Human error Analysis of commercial aviation accidents : Application of the Human Factors Analysis and Classification system (HFACS) (original) (raw)
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Human Error and Commercial Aviation Accidents
Objective: The aim of this study was to extend previous examinations of aviation accidents to include specific aircrew, environmental, supervisory, and organizational factors associated with two types of commercial aviation (air carrier and commuter/ on-demand) accidents using the Human Factors Analysis and Classification System (HFACS). Background: HFACS is a theoretically based tool for investigating and analyzing human error associated with accidents and incidents. Previous research has shown that HFACS can be reliably used to identify human factors trends associated with military and general aviation accidents. Method: Using data obtained from both the National Transportation Safety Board and the Federal Aviation Administration, 6 pilot-raters classified aircrew, supervisory, organizational, and environmental causal factors associated with 1020 commercial aviation accidents that occurred over a 13year period. Results: The majority of accident causal factors were attributed to aircrew and the environment, with decidedly fewer associated with supervisory and organizational causes. Comparisons were made between HFACS causal categories and traditional situational variables such as visual conditions, injury severity, and regional differences. Conclusion: These data will provide support for the continuation, modification, and/or development of interventions aimed at commercial aviation safety. Application: HFACS provides a tool for assessing human factors associated with accidents and incidents.
University of Otago, 2009
Within aviation, a human error classification system theoretically allows researchers to analyse post-accident data in an objective yet consistent manner. The primary objective of the present study was to explore human error using two widely known classification systems-the Human Factors Analysis and Classification System (HF ACS) and the I would further like to thank my family for their continual support and encouragement. And fmally, I would like to thank my partner Andrew for his constant, unfailing belief in me. Ill
Accident Analysis & Prevention, 2008
The human factors analysis and classification system (HFACS) is based upon Reason's organizational model of human error. HFACS was developed as an analytical framework for the investigation of the role of human error in aviation accidents, however, there is little empirical work formally describing the relationship between the components in the model. This research analyses 41 civil aviation accidents occurring to aircraft registered in the Republic of China (ROC) between 1999 and 2006 using the HFACS framework. The results show statistically significant relationships between errors at the operational level and organizational inadequacies at both the immediately adjacent level (preconditions for unsafe acts) and higher levels in the organization (unsafe supervision and organizational influences). The pattern of the 'routes to failure' observed in the data from this analysis of civil aircraft accidents show great similarities to that observed in the analysis of military accidents. This research lends further support to Reason's model that suggests that active failures are promoted by latent conditions in the organization. Statistical relationships linking fallible decisions in upper management levels were found to directly affect supervisory practices, thereby creating the psychological preconditions for unsafe acts and hence indirectly impairing the performance of pilots, ultimately leading to accidents. (D. Harris). HFACS was developed from Reason's organizationally based model of human error . In this model active failures (errors) of front-line operators (in this case pilots) combine with latent failures lying dormant in the system to breach its defences. These latent failures are spawned in the upper levels of the organization and are related to management and regulatory structures.
Bureau d'Enquêtes et d'Analyses pour la sécurité de l'aviation civile (BEA), Le Bourget, France Cabon (P.) ; Rome (F.) ; Wolff (M.) ; Mollard (R.) Laboratoire d'Anthropologie Appliquée (LAA)-Unité Ergonomie (EA1753)-Université Paris 5, France Sharing safety information is a key issue to improve aviation safety. Therefore, it appears necessary to have a common way to describe aviation accidents/incidents in order to get consistent data that will be used to produce relevant safety indicators. This implies to use the same taxonomy, the same compatible software to facilitate data sharing, and, more important, a common method to encode occurrences into safety data. The way human factors are taken into account in the database must be improved since statistics usually provided, deal with accident/incident categories and not with their various causes (most of them are human factors related). The BEA in cooperation with the LAA has developed a methodology for the encoding and the analysis of aviation accidents and incidents. This tool has been successfully used during several investigations but still needs to be scientifically validated. This paper aims at putting safety analysis into perspective. It also discusses the methodology that incorporates the Human Factors SHELL model and a validation study.
Pilot error and its relationship with higher organizational levels: HFACS analysis of 523 accidents
2006
INTRODUCTION Based on Reason's model of human error, the Human Factors Analysis and Classification System (HFACS) was developed as an analytical framework for the investigation of the role of human error in aviation accidents. However, there is little empirical work that formally describes numerically the relationship between the levels and components in the model (the organizational structures, psychological precursors of errors, and actual errors). METHOD This research analyzed 523 accidents in the Republic of China (ROC) Air Force between 1978 and 2002 through the application of the HFACS framework. RESULTS The results revealed several key relationships between errors at the operational level and organizational inadequacies at both the immediately adjacent level (preconditions for unsafe acts) and higher levels in the organization (unsafe supervision and organizational influences). CONCLUSIONS This research lends support to Reason's model that suggests that active failure...