This month, CALLBACK presents incidents revealing types of hazards that Ramp Agents face daily. We thank and salute Ramp Agents everywhere for their professionalism and excellence in safely handling aircraft around the world.

This month, CALLBACK continues its informal survey of ASRS’s Human Factors (HFs) with a brief look at physiological incidents in aviation. “Aviation Physiology deals with the physical and mental effects of flight on air crew personnel and passengers.”

This month, CALLBACK has selected reports that demonstrate the high impact that maintenance can wield, be it positive or negative. Examine the scenarios, details, and Human Factors; then consider how the outcomes may have been affected with changes in the smallest details.

This month, CALLBACK looks at incidents in which operators likely have wished some actions or decisions were rescindable and could be done over. Examine the human and other contributing factors in each undesirable situation. Extrapolate what could have resulted, and humbly savor the lessons, which might feel closer to home than we all would like to admit.

This month, CALLBACK again offers the reader a chance to “interact” with the information given in a selection of ASRS reports. In “The First Half of the Story,” you will find report excerpts describing an event or situation up to a point where a specific decision must be made, an immediate action must be taken, or a non-normal condition must be actively managed. You may then exercise your own judgment to make a decision, determine a possible course of action, or devise a plan that might best resolve the situation.

Thorough and comprehensive training is a crucial prerequisite, much like aptitude, ingenuity, skills, dedication, discipline, and drive, that Aviation Maintenance Technicians (AMTs) must have in order to master their craft. Its import and impact on day-to-day flight operations are unequivocal and can range from routine and unnoticed to profound.

An aircraft unusual attitude or upset can challenge and test a pilot’s ability to maintain aircraft control. The unusual attitude is generally unintentional, unanticipated, and may consist of extreme aircraft attitudes, and yet, it might not exceed the parameters to be termed an upset. During flight or training, an upset generally refers to an unintentional pitch attitude exceeding 25o nose up or 10o nose down, or a bank angle exceeding 45o , or being within those parameters and operating at an airspeed inappropriate for the conditions.1 Usual suspects in unusual attitude and upset incidents include environmental conditions, wake vortex encounters, mechanical issues, and Human Factors such as confusion, distraction, fatigue, human-machine interface, physiological conditions, or situational awareness. With aircraft control in the balance, it is crucial that every pilot be proficient in identifying and recovering from unusual attitudes and aircraft upsets. FAA mandates Upset Prevention and Recovery Training (UPRT) for Part 121 operators and encourages it for all others.1 This month, CALLBACK shares unusual attitude incident reports, primarily from Part 91 operations, that display Human Factors along with some external stimuli. Enjoy the narratives, the lessons, and the cause-and-effect connections.

Callback Issue 517: The Aviation and Telecommunication industries are unmistakable giants of our national identity that are currently engaged in solving a high-stakes problem. New 5G cellular emissions lie near the frequencies used by Radio/Radar Altimeters (RAs) installed in many aircraft. Aviation groups have expressed concern that interference from the 5G signals can degrade performance of RAs and other dependent aircraft systems such that flight safety may be compromised.

Training and qualification, we do a great job of hounding the same old basic indoc over and over again. There is immense value in having a refresher, but the one thing that stands out in all of these examples, is that a lot of the time it’s the odd ball stuff we never talk about that gets us. It’s the step between steps for the maintenance professionals in an unusual work order. Or the seldom used back course approach for the pilots (remember its like looking in a mirror, needle left=airplane left). Below are a selection of examples from the ASRS database that the submitter has felt training was a major contributing factor. It’s important to look beyond the words of these reports. A fair few of them have training buried deep in the root causes of these which are not captured. We challenge you to use these not just as a resource to see what errors exist; but also as a training tools for yourselves. Select a few of these and run a root cause analysis to see where your safety team ends up. You never know, maybe you’ll save the world!

Time is the one commodity we can never have to much of, Time in type, time at home, time to think. Most of these are due to high workloads in high pres-sure situations. Did you get turned late onto the ILS? Can you run a checklist before the FAF? Are you on fire? (hopefully not), but that sure would limit your available time. We all have some form of time management strategy. For the average person, it will work almost always. In aviation however, time is a fluid concept. Where once you had an hour and a half to plan, now you’ve got 2 minutes. What you will find below is a selection of reports, where the submitter indicated time pressure as a critical factor. Some are fairly be-nign, missed radio calls, altitude changes, etc. The common errors we find so often. The opportunity exists for a more serious incident however. Because of this we feel it pertinent (so does the FAA) to highlight the associated hazards.

In the air, there are a lot of words being thrown around at the exact same time. Between checklists, call outs, radio calls, passenger briefings, all the odd dings and dongs from the annunciators, and of course, all the transmissions are as clear as Verizon on a cloudless day. (Can you hear me now? Might just be some of the worst words to hear from ATC). In this quarter’s issue of the Readback, we will take a look at some instances where communication has broken down.

It goes without saying, that aircraft are complex machines. The physical act of keeping the blue above the brown is only part of the task. We also need to make the pointy end face the direction we’re intending to travel, and mesh with the thousands of other flying saucers sharing the skies. To do this, the boffins that create these majestic flying machines have given us some of the most tailor made electronics humanity can create. Utilizing them becomes an art form in and of itself.

PRISM Solutions offers an ICAO, FAA AC 120-92D and IS-BAO compliant SMS manual for an independent fee. It can be provided to subscribers in PDF form, along with a modifiable MS Word document. It may be incorporated in whole or as part of an existing Safety Manual in your flight department. In each section of the SMS manual, features are listed which require the joint participation of the Safety Officer and PRISM Solutions. This unique approach allows any operator with limited safety resources to capture a level of safety education, research, analysis, and risk management comparable to larger operations.

Your organization's SMS manual should be reviewed on an annual basis and documented that it has been completed. Any changes should be reflected on the revision control page of the manual.

If you are interested in obtaining this document, please contact the PRISM staff. A sample of a typical table of contents is provided below.

Guidance material on safety management principles and concepts, State Safety Program and Safety Management System are contained in the ICAO Safety Management Manual (SMM)-Doc 9859.

Fourth Edition, Doc 9859, was published in 2018.
Chapter 9 contains the details of the SMS Framework

In addition, further sector specific safety management guidance material can be found in ICAO manuals** supporting the following Annexes: Annex 1 — Personnel Licensing; Annex 6 — Operation of Aircraft, Part I — International Commercial Air Transport — Aeroplanes, Part II — International General Aviation —Aeroplanes and Part III — International Operations — Helicopters; Annex 8 — Airworthiness of Aircraft; Annex 11 — Air Traffic Services; Annex 13 — Aircraft Accident and Incident Investigation; and Annex 14 —Aerodromes, Volume I — Aerodrome Design and Operations.

PRISM Solutions offers an IS-BAO and ARGUS compliant ERP manual for an independent fee. It can be provided to subscribers in PDF form, along with a modifiable MS Word document. It may be incorporated in whole or as part of an existing Corporate Emergency Response Plan. If you are interested in obtaining this document, please contact the PRISM staff. A sample of a typical table of contents is provided below.