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Human Factors And Accidents In Aviation Industry Case Study

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Introduction :Human Factors And Accidents In Aviation Industry

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Human factors in aviation are the most important topic as they can help to promote high-quality services which discard the issue of plane crashes all over the country. It basically includes the study of both physical and mental ability through which the pilots are able to analyse the aspects related to safe take-off and landing (Claiborne, 2021). Human factors also make it easier to fly planes through which the risks of human errors, such as poor forecasting of the weather or making quick landing decisions, can be mitigated in the current or future period. The main component of the human factors includes the intention of the pilot with the technological systems implemented in the aircraft and to maintain proper engineering skills through which the landing of the aircraft can be in control (Claiborne, 2021). To further enhance the human factors, various kinds of on-job and off-job training are provided to the individuals so that they are able to manage the unfavourable circumstances easily and effortlessly. The study, in this case, provides a brief overview of the rewired human factors in the aviation sector, including appropriate decision-making processes, stress management and threat or error management, which can reduce accidents or help the pilots to address the challenges. The study also provides information on accidents which happened in DuPage and the main causes of the accidents.


Description of the accident 

The accident happened in November 2011 when a 47-year-old pilot was travelling with his two daughters and his youngest daughter's boyfriend. The pilot was taking 23 Charlie Delta, which is owned by a private company, and the flight was a two-way channel between Indiana and Chicago as the pilot had to return back to his hometown after dropping off his elder daughter in the college (case study). Before the flight, the pilot did not take any prior information on the weather of Chicago and decided to do a VFR landing on his own which shows his first mistake for the contemporary failure.

Flight Plan of 23 Charlie Delta

Figure 1: Flight Plan of 23 Charlie Delta

(Source: Case Study on the Accident)

Apart from this, the pilot was also uninformed regarding the landing in the different ports of Chicago, which are Palwaukee, formerly known as the executive and DuPage, through which major confusion increased the risks of accidents at that particular time. The pilot intended the flight at 8 am in the morning, and it was going to take him around 1 and a half hours to reach the desired destination (case study). However, as per the reports, the area between Indiana and Chicago shows that there were slight chances of rain from 9 am till 11 am, overcast the level of 4000 m. In association with this, the DuPage also forecasted rain around 10 am, which is the departure time of the flight which poor visibility of around 6m through which the landing could have become riskier.

Weather forecast of DuPage on 2nd November

Figure 2: Weather forecast of DuPage on 2nd November

(Source: Case Study on the Accident)

The terminal area forecast (TAF), which is done by DPA, has also shown that the wind was going to blow at a rate of 200 degrees with 12 knots, through which the landing below 2500 feet was inappropriate in DuPage (case study). The next mistake was made by the pilot in terms of noting the suggestions provided by the informer at the landing unit of DuPage regarding the height of the aircraft through which he was unable to maintain proper balance while turning the plane. The informers have also suggested the pilot land at the executive port, but as he was planning to maintain a VFR in DuPage, he did not consider the consequences which he might face because of the poor weather of the region. Yet he decided to turn the plane to the utmost right at any cost, which further led to the crash and the on-spot death of the four individuals travelling on the plane. One of the last mistakes made by the pilot is that he was just a trainee of IFR, and he did not have any proper knowledge or certificate related to IFR, through which he was unable to land with the guidance provided by the informers at the landing port (case study).

In association with this, various accidents related to the aircraft are caused due to the inefficacy of training of VFR or the poor technique of the IFR because while driving the aircraft, these factors are least noted by the pilots, which is their biggest mistake. Apart from this, it was also noted through the case study that other accidents are caused by thunderstorms, turbulence or the icing of the clouds because the temperature of the clouds can be changed anytime, through which the chances of the immediate deaths of the passengers increases. This can further reduce the customer retention in the aircraft industry of the country for the long run.

Types of accidents in 2010

Figure 3: Types of accidents in 2010

(Source: Case Study on the Accident)

In this case, the pilots shall focus on the safety of the passengers and shall also help to understand the dynamics of the complex nature of the situations related to VFR or the IFR so that they are able to reduce the accidents such as the 23 Charlie Delta.

Analysis of the accident in terms of Human factors 

In terms of the pilot or the accident in Chicago in 2011, the human factors include the preconditions of landing or the unsafe act of the pilot. This further includes that the physical environment of DuPage was inappropriate as rain and mist with a high moving wind was forecasted in that specific region, and the technical terms, such as the height of the aircraft while landing, explained by the informer in terms of IFR, was also not acknowledged by the pilot because he was just a trainee (Madeira et al., 2021). In this case, it was also noted that the adverse mental state of the pilot was also not stable, which falls into the condition of the operator as he was worried about the life and safety of his daughters, which has increased his pressure. The physical inability of the pilot is another factor which increased his stress through which he was unable to land the aircraft safely as per the requirements of IFR in DuPage. Lastly, the personal factors of the pilot which led to the accidents included improper resource management by the Crew because they were unable to suggest any further delay in the landing of the flight, which might have saved the lives of the individuals present in the aircraft from that particular accident due to the poor weather of Chicago around 10 am.

Human factors in aviation

Figure 4: Human factors in aviation

(Source: Madeira et al., 2021)

As per the above image, it can also be said that the unsafe act of the pilot, such as the improper decision-making process through which the issues of accidents increase. In this case, the skill-based error, like the improper turning of the aircraft through which the pilot was unable to maintain a proper balance of the aircraft and the poor knowledge of the IFR, also led to the accident in Chicago (Madeira et al., 2021). The violation of the routine, on the other hand, as per the guidance of the informers regarding the landing of the aircraft in the executive with a 900 m pace, was another human factor which led to the accident. 

As per the study by Kelly & Efthymiou (2019), it was also noted that 75% of the accidents in the aviation industry all over the world have been caused by the errors of pilots due to the poor knowledge of human factors. However, the particular accident which was caused in Chicago was a formal procedure of unintentional human error as the pilot had no idea about the collision until he lost all his control over the panel after the major confusion in landing and with the thought of losing his family. In this case, it can be said that the controlled flight into terrain (CFIT) was one of the most significant human factors which led to the accident in Chicago as the pilot completely lost control in the flight through which the plane was found crashed after a day in the region of DuPage. It can also be noted from the study of Bernard et al. (2020) that human factors can be accessed through the help of simulation tools, which can reduce the accidents of aircraft and can save the life of a lot of individuals per year. The tools like digital mock-ups and physical mock-ups can help to enhance the integrity and skills of the pilots while they are ready for the VFR or the IFR landing of the aircraft so that the chances of accidents can be reduced. In association with this, digital human modelling (DHM) can also be used by ergonomics so that they are able to provide high-class training to the pilots because it includes the aspects of virtual reality to reduce aircraft accidents in future (Bernard et al., 2020).

Apart from this, ethical issues are also considered as one of the human factors which can lead to the accidents, such as the increase in the work pressure of the pilots without even proper training or development in the wage structure (de Sant & de Hilal, 2021). This can also lower the growth of the industry through which the pilots will be unable to maintain personal or professional development. The managers of the aviation industry are responsible for the human risks or facts faced by the pilots as they are the only ones who can help to maintain the standards or the strategies of the company at the same time (Kucuk Yilmaz, 2019). Air traffic management (ATM) is another human factor which has caused the accident in Chicago, and to reduce any further accidents in the future of the aviation industry, the managers shall give proper knowledge on the maintenance of the aircraft, take-off of the aircraft or the ground handling which can be helpful to increase the performance of the pilots.

Threat or risk management is also a human factor which has increased the chances of the accidents of 23 Charlie Delta in Chicago, as per the study by Wan et al. (2020). In this case, it can also be said that the pilot was unable to prevent the accident because a complete increase in his stress was noted, through which he was unable to spread awareness regarding the curricula stage of the aircraft landing to the passengers or his family. Furthermore, the pilot should also have focused on reasonable activities such as inspecting the units on the aircraft or trying to find another way to escape using the airbags found on the backseats of the aircraft to save the life of the individual, but due to improper threat management he was also unable to do so (Stanton et al., 2019).


It can be concluded through the study that the Human Factor Analysis and Classification System (HFACS) can be used by the managers of aviation companies to detect the issues of pilots in terms of human errors or gaps in the skill sets regarding the improper handling of the aircraft. It was also noted that one of the main causes of the accidents is improper training in terms of IFR or VFR landing and the increase in the mental pressure of the individuals due to natural causes such as turbulence or icing, which can further lead to the accidents. To further resolve the issues, the managers can timely support the skill sets of the pilots with the help of the training sessions so that they are able to make safe landings of the aircraft even in tough situations like turbulence or no chances for the IFR practices. Apart from this, to reduce the issues of human errors and to maintain high performance, the managers can use Fault Tree analysis or the Fuzzy Cream approach through which the rates of accidents can be reduced over time (Wan et al., 2020). 


  • Bernard, F., Zare, M., Sagot, J. C., & Paquin, R. (2020). Using digital and physical simulation to focus on human factors and ergonomics in aviation maintainability. Human factors, 62(1), 37-54. DOI: 10.1177/0018720819861496 
  • Claiborne, M., (2021, February 6). The human factors in aviation. Aero Corner. 
  • de Sant, D. A. L. M., & de Hilal, A. V. G. (2021). The impact of human factors on pilots’ safety behaviour in offshore aviation companies: A Brazilian case. Safety science, 140, 105272. 
  • Johnson, I., Blickensderfer, B., Whitehurst, G., Brown, L. J., Ahlstrom, U., & Johnson, M. E. (2019). Weather hazards in general aviation: Human factors research to understand and mitigate the problem. In 20th International Symposium on Aviation Psychology (p. 421). CORE Scholar - Wright State University 
  • Kelly, D., & Efthymiou, M. (2019). An analysis of human factors in fifty controlled flight into terrain aviation accidents from 2007 to 2017. Journal of safety research, 69, 155-165. 
  • Kucuk Yilmaz, A. (2019). Strategic approach to managing human factors risk in aircraft maintenance organization: risk mapping. Aircraft Engineering and Aerospace Technology, 91(4), 654-668. 
  • Madeira, T., Melício, R., Valério, D., & Santos, L. (2021). Machine learning and natural language processing for prediction of human factors in aviation incident reports. Aerospace, 8(2), 47. 
  • Stanton, N. A., Li, W. C., & Harris, D. (2019). Ergonomics and human factors in aviation. Ergonomics, 62(2), 131-137. 
  • Wan, M., Liang, Y., Yan, L., & Zhou, T. (2020). Bibliometric analysis of human factors in aviation accident using MKD. IET Image Processing. 
  • Yiannakides, D., & Sergiou, C. (2019). Human Factors in Aircraft Maintenance. CRC Press. Human Factors in Aircraft Maintenance - Demetris Yiannakides, Charalampos Sergiou - Google Books
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