient / inappropriate procedures.
• Confusing or ambiguous symbols and checklists.
21
The SHEL model

Liveware-Hardware (L-H)
Hardware
• Physical items.
• Requires mechanical interactions.
Examples of hardware
• Example tools, test equipment, the physical structure of
aircraft, design of flight decks, positioning and operating
sense of controls and instruments, etc.
• Poorly designed equipment.
• Badly located or coded instruments and control devices.
22
The SHEL model

Liveware-Environment (L-E)
Environment
• Conditions of the workplace.
Examples of environmental conditions

• Example physical environment such as conditions in the hangar,
conditions on the line, etc. and work environment such as work
patterns, management structures, public perception of the
industry, etc.
• Visual illusions during aircraft approach/landing at night time.
• Irregular work-sleep patterns.
23
The SHEL model

Liveware-Liveware (L-L)
Liveware
• Other persons in the workplace.
• Requires social interactions.
Examples of liveware
• That is the person or people at the centre of the model,
including maintenance engineers, supervisors, planners,
managers, etc.
• Miscommunications.
• Imbalanced authority relationships.
24
The SHEL model
25
The SHEL model

Videos on SHEL Model
SHEL model: Hardware :
https://www.youtube.com/watch?v=_eajZXrxpJA
SHEL model: Software :

https://www.youtube.com/watch?v=9UAWNyXcheE
SHEL model: Liveware:

https://www.youtube.com/watch?v=SolXcjO3UTw
SHEL model: Environment

https://www.youtube.com/watch?v=qFiJQAclUMI
26
Team Presentation
Each team will present the assigned topics of CA2 (Powerpoint)
Other teams can pose questions to the presenting teams ( peer critique &
collaborative learning)

E238 Lesson 1 To 6 Combined

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OFFICIAL (CLOSED) \ NON-SENSITIVE

Incorporating CAAS SAR Part 66:

For Training Purpose Only Issue No: 0

‘Aviation Human Factors’

Discuss in team and share with the class:

List down the key human factors' issues.

How Perfect Twins Maintenance have

The need to take human factors into account

Why do we need to maintain an equipment?

The cost of maintenance error

For example, in the case of a large aircraft such as a Boeing 747-

‘Human Factors’ defined

What is ‘human factors’?

Thus, human factors include such attributes as:

Why Aviation Human Factors?

Unique human factors issues in aviation maint.

• Maintenance technicians work can be;

Unique human factors issues in aviation maint.

Incidents and accidents attributable to human

It is clear from such studies that

• Eastern Airlines, L-1011, 1983

• Aloha Airlines, Boeing 737, 1988

Incidents and accidents attributable to human

• Air Midwest, Beech 1900D, 2003

• British Midland, Boeing 737-400, 1995

Discuss in team and share with the class:

List the common issues and errors.

The Error Chain

Can be prevented by;

• The belief that an accident will

• When attempting to convince individuals or organisations of the

Watch the video on British Airways Flight 5390 incident.

• It is important that maintenance tasks on aircraft are within the

It is always advisable to be wary of changes to procedures or parts,

• Tools for Visual inspection;

• Often the principal method used to identify degradation or defect in

Downside of visual inspection;

Overcoming low arousal;

With a complex system, it should still be clear to an aircraft

Human Performance and

‘Human Performance and

“What the Experts say: Human Performance and its

Human Performance and Limitations

• Physical and Mental Human performance characteristic

Iris and pupil

• Made up of a complex layer of nerve cells connected to the

Figure 1. The human eye 42

Short sight (near-sight) - known as myopia

Long sight (far sight) - known as hypermetropia, or hyperopia

Colour loss at night

Components of the ear

The audible frequency range that a young person can hear is

Impact of noise on performance

Noise can have various negative effects in the workplace. It

140 decibels (noise causes pain).

It is normally accepted that a TWA noise level exceeding 85 dB

• Normal human hearing range is 20

Noise levels can be reduced (attenuated) by up to 20 decibels

• It is good practice to reduce noise levels at source, or move noise